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A woman with ADHD covers her face in despair due to difficulty concentrating.

What are the Barriers to Diagnosing Adult ADHD?

Reading time | 5 mins

Nowadays, it seems like everyone “has” attention deficit hyperactivity disorder (ADHD).

Throughout the day, we’re checking emails, texting friends, family, and colleagues, browsing social media, and rushing through our workday. When we get home, there’s dinner to be made, kids to run after, or social events to attend, and every day seems to end in complete exhaustion.

With all there is to juggle in our lives and the massive new technologies begging for our attention, is it any wonder that we are a society of the overwhelmed and overextended? Now, people tend to use “ADHD” as shorthand for “distracted and overstimulated” as they struggle to keep up with the demands of modern life.

This makes it all the more difficult for the adult with real, biologically based attentional issues, because people without ADHD (sometimes referred to as neurotypicals), are having more difficulties staying on track, getting things done, paying attention — many things that people with ADHD have struggled with daily for many, many years.

Could these challenges be due to the fast-paced life we lead? Or do the harried and hurried actually have ADHD?

To add to the confusion are the skeptics who believe that there is no such thing as ADHD, and that all those distracted folks need is simply more discipline. There are yet others who believe that ADHD is a made-up disorder designed to sell pills. And to take it even further, there are groups whose religious philosophy states that ADHD is a made-up disorder and that it’s a sin to take medication for it, let alone be diagnosed with it.

As a psychotherapist specializing in ADHD — and an adult living with ADHD myself — to all these theories I say: rubbish.

The top ADHD experts in the world who have spent their entire careers learning about ADHD and how it affects adults agree with me. We now know that ADHD is acknowledged and accepted by the top health organizations in the world, such as the American Medical Association, the American Academy of Pediatrics, the American Psychiatric Association, and the National Institutes of Health, as a true psychiatric disorder.

Barriers to diagnosis

There are many factors that make it so difficult for an adult to get properly diagnosed with ADHD. In my experience, some of the more common reasons are:

Lack of clinical training

Many medical professionals are not well versed in how to evaluate adults with ADHD, and there is, in many cases, a lack of knowledge around the specific diagnostic criteria for ADHD. The majority of women I work with in my practice have initially been misdiagnosed as having depression, something that primary care physicians feel more comfortable identifying and treating.

Too few experts

While most psychiatrists may be able to diagnose ADHD, finding mental health professionals or healthcare providers that specialize in ADHD can be hard to find. Most adults have to travel many miles to find one, and many are unable to do just that.

Stigma

Adults with ADHD often feel stigmatized by their condition, and may avoid exploring their symptoms with a professional. As a result, they lose out on the appropriate condition management tools that can make a huge and positive impact on their lives.

Financial issues

Many insurance companies still aren’t on board with covering the expense of ADHD evaluations and treatment. This puts many adults out of the ballpark of getting the help they need because of financial constraints.

Misperceptions about ADHD

There’s still this myth that adults can’t have ADHD — that only children get ADHD, and they often outgrow it. This couldn’t be further from the truth. Research has shown over and over again that childhood ADHD often continues into adulthood.

Symptoms mistaken for other conditions

Being distractible, hyperactive or hypoactive (sluggish), having difficulty finishing tasks, and not paying attention can all be symptoms of other medical conditions. When adults visit their primary care physician complaining of ADHD or ADHD-like symptoms, there’s a pretty good chance that their doctor will, indeed, screen for conditions that mimic ADHD.

Even if the labs come back normal (which they often do), the patients are either sent home or referred to a therapist or counselor who may or may not be trained to look for signs of ADHD.

Additionally, adults may be struggling with anxiety, depression, substance abuse or other addictions, and simply have no clue that ADHD could be the underlying cause for these issues.

The process of misdiagnosis can go on for years. In the worst scenarios, adults struggling with these symptoms may lose jobs and relationships, and experience a severe drop in self-esteem.

What can you do if you suspect you might have ADHD?

If you’ve been experiencing symptoms you think might be caused by ADHD, follow these steps:

  1. First, do check-in with your healthcare provider to rule out other possible medical reasons for your symptoms. Remember, symptoms of other conditions may mimic those of ADHD.
  2. If your symptoms aren’t caused by another medical condition, find an experienced mental health clinician and get yourself evaluated for ADHD. You may even want to ask your provider for a recommendation.
  3. Educate yourself. There are lots of excellent books and websites to help guide you. Just make sure they are from reputable sources.
  4. If you are told you don’t have ADHD but you suspect that you do, get a second or even third opinion.
  5. Get support. There are national ADHD organizations like CHADD and the ADDA that have support groups and conferences where you can connect with others who also have ADHD, as well as robust adult ADHD communities on social media. Connecting with others removes the feeling of isolation and not being understood.

There is still a stigma to having ADHD, and it can make adults with ADHD avoid getting evaluated and pursuing appropriate ways to manage their symptoms. The way to break down these barriers is to learn self-acceptance, self-education, and self-advocacy, and to share your understanding of adult ADHD with others who may be uninformed.

If you’re like a lot of adults with ADHD, and have been struggling in silence for years or wondering “What is wrong with me?” – it may be time to talk to your doctor .

The information presented is solely for educational purposes, not as specific advice for caregivers or the evaluation, management, or treatment of any condition.

NPS-US-NP-00290 May 2018