Is ADHD Overdiagnosed in Adults?: How Misunderstood Adult ADHD Is

There’s a growing awareness about ADHD and its symptoms, and because of this, many more adults have received diagnosis and treatment.

The increased exposure has many people wondering if ADHD is overdiagnosed. Maybe you’re concerned whether you got the right diagnosis yourself.

Fortunately, there are steps you can take to ensure you get an accurate diagnosis for your symptoms. This will open the door to treatment to help you overcome challenges and achieve your goals.

The Debate Around the Overdiagnosis of ADHD

The prevalence of ADHD has grown from 6.1% to over 10% in 20 years. As a result, some experts have become concerned about the overdiagnosis of ADHD.^[1]

There are several possible reasons why ADHD may be overdiagnosed or misdiagnosed, including the following:^[2]

• Use of long-term recall in diagnosis: Your doctor needs to determine that ADHD was present during childhood to diagnose ADHD. This process uses long-term recall, which may be inaccurate or influenced by your current experience.
• Reliance on psychological assessments: There is no single test to diagnose ADHD. The diagnosis can be made using a mix of psychological testing and rating scales. But these can sometimes lead to false positives (saying that ADHD is present when it isn’t.)
• Increase in ADHD awareness: An increase in awareness may lead to more people seeking a diagnosis for ADHD, even if they don’t have the condition. There could also be pressure for a quick solution. This might cause doctors to prescribe treatment without doing a thorough examination.
• Overlooking a different diagnosis: Other conditions can cause poor attention and focus, not just ADHD. Examples include depression and anxiety disorders, which might be misdiagnosed as ADHD.

These reasons explain why ADHD might be mistakenly diagnosed even when it’s not present. However, by seeking the assessment of an experienced medical professional, you can significantly reduce the risk of this.

Some facts are no longer considered up for debate by those who study ADHD. Presentation and symptoms can be very different in adulthood than in childhood, yet ADHD is a life-long condition. And each person has a unique set of symptoms, some easier for clinicians to observe than others.

For example, inattentive ADHD is more likely to be overlooked, which particularly impacts women’s ability to be diagnosed and access treatment.

If you think you might have symptoms of ADHD, look for an expert with experience helping people like you.

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ADHD Misdiagnosis and Its Implications

In some cases, symptoms of ADHD and other conditions may overlap. This can cause confusion and a misdiagnosis.

Take, for example, depression, which is linked to difficulty concentrating and remembering details, as well as restlessness.^[3] These symptoms are similar to those of ADHD. As a result, your depression may be wrongly diagnosed as ADHD or vice versa.

An incorrect diagnosis might cause you to receive ineffective medications and treatment. This makes it harder to manage the challenges you face in your work, school, or social life. That’s why it’s crucial to get an accurate diagnosis.

If you’re concerned, you can seek a second opinion from a medical professional specializing in mental health.

The Reality of ADHD Underdiagnosis

ADHD can be overdiagnosed or misdiagnosed. But the reality is that there’s a much higher chance of it being underdiagnosed in the adult population.

Research suggests that less than 20% of adults with the condition are appropriately diagnosed and treated for their symptoms.^[4]

This risk of an underdiagnosis is even higher in women with ADHD.

There are several possible explanations as to why ADHD is likely underdiagnosed in adults, especially women:^[4]

• Predominantly inattentive ADHD is the most common among adults. These symptoms of inattention are more subtle and easier to mask. So adults are less likely to seek help for them.
• Adults, especially women, tend to develop compensatory mechanisms to mask their ADHD. Some examples include showing up early to appointments or only going out in big groups to avoid standing out.
• Healthcare professionals might not be well-versed in how adult ADHD presents. That’s because the focus of this condition has typically been on young boys. ADHD in adults can look very different from that in young children, which can lead to a missed ADHD diagnosis.
• There is a symptom overlap between ADHD and other medical conditions. ADHD might be misdiagnosed in adults for something else, like a mood disorder.
• ADHD often co-exists with other conditions. Adults who have been diagnosed with a co-existing condition might not go on to get assessed for ADHD.
• Childhood ADHD needs to be present for a diagnosis. However, adults may have trouble recalling their past struggles and challenges. On top of that, doctors may only look for obvious signs of ADHD in childhood, such as failing a subject. Subtle symptoms, like excessive time spent studying or procrastination, may be missed.

Due to these reasons, adult ADHD can be overlooked.

That said, the more you learn about ADHD, the better educated and empowered you’ll be to get the proper diagnosis for yourself or a loved one.

Ensuring Accurate Diagnosis in Adults

You can take some steps to ensure you’re diagnosed correctly for your symptoms.

To get a proper ADHD diagnosis, the best thing to do is to seek an evaluation and assessment from a qualified professional with the necessary credentials and certifications. This may be a psychiatrist or psychologist.

They should also have training and experience in diagnosing and treating ADHD, specifically in adults.

You can always ask your healthcare professional about their training and experience in adult ADHD. Most clinicians will be happy to provide this information.

The following are ways you can go about finding a qualified professional:

• Ask your primary healthcare provider for a referral
• Seek recommendations from members of an ADHD support group or community
• Get a list of recommendations from your insurance provider
• Look online for a professional directory, such as the one provided by ADDA

Ideally, the medical professional you choose should also have training in cultural sensitivity.

Considering Comorbidities

One factor that might affect your ADHD diagnosis is the presence of a co-existing condition.

Researchers have found that up to 80% of adults with ADHD have also reported another comorbid mental health condition. So it isn’t unusual for an adult ADHDer to also struggle with something else, like depression, anxiety, or bipolar disorder.^[5]

Your doctor should screen for any co-existing conditions when assessing your symptoms because these conditions may sometimes affect how ADHD symptoms present. If there are any comorbidities, they should be addressed alongside your ADHD.

Life After Diagnosis: What Next?

If you have ADHD, your healthcare team will work with you to build a personalized management plan. This may include:

• Medications
• ADHD therapy, such as cognitive behavioral therapy (CBT)
• ADHD coaching
• Support group for adult ADHDers

Your doctor may also walk you through lifestyle modifications that can help. For instance, having a regular sleep schedule or modifying your diet may help reduce symptoms related to ADHD.

The Right Diagnosis Can Make All the Difference

Seeking the correct diagnosis for your symptoms can be overwhelming. But it’s a massive step in the right direction, and it will help you get the help you need.

Whether you have ADHD or another condition, proper treatment empowers you to achieve your goals and build meaningful relationships with those you love.

If you want to learn more about ADHD, ADDA+ has all the resources and tools you need.

Through ADDA+, you’ll gain access to a community of supportive adult ADHDers who understand your challenges. You’ll also have the opportunity to learn more about the condition through expert-driven resources, webinars, and online courses.

References

[1] Abdelnour, E., Jansen, M. O., & Gold, J. A. (2022). ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis? Missouri Medicine, 119(5), 467–473.

[2] Paris, J., Bhat, V., & Thombs, B. (2015). Is Adult Attention-Deficit Hyperactivity Disorder Being Overdiagnosed?. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 60(7), 324–328. https://doi.org/10.1177/070674371506000705

[3] National Institute of Mental Health. (2023, September). Depression. National Institute of Mental Health; National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/depression

[4] Rivas-Vazquez, R. A., Diaz, S. G., Visser, M. M., & Rivas-Vazquez, A. A. (2023). Adult ADHD: Underdiagnosis of a Treatable Condition. Journal of Health Service Psychology, 49(1), 11–19. https://doi.org/10.1007/s42843-023-00077-w

[5] Choi, W. S., Woo, Y. S., Wang, S. M., Lim, H. K., & Bahk, W. M. (2022). The prevalence of psychiatric comorbidities in adult ADHD compared with non-ADHD populations: A systematic literature review. PloS one, 17(11), e0277175. https://doi.org/10.1371/journal.pone.0277175