ADHD
A clear evaluation can bring answers, and the right plan can bring focus to daily life.
This information is educational and is not a diagnosis. Diagnosis requires a comprehensive psychiatric evaluation.
If you are in crisis, call or text 988 (Suicide & Crisis Lifeline) or call 911.
What it is
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects attention, activity level and impulse control. It begins in childhood and often continues into adulthood, where it may look different: less visible hyperactivity, more restlessness, disorganization and difficulty managing time.
ADHD is not caused by laziness, poor parenting or lack of intelligence. Many adults are diagnosed for the first time after years of struggling and compensating, and an accurate diagnosis can be a turning point.
Diagnostic features (DSM-5-TR)
A plain-language summary of key features described in the DSM-5-TR. This is not the official criteria text and is not a self-diagnosis tool.
Inattention
- Examples: careless mistakes, trouble sustaining attention, seeming not to listen, not following through on tasks, difficulty organizing, avoiding tasks that require sustained mental effort, losing things, being easily distracted and forgetfulness in daily activities.
- Children (up to age 16) need six or more of the nine symptoms; teens 17 and older and adults need five or more. Symptoms must last at least 6 months and be inconsistent with developmental level.
Hyperactivity and impulsivity
- Examples: fidgeting, leaving one's seat, restlessness (in adults, often an inner feeling of restlessness), difficulty doing activities quietly, being constantly "on the go," talking excessively, blurting out answers, difficulty waiting and interrupting others.
- The same thresholds apply: six or more symptoms for children, five or more for ages 17 and older, for at least 6 months.
Requirements for all presentations
- Several symptoms were present before age 12.
- Several symptoms are present in two or more settings, such as home, school, work or with friends.
- Clear evidence that symptoms interfere with or reduce the quality of social, school or work functioning.
- Symptoms are not better explained by another mental disorder and do not occur only during a psychotic disorder.
Three presentations
- Predominantly inattentive presentation: inattention criteria met, hyperactivity-impulsivity criteria not met, for the past 6 months.
- Predominantly hyperactive-impulsive presentation: hyperactivity-impulsivity criteria met, inattention criteria not met.
- Combined presentation: both sets of criteria met. Presentation can change over a person's life, and severity is described as mild, moderate or severe.
Common signs
- Trouble staying focused on tasks, reading or conversations
- Frequently losing keys, phone or paperwork
- Procrastination and missed deadlines
- Difficulty organizing tasks and managing time
- Starting many projects but finishing few
- Restlessness or difficulty sitting still
- Interrupting others or blurting things out
- Impulsive decisions or spending
- Forgetfulness in daily routines
How it's evaluated
A thorough ADHD evaluation includes a detailed clinical interview about current symptoms and childhood history, validated rating scales such as the Adult ADHD Self-Report Scale (ASRS) or Vanderbilt scales for children, and, when possible, input from family, teachers, partners or school records.
I also screen for conditions that can mimic or accompany ADHD, including anxiety, depression, sleep disorders, thyroid problems, learning disorders and substance use. Before stimulant medication, I review heart health and family cardiac history and check blood pressure and heart rate.
Evidence-based treatment options
Stimulant medications
Methylphenidate- and amphetamine-based medications are the most studied and effective treatments for ADHD symptoms. They are controlled substances that require careful prescribing and regular monitoring.
Non-stimulant medications
Atomoxetine, viloxazine, extended-release guanfacine and extended-release clonidine are options, especially when stimulants are not suitable or tolerated.
Behavioral treatment
For children under 6, parent training in behavior management is recommended first. School supports, such as an IEP or 504 plan, help students of all ages.
Skills and CBT for adults
Cognitive behavioral therapy and ADHD coaching build practical skills for planning, organization and time management, and work well alongside medication.
How I can help
I provide clear, thorough ADHD evaluations for children, teens and adults, so you get a real answer rather than a guess. If ADHD is diagnosed, I explain the results and walk through treatment options, benefits and risks.
When medication is part of the plan, I prescribe carefully, monitor blood pressure, heart rate, sleep and appetite, and follow up regularly to find the right medication and dose. I also treat co-occurring anxiety, depression or sleep problems so the whole picture improves.
Insight
Adults often describe ADHD less as a lack of attention and more as difficulty directing it. Hyperfocus on something interesting alongside trouble with routine tasks is a common experience.
Sources
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).
- Centers for Disease Control and Prevention (CDC): ADHD
- National Institute of Mental Health (NIMH): Attention-Deficit/Hyperactivity Disorder
- American Academy of Pediatrics (2019): Clinical Practice Guideline for ADHD in Children and Adolescents
- NICE guideline NG87: Attention deficit hyperactivity disorder: diagnosis and management
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