ADHD can only be diagnosed by a doctor or licensed mental health professional. You may suspect you or your child have problems with attention, but it’s important to get a good diagnosis, because there are other issues and conditions that can mimic some of the symptoms. These include bipolar disorder (manic depression), thyroid problems and schizophrenia (particularly before it’s fully manifested). It’s important to rule out other diagnoses at the same time you consider ADHD.

The Diagnostic and Statistical Manual, 4th edition text revision (DSM-IV-TR) is the “bible” that psychiatrists, psychologists and social workers use to diagnose a variety of issues involving the mind. It’s also the criteria health insurance companies use in deciding what types of treatment will be covered.

According to the DSM-IV-TR, there are certain criteria that indicate a diagnosis of ADHD. These are listed in layman’s terms below:

I The person must meet the criteria under either A or B in this section:

1. Doesn’t pay attention to details or makes “careless” mistakes.
2. Has trouble keeping attention on what they’re doing
3. Appears not to be listening when spoken to
4. Doesn’t follow directions or doesn’t finish things (presuming they can understand the directions and aren’t being defiant)
5. Has trouble staying organized
6. Avoids activities that require a lot of mental effort or attention
7. Loses things they need
8. Is easily distracted
9. Is forgetful about day to day things

B Six or more of these symptoms for more than 6 months. (Not age appropriate and are interfering with regular activities):

1. Fidgets or squirms
2. Gets up when they’re supposed to stay seated
3. Runs around or climbs when it’s not appropriate (in teens and adults, feels extremely restless)
4. Has trouble playing or doing relaxing things quietly
5. Is always “on the go” or “driven by a motor”
6. Talks too much
7. Blurts out answers before the question is finished
8. Has trouble waiting their turn
9. Interrupts or intrudes on others

II Some of the symptoms started before age 7

III The symptoms interfere with life in two or more different settings (e.g. work, home, school)
IV Symptoms interfere in a significant way with normal functioning in work, school, or relationships.
V Symptoms do not only happen as part of an autism spectrum disorder or psychotic disorder such as schizophrenia, and are not better explained by another mental illness.

If you see yourself or your child in these criteria, you might have ADHD. Your next stop should be a doctor or mental health professional who has a lot of experience with attention problems.
It’s important to notice that the diagnostic criteria say that these symptoms have to seriously get in the way of normal functioning. That’s something of a subjective criteria. However, a specialist will have a good idea of what’s within the range of normal and what’s not. Another way to say it is this: you can have all the symptoms of ADHD, but if you’re doing well in the things you need to do in life, you don’t have ADHD.

Unlike cancer, strep throat or a broken arm, there is not definitive test for ADHD. No blood or urine test or x-ray shows whether you have it. Diagnosis is based on your symptoms.
To diagnose ADHD, the doctor or mental health professional will collect information from the patient and others about their symptoms. For children, this will most likely include a checklist-type survey such as the Conner’s Rating Scale or the Behavior Assessment System for Children (BASC). These are scales that are filled out by both the parents/guardians and the child’s teacher(s). Some scales also have questions for the child themselves. In adults, information will come from the patient and other members of the family.
It’s very important to get information from more than one source in diagnosing ADHD. That’s because people often act differently in different settings, and because someone’s symptoms may look different depending on the expectations of them. For example, not being able to sit still is not a problem on a soccer team, but it may be in school. Similarly, a parent might be driven crazy by a kid who doesn’t get chores done, but the same child may be doing just fine in school.

Many people don’t want to get diagnosed or have their child diagnosed with ADHD because they don’t want to use medication. It’s important to remember that
diagnosing ADHD is not the same thing as deciding how to treat it. The fact that someone is diagnosed with ADHD does not necessarily mean that they should take medication, and it doesn’t tell you which medication is right even if medication is chosen as a treatment.
Medication for ADHD is like the brakes on a car – it makes it easier to slow down. However, there are other ways to stop a car, and there are other ways to treat ADHD. No one thing is right for everyone. If medication is recommended, it’s also important to remember that it is only one piece of treatment. If you’ve been driving a car with no brakes, you don’t just have to get brakes, you also need to learn how to use them appropriately.
You may also wonder why doctors don’t use medication as a way of diagnosing ADHD. Why not try the medication and see if it works? The problem is that the same medications that treat ADHD will help anyone – with ADHD or not – concentrate better. The fact that an ADHD medication helps does not tell you whether ADHD was really the underlying problem.