In clinical terms, ADHD is defined as a ‘neurodevelopmental disorder’. To be defined by a clinician, enough evidence of impairment must exist across two main categories describing inattention and hyperactivity-impulsivity. This evidence must be present before age 12, exist across two or more settings (School, work, home) and reduce quality of social, academic or work functioning.
A GP, Psychotherapist or ADHD Coach cannot diagnose ADHD. Clinical or Counselling Psychologists and Psychiatrists are the clinical roles that can provide a formal diagnosis, using structured interview(s) based on criteria from a manual called DSM-5, and self-report screening tools.
Before I lose you, let’s step back from this for a moment.
The DSM was created in 1952 to aim to define, diagnose and classify mental health and neurodevelopmental conditions. It is the source of truth for clinicians to diagnose Anxiety Disorders, Depressive Disorders, PTSD as well as ADHD and Autism Spectrum Disorder. We are on version 5 of this manual - ADHD was added in the 1980s, and updated to reflect the possibility to diagnose adults in 2013.
Why am I telling you this?
Because it is absolutely fine to question the root of ADHD diagnosis, but by doing so you are also questioning an entire model of clinical assessment.
Honestly, I spent a year of psychopathology training questioning these models of assessment - in fact, we were encouraged to. I remember feeling particularly passionate about how we define the line between the regular human experience and a disorder, and that postpartum depression isn’t listed as a condition.
Here is why I don’t believe this is a good use of time.
For the majority of people I’ve met who landed in front of a psychiatrist or psychologist, they’re not there because they’re looking for a trendy label. They’re looking for an explanation for their experience, to validate experience, reduce shame and to access practical, medical and legal avenues.
The diagnosis alone does not provide all of the above. It is only the start of the process of self-understanding that will shape their lives post diagnosis. I recommend instead of starting with the question about whether a diagnostic process is valid, start with ‘What can be done to help this person right now?’
