Can I Diagnose Myself?
By Nancy Pletcher, MSN, PMHNP-BC
5 minute read
As we have a wealth of information readily available through an easy search, it’s often tempting to self-diagnose any issues we may have. While I somewhat agree with professional colleagues who discourage investigating your symptoms through a Google search, if it gets you in for a proper assessment, then I celebrate it.
So, the short answer is no, you can't diagnose yourself with ADHD, although I would encourage you to address any concerns you have with a qualified provider. I've had countless clients come to me after hearing about ADHD symptoms on a podcast or social media. From there, we were able to either rule out or diagnose ADHD and make a treatment plan accordingly.
ADHD in adulthood can be tricky, both for the clinician and the client. Only recently has adult-onset ADHD been recognized as a valid phenomenon among the clinical community. Previously, you would have had to exhibit symptoms from childhood in order to meet criteria for a diagnosis, regardless of the severity of your symptoms.
It is no secret that first line treatment for ADHD involves stimulants, which are controlled substances due to their liability for dependence and abuse. Close oversight of prescription substances with abuse potential is nothing new. The term “controlled substances” means exactly what it sounds like: the government controls the manufacturing, handling, storage, and distribution of these drugs. Prescribing and taking controlled substances have been under greater scrutiny in recent years, and prescribers make extra careful considerations when prescribing medication.
Increased Prevalence of ADHD Among Adults
During the pandemic, diagnoses of ADHD went up substantially among adults, and with that, prescriptions for stimulants. This led to a still-ongoing shortage of ADHD medications. Some argue the increase in diagnoses occurred because the lifestyle imposed by the pandemic “unmasked” ADHD symptoms, while others suggest that the condition was simply overdiagnosed. Regardless of the reason, this has drawn even greater attention from regulating bodies to the assessment and prescribing practices of clinicians, resulting in more strain in the current environment.
There is good reason to respect the risks of taking stimulants. They have short and long-term side effects that must be considered along with their benefits. As clinicians, we work closely with clients to prescribe stimulants only when appropriate, while recognizing that untreated ADHD can lead to long-term negative physical and mental health outcomes.
Other Causes of ADHD Symptoms
One of the challenges in ADHD self-diagnosis is overlooking the cause of your symptoms. After a good assessment with your provider, you may find out you don't have ADHD. However, it may be a neurodevelopmental or psychiatric disorder that needs to be treated. A clinician will be able to assess conditions that look like or share characteristics with ADHD. They’ll also ensure that any medical cause of your symptoms has been ruled out, like a hormone imbalance or neurological condition. Your psychiatric care should always be done in collaboration with good primary care. You need and deserve the clinical finesse that comes with expertise, experience, and comprehensive care to ensure you get the best treatment.
A Culture of Inattention
There are social and cultural components to all of this. The spike in ADHD diagnoses recently may not just be related to increased awareness, but also to lifestyles that foster inattention.
The myth of multitasking is omnipresent. It's a myth because our minds and bodies only actually can do only one task at a time. Just because you have multiple tabs open and multiple screens alight doesn't mean you're multitasking. It just means you are jumping quickly from task to task. Every mental switch between tasks requires a level of cognitive effort that accumulates and fatigues. It's like driving somewhere while rapidly taking your foot on and off the gas. You'll certainly get to where you're going, but you'll run out of fuel quickly, likely do damage to the car, and it won't be a pleasant ride.
It doesn't help that we live in a world that capitalizes on a short attention span. The overstimulation of daily life is a challenge we must also contend with. At this point a 3-minute video is too long for many to watch in its entirety. Furthermore, many of us find the mindlessness of social media or video games to be a much needed break from our busy lives.
Subclinical Symptoms
Just like your body can suffer if you don't have good physical habits, your concentration can suffer if you don't have good mind practices. There is such a thing as "subclinical" inattention or hyperactivity, which means that your symptoms are real but don’t meet diagnostic criteria for a disorder. In the same way that a few days of a wheezing cough doesn't mean you have asthma, experiencing periods of time where your concentration is compromised does not mean you have ADHD.
In short, just because you sometimes feel frazzled or distracted may not mean you have ADHD. There are cases of individuals exhibiting ADHD symptoms who experience full remittance once they changed their habits, or engaged in certain types of behavioral therapy that focus on enhancing executive function, which is implicated in many ADHD symptoms.
There is strong evidence to support the use of cognitive and behavioral interventions to manage symptoms of inattention, both in ADHD and in those with subclinical symptoms. I imagine it won’t be long before we are suggesting these practices among other comprehensive lifestyle recommendations of good sleep practices, a healthy diet, and adequate exercise.
How to Determine if You Have ADHD
So, let's say you are listening to your favorite podcaster describe their ADHD and how their life changed for the better when they got it treated. You relate strongly to the symptoms described. What now?
Make an appointment with a specialized provider in ADHD. Depending on the nature of your symptoms, you will go through various screening processes. This may include cognitive testing, corroboration from family members (with your consent), and in-depth questionnaires. Expect that you may meet with your provider a few sessions before confirming a diagnosis and determining a treatment plan for you. Multiple factors will be considered by an experienced clinician when exploring best treatment options. For the reasons described, ADHD requires careful, thoughtful, and thorough diagnostic practices, particularly in adults.
If you don’t know where to go, Lavender can help. You’re not alone. Lavender offers online appointments with board-certified psychiatric nurse practitioners who can provide both talk therapy and medication options as you navigate your feelings together.
