For every child and adult who is correctly diagnosed with Attention Deficit Hyperactivity Disorder, there is another child and adult who is improperly diagnosed with ADHD (and potentially mis-medicated for it), and another child and adult who has ADHD who is not diagnosed at all, or diagnosed with something totally different. So, what makes this diagnosis so tricky?

Probably the number one reason for this difficulty is that the patient him/herself rarely reports distress, unless they are either significantly older or the disorder is quite severe. Simply put, their brain has always worked in this way, and they think it is normal. They do not recognize their ADHD as anything out of the ordinary. It is their parents, teachers and spouses who are the ones complaining, not the patients themselves.

Secondly, ADHD can present behaviorally like several other conditions, mostly commonly:

1. Anxiety. And this is a tricky one – often, anxiety and ADHD co-exist, and one is addressed and/or medicated, the other has a tendency to increase in severity. Additionally, unaddressed ADHD can LEAD to anxiety, as the patient feels more and more behind at school and at work; as important papers keep getting misplaced, and as they continue getting in trouble for “forgetting” important due dates and their constant lateness and messiness.
2. Depression. When a person has to live with unremitting anxiety and fears of being in trouble or ridiculed for their shortcomings, they might slip into depression.
3. Substance Abuse. Many patients with Attention Deficit Disorder reach for substances, both legal and illegal, to make themselves feel a little better. They soon find that they like the feeling of being high, and that they can blame their failures at school and at work on intoxication (at least to themselves), and therefore spare themselves the embarrassment and shame of constant failure. Some even swear that drugs make their ADHD better.
4. Social problem. This may include various conditions, such as the mild end of the Autistic Spectrum. When a child fails to attend to social cues from a very early age, they grow up deficient in social niceties and the basic understand of how human interactions work. They may appear like they don’t care about how they ought to behave, but they may actually care deeply – they just may be able to pay attention long enough to learn.
5. Behavior problems. Violence towards siblings and parents, temper tantrums, yelling, swearing – the lot. Children with ADHD also often lack the ability to pay attention to their own feelings, emotions and bodily needs. They rarely know when they are hungry or tired, they cannot tell you that they are scared or anxious, they won’t share what makes them sad – but they will act out all of these emotions, and often in a very negative way.

So, what do I recommend a parent do? First, get educated about ADHD – the resources out there in 2019 are fabulous. Here are a few to get you started:

1. https://chadd.org/–  CHADD – a non-profit organization with classes and resources dedicated to improving the lives of patients with ADHD and their families.
2. Books, such as Dr. Amen’s “Healing ADD”. https://www.amazon.com/Healing-ADD-Revised-Breakthrough-Program/dp/0425269973/ref=pd_ybh_a_4?_encoding=UTF8&psc=1&refRID=KPX3MAJ02ZY91DYPFDXD
3. And Dr. Hallowell’s “Delivered from Distraction”. https://www.amazon.com/Delivered-Distraction-Getting-Attention-Disorder/dp/034544230X/ref=sr_1_1?crid=2VG0W0N50P20L&keywords=delivered+from+distraction+by+hallowell&qid=1554404185&s=books&sprefix=Delivered+f%2Cstripbooks%2C194&sr=1-1

Additionally, we at Your Parenting Coach (www.yourparentingcoachcmi.com) and Dr. Natasha Kendal and Associates (kendalclinic.com) are here to help – home-based, school-based and office-based evaluation and treatment options are available.