Is ADHD real? A skeptic’s guide to diagnosis.
With rates of ADHD skyrocketing, people are asking about the validity and meaning of the diagnosis. Is ADHD real? Is the label helpful? Why are so many people being diagnosed with ADHD, and how does it relate to anxiety?
What is a mental diagnosis?
ADHD is a specific diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). DSM-5 diagnostic labels are a type of short-hand to help us communicate with one another about our experiences.
Unlike conditions diagnosed with blood tests in medical labs, psychological diagnoses are a bit more arbitrary - they are descriptions that the psychological community has agreed upon to describe different types of emotional and behavioral challenges.
As the types of diagnostic labels have grown over the years, we have more and more descriptors of our different types of challenges. It has been said that most of us fit some type of diagnostic label, given that all humans experience emotional and behavioral challenges in some way.
At the same time, the labels rarely feel like an exact fit for anyone, and someone seeking a diagnosis can find that different providers have different opinions about what diagnosis is the best descriptor of their experience. As the client, you may also disagree with a diagnosis given.
What is ADHD?
ADHD is a neurodevelopmental condition characterized by patterns of inattention, hyperactivity, and impulsivity that can affect daily functioning. It often begins in childhood but can persist into adulthood, impacting work, relationships, and emotional well-being. Common symptoms of ADHD are:
Difficulty sustaining attention
Impulsivity and restlessness
Challenges with organization and time management
Forgetfulness and distractibility
Receiving an Attention-Deficit/Hyperactivity Disorder (ADHD) diagnosis can bring a mix of relief, confusion, and questions, and even deciding to seek the diagnosis can feel overwhelming. Understanding what ADHD means can add clarity and hope for navigating your mental health journey.
How is ADHD diagnosed?
When a psychologist or other provider is diagnosing a mental disorder, the core tool is the clinical interview. This involves gathering a careful history of symptoms, and the provider will be gathering information to help understand how closely the patterns in your life experience fit with the diagnostic criteria.
Which ADHD symptoms have you experienced, as listed in the DSM-5?
How severe have these symptoms been? How have they impacted your functioning?
How frequently have they occurred and for how long?
Are the symptoms triggered by anything in particular, or are they part of your baseline experience?
In addition to the clinical interview, other tools are sometimes used in the process of diagnosing ADHD.
symptom checklists (completed by you as the patient and sometimes also by others who know you well)
computer tests of attention
measures of intelligence or learning (to add understanding about your cognitive experience)
Providers check for other conditions too that might “mimic” the inattentiveness and psychomotor agitation of ADHD, such as Generalized Anxiety Disorder or Bipolar Disorder.
How can I know if I have ADHD?
If you are seeking a possible ADHD diagnosis, you have a few options of how to proceed.
Full Psychological Assessment: Meeting with a testing psychologist for a full battery of psychological tests is the most comprehensive way to determine whether or not you qualify for a diagnosis of ADHD.
This tends to take several hours and can require a significant financial investment. Wait lists for testing can be long.
The result is a comprehensive assessment and written report that will be highly useful in any situation where you need ADHD medication, academic accommodations, or similar supports regarding your symptoms.
This approach is especially helpful if you are also wondering about a learning disability, if you would like to better understand your unique intelligence patterns, and if you are seeking a range of recommendations beyond just medication.
Examples of full psychological assessment in Grand Rapids, MI, would be Stratus Psychological Services and Eastown Psychological Assessment.
Therapeutic Assessment: Many psychologists (and some other licensed mental health professionals) can conduct an in-depth clinical interview with you in the context of therapy to determine whether or not you qualify for an ADHD diagnosis.
This does not result in a written diagnostic report, but can help provide you with some clarity about whether you have ADHD.
Be aware that if you’re hoping for medication to manage your symptoms or academic accommodations, it is possible that you will need the full psychological assessment instead (see above). But even so, starting with this type of shorter therapeutic assessment can serve as a helpful screener for you as you decide whether a full psychological assessment is worth your investment.
Working with a psychologist/therapist for diagnostic clarity can support your work in counseling, as you seek to better understand yourself and your relationships.
A diagnostic assessment of this type is available as part of the therapeutic process through Dwell Psychological Services.
Psychiatric Assessment: Many psychiatrists - these are medical doctors specializing in psychiatric medications - can conduct their own diagnostic assessment for ADHD.
This is unlikely to result in a written diagnostic report, but the diagnosis of psychiatrists do carry significant weight.
The psychiatrist may be able to prescribe medication to help manage your symptoms based on their own diagnosis, without requiring a full psychological assessment. This can be a shorter route to medication treatment, if that is your primary focus. Be aware that some psychiatrists may still require the full psychological assessment.
Examples of psychiatric assessment providers in Grand Rapids would be Pine Rest outpatient services, or any of the major medical systems, such as Trinity Health, Corewell, or University of Michigan Health-West.
The diagnostic route you choose will likely be guided by your goals of how you would like to proceed after the diagnosis. Are you seeking an in-depth diagnostic explanation, with options to pursue psychiatric medication and academic accommodations? Or are you simply curious to get a better understanding of your experience for now?
How ADHD and Anxiety Are Connected
Many people with ADHD also experience anxiety in the following ways:
Feeling overwhelmed: Struggling to manage ADHD symptoms can lead to feelings of overwhelm and worry. When it’s hard to focus or complete tasks, it can seem as if you don’t have the resources to manage everything coming at you.
Uncertainty: ADHD can make it difficult at times to think clearly or identify specific steps toward a goal, and this creates uncertainty. Anxiety about performance and outcomes cab be the result of this type of brain fog experience.
Emotional dysregulation: With attention difficult to regulate in the midst of ADHD, emotions also become difficult to regulate. Anxiety and other emotions may feel as if they swing more significantly and unpredictability.
Anxiety also can include symptoms that look like ADHD, even when full ADHD is not present. This is because anxiety often causes difficulty concentrating, physical restlessness, and other symptoms that overlap with ADHD. Before pursuing treatment, it is important to determine if both diagnoses are actually present or if just one of the diagnoses can sufficiently explain the symptoms that you are experiencing.
Faith-Integrated Perspective on ADHD and Anxiety
Understanding ADHD and anxiety through a lense of Christian faith can add richness to the healing journey, helping you live into your experiences with both joy and self-compassion.
Trusting the design: God created you uniquely and beautifully. ADHD is sometimes described as a “thinking style” more than a “disorder,” and good things come from this approach to life. People diagnosed with ADHD tend to be creative, fun, inspirational, and energetic.
Meeting God at your point of need: When ADHD, anxiety, or other mental diagnosis is part of your lived experience, these challenges provide opportunities for you to meet with God in your moments of need. This is how many people were drawn to connect with Jesus’ love on earth - through illness or fear.
Prayer and mindfulness: Faith-based practices like Centering Prayer and Christian mindfulness can be helpful in reducing anxiety and increasing mental focus. We can also benefit from incorporating spiritual awareness into other coping skills, such as taking walks, listening to music, or spending time with uplifting people.
Community and support: Healthy communities of faith can offer encouragement and understanding as you manage emotional challenges. When churches are places of acceptance, support, and compassion, we can experience the love of God through one another. This helps us fully accept ourselves, with all of our unique and shared challenges, as we walk the (often bumpy) journey of life together.
A specialty at Dwell Psychological Services is exploring your emotional, cognitive, and behavioral experiences in the context of God’s care for you. Far from a judgmental or “pray it away” approach to mental struggles, we are invited to a fully accepting and loving relationship with God in the midst of our difficulties because he cares for us.
Practical Steps for Managing ADHD and Anxiety
Seek professional support: Therapy tailored to ADHD and anxiety can provide coping strategies and skill-building. Medications can be a helpful adjunct for managing chronic or intense symptoms.
Develop routines: Structured daily routines help reduce overwhelm and improve focus. This includes prioritizing basic acts of physical self-care, like eating, sleeping, and moving.
Practice silence: Mindfulness meditation, along with other meditation and prayer practices, can calm the nervous system and increase present-moment awareness. This helps you develop an inner place of calm that is accessible to you when things start to feel overwhelming.
Use faith resources: Scripture, prayer, and spiritual community can nurture emotional resilience. Accessing these resources can help strengthen you for the journey.
Build support networks: Connect with others who understand ADHD and anxiety, especially those you can talk with in-person. It’s surprising how much benefit we receive from simple reminders that we are not alone.
Invitation to Therapy with Irene Kraegel
If you’re seeking support from a psychologist experienced in integrating faith with evidence-based care, I’d be honored to walk with you. Together, we can explore personalized strategies to manage ADHD and anxiety, fostering hope and healing.
Services are available in-person in Grand Rapids, MI, as well as online in 43 PsyPact states.
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