ADHD – or attention deficit/hyperactivity disorder – is getting a lot of attention these days.
ADHD diagnoses are on the rise, especially in kids. The Centers for Disease Control and Prevention called ADHD an “expanding public health concern."
And TV shows and social media influencers continue to drive public awareness.
A new national survey by the Ohio State University Wexner Medical Center finds that as many as one in four adults suspect they have an undiagnosed case of ADHD, but only a fraction of them – 13% – have talked to their doctor about it, raising concerns that self-diagnosis may be leading to incorrect treatment.
WOSU’s Matthew Rand, discussed the findings with Justin Barterian, PhD, a psychologist with the Ohio State University Wexner Medical Center.
Rand: There's a lot of attention on ADHD right now, and, I think, a fair amount of armchair quarterbacking over whether ADHD is under- or over- diagnosed. Can you first quickly walk us through what ADHD is and what are the challenges with diagnosing it?
Barterian: So, ADHD is a developmental disorder that begins in childhood and can continue into adulthood for many people. It consists of symptoms of inattention or difficulty with focus and concentration and/or symptoms of hyperactivity, impulsivity, such as difficulty sitting still, fidgeting and those sorts of things. And these symptoms significantly impair the person in multiple settings, such as at work, at home or in social relationships.
Rand: I understand ADHD is generally thought of as a lifelong disorder. How does it typically present itself in adults that's different from how it shows up in children?
Barterian: So, in general, what we'll see is the hyperactivity and impulsivity will somewhat resolve for some people into adulthood, and it's kind of replaced by more of an internal restlessness rather than that outward hyperactivity, but those symptoms of inattention remain present. So, difficulty with focusing, difficulty staying on task, difficulty with forgetfulness and those sorts of things.
Rand: The new Ohio State survey finds that less than 1 in 5 adults who think they may have ADHD still aren't getting themselves checked out by their doctor. What's going on and why is this so concerning?
Barterian: It's concerning in the sense that we know that undiagnosed ADHD can have a significant impact on somebody's life. It can affect them at their work performance. It can even affect health. So, you know, ADHD can affect keeping up with routine health appointments and those sorts of things that could have long term impacts down the line. In terms of why people aren't getting checked out, it could be many factors. There's a lot of long waits to get evaluated, sometimes by a psychologist or psychiatrist. Also, I think there's a sense of concern about being judged or being seen as trying to pretend like something's wrong or those sorts of things. And I think that's why it's really important to have a conversation with your doctor. So that way, you can get referred for a more comprehensive psychological or psychiatric evaluation.
Rand: What are some perhaps unhealthy ways people who think they may have ADHD may try to manage it on their own?
Barterian: You can sometimes see excessive caffeine use, for example. So, we know that caffeine wakes us up a little bit, helps us pay attention, those sorts of things. And so, you might see excessive caffeine use. Similarly, we know that our individuals with ADHD oftentimes will have a history of nicotine use as well for those same sorts of reasons. It can kind of increase attention and those sorts of things. And those tend to be unhealthy ways of coping.
Rand: Finally, prescription medications for ADHD, such as Adderall, have been in short supply for a while now. What's your advice for patients trying to navigate this at the pharmacy?
Barterian: Stay in close contact with your doctor. There may be other medications that are options for you as well that may not be part of the shortage at this moment. But in general, I would recommend working with your doctor and then working with pharmacy to try to find a pharmacy that is carrying that medication.
