Question:

I am 17 and I think I have ADD, but I am not totally sure and am too scared to go for help. I have read lots of internet sites and some books, and I fit into all their descriptions of ADD and have most if not all of the symptoms listed. The only thing holding me back from seeking help is that I sometimes doubt my symptoms are serious enough. Do symptoms of ADD have to be present 100% of the time, or can they be a little less problematic on some days, especially when there is interest in what is going on? Do you think I should go for help? Your opinion would be GREATLY appreciated, because I am quite frustrated by the way I am and will glady accept any help offered. Thanks so much!

Kimberley

Answer:

Dear Kimberley:

Thank you for your question. I wish that I could provide you with a simple fill-in the blank test to determine if you have ADHD. However, none exists, nor is ADHD like a medical disease that can be diagnosed with a simple blood test. Symptoms vary from one person to the next and even within an individual over their lifespan. For example, many people who as children were diagnosed with ADHD, impulsive-impulsive or combined type, become less hyperactive when they reach puberty and later qualify as inattentive type. Some individuals who required medication at some point in their life may have periods in life when medication is not necessary.

A hallmark of ADHD is inconsistency. Everyone has periods when they have difficulty attending and organizing. However, the person with ADHD experiences longstanding, severe impairment. Also, most people with ADHD do have a few activities in which their impairments are absent. These tend to be those that rely on active involvement such as sports, computer use, video production, or mechanical activities. Some experts believe that symptoms for women can become more severe before or during their menstrual periods.

Since I don't know you personally, I certainly cannot tell you if your concerns are well-founded. However, I strongly urge you to speak with your parents or school counselor about seeing a professional, particularly since your difficulties are troubling to you. Only a diagnosis by a trained clinician will ease or confirm your fears and give you suggestions about what you can do to alleviate the symptoms that concern you. Also, only a trained clinician can suggest a course of action if you have a diagnosis other than ADHD.

Since you are 17 years old, you should be closely involved in all aspects of a potential assessment. You should help your parents interview the possible candidates for conducting the assessment and should participate in interviews, rating scales, and all other aspects of the assessment.

Assessment by a physician in an hour or less office visit is not now considered to be sufficient. Expect to spend a minimum of two visits in a clinical setting. In a previous Ask A Specialist answer, a link was given to guidelines published by the American Academy of Pediatrics (AAP). In addition to pediatricians, other professionals qualified to diagnose ADHD are:

• Psychiatrists
• Clinical and school psychologists
• Clinical social workers
• Family practitioners
• Neurologists

To give you some idea of what to expect when you do seek an evaluation, I've listed some basic components of a thorough assessment.

• A thorough history of your symptoms than includes interviewing both you and your parents
• Behavior rating scales
• Teacher reports
• A review of school records
• Direct observations
• Physical exam
• Academic and intelligence testing

Some professionals also use computerized "performance tests" consisting of computer tasks that involve inhibiting impulses and organizing responses to visual information. These are not required for an accurate diagnosis. Keep in mind that an assessment will require parent and school participation. However, you can be in the driver's seat.

Some excellent resources about teens with ADHD can be found at Chris Dendy's website: www.chrisdendy.com

Chris is the mother of two boys with ADHD and has collaborated with her son to write a book for teens and young adults called, A Bird's Eye View. This book offers down-to-earth tips for coping with issues such as disorganization, forgetfulness, always being late, sleep problems, memorization procrastination, restlessness, medication, writing essays, and algebra. Contributions are written by teens and young adults with ADHD. Another resource is the video, Teen to Teen: the ADD Experience. This is a great video that features teens on a panel of "experts." The experts are interviewed by other teens and adults about their life experiences. You'll be surprised how normal these kids are!

Good luck in putting together your assessment. Remember to make use of your adult resources. Whether or not you have ADHD, it takes courage to discover who you are.