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How do doctors diagnose ADHD in adults?

Quick answer: Doctors diagnose adult ADHD using clinical interviews, validated rating scales, and evidence of several symptoms since earlier life with clear impairment in at least two settings. They also rule out other explanations such as sleep disorders, anxiety, depression, or substance effects.

Clinicians use DSM‑5 criteria, structured interviews, and rating scales (for example the ASRS) and review school and work history and current functioning. A key point for adults is that several symptoms were present since earlier life, even if recognition came late.

Evaluation confirms that patterns cause impairment in at least two settings (for example home and work) and were not better explained by sleep problems, anxiety, depression, substance use, or medical conditions such as thyroid disease.

Collateral information can help. Past report cards or feedback from a close person often clarifies long standing patterns. A physical exam or labs may be ordered to rule out other causes where appropriate.

For adults, DSM‑5 uses a threshold of 5 or more symptoms in inattentive and/or hyperactive impulsive domains, with clear impact on daily life. Clinicians also document strengths and goals to guide a practical plan.

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