Disclaimer: I am not a clinician, and this is not medical advice. I do not represent the American Psychiatric Association or the DSM-5. Consult a doctor and/or therapist!

This is Part Two of “Does Everyone Have ADHD?!”. Please check out Part One first for the DSM-5-TR definition of a mental disorder, thoughts on what makes a disorder a disorder, social media’s treatment of ADHD, the risk of misrepresentation, and the relationship between technology and ADHD-style behaviors.

Okay, But What Is ADHD?!

Let’s go back to the DSM-5-TR to break down what ADHD really is. In the section for ADHD (Attention-Deficit/Hyperactivity Disorder, under Neurodevelopmental Disorders), the diagnostic criteria contain five main criteria (letters A through E), which include:

• A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2) [we’ll get back to this in a second].
• B. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years.
• C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).
• D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.
• E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).

There are also important specifications about the criteria (please check it out yourself, starting on Internet Archive page 232 of 1924).

Getting back to A, there are two sections under this that each have their own set of letters. First we have “Inattention”, where “Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and
academic/occupational activities”. Five symptoms are required for adults and older adolescents. This is what I would consider the “attention deficit” section. The listed symptoms are as follows:

• a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).
• b. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
• c. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
• d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., Starts tasks but quickly loses focus and is easily sidetracked).
• e. Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
• f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).
• g. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
• h. Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
• i. Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).

As a reminder, at least six symptoms are required (five for adults and older adolescents).

The next section is “Hyperactivity and impulsivity”. Again, six or more symptoms are required that have persisted for at least six months and are inconsistent with developmental level and negatively impact social and academic/occupational activities. Those symptoms are:

a. Often fidgets with or taps hands or feet or squirms in seat.
b. Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place).
c. Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless.)
d. Often unable to play or engage in leisure activities quietly.
e. Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).
f. Often talks excessively.
g. Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for turn in conversation).
h. Often has difficulty waiting his or her turn (e.g., while waiting in line).
i. Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).

Can we be honest with ourselves? Do these really apply to us personally? Can we confidently state that we experience at least five or six of these on a regular basis, for at least six months, in two or more settings, that they genuinely interfere with our quality of life, and that there isn’t a better explanation for these things?

But please note, this is not intended to be used as a tool for self-diagnosis. See a counselor!! This is only intended to get you thinking.

Hopefully you’re seeing the complexities that come with a diagnosis. Because….

There are also included diagnostic features and associated features, the consideration of development and course, the risk and prognostic (likely outcome) factors, culture-related diagnostic issues, gender-related issues, the lack of diagnostic markers, the risk of suicidal thoughts and behaviors, the functional consequences of the disorder, differential diagnoses (aka, it might not be ADHD), and co-morbidities (other physical and mental illnesses you have or may have). Not to mention that this is just what America thinks of ADHD.

The Bottom Line

The bottom line is that there is a lot that goes into a diagnosis, as well as management of the disorder. Self-diagnosis is risky business, not only in that you risk harming yourself but you risk spreading misinformation and potentially harming others. And on that note, please, again, do not take this as medical advice. I am not a clinician. You need to talk to a licensed therapist for clear and current medical information and especially for input on your own experiences and your personal life.

My hope and goal in this is to help people understand that this stuff is complicated, especially when you have other diagnoses (or maybe you’re undiagnosed, which adds further complications). This is my layperson’s opinion based on my own personal experiences and line of work. I’m just a woman who likes research. However, I know that I have barely scratched the surface here, despite the length of this post. And I want to encourage you to dig deeper on your own. We can’t take everything we see on a social media reel as fact. Look into what the professionals say.

A lot of people get autism wrong, too. And before you lift your pitchforks…that is also another post for another day.

Parents: What To Know About How Doctors Diagnose ADHD