Our team of licensed psychiatric-mental health nurse practitioners (PMHNPs) practicing at Triumph Behavioral Health here in Maryland often receives this question: “Can adults get diagnosed with ADHD?” This acronym stands for Attention‑Deficit/Hyperactivity Disorder and is most commonly diagnosed in children – but it can be diagnosed in adults, too!
That is the short answer, but the more complete response is a bit more nuanced. Today, we are going to clarify how ADHD is evaluated in adults, what the criteria are for this diagnosis, how adult ADHD differs from childhood ADHD, and how one might proceed if they suspect they may have undiagnosed ADHD. Let’s get started.
Why Adult ADHD Matters
ADHD is often thought of as a childhood disorder – but, as research and clinical experience show, the condition does not necessarily disappear once someone reaches adulthood. Many adults either were diagnosed in childhood and continue to deal with challenges, or they were never diagnosed as children and only recognize the impact of ADHD in their adult life.
According to the CDC (Centers for Disease Control and Prevention), ADHD “often lasts into adulthood” with symptoms perhaps looking different in older age – greater restlessness rather than overt hyperactivity, for example. Recognising ADHD in adults is important because untreated or unrecognised symptoms can lead to difficulties in work, relationships, self-management of daily responsibilities, and overall quality of life.
Diagnostic Criteria for ADHD in Adults
When our providers evaluate adults for ADHD, we look to the criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) as well as empirically‐informed guidelines for adult diagnosis. Some key elements include…
In adults (age 17 and older), the criteria require at least five symptoms of inattention and/or hyperactivity-impulsivity (whereas childhood criteria require six).
Symptoms must have been present for at least six months, and to a degree that is inconsistent with developmental level and causes impairment.
Several symptoms must have been present prior to age 12 (this helps us understand that this is not something that just began in adulthood).
Symptoms must be present in two or more settings (for example, at home and at work; or in social and occupational domains).
The symptoms must clearly interfere with, or reduce the quality of, functioning (social, academic, or occupational) and cannot be better explained by another mental disorder (such as a mood disorder, anxiety disorder, or substance use) or by a medical condition.
One helpful summary for us clinicians: Make sure the symptoms are persistent, begin early (childhood), show up in multiple domains, and are clearly causing impairment. Diagnosable ADHD is not just being “quirky” or “scatterbrained.”
Why Diagnosing Adults With ADHD Can Be More Challenging
At Triumph Behavioral Health, one of the common issues we see is that adult ADHD can look different than childhood ADHD, and many adults have developed coping strategies (some healthy, some maladaptive) that mask classic symptoms. Here are some common challenges:
Symptom Presentation Changes: Adults may not “run around the room” or climb on furniture, but they may feel restless, have difficulty relaxing, fidget, or constantly “on the go.”
Overlap With Other Conditions: Depression, anxiety, sleep disorders, substance use, thyroid problems, even trauma or PTSD can all mimic or co‐occur with ADHD. A careful differential diagnosis is essential.
Retrospective Recall: To diagnose ADHD in adults, one must typically document symptoms from childhood (before age 12), but many adults either do not remember clearly or never had formal records. In such cases, collateral information and structured interviews are helpful.
Functional Impairment: Since adults have many roles (work, relationships, home responsibilities), the diagnosis hinges on symptoms causing meaningful impairment. For example, think of missing deadlines, chronic disorganization, frequent job changes, relationship strain, etc.
Diagnostic Guidelines Are Still Evolving: Although many mental health providers rely on DSM-5, the specific adult ADHD guidelines (such as from the American Professional Society of ADHD and Related Disorders) are still being refined.
Because of these challenges, we like to take a “stepped diagnostic” approach: collecting a thorough history, checklists, collateral input (when available), ruling out other causes, and assessing functional impairment.
What to Expect in a Clinical Evaluation for Adult ADHD
If you come to a behavioral health practitioner seeking evaluation for adult ADHD, here is what you can typically expect:
Comprehensive Intake Interview: You will likely be asked about your history, including childhood behavior, school/work performance, social functioning, how long you have had symptoms, how they have changed over time, what settings they occur in, and what difference they make in your life.
Screening Tools: PMHNPs or other providers often use standardized rating scales (for example, the Adult ADHD Self‐Report Scale) to guide the assessment. These are not by themselves diagnostic, but they are useful.
Collateral Information: If possible, it can be helpful to gather information from someone who knew you in childhood or adolescence (often a parent, sibling, or teacher) to document earlier symptoms.
Rule Out Other Causes: It is important to also assess for mood disorders, anxiety, sleep disorders (e.g., sleep apnea), substance use, thyroid problems, or other medical issues. Sometimes, a provider will order labs or refer you for further medical evaluation.
Impairment Evaluation: A provider will look to see how your symptoms affect multiple life domains such as work, education, home life, and social relationships. Do the symptoms cause an ongoing struggle in many different areas?
Formulation and Diagnosis: If the criteria are met, then your provider may diagnose adult ADHD. If not, the provider may determine that symptoms are sub-threshold, or that another condition is the primary issue.
Treatment Planning: If diagnosed, you work with your mental health provider on a plan that could include medication management, psychotherapy, behavioral interventions, coaching, accommodation strategies, and monitoring.
Get the Support You Need for Adult ADHD at Triumph Behavioral Health
There is strong evidence that treatment in adults with ADHD can yield meaningful improvement to your life. The pathway to diagnosis is rigorous, but it can bring clarity and open the door to meaningful change.
If you suspect you may have adult ADHD, we encourage you to reach out and schedule a thorough evaluation rather than rely on self-diagnosis or unchecked assumptions. With the right partner in care, you can explore whether ADHD may be part of your story. If so, we will work together toward a treatment plan tailored to you and your life.
Reach out to our team at Triumph Behavioral Health today to schedule a same week therapy appointment.