In my work as a clinical psychologist, I’m often asked to provide an evaluation to determine if an adult client has ADHD. Clients come to me reporting that they can’t focus their attention long enough to complete a mundane task. They start several projects and complete none. They can’t manage their multiple responsibilities. Completing their work tasks is drudgery. They can’t keep up with the productivity expectations of their employer. They can’t slow their thoughts enough to focus on what’s in front of them. They are chronically distracted. Their minds race even as they try to sleep. (All client stories in this article are composite examples.)
Whether these problems are the result of ADHD or are due to some other diagnosis or are just part of life—this is what I try to figure out. But in recent years there is only one answer people want to hear, and it’s that they have ADHD.
I’m not talking about people who meet the diagnostic criteria, which includes clear evidence of significant attention problems beginning in childhood and causing verifiable impairment in work, school, or social functioning. Many of those who seek a diagnosis have no clear history of clinically significant attention problems. Still, they have begun to perceive themselves as having a disorder of some kind. (My evolving perspective is based on anecdotal experience and on my discussions with colleagues, not on any specific research.) They look to my assessment not to understand what’s really wrong but to get confirmation that what’s wrong is that they have ADHD. But why would people desire a clinical diagnosis that is defined by the DSM5 as a neurodevelopmental disorder?
Some clients want medication, specifically Adderall, which they imagine will help them overcome their challenges. Students often want academic accomodations—support like extended time on testing, designated note takers, and flexible deadlines. And some just want to belong to an identifiable group. The sense of belonging, of not being alone in their struggles, can be a powerful driver in the quest for diagnosis.
