Getting Tested for ADHD as an Adult: What to Expect and Where to Start

You’re at your desk. You’ve been trying to read one paragraph for the past hour. Your phone somehow is still unlocked. You have seven browser windows open with things you don’t remember researching but could probably guess why they’re there. Oh and that email you wanted to send this morning? Yeah, still in drafts.

Does this sound all too familiar? You’re not alone. More and more adults are questioning whether ADHD is the culprit. But testing feels like A LOT…where do you go? Do you need a referral? Will your insurance cover it? What if you’re just not very good at being an adult? These rhetorical questions prevent many people from even trying.

Why Adults are Getting Tested for ADHD Now

It’s becoming more apparent that ADHD is not just the hyperactive little boy bouncing off walls in the classroom. ADHD is a chronic state of affairs that results in being late to meetings regardless of good intentions. It’s getting excited about a project and never finishing it. It’s being able to hyperfocus on an interesting task for six hours yet unable to sit through a 30-minute meeting without thinking about seventeen different things.

Many adults, and especially women, fall into this category. Adults who were daydreamers, “smart but does not apply herself,” just making it by on pure intelligence without the development of study or attention skills needed to persevere. Then life hit out of college or university and whirlwind adult tasks came crashing down—organizing finances, having to pay bills on time, being expected to focus on general adult responsibilities—and the coping mechanisms that worked in a classroom setting were no longer helpful.

Add this awareness into the mix of COVID—many people had structure they didn’t know was surrounding them. The build-up of homes and offices, coworkers watching over their shoulders, a sense of public accountability—and then boom. Home offices with no separation of responsibilities made people realize how difficult it was for them to advocate or even pinpoint their own executive functioning.

First Steps: Screening vs. Diagnosis

Before discussing what happens during the testing process, there’s an important distinction to make between screening and diagnosis because much of this causes unnecessary confusion and complication.

Screening is like a test run. It’s a series of questionnaires or assessments to determine whether ADHD is likely and whether further investigation is needed—or not. In other words, screening is the “you should get this checked” stage. Thus, many adults assessing their likelihood of ADHD begin with a free adhd test for adults online to see if the symptoms align enough to spend potential time and money getting tested.

Diagnosis, however, is completed through a licensed medical or mental health professional and is the stamp of approval necessary for ADHD medication or therapy should ADHD be found through the process. Thus, one cannot diagnose themselves with the aforementioned online tests but instead use those resources to advocate for further testing.

The ADHD Testing Process

The process is much more than sitting down and taking a test (although part of it IS that!) A comprehensive ADHD evaluation for adults includes:

An extensive interview about your history—childhood, school years, work years, relationship patterns—for a clinician to ascertain whether there are patterns of assessment through adult life (as it’s important to note that ADHD as a neurodevelopmental disorder begins in childhood, even if it was never diagnosed).

Adult evaluators will send you standardized rating scales question by question as opposed to the automated assessments given online as these include specific symptomatology and severity of consequences on functioning. These questions are validated assessment instruments—and most common include the ASRS (Adult ADHD Self-Report Scale) and CAARS (Conners’ Adult ADHD Rating Scales).

Many evaluators request an additional assessment be given to someone who knows you well—a partner or family member—as often ADHD impacts how individuals perceive themselves and if they’ve compensated well enough, they may not even realize how much energy they’re burning through for minimal output.

Some professionals give cognitive testing or continuous performance tests—which assess attention span, impulse control and executive functioning—but these are merely ancillary pieces of information about how one’s brain works during the evaluation process—not necessary for a diagnosis.

Who Can Diagnose Adult ADHD?

This depends on where you live but generally speaking, psychiatrists, psychologists and GP’s (general practitioners) with certification or nurse practitioners are all okay to diagnose adult ADHD. In the United Kingdom, however, diagnosis often comes with an NHS psychiatrist referral or ADHD specialist; however, it’s possible to pay privately if one doesn’t want to wait (and the NHS waiting lists can be staggering—18 months in some cases).

In the United States it’s generally assessed through one’s primary care physician (after some initial screening) and then passed along to a psychiatrist or psychologist with ADHD specialty (sometimes even through employee assistance programs with work).

However, it’s important to note that not all mental health professionals recognize adult ADHD so it’s critical to ask their experience with adult ADHD specifically before booking an evaluation—and wasting time and money—if they’re not educated in this realm.

The Cost of Diagnosis

Money matters because this stops many people from making appointments. If insurance offers coverage through the NHS there may only be a nominal fee to pay (if any) besides your usual co-pay or tax contributions for effort put in; however, when waiting months for an appointment it can become frustrating.

Private assessments within the UK usually range between £500-£1500 depending on comprehensiveness and location while in the United States this can amount anywhere from $1,000-$2,500 for a neuropsychological comprehensive evaluation.

Some people opt for less expensive options—adults assessment services providing assessments that charge about £100-£200 or $100-$250 (not including any prescriptions) where someone can sign on virtually for an hour assessment only providing diagnosis if they believe it’s necessary. However, many find that this option isn’t as comprehensive compared to in-person testing which provides diagnoses more easily.

Preparation for your Assessment

If you’re making an assessment appointment, there’s nothing wrong with preparing beforehand. For instance:

Start documenting when your symptoms come out most—what strategies you’ve used in the past to mitigate success/ failure versus success. Make a note of how these factors impact your work life, home life, interpersonal relationships.

Try to find old report cards, if possible, as notes like “bright but distracted,” “doesn’t work up potential,” “needs greater focus” are great pieces of evidence across time for any diagnostician looking for evidence from childhood.

If applicable, note other mental health considerations as well; often those with ADHD co-morbidity with depression and anxiety or de facto depression/anxiety secondary from suffering for so long with under-diagnosed (or undiagnosed) ADHD—which all impact the full picture of adult functioning—and helpful information during testing.

What Happens After Testing?

After-all’s said and done—whether diagnosed or not diagnosed is secondary. If diagnosed with ADHD, at least there are options for medications, coaching strategies and societal accommodations at work; if it’s found that an individual does not have ADHD at least one potential option has been ruled out.

Often relief sets in once an assessment occurs—the years of hoping there wasn’t something wrong with them but feeling like something was wrong finally becomes apparent; it’s no longer character flaw laziness coupled with poor motivation skills—it makes neurological sense and there’s treatment options available!

Moving Forward

Thus, testing when you realize that adulthood impacts your quality of life through attention span limitations and executive functioning issues is critical—because once you eliminate conjecture you can no longer understand what’s impacting your quality of life unless you acknowledge something is wrong in the first place but don’t know what it is yet.

So, take it step by step: assess yourself through screening; find a qualified professional; gain your evaluation; and assess whatever comes next—treatment options? Learning more about yourself? At least it’ll help!