Many struggle to focus on their tasks. They might go to the kitchen for coffee and start doing dishes when they see them unclean. When they see that the water flow is slow, they start inspecting the pipes, leaving the dishes midway.
Later, they get irritated as nothing got done. They didn’t even get their coffee. Neither do they remember what they were doing before going to the kitchen. One small trigger after this, and that is enough to make them lose all their calm.
As time goes by, you notice this becoming a pattern, the distractions, the restlessness, and begin to wonder what it all really means. Is it just stress? A phase? Or could it be something more, like ADHD?
With already so much going on, wondering who you should visit can be a lot on your plate. To answer the core question, yes, a neurologist can diagnose ADHD. Knowing they can help is, however, only the tip of the iceberg, and it is equally important to know why this question can be confusing and how a neurologist can help with ADHD.
According to the National Institute of Mental Health, ADHD is “marked by a persistent pattern of inattention and/or hyperactivity and impulsivity that makes it hard to function in at least two areas of life, such as at home, school, or work.”
Many adults do away with the thought that they have ADHD because they have the misconception that it only affects children. In reality, as of 2020, over 139 million adults have had ADHD since their childhood, while over 366 million adults are affected by it regardless of when it first started.
Why does this question come up so often?
The question “Can a neurologist diagnose ADHD?” isn’t an odd one. The confusion is actually quite common amongst people, because even though ADHD is a neurodevelopmental disorder, it often manifests as a behavioural issue.
Many have a misconception that a brain disorder means some physical damage to the brain. It could be something like trauma or tumors that they can see on an MRI report. In reality, any condition that prevents your brain from functioning normally or affects its chemistry is a brain disorder. ADHD is one such condition with functional consequences.
People are mostly unsure who to visit because of how neurologists diagnose ADHD. Instead of routine neurological check-up methods like CT scans, EEG, and ENG, what ADHD testing encompasses is the patient’s history, clinical interview, and rating scales.
These are the tools that a psychiatrist commonly uses, so it is normal to be confused about who you should visit, a psychiatrist or a neurologist. The answer is both.
Our bodies work in beautiful yet complex ways, and ADHD sits right at the junction of both neurology and psychiatry. It is fine to approach either a psychiatrist or a neurologist as long as they are an expert who listens to you and helps you get clarity.
What causes ADHD in the brain?
Now that you know it’s not easy to hold your attention for long, when you start working on something, you leave it midway, whenever you try to sit quietly somewhere, you keep fidgeting. You might wonder why this happens, because you are not doing it intentionally, and even when you try to control these, most of the time it doesn’t work.
To understand this, we need to know how the human brain functions. Our brain has a part called the prefrontal cortex (PFC), which acts as the command center. It is located at the front side of our brains and is in charge of our attention, behaviors, and how we feel.
The PFC circuit or the neural pathways that connect the frontmost part of the brain with the rest of the brain are comparatively more fragile in a person with ADHD than in others.
Since the channel is affected, the high-level cognitive functions carried out by them are also affected. The right hemisphere of the prefrontal cortex is especially influenced by this. It specializes in managing how you behave. This explains why you frequently face challenges in controlling your behavior.
In addition to this, the prefrontal cortex needs enough dopamine and norepinephrine, the neurotransmitters that help your brain communicate, to function properly. With these chemicals disrupted by ADHD, you might not find enough motivation to initiate a task.
Even if you do, you possibly leave it in between because dopamine, the chemical that is responsible for giving a sense of satisfaction, is disrupted, and you are simply not satisfied doing a few things.
Similarly, Norepinephrine assists us with focusing, but when you have ADHD, your ability to focus takes a hit, and this is why your attention keeps wandering.
It is important to understand that it is not a flaw on your part, nor is this your fault. It is simply how your brain functions, and it is absolutely biological.
Who is a neurologist?
A neurologist is a doctor having expertise in the central and peripheral nervous systems and has a great understanding of how the brain, spinal cord, and nerves function. To understand what a neurologist can do for ADHD, you need to understand a little about the brain.
Our brain is mainly divided into three parts, with each part working in coordination but having separate roles. These are:
- The hindbrain: It is the lower part of the brain that consists of the spinal cord (the top portion), the brainstem (which connects the cerebrum with the spine and the cerebellum), and the cerebellum. Certain essential functions, like respiration and heart rate, are managed by the hindbrain.
- The midbrain: It is located on top of the brainstem and is in charge of your reflexes and voluntary movements.
- The forebrain: It is the most advanced part of your brain, taking most of its space, and includes the cerebrum and, below it, the hypothalamus, hippocampus, and the basal ganglia.
When you plan to cook a special dinner, you go out, remind yourself of the ingredients and buy them, come back home and cook them, just the way your family likes it. This thinking, actions, and memories are all managed by this part of the brain, the forebrain.
Your brain is the organ that works the hardest of all, and when it is healthy, it works so effortlessly that we do not even need to do anything. It works automatically. Any problem in the brain, however, can be disastrous.
A neurological disorder targets your brain, spinal cord, nerves, and muscles. Some common neurological disorders include:
- Seizures: Sudden and abnormal electrical activity takes place in the brain during a seizure and can influence a person’s consciousness, behavior, memory, or even how they feel.
- Stroke: Stroke occurs when the blood flow to the brain is blocked or when there is bleeding inside the brain. It damages the brain cells because of the bleeding, or they die when the nutrients and oxygen do not reach them.
- Parkinson’s disease: The condition affects the substantia nigra, located under the basal ganglia, and causes movement issues such as slow movements, stiffness, or tremors.
A neurologist acts as a detective, a medical one, to find the origin of any disorder and which areas it can affect in the brain. For instance, the neurologist finds out where exactly in the brain a seizure began, what caused it, and then provides a personalized treatment for the patient.
Addressing these issues, however, is not always easy because the brain hardly works simply. Many symptoms often do not remain within one category and can overlap with other conditions.
When do ADHD symptoms overlap with neurological conditions?
Although ADHD is often marked by inattention and restlessness, these symptoms can also signal other neurological conditions. ADHD affects the forebrain primarily, but any injury or disease affecting the same region can also mimic symptoms often associated with ADHD.
- Traumatic brain injury (TBI): Physical damage to the brain, especially among children and teenagers, can cause the development of secondary attention deficit/hyperactivity disorders (SADHD). It has been found that even years after the traumatic brain injury, they can have attention problems all over again, irrespective of the severity of the injury.
- Cognitive disorders: Age-related cognitive decline often overlaps with concentration and forgetfulness associated with ADHD. There is, however, a critical difference. When an individual has ADHD, they are distracted, so they never record the information.
Whereas with a cognitive disorder, an individual records the information but cannot retrieve it. One is an encoding issue, while the other is a retrieval error.
- Silent seizure: This is a dangerous overlap. When a person, usually a child, zones out from a conversation and stares blankly, it looks like they are not into the conversation, but that might not be the case. They can experience a temporary blackout for a few seconds and not remember it afterwards
Since the line between ADHD and other neurological conditions often blurs at the surface level, a professional diagnosis becomes critical to rule out other possibilities before focusing on ADHD treatment.
How is ADHD treated in adults?
Evaluating ADHD can be challenging sometimes since the symptoms, to some extent, are also found in other people. A neurologist needs to go deeper in understanding what the person is going through and then figure out why.
The patient is interviewed by a neurologist who asks them about all the details, their personal life, professional life, and how they behave socially. This clinical interview lays the foundation for a proper evaluation.
Since ADHD symptoms often begin in childhood, and from that point to being an adult is a long way, one might not properly recollect all their childhood memories. Even if they remember, the accuracy needs to be verified.
Those close to the patient, who have known the patient since their childhood, become an important source of information. In the absence of such people, school records become important collateral data that can reflect impairment levels in the patient and help assess their current symptoms.
Knowing about the symptoms alone is not enough. Clinicians evaluate how those symptoms affect your daily functioning. They often try to learn if you frequently miss your deadlines. They would want to know if you have lost any dear one because they thought you were unreliable.
Adults also need to be screened for certain comorbid conditions, such as anxiety, depression, and personality disorders, because they are common in ADHD patients. This is also to ensure that the person receives the best treatment for both ADHD and the comorbidities.
Knowing about your history and your daily habits is the only way to make sure the diagnosis is accurate for you. Without these, ADHD is shadowed by your emotional ups and downs and potentially keeps you from seeking appropriate treatment.
Why is ADHD misdiagnosed?
ADHD is a disorder whose impact reaches every aspect of life. One is bound to question why it happens to them. Even after giving so much effort, why does everything seem to fall apart?
Failure after failure doesn’t just make you worry anymore, but now they keep you on a constant edge. This ‘constant edginess’ is something that you experience when anxious.
Because mundane tasks like paperwork, cleaning dishes, or doing laundry don’t give you the satisfaction that others get, you are easily bored and find yourself ‘stuck’ because most of the things do not intrigue you. This is similar to the loss of interest that happens in depression.
Adults are trained throughout their childhood and adolescence on how they are expected to behave and how to fit into society. They feel it is a must to hide their symptoms, their feelings from others, at times even from those close to them, to keep the relationships intact.
By masking their emotions, adults with ADHD seem absolutely fine or even successful on the outside to others, but on the inside, it is a total contrast. It is only exhaustion and burden that they carry alone. ADHD is often misdiagnosed because of this confusion with other issues and suppression of symptoms.
When to seek help for ADHD?
After spending quite some time wondering ‘what is the matter with me’, you might start thinking about what you should do about it. Not everyone is excited about work all the time; at some point, their work doesn’t give them the reward or the satisfaction, so they don’t do it.
An individual is not always in the present, and it is natural to zone out when they have a lot going on. One should, however, consider visiting a doctor when:
- If you experience a head injury or even if it is years old, you should consider getting checked to rule out SADHD. You should not skip a medical check-up just because you think the injury is not serious enough.
- When concentration problems start interfering with what you do. Getting distracted from the work to check the notifications on the phone is something everyone does, but if you keep jumping from one task to another and get nothing done at the end, it may be concerning.
- You are suddenly having trouble remembering things that were not an issue earlier, difficulty making decisions, or are unable to process information like you usually do. Cognitive decline is not always due to stress.
- Finding yourself being impulsive or making decisions without thinking them through. You are reacting in a way that you may not, and that can have serious consequences.
- When you become restless or get irritated and angry over minor things, and then regret your behaviour. This emotional dysregulation is often a sign to seek help.
You should not wait for your symptoms to get worse. You should not wait to confirm your symptoms. If you need clarity, a professional can help you find that. You don’t have to tire yourself in an attempt to figure it out all on your own.
Moving from ‘almost’ to completion
When living with ADHD, the day becomes a series of “almosts”. Almost sent that email. Almost washed the car. Almost decided on what film to watch. Almost…
It is natural to feel frustrated, but what you are experiencing is also natural. It is biological, in fact. You are not an irresponsible adult. You are just someone whose brain works slightly differently, and different does not mean bad.
You have lived trying to understand what you are going through long enough. Now you should let a professional help you carry the rest. You can visit a neurologist for ADHD. Many times, they work with psychiatrists to provide the best treatment to the patient.
If you’re tired of the ‘almosts,’ our team of specialists, such as a neurologist near me, is here to help you find a clear path forward and finish what you started.