Difficulty Concentrating: Assessing for ADHD and When to Seek Help
Do you often find it hard to stay focused on tasks, even when you want to concentrate? Occasional lapses in attention are normal, especially during tasks that require sustained mental effort or are less enjoyable. For some individuals, however, difficulty concentrating happens frequently and can interfere with work, school, relationships, and daily life.
What Causes Difficulty Concentrating?
Difficulty concentrating can stem from a variety of factors, ranging from lifestyle habits to medical or mental health conditions.
Common lifestyle-related causes include:
Medical or mental health causes may include:
Because there are multiple potential causes, determining the root of concentration difficulties requires a careful evaluation.
Evaluate Lifestyle Factors
Check Your Health
Consider Mental Health Support
Difficulty concentrating is a common challenge with multiple potential causes. By addressing lifestyle habits, checking in with healthcare professionals, and seeking support for mental health concerns, individuals can often restore focus, reduce frustration, and improve productivity.
A clinician regulated by the College of Psychologists can complete a screening and assessment to help determine if a mood, anxiety, or other mental health condition such as ADHD or other factors are causing your challenges with staying focused.
What about ADHD?
For some people disruptions in concentration are caused by ADHD. Approximately 11% of children have ADHD (Merikangas et al., 2010). Although the average age of onset for ADHD symptoms is six years old, the lifetime prevalence rate of ADHD in adolescents is 8.7%. According to NIMH, in adults, the prevalence rate for ADHD is 4.4%.
ADHD is a neurological disorder that affects how the brain functions. In particular, ADHD leads to persistent disruptions in executive functioning. Disrupted executive functioning can appear as a lowered ability to start and finish tasks, self-monitor, follow directions, tolerate frustration etc.
Although overwhelmingly, most people who have disrupted concentration do not have ADHD, after considering all the above issues, it could be helpful to also rule out ADHD or ADD.
There are three types of ADHD. The first type is characterized primarily by difficulties with focus and concentration, as some people experience issues with attention but not problems with hyperactivity. This type of ADHD is the “inattentive” type or ADD.
The second type of ADHD involves an absence of attention issues, and the primary concern is hyperactivity and impulse control issues. This type of ADHD is known as ADHD, hyperactive type.
Both inattention and hyperactivity characterize the third type of ADHD. This type of ADHD is known as ADHD, combined type.
Assessing for ADHD:
ADHD is considered a neurobehavioral disorder. ADHD is a condition that develops in childhood as the brain develops, and ADHD does not start in adulthood. Because the symptoms can overlap with other conditions or may be mild, sometimes AHDH is not diagnosed until adulthood.
It’s important to note that only a physician, psychiatrist or psychologist can diagnose ADHD. Because so many overlapping conditions or concerns can contribute to issues within inattention, a thorough ADHD assessment is essential.
When a clinician assesses for ADHD, they assess for the presence of 6 or more symptoms in each domain of inattention and hyperactivity/impulsivity. Symptoms must be present for at least six months and include:
Inattention
Often having difficulty sustaining attention on tasks.
Often failing to pay close attention to details or making careless mistakes.
Often not listening or paying attention when spoken to.
Often not following instructions or completing tasks, duties or work.
Often having trouble organizing tasks and activities.
Often avoiding or strongly disliking tasks that require sustained mental effort.
Often losing things necessary for important tasks or activities, such as work or school materials, phones, wallets, keys, etc.
Often being easily distracted.
Often being forgetful in daily activities.
Hyperactivity/ impulsivity
Often fidgeting, or tapping hands or feet or squirming in one’s seat.
Often leaving one seat when expected to be seated.
Often running or climbing in situations where it is not appropriate or frequently feeling very restless.
Often being unable to play or take part in leisure activities quietly.
Often “on the go” or acting as if “driven by a motor.”
Often talking excessively.
Often blurting out an answer before a question has been completed.
Often having trouble waiting their turn.
Often interrupting or intruding on others.
Aside from experiencing sufficient symptoms in each criterion, symptoms must also be present before age 12 years.
To receive a diagnosis of ADHD, the symptoms must arise in more than one setting. Settings can include school, work, home, social situations or out in the community. For an ADHD diagnosis to be appropriate, a person’s symptoms must also significantly reduce the quality of their life or functioning. The ADHD symptoms cannot be better explained by another mental disorder such as PTSD or Major Depression.
What should I do if I think I have ADHD?
First, do not try to self-diagnosis or use a cheap (under 2 hours) assessment service. Proper ADHD diagnosis is complex and involves several processes in order to help avoid an incorrect diagnosis.
To help screen for adult ADHD symptoms, consider completing a measure such as the ADHD Self-Report Scale (ASRS-V1.1).
If you suspect you could have ADHD, seek out a psychologist (you can contact us) to conduct further screening and an assessment. Gather report cards or some form of written confirmation of disruption in executive functioning skills before age 12.
If you are attending a good quality assessment, expect to attend at least 2-3 sessions for the assessment. Having a parent or partner attend is encouraged. The first session or two is usually used to screen for other causes, including mood and anxiety disorders, and complete a diagnostic interview like the DIVA. A standardized measure such as a BRIEF is often administered. A follow-up session is usually scheduled to provide feedback, confirm a diagnosis and provide treatment or symptom management suggestions.
For suggestions on managing ADHD symptoms, stay tuned for part 2 of this blog series on ADHD: How to cope with adult ADHD symptoms.
References:
American Psychiatric Association: diagnostic and statistical manual of mental disorders, common fifth edition. Arlington, VA., American Psychiatric Association, 2013.
Attention-Deficit/Hyperactivity Disorder (ADHD), National Institute of Mental Health
Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):980-9.
By clinical Psychologist Dr. Jennifer Barbera PhD
