ADHD Part 1: The Long Road to Diagnosis

ADHD Part 1: The Long Road to Diagnosis

Last week, we sent out two reporters to interview students about getting diagnosed with ADHD. Apparently they met a really, really interesting group of students with great takes on the situation, but our reporters - both of whom have diagnosed ADHD - were so excited about the interview that they forgot to record it. 

Such is life with ADHD, though. Ideas about ADHD aren’t limited to snotty 7-year-old boys anymore, and discussions of the disorder have entered the mainstream. Obtaining a diagnosis, however, remains tricky. Critic has already covered the “lost generation” of women who struggled to get their disorder recognized, which you can read about on our website, but we wanted to see what people thought of the condition's recent entrance into mainstream culture.

Either you know someone with ADHD or you know someone who thinks they have ADHD. It’s like it’s everywhere. For many it seems a bit too common, given the fact that the current percentage of adults with ADHD in the wild is estimated to be about 4.4%. That’s a wee bit lower than you might expect based on a casual survey of your friends. Of course, undiagnosed cases are not represented in that number, and getting diagnosed as an adult, as we’ll soon see, is no easy task. So, what gives? Either the reported number is way too low, or a significant portion of the young people we see on social media claiming to have ADHD are misguided.

An ADHD diagnosis is a tricky thing to come by. Dr. Dione Healey, Associate Professor in Otago’s Psychology Department and a registered Clinical Psychologist, explained that a diagnosis for the disorder is not just about having a case of the fidgets and a restless mind. “There needs to be significant impairment,” she said, and both impairment and symptoms need to be present from childhood into adulthood. There are boxes that need to be ticked in order to receive a diagnosis. 

And ticking these boxes is where many students get stuck. Obtaining a diagnosis through Student Health involves what Dr. Healey described as a “conservative” approach, one which a student described as “an absolutely hopeless nightmare”. This arduous process is not without reason, though. Student Health is not staffed by unlimited professionals, nor do they have infinite time with which to investigate applications.

Kit*, who we interviewed in the second part of this article, is one of many students who didn’t go through Student Health for their diagnosis. Kit said that outside of Student Health, obtaining a diagnosis as an adult can cost you anywhere between $400-$1,000, and that there are only a handful of places in New Zealand that will actually run the tests in the first place. Dr. Healey told us that a few years back there was a way to get the diagnosis online, without ever meeting the doctor, but that option has now shut down. 

The inaccessibility to testing has led many students to self-diagnose. Pam*, a second-year at Otago, said that she self-diagnosed “because it felt like the right thing to do”. She said that the disorder “clearly runs” in her family, but since nobody is officially diagnosed, she didn’t feel like she had a shot at an official diagnosis. “So I just went online, checked the criteria, and felt like every single point was talking about me. So I made the call myself,” she said. “I don’t think it’s a problem.”

Self-diagnosis is a controversial approach. Some students that we spoke to were angry at the trend, with one telling us that it devalues their genuine claims to a disorder and makes society “see my problems as less of a problem”. They also complained that with “everyone” claiming to have ADHD, their own path to diagnosis was steeped in scepticism from doctors. But not everyone agreed. Another student, Keira, said something about how social media and people claiming to have it or who self-diagnose are actually really good for the overall movement, because it gives a spotlight to people and maybe encourages them to seek help. The fact that wider discussion has normalised the disorder was a good thing, according to Keira. Apparently, anyway. This is the interview that our reporters lost.

Anyone who self-diagnosed, like Pam, probably googled around until they ended up reading the DSM-5, a sort of Bible for clinical psychology. In the newest edition, changes have been made to the ADHD criteria. One notable change was a note about Autism Spectrum Disorder, which previously was not considered to be comorbid with ADHD as they’re similar neurodevelopmental disorders. But the two can exist in the same person at the same time, and students like Charlie* have struggled in the past to reconcile the two conditions as their stereotypes can conflict with each other. “I am one with the ‘tism, but now I have ADHD as a side piece,” said Charlie. She received her autism and ADHD diagnoses within the last few years. Outside of a few “autistic special interest” moments, Charlie said that her ADHD primarily gets in the way of day-to-day life. “I would love to be the ‘colour coded day planner / bullet journal / google calendar’ flavour of autistic but instead I wake up at a different time every day and havent eaten meals at an even vaguely regular time since I was a kid. Is breakfast at 9 or at 2pm? Is dinner at 6 or at midnight? I don’t fucking know I, just go with it. I’m eating carrots for dinner.” 

New Zealand’s path to an ADHD diagnosis is steeper than in other parts of the world. Frederick was diagnosed with ADHD in the United States and said “it’s definitely easier over there”. Frederick reported that he paid about $400 for a diagnosis. While he agreed that he did indeed have the disorder, he thought it was strange that rates of the diagnosis “seem to have gone up”. He speculated that this was not because people are lying, but maybe more because “we’ve been raised alongside smartphones, computers, and a whole world of technology that encourages us to be constantly distracted.”

Fredrick reported that in the States, “pretty much everyone you meet our age will claim to have it, almost as if it’s been accepted as a way to excuse any failed work attempt, any forgetfulness, anything. It’s just a catch-all excuse for imperfection. But that’s not actually what the condition is about at all, it’s about not getting out of bed, it’s about not feeling like you can finish anything you ever start. It’s not ‘cool’, it’s infuriating.” Fredrick further bemoaned that “ADHD is like a rallying call for anyone of this generation who thinks they have a problem because they can’t function in a society designed to turn everyone into typewriters. And guess what? Everyone has a problem with that. No wonder they feel out of place.”

An ADHD diagnosis, for some, is a coveted means to free drugs. For others, it is a coveted means to a quieter mind. For most, it seems to be the solution to feeling like they don’t fit in with the rest of the world, and for all, it’s a path not easily travelled. But instead of medicating our neurodivergent population and leaving it at that, advocates suggest we should instead address the broader system that makes them feel out of place in the first place. Scholars like David Graeber suggest that we should examine why we stopped valuing a neurodivergent brain as an asset, and started labelling it a disorder. Perhaps we should consider how our work-obsessed culture might have encouraged so many young people to think that because they can’t work eight hours a day, five days a week, that something must be wrong with them, instead of asking if there was something wrong with the system that put them there. 

This article first appeared in Issue 4, 2022.
Posted 2:16pm Sunday 20th March 2022 by Fox Meyer.