A Realistic ADHD Assessment
I have mixed feelings about diagnosis and everything that the process entails. Having a framework to conceptualize symptoms and issues can be helpful, but I find that so many diagnostic tools and assessments are outdated and non-inclusive across different cultures and genders. I sometimes struggle to identify an accurate diagnosis for my clients after the first session, or even the first month(s) of working together. Some diagnostic criteria requires information about the onset of symptoms beginning earlier in life, which can be hard to self-report on if you can’t remember your childhood… or if you were the “pleasure to have in class” kid that was quiet and polite but silently suffered with schoolwork.
Women are more likely to internalize their symptoms and mask them well at work or in school, only to “let loose” at home. This might look like impulsively starting projects without ever finishing them, or being overly talkative and distractible during conversations with others. Not everyone with ADHD will display symptoms of hyperactivity or fit the image of what most people typically think of when discussing ADHD: a young boy being disruptive in class or having too much energy to stay still. I wish there was more representation beyond the norms that were created decades ago, when so many things about life were different than how they are now.
We all know that the medical field has historically ignored and neglected accurate and appropriate care for women. I am glad to now see more exceptions to this within the realm of professionals who diagnose mental health disorders, but it is certainly not the new standard of care across the board just yet. I will never forget when I saw an older male doctor about my concerns in graduate school and they told me I was working too much and I should take some Benadryl. Yikes.
I see a lot of adult women who experience both grief and relief when they learn that they have ADHD. They wonder why no adults in their life caught their symptoms, and wonder what could have been different or what more they could have achieved if they knew how to appropriately manage their symptoms earlier in life. This is where a diagnosis can be validating, though- some feel that it serves as “proof" that they haven’t made up certain barriers that have affected them throughout their lifetime. Adults who have worked extra hard to navigate executive dysfunction are often shocked to learn that not everyone feels the same way they do, and life doesn’t actually have to be so hard forever. I could stay on a soapbox for hours just ranting about diagnosis and my complaints with the medical model of counseling, but I'll refrain.
Here’s the ADHD assessment that I wish existed in 2026:
Do you fast forward TikToks or other short form content when the creator is speaking too slowly or takes too long to get to the point?
Do you have jars that you keep meaning to clean and repurpose that you end up recycling after they sit in your sink for a week?
Did you put off having your winter coats dry cleaned for months until you felt that you waited too long and you should just get them cleaned at the start of next winter instead?
How many tabs do you have open on your computer and phone? How often do you actually look at them and close them out?
Do you struggle with object permanence, where you forget what you have in your refrigerator or closet unless it’s easily visible to you?
Have you ever bought something at the grocery store only to realize you have two unopened packages of the same thing at home?
How often have you looked at an empty shampoo bottle in your shower that you meant to throw out, and then you forget as soon as you step out of the shower? Do you also repeat this process several times before you get yourself to throw it out, possibly by tossing it onto the bathroom floor during the middle of your shower in a fit of rage?
Do you save posts on Instagram that you never return to?
Do you eat the same meals for weeks on repeat, hyperfixating on an obsession until you get tired of it?
How long did it take you to hang up your artwork when you moved into your current home?
Can you recite the names of the main characters in the show you are currently watching?
How many hobbies have you tried that you did not stick with?
How often do you forget whether or not you put on deodorant or took your medicine in the morning?
Do you feel crushed with the weight of shame and doubt about what you are capable of achieving?
Did you skip around the contents of this post or skim any of the writing?
I like asking these questions to clients who suspect they may have ADHD because symptoms and executive dysfunction affect all areas of one’s life, not just work or school. It’s not enough to have trouble sustaining focus during a boring meeting, or sometimes forgetting where you put your keys. To meet criteria for an ADHD diagnosis, symptoms need to have been present before adulthood and create significant difficulty with daily functioning. I find that ADHD presentation can sometimes overlap with other diagnoses or concerns that may not warrant a diagnosis, especially with factors relevant to today’s society with many people working exclusively from home and having the ability to split attention between various screens or tasks at the same time.
If you suspect that you could have ADHD, I hope you have or can find a trusted professional to share your thoughts with if you want a conclusive answer. I believe that regardless of whether or not someone meets diagnostic criteria, if they share concerns with me in the therapy room about how their daily life or routines feel, it’s worth discussing to understand more and to see if there are strategies for managing whatever the root of the concerns are. I hope to continue witnessing the empowerment women feel when they learn how they can function in the best way possible with their own unique abilities.