October 7, 2025 • 16 mins
The line between genuine ADHD and everyday distractibility can feel blurry—until you know what to look for. We open the case file and walk through a clear, practical way to identify ADHD: symptoms that begin before age twelve, persist over time, and cause real impairment across settings like home, school, and friendships. No shortcuts, no vibes—just a grounded approach that blends criteria with real-life context.
Together, we unpack what inattention really looks like beyond “spacing out,” and how hyperactivity differs from normal kid energy by its severity, persistence, and resistance to willpower. You’ll hear the exact questions we use when assessing teens and adults, how to gather collateral from parents and teachers, and the surprising role sleep plays in amplifying or masking symptoms. We also map the classroom realities: the fidgeting that never ends, the detours under desks, and the conversational zigzags that jump tracks from hot dogs to Hawaii.
Differential diagnosis is the make-or-break step, so we draw sharp lines between ADHD and common lookalikes. Depression can tank concentration, but usually in episodes; PTSD may mimic restlessness and distractibility in kids, especially when hypervigilance is high; intermittent explosive disorder shares impulsivity but adds consistent aggression. Understanding these differences protects against misdiagnosis and steers better care—behavioral strategies, school supports, coaching, and when appropriate, medication. If you’re studying the DSM-5-TR or navigating a possible diagnosis for yourself or a child, this conversation gives you a field-tested checklist and a narrative lens to see the whole person, not just a list of symptoms.
If this helped clarify the ADHD picture, follow the show, share this episode with someone who needs it, and leave a quick review to help others find thoughtful mental health content.
If you need to study for your national licensing exam, try the free samplers at: LicensureExams
This podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
LINTON (00:14):
Okay, ADHD is up next.
Hannah, why don't you give usan overview of that disorder?
HANNAH (00:21):
All right.
Moving right along here.
We're talking about attentiondeficit, hyperactivity disorder,
commonly referred to as ADHD.
So we talk about ADHD, it'sgoing to involve persistent
patterns of inintention orhyperactivity, impulsivity that
interferes with the person'sfunctioning or their actual
(00:43):
development.
So I want you to think six.
So think six.
So to meet criteria for thisdisorder, think six.
Children need at least sixsymptoms of inintention or six
symptoms of hyperactivity andimpulsivity.
But if the client is older, youonly need five.
So think age 17 and older, theyactually only need five
(01:04):
symptoms.
So it is crucial to understandthat in order to meet the
criteria for ADHD, you do haveto show symptoms before the age
of 12.
Before the age of 12.
I will always reiterate thatbecause it is neural
developmental.
So when you're understandingit, you need to ensure there's
there needs to be collateral uhbefore the patient age of 12.
(01:25):
You're either born with it oryou're okay.
STACY (01:29):
Right.
You didn't just develop it whenyou were in your 50s.
HANNAH (01:31):
Just no, no, you have ADHD suddenly.
LINTON (01:34):
If you're seeing a client that's 15, how are you
gonna know that that it happenedbefore age 12?
HANNAH (01:39):
I mean, honestly, for or at least for me, I talk to mom
and dad.
Usually are guardians,grandparents, I contact any
teachers that, hey, what schooldo they go to?
Can I, you know, fill outobviously ROI to let me have
that conversation?
Any doctors, somebody who'sbeen in their life before the
age of 12, any, you know,relatives.
You're basically looking, youknow, I've even had people bring
(02:02):
me in work from that age.
So say like elementary school,like schoolwork, do you have
some of the habits you do inschool?
I would have them bring that inand I would review that.
And so you're looking just forthat evidence that like this has
been an issue, you know, thishas this is not me just
developing this.
Because if it's just you nowhaving it, I'm looking more at
(02:23):
like anxiety, right?
Like, I'm looking more for likeyou're probably in this area
versus ADHD.
But if you can show me you'vehad it or people have really can
tell me that you did, we cannow kind of move forward with
more, you know, investigationtowards that.
STACY (02:37):
Gotcha.
And and what if so what ifyou're seeing an adult then?
What would you would you beasking them particular questions
about tell me about yourchildhood or like, you know, not
just focused on what'scurrently going on for them, but
you'd be taking it back aways?
HANNAH (02:51):
I'd be taking it back a ways.
Yeah.
I would be taking it, you know,one of the I don't know what's
the easiest, but one of theeasiest ways is just talk about
school, talk about theiracademic career.
You know, how were you inschool?
Did you get in trouble a lot?
You know, did people ever tellyou to slow down?
Oh, that's a big one, right?
So did you slow down a lot?
Was it ever hard to really payattention when you were in
(03:12):
school?
Did you get, you know, did youget detention because you were
up and down out of your seat aton?
You know, so you're it's justyou're asking these very pointed
questions and then with the athome, were you ever the same
way?
You know, how is your sleep?
I'm always people get soannoyed.
I'm always asking about sleep.
But like it's true, like, youknow, the research has shown a
lot about how that can correlateas well.
(03:32):
And so we are diving into that.
You're really lookingholistically and at a very
comprehensive level to ensurethat these are the symptoms that
are lining up.
And it's not just that you werea high energy kid, right?
It's not that you were just achild with you were just
rambunctious.
It's you had a very severe caseof I even if I want to, I can't
(03:55):
do it.
I can't stand still, I can'tpay attention.
You know, it's so it's it'sjust a really I always say put
your detective hat on and lookfor clues.
You're always looking for cluesin the history.
Always, always, always.
STACY (04:06):
Yeah.
Linton, I've been seeing yousmiling as Hannah's talking.
Looks like maybe some of theseare childhood.
LINTON (04:14):
You know, I always thought detention was my second
home.
STACY (04:20):
No, this is just normal.
We know where I go everyThursday.
Yeah.
So let's talk a little bitabout the inattention aspect.
So um, so when we're talkingabout inattention, um, it's
different than just occasionallyspacing out or like getting
temporarily distracted, right?
With ADHD, the inattention ismuch more severe and it's
(04:41):
persistent over time.
I think that's really the key,right?
It's not just a one-off whereyou're having a really high
stress, you know, season orsomething.
LINTON (04:48):
Right, right.
For example, the child mayfrequently make careless
mistakes in schoolwork,struggling to stay focused
during activities, seem likethey're never listening to you,
fail to follow through oninstructions, have trouble with
organized tasks, avoidactivities requiring sustained
mental effort, like pullingweeds or doing homework, getting
(05:11):
distracted by irrelevant thingsor forgetting to take care of
their daily responsibilities,like brushing their teeth or
washing their hands or all thatkind of stuff.
STACY (05:23):
Got it.
Well, that was a really goodsummary of those typical
symptoms uh that you'd see withinattention.
And how about going back to thehyperactivity portion, which I
think is a little bit more ofthe like people think of ADHD
and think of just really hyper?
Aren't kids kind of known fortheir high energy levels, right?
Like when does it really crossthat line into clinical?
HANNAH (05:43):
That's that's actually a really important distinction to
make.
And I get that question quiteoften working with kids and
parents and families.
So we know that children arenaturally just hyperactive.
Like they just they love it.
They're ambunctious, they canbe impulsive, like they don't
have a frontal lobe yet.
Like it's not there yet, it'snot developed.
(06:03):
So when we look at ADHD, we'relooking at the hyperactivity as
like you were mentioning, moresevere and persistent.
So it's definitely one of thosethings to where, like I said
before, where the child willwant to do the thing, but they
literally cannot.
They literally can't stop theirbody from moving or paying
attention.
(06:24):
And they've tried and tried andtried and tried.
So they may frequently fidget.
Um, a lot of kids fidget, a lotof kids tap things, either may
it be their hands, theirfingers, they're playing with
their hair, the buttons on theirshirts, they're wiggling around
in their seat, which is oftenthe case in schools.
You'll see a lot of childrenwhere they're up and down.
I've seen cases where childrenwere underneath the desk, right?
(06:47):
They just could not sit attheir, you know, their chair.
They wanted to be underneaththe desk, they were across the
room.
They were like, oh, that lookscool.
Let me walk over there.
They're walking across likethey're just like wherever their
impulse is taking them is wherethey're going.
You can often see kids like runand climb at inappropriate
times, it's struggle to playquietly, and it's not just, oh,
(07:07):
you're being too loud, it's avery, again, severe, persistent
display of loudness.
You're looking for kids whotalk excessively, which in my
experience, talking excessivelyoften like, oh, that kid's
outgoing, or oh, that's just youabout that's just how they are
and stuff.
But if it's consistent andyou're noticing even just kind
(07:28):
of odd social patterns wherethey are cutting people off, or
you're talking to them kind ofdirectly, and then they're not
responding to anything you justsaid, and instead they're
they're going off on their theirown hyperfixation, right?
Trains, cars, like they'relike, I don't even care what you
just said.
Did you see this cool thing?
You know, so we're looking forthat type of thing.
(07:49):
Um, but it's true.
Uh blurting out stuff, um,trouble waiting their turn,
which every kid has, but again,severity.
We're we're looking at kids asif they're driven by a motor.
I love that description becauseI think it really helps put in
our mind of how much thesekiddos are just truly driven by
(08:09):
endless amounts of thishyperactivity impulsivity heart.
They rush into things withoutthinking, right?
Impulsive.
So just want to reallyemphasize that word severe
because all of these otherthings, like you're probably
nodding your head and beinglike, Yeah, that sounds like a
six-year-old or seven-year-old,right?
But we're looking, we'retalking about kids who are
really sticking out from thatcrowd, right?
(08:30):
They're the ones that even ifthey're talking to a friend, say
a seven, eight-year-old, butthey're be they're fidgeting
with their, you know, whatever,and their their conversation
patterns are so tangible thatyou're like, how did we even get
to start talking about Hawaiiwhen we were talking about hot
dogs, right?
Like, somebody in it, you know,and it it'll it'll end up being
(08:51):
like that.
So we're it's sometimes a childwho will also like get in
trouble.
Kind of when I was joking aboutlike, oh, they get detention
all the time.
But it's kind of in a waywhere, like me, when I was a
school counselor working inschools full-time, I would get
kids sent to the office, theywould come see me, and it was
like, oh miss, I don't know whyI couldn't sit still, or I I
(09:13):
just didn't want to stand inline, so I ran off in the
hallway.
And you know, and so they don'ttruly even understand their own
behaviors, and even if theywant to listen and want to stand
in line, their little bodiesand brains and and stuff just
they just take off.
So um we're looking for thatkind of thing.
So it's just important whenwe're looking at any disorder to
(09:33):
how it'll present in real life.
People are not criteria, peopleare people.
So it's really important tothink to ourselves how would
this look like in a real person?
And then that really can helpus be able to one, understand it
better, but two, be able toreally spot it from being just a
normal kid reaction.
LINTON (09:52):
Yeah, and it's not enough for a person to just have
six symptoms of inattention orsix symptoms of hyperactivity
and policyspathy, but uh to meetthe criteria for ADHD.
You know, several of thesymptoms must be presented, like
you said, before the age of 12and are present in more than one
(10:14):
situation.
In other words, it just doesn'thappen at school, it happens at
home, it happens with friends.
And basically the the they'renegatively impacted by the
client's functioning.
STACY (10:26):
And that's really the key here.
So just because you have amessy desk, just like the
laundry, those piles seem tomysteriously multiply overnight,
or you're prone to misplacingyour phone in very weird places
like the chicken coop.
Yes, I have actually done this.
Um, that does not mean that youhave ADHD.
Or they're like my husband andhe has his little messy piles at
(10:47):
home, which I've come to love.
But then, you know, in anoffice somewhere, he can have
the neatest desk.
So you're really looking atlike more than one setting,
right?
Like not just your home turf,but elsewhere.
Yes.
Yes.
Exactly.
LINTON (11:02):
Yeah.
Now on to differentials, whichis Hannah's favorite, I think.
And I noticed that list thatyou have of uh differentials for
ADHD is longer than thecheckout line at Publix on sushi
on Wednesday.
STACY (11:16):
Linton, you have a very uncanny ability to casually sort
of sneak in sushi intopractically any conversation.
And I wonder what Freud wouldsay about that.
Oh, that's a good point.
LINTON (11:29):
Well, before we go down that rabbit hole, let's go over
a few of the differentials forADHD, okay, Hannah?
HANNAH (11:38):
Okay, but seriously, guys, I do love sushi.
STACY (11:41):
So my stomach is grumbling right now.
HANNAH (11:44):
I did grow up in Japan, so I am very, you know, I could
literally probably eat it everyday.
Um but anyway, okay, soonwards.
So yes, the CVS receipt, if youknow, you know, there's a lot
of differentials.
There's a lot of differentials.
Um, but one of the tricks todifferentials is to think of
(12:06):
them as disorders that are alikein some way.
And I always say they overlapthe symptoms, right?
So, for example, if you'retalking about ADHD and
intermittent explosive disorder,both like high levels of
impulsive behaviors.
But clients with intermittentexplosive disorders also show
that aggression, thataggression, which is not
(12:28):
characteristic of ADHD.
So ADHD, and you can add insome broad strokes of
understanding, but ADHD affectsthe executive functioning center
of the brain.
So, like our frontal lobe, wewere talking about earlier, how
this everything kind of workstogether.
That's really effective when wetalk about the ADHD.
85% of children who have ADHDwill have symptoms in adulthood.
(12:53):
They just manifest differently.
I always like to say when we'retalking about ADHD, that it is
a disorder to which the brain isjust or really just the frontal
low of the executivefunctioning part of your brain
is really just behind a coupleyears every time.
So anytime I give thisdiagnosis, I'm having this
conversation because it's reallyimportant for people to realize
(13:15):
that some people do what I callplay catch-up.
And that is when you are giventherapies at a young age, you
have that early interventiontimeline you can hop on.
You're giving theseinterventions to where they can
learn how to manage theirbehaviors.
Will ADHD always be there?
Probably, yes.
Will it seem as if they grewout of it later on in life
because they've been doing allthese things since a young age?
(13:36):
Also, yes.
Right.
So there are these ways towhere when we're explaining this
disorder, you really want tohave a solid understanding of
brain development and basic, andlike we talked about a bunch
was basic neuroanatomy.
You really have to be able tohave those conversations and
understand that in adulthoodthings, or even I would say even
elder adolescents will see willsee this look very, very
(13:58):
different.
Um but one of the things is asimilarity between ADHD and
depression.
So one of the symptoms that weoften see in depression is that
difficulty concentrating.
So that a lot of people willcome to and say, Oh, just having
this difficulty.
And we also know that's alsopart of that inattentive type of
(14:19):
ADHD, when someone says, Oh, Ijust can't pay attention.
I can't, I can't, I don't evenknow what was said.
I got distracted by the fly onthe wall, you know.
So, but the thing we're gonnalook at is if that depression
inattentiveness is that onlythere during a depressive
episode.
Outside of that are you able topay attention.
(14:40):
Outside of that are thingsokay.
With ADHD, it's constant, it'severy single day.
It's not nothing can change it.
It's always gonna be there,it's always very, very effortful
to even try to pay attention.
We also can talk about thepost-traumatic stress disorder.
So PTSD.
PTSD in children can mimic ADHDsymptoms.
(15:05):
This is a very careful thing totalk about with people who've
experienced trauma and justremaining very trauma-informed.
But young children will presentwith trauma-related symptoms
like anattention, poorconcentration, restlessness.
You can even say the highanxiety, you know, behaviors
(15:26):
where they're fidgety, um, theyhave headaches a lot.
You know, it's really, reallyimportant to be able to
differentiate and distinguishbetween those two.
And using comprehensiveassessments and just checking
for any previous exposure totrauma can be extremely helpful
in order to rule out that it'snot trauma-based.
It is very much this ADHDpresentation.
STACY (15:48):
Yeah, that makes a lot of sense.
Um, so as you are studying foryour exam, we really encourage
you to familiarize yourself withyour DSM5TR and definitely,
definitely take a look at thatlist of differential diagnoses
for the um disorders.
Uh, it's really not asintimidating as it seems when
you remember that a differentialdiagnosis is, as we've been
talking about, a disorder thatshares some features in common
(16:11):
with another disorder.
So for these neurodevelopmentaldisorders that we're talking
about, their differentialdiagnoses will always have some
kind of a symptom, sign that iskind of overlaps with another
disorder.
Okay, ADHD is up next.
Hannah, why don't you give usan overview of that disorder?
HANNAH (00:21):
All right.
Moving right along here.
We're talking about attentiondeficit, hyperactivity disorder,
commonly referred to as ADHD.
So we talk about ADHD, it'sgoing to involve persistent
patterns of inintention orhyperactivity, impulsivity that
interferes with the person'sfunctioning or their actual
(00:43):
development.
So I want you to think six.
So think six.
So to meet criteria for thisdisorder, think six.
Children need at least sixsymptoms of inintention or six
symptoms of hyperactivity andimpulsivity.
But if the client is older, youonly need five.
So think age 17 and older, theyactually only need five
(01:04):
symptoms.
So it is crucial to understandthat in order to meet the
criteria for ADHD, you do haveto show symptoms before the age
of 12.
Before the age of 12.
I will always reiterate thatbecause it is neural
developmental.
So when you're understandingit, you need to ensure there's
there needs to be collateral uhbefore the patient age of 12.
(01:25):
You're either born with it oryou're okay.
STACY (01:29):
Right.
You didn't just develop it whenyou were in your 50s.
HANNAH (01:31):
Just no, no, you have ADHD suddenly.
LINTON (01:34):
If you're seeing a client that's 15, how are you
gonna know that that it happenedbefore age 12?
HANNAH (01:39):
I mean, honestly, for or at least for me, I talk to mom
and dad.
Usually are guardians,grandparents, I contact any
teachers that, hey, what schooldo they go to?
Can I, you know, fill outobviously ROI to let me have
that conversation?
Any doctors, somebody who'sbeen in their life before the
age of 12, any, you know,relatives.
You're basically looking, youknow, I've even had people bring
(02:02):
me in work from that age.
So say like elementary school,like schoolwork, do you have
some of the habits you do inschool?
I would have them bring that inand I would review that.
And so you're looking just forthat evidence that like this has
been an issue, you know, thishas this is not me just
developing this.
Because if it's just you nowhaving it, I'm looking more at
(02:23):
like anxiety, right?
Like, I'm looking more for likeyou're probably in this area
versus ADHD.
But if you can show me you'vehad it or people have really can
tell me that you did, we cannow kind of move forward with
more, you know, investigationtowards that.
STACY (02:37):
Gotcha.
And and what if so what ifyou're seeing an adult then?
What would you would you beasking them particular questions
about tell me about yourchildhood or like, you know, not
just focused on what'scurrently going on for them, but
you'd be taking it back aways?
HANNAH (02:51):
I'd be taking it back a ways.
Yeah.
I would be taking it, you know,one of the I don't know what's
the easiest, but one of theeasiest ways is just talk about
school, talk about theiracademic career.
You know, how were you inschool?
Did you get in trouble a lot?
You know, did people ever tellyou to slow down?
Oh, that's a big one, right?
So did you slow down a lot?
Was it ever hard to really payattention when you were in
(03:12):
school?
Did you get, you know, did youget detention because you were
up and down out of your seat aton?
You know, so you're it's justyou're asking these very pointed
questions and then with the athome, were you ever the same
way?
You know, how is your sleep?
I'm always people get soannoyed.
I'm always asking about sleep.
But like it's true, like, youknow, the research has shown a
lot about how that can correlateas well.
(03:32):
And so we are diving into that.
You're really lookingholistically and at a very
comprehensive level to ensurethat these are the symptoms that
are lining up.
And it's not just that you werea high energy kid, right?
It's not that you were just achild with you were just
rambunctious.
It's you had a very severe caseof I even if I want to, I can't
(03:55):
do it.
I can't stand still, I can'tpay attention.
You know, it's so it's it'sjust a really I always say put
your detective hat on and lookfor clues.
You're always looking for cluesin the history.
Always, always, always.
STACY (04:06):
Yeah.
Linton, I've been seeing yousmiling as Hannah's talking.
Looks like maybe some of theseare childhood.
LINTON (04:14):
You know, I always thought detention was my second
home.
STACY (04:20):
No, this is just normal.
We know where I go everyThursday.
Yeah.
So let's talk a little bitabout the inattention aspect.
So um, so when we're talkingabout inattention, um, it's
different than just occasionallyspacing out or like getting
temporarily distracted, right?
With ADHD, the inattention ismuch more severe and it's
(04:41):
persistent over time.
I think that's really the key,right?
It's not just a one-off whereyou're having a really high
stress, you know, season orsomething.
LINTON (04:48):
Right, right.
For example, the child mayfrequently make careless
mistakes in schoolwork,struggling to stay focused
during activities, seem likethey're never listening to you,
fail to follow through oninstructions, have trouble with
organized tasks, avoidactivities requiring sustained
mental effort, like pullingweeds or doing homework, getting
(05:11):
distracted by irrelevant thingsor forgetting to take care of
their daily responsibilities,like brushing their teeth or
washing their hands or all thatkind of stuff.
STACY (05:23):
Got it.
Well, that was a really goodsummary of those typical
symptoms uh that you'd see withinattention.
And how about going back to thehyperactivity portion, which I
think is a little bit more ofthe like people think of ADHD
and think of just really hyper?
Aren't kids kind of known fortheir high energy levels, right?
Like when does it really crossthat line into clinical?
HANNAH (05:43):
That's that's actually a really important distinction to
make.
And I get that question quiteoften working with kids and
parents and families.
So we know that children arenaturally just hyperactive.
Like they just they love it.
They're ambunctious, they canbe impulsive, like they don't
have a frontal lobe yet.
Like it's not there yet, it'snot developed.
(06:03):
So when we look at ADHD, we'relooking at the hyperactivity as
like you were mentioning, moresevere and persistent.
So it's definitely one of thosethings to where, like I said
before, where the child willwant to do the thing, but they
literally cannot.
They literally can't stop theirbody from moving or paying
attention.
(06:24):
And they've tried and tried andtried and tried.
So they may frequently fidget.
Um, a lot of kids fidget, a lotof kids tap things, either may
it be their hands, theirfingers, they're playing with
their hair, the buttons on theirshirts, they're wiggling around
in their seat, which is oftenthe case in schools.
You'll see a lot of childrenwhere they're up and down.
I've seen cases where childrenwere underneath the desk, right?
(06:47):
They just could not sit attheir, you know, their chair.
They wanted to be underneaththe desk, they were across the
room.
They were like, oh, that lookscool.
Let me walk over there.
They're walking across likethey're just like wherever their
impulse is taking them is wherethey're going.
You can often see kids like runand climb at inappropriate
times, it's struggle to playquietly, and it's not just, oh,
(07:07):
you're being too loud, it's avery, again, severe, persistent
display of loudness.
You're looking for kids whotalk excessively, which in my
experience, talking excessivelyoften like, oh, that kid's
outgoing, or oh, that's just youabout that's just how they are
and stuff.
But if it's consistent andyou're noticing even just kind
(07:28):
of odd social patterns wherethey are cutting people off, or
you're talking to them kind ofdirectly, and then they're not
responding to anything you justsaid, and instead they're
they're going off on their theirown hyperfixation, right?
Trains, cars, like they'relike, I don't even care what you
just said.
Did you see this cool thing?
You know, so we're looking forthat type of thing.
(07:49):
Um, but it's true.
Uh blurting out stuff, um,trouble waiting their turn,
which every kid has, but again,severity.
We're we're looking at kids asif they're driven by a motor.
I love that description becauseI think it really helps put in
our mind of how much thesekiddos are just truly driven by
(08:09):
endless amounts of thishyperactivity impulsivity heart.
They rush into things withoutthinking, right?
Impulsive.
So just want to reallyemphasize that word severe
because all of these otherthings, like you're probably
nodding your head and beinglike, Yeah, that sounds like a
six-year-old or seven-year-old,right?
But we're looking, we'retalking about kids who are
really sticking out from thatcrowd, right?
(08:30):
They're the ones that even ifthey're talking to a friend, say
a seven, eight-year-old, butthey're be they're fidgeting
with their, you know, whatever,and their their conversation
patterns are so tangible thatyou're like, how did we even get
to start talking about Hawaiiwhen we were talking about hot
dogs, right?
Like, somebody in it, you know,and it it'll it'll end up being
(08:51):
like that.
So we're it's sometimes a childwho will also like get in
trouble.
Kind of when I was joking aboutlike, oh, they get detention
all the time.
But it's kind of in a waywhere, like me, when I was a
school counselor working inschools full-time, I would get
kids sent to the office, theywould come see me, and it was
like, oh miss, I don't know whyI couldn't sit still, or I I
(09:13):
just didn't want to stand inline, so I ran off in the
hallway.
And you know, and so they don'ttruly even understand their own
behaviors, and even if theywant to listen and want to stand
in line, their little bodiesand brains and and stuff just
they just take off.
So um we're looking for thatkind of thing.
So it's just important whenwe're looking at any disorder to
(09:33):
how it'll present in real life.
People are not criteria, peopleare people.
So it's really important tothink to ourselves how would
this look like in a real person?
And then that really can helpus be able to one, understand it
better, but two, be able toreally spot it from being just a
normal kid reaction.
LINTON (09:52):
Yeah, and it's not enough for a person to just have
six symptoms of inattention orsix symptoms of hyperactivity
and policyspathy, but uh to meetthe criteria for ADHD.
You know, several of thesymptoms must be presented, like
you said, before the age of 12and are present in more than one
(10:14):
situation.
In other words, it just doesn'thappen at school, it happens at
home, it happens with friends.
And basically the the they'renegatively impacted by the
client's functioning.
STACY (10:26):
And that's really the key here.
So just because you have amessy desk, just like the
laundry, those piles seem tomysteriously multiply overnight,
or you're prone to misplacingyour phone in very weird places
like the chicken coop.
Yes, I have actually done this.
Um, that does not mean that youhave ADHD.
Or they're like my husband andhe has his little messy piles at
(10:47):
home, which I've come to love.
But then, you know, in anoffice somewhere, he can have
the neatest desk.
So you're really looking atlike more than one setting,
right?
Like not just your home turf,but elsewhere.
Yes.
Yes.
Exactly.
LINTON (11:02):
Yeah.
Now on to differentials, whichis Hannah's favorite, I think.
And I noticed that list thatyou have of uh differentials for
ADHD is longer than thecheckout line at Publix on sushi
on Wednesday.
STACY (11:16):
Linton, you have a very uncanny ability to casually sort
of sneak in sushi intopractically any conversation.
And I wonder what Freud wouldsay about that.
Oh, that's a good point.
LINTON (11:29):
Well, before we go down that rabbit hole, let's go over
a few of the differentials forADHD, okay, Hannah?
HANNAH (11:38):
Okay, but seriously, guys, I do love sushi.
STACY (11:41):
So my stomach is grumbling right now.
HANNAH (11:44):
I did grow up in Japan, so I am very, you know, I could
literally probably eat it everyday.
Um but anyway, okay, soonwards.
So yes, the CVS receipt, if youknow, you know, there's a lot
of differentials.
There's a lot of differentials.
Um, but one of the tricks todifferentials is to think of
(12:06):
them as disorders that are alikein some way.
And I always say they overlapthe symptoms, right?
So, for example, if you'retalking about ADHD and
intermittent explosive disorder,both like high levels of
impulsive behaviors.
But clients with intermittentexplosive disorders also show
that aggression, thataggression, which is not
(12:28):
characteristic of ADHD.
So ADHD, and you can add insome broad strokes of
understanding, but ADHD affectsthe executive functioning center
of the brain.
So, like our frontal lobe, wewere talking about earlier, how
this everything kind of workstogether.
That's really effective when wetalk about the ADHD.
85% of children who have ADHDwill have symptoms in adulthood.
(12:53):
They just manifest differently.
I always like to say when we'retalking about ADHD, that it is
a disorder to which the brain isjust or really just the frontal
low of the executivefunctioning part of your brain
is really just behind a coupleyears every time.
So anytime I give thisdiagnosis, I'm having this
conversation because it's reallyimportant for people to realize
(13:15):
that some people do what I callplay catch-up.
And that is when you are giventherapies at a young age, you
have that early interventiontimeline you can hop on.
You're giving theseinterventions to where they can
learn how to manage theirbehaviors.
Will ADHD always be there?
Probably, yes.
Will it seem as if they grewout of it later on in life
because they've been doing allthese things since a young age?
(13:36):
Also, yes.
Right.
So there are these ways towhere when we're explaining this
disorder, you really want tohave a solid understanding of
brain development and basic, andlike we talked about a bunch
was basic neuroanatomy.
You really have to be able tohave those conversations and
understand that in adulthoodthings, or even I would say even
elder adolescents will see willsee this look very, very
(13:58):
different.
Um but one of the things is asimilarity between ADHD and
depression.
So one of the symptoms that weoften see in depression is that
difficulty concentrating.
So that a lot of people willcome to and say, Oh, just having
this difficulty.
And we also know that's alsopart of that inattentive type of
(14:19):
ADHD, when someone says, Oh, Ijust can't pay attention.
I can't, I can't, I don't evenknow what was said.
I got distracted by the fly onthe wall, you know.
So, but the thing we're gonnalook at is if that depression
inattentiveness is that onlythere during a depressive
episode.
Outside of that are you able topay attention.
(14:40):
Outside of that are thingsokay.
With ADHD, it's constant, it'severy single day.
It's not nothing can change it.
It's always gonna be there,it's always very, very effortful
to even try to pay attention.
We also can talk about thepost-traumatic stress disorder.
So PTSD.
PTSD in children can mimic ADHDsymptoms.
(15:05):
This is a very careful thing totalk about with people who've
experienced trauma and justremaining very trauma-informed.
But young children will presentwith trauma-related symptoms
like anattention, poorconcentration, restlessness.
You can even say the highanxiety, you know, behaviors
(15:26):
where they're fidgety, um, theyhave headaches a lot.
You know, it's really, reallyimportant to be able to
differentiate and distinguishbetween those two.
And using comprehensiveassessments and just checking
for any previous exposure totrauma can be extremely helpful
in order to rule out that it'snot trauma-based.
It is very much this ADHDpresentation.
STACY (15:48):
Yeah, that makes a lot of sense.
Um, so as you are studying foryour exam, we really encourage
you to familiarize yourself withyour DSM5TR and definitely,
definitely take a look at thatlist of differential diagnoses
for the um disorders.
Uh, it's really not asintimidating as it seems when
you remember that a differentialdiagnosis is, as we've been
talking about, a disorder thatshares some features in common
(16:11):
with another disorder.
So for these neurodevelopmentaldisorders that we're talking
about, their differentialdiagnoses will always have some
kind of a symptom, sign that iskind of overlaps with another
disorder.
Popular Podcasts
Las Culturistas with Matt Rogers and Bowen Yang
Ding dong! Join your culture consultants, Matt Rogers and Bowen Yang, on an unforgettable journey into the beating heart of CULTURE. Alongside sizzling special guests, they GET INTO the hottest pop-culture moments of the day and the formative cultural experiences that turned them into Culturistas. Produced by the Big Money Players Network and iHeartRadio.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
The Brothers Ortiz
The Brothers Ortiz is the story of two brothers–both successful, but in very different ways. Gabe Ortiz becomes a third-highest ranking officer in all of Texas while his younger brother Larry climbs the ranks in Puro Tango Blast, a notorious Texas Prison gang. Gabe doesn’t know all the details of his brother’s nefarious dealings, and he’s made a point not to ask, to protect their relationship. But when Larry is murdered during a home invasion in a rented beach house, Gabe has no choice but to look into what happened that night. To solve Larry’s murder, Gabe, and the whole Ortiz family, must ask each other tough questions.