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Diagnosing when you have other things going on can be tricky.
In the business, we call ADHD a diagnosis of exclusion, meaning we have to rule out alternative explanations.
(This would satisfy this part of the criteria… “The symptoms do not happen only during the course of schizophrenia or another psychotic disorder. The symptoms are not better explained by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).”)
Generally speaking, many therapists are not trained in doing full differential diagnostics in a comprehensive, psychometric evaluation the way that some neuro’s, psychologists, or developmental pediatricians are trained. Furthermore, even when you have a psychiatrist that knows how to do this, their caseloads and time per patient are a limiting factor.
This is also complicated by the fact that a lot of folks with undiagnosed ADHD can develop a secondary depression due to the years of frustration and failures.
It is not necessarily cheap or always covered by insurance, but I prefer seeing a complete evaluation done by a neuropsychologist for these reasons.