The ADHD Dilemma: When Symptoms Overlap and Tools Mislead

In recent years, there has been a noticeable surge in patients walking into my practice convinced they have ADHD. This trend isn't entirely surprising. The internet is flooded with ADHD content—TikTok reels, blog posts, self-assessments—and, most importantly, freely available screening tools that lack appropriate disclaimers or guidance.



While these tools can serve as a useful starting point, they often lead to self-diagnosis without the critical clinical context. One major issue is that many symptoms of ADHD—such as difficulty concentrating, restlessness, irritability, and forgetfulness—can also be present in anxiety disorders, depression, trauma-related conditions, and even sleep disturbances. When taken at face value, a symptom checklist can easily generate a "false positive," especially when used outside of a structured clinical evaluation.

ADHD is a nuanced neurodevelopmental condition. While symptom checklists might suggest the possibility of ADHD, they cannot differentiate between ADHD and its many mimics. This is where a thorough clinical history and objective evaluation become indispensable. Understanding the timeline of symptoms, the presence of functional impairment across multiple domains (home, work, school, relationships), developmental history, and co-occurring conditions is essential. A hasty diagnosis based on limited information can lead to inappropriate treatment, missed comorbidities, and frustration for both patient and clinician.



Unfortunately, in some settings, even clinicians may overly rely on a brief consultation or quick screening without digging deeper. A detailed diagnostic assessment must go beyond symptom checklists—it must include a comprehensive clinical interview, collateral information (when possible), and a clear understanding of the patient's lived experience.

In my clinical experience, I often see patients who initially present with what appears to be textbook ADHD but, upon deeper evaluation, are actually dealing with burnout, anxiety, unresolved trauma, or depressive disorders. Treating the wrong condition not only delays recovery—it can worsen the underlying issue.

We must move toward a more responsible diagnostic culture—one that emphasizes careful evaluation, acknowledges symptom overlap, and educates patients about the limits of online tools. ADHD is real, but so is diagnostic complexity. Let’s not reduce mental health care to checklists and shortcuts.

Dr Zoheb Raj, MD

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