Is It Really ADHD? TikTok Says Yes. We Say: Differential Diagnosis & Diagnostic Hierarchy

Описание: Adult ADHD diagnoses are skyrocketing, with social media platforms like TikTok fueling a new attention span crisis and making everyone wonder if they have ADHD. In this episode, two psychiatrists discuss ADHD overdiagnosis and explain how they differentiate true ADHD from other issues (like depression, anxiety, trauma, or OCD).

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0:00 Introduction and Clinician Burnout
1:00 The Rise in ADHD Presentations in Outpatient Psychiatry
3:36 Medication Gatekeeping and the ADHD Diagnosis Dilemma
8:01 Modern Attention Crisis
10:59 Psychosocial Interventions vs. Medication for ADHD
12:47 Self-Fulfilling Beliefs and Internet Misconceptions
14:03 Differential Diagnosis for Inattention
17:39 Diagnostic Hierarchy in Psychiatry
23:02 ADHD vs. Depression, Anxiety, and Trauma
30:05 OCD, Sleep, and Bipolar Disorder as ADHD Mimics
44:00 Substance Use, Lifestyle Factors, and Mismatched Environments
53:01 Personality Disorders and Overlapping ADHD Traits

In this mental health podcast episode, two psychiatrists dive into why it suddenly seems like everyone has ADHD. They discuss the surge in adult ADHD diagnoses and how platforms like TikTok and Instagram are fueling an attention span crisis. With short-form videos and endless streams of content, our ability to focus is being constantly challenged – and many people are now self-diagnosing ADHD after seeing relatable online posts. The doctors share their firsthand experiences from the clinic, noting that they often get multiple new patients a day asking “Do I have ADHD?” This trend has even led to psychiatrist burnout and general clinician burnout, as providers feel pressure to evaluate and prescribe stimulants like Adderall in back-to-back appointments. The episode acknowledges the very real struggle of inattention in modern life, but asks: is it truly ADHD or something else?

Drawing on years of clinical expertise, the hosts walk through the ADHD differential diagnosis – all the other conditions and factors that can look like ADHD symptoms. They explain how issues such as depression, anxiety, and chronic stress can cause difficulty concentrating and trouble focusing just like ADHD does. Trauma (e.g. PTSD) can lead to irritability and distractibility, and OCD can make someone lose focus due to intrusive thoughts or perfectionism. Even untreated bipolar disorder or psychosis may initially be mistaken for ADHD, especially in young adults. The psychiatrists emphasize using a thorough diagnostic hierarchy: ruling out medical problems, substance use effects, and other mental health disorders before settling on an ADHD diagnosis. For instance, poor sleep or an unmanaged thyroid condition can wreck your focus, and taking a detailed history might reveal that what looks like “ADHD at work” is actually burnout or a bad job fit rather than a neurodevelopmental disorder. They caution that jumping straight to stimulant medications for anyone who is easily distracted can lead to misdiagnosis – and even make conditions like bipolar worse if the underlying issue isn’t addressed.

The conversation also tackles some ADHD myths and controversies. The hosts address the online trend of attributing every difficulty to ADHD – including popular terms like “rejection sensitivity dysphoria (RSD)” that often circulate on social media. While ADHD is a real condition, they stress that not every case of procrastination or forgetfulness is due to it, and not everyone who finds it hard to focus needs an immediate prescription stimulant. They advocate for an integrated approach to ADHD treatment: yes, ADHD medications (like stimulants) can be very effective for true ADHD, but many people also benefit from therapy, skill-building, better habits, and lifestyle changes that improve executive function. The psychiatrists share tips for both patients and providers – for patients, to stay open-minded about causes of their concentration troubles and to work on healthy routines; for providers, to set boundaries, be okay with saying no to inappropriate medication requests, and to prevent burnout by “not working too hard” emotionally on cases beyond their control. By the end of this in-depth discussion, you’ll understand why careful ADHD diagnosis matters. The episode dispels the notion that “everyone has ADHD” by illuminating other explanations for ADHD-like symptoms, helping listeners figure out what’s really going on, and how to get the right help.