Common Barriers to ADHD Recognition

Though a common disorder, many obstacles still exist for some patients struggling with attention-deficit/hyperactivity disorder (ADHD), making it difficult for people to get the help they need. While at NP Insitute In-Person 2023 in Boston, Massachusetts, Elizabeth Judd, NP, MHS, CEO of Elizabeth Judd, LLC, and Gregory Mattingly, MD, associate clinical professor at Washington University, sat down after their session "Exploring Stimulants and Non-Stimulants in the Treatment of ADHD" to discuss the remaining barriers to treatment as well as why some professionals may still be under-trained to recognize ADHD when they see it in practice. 

Save the date for NP Institute In-Person, March 27 to 30, 2025 in Orlando, Florida! For more information, visit the meeting website.

Read the Transcript: 

Greg Mattingly, MD: What would you say are some of the common barriers to recognizing ADHD?

Nurse Judd: I think most commonly, we look at diagnosing other things, like anxiety or depression or other mood disorders without actually screening for or asking the questions that we should be asking to think about ADHD. Other barriers are people being embarrassed or not wanting to get a diagnosis of ADHD.

Dr Mattingly: I would say if you weren't trained to think about it, it's not even on your radar screen. So I know for a lot of clinicians my age, we weren't trained in adult ADHD. And back then, 20, 30 years ago, we used to think that it was boys, not girls. You grew out of it. And we know a lot of those are myths about ADHD.

Nurse Judd: And I think a lot of people, when they're going to go see a psychiatrist or mental health provider, people think right off the bat, anxiety, depression, bipolar, schizophrenia. ADHD doesn't get thrown in there that often, even though it's extremely common.

Dr Mattingly: As a busy nurse practitioner, what percent of your client load has ADHD plus something else?

Nurse Judd: Probably 70%. Of my private practice, probably 70%. It's huge.

Dr Mattingly: So it's a high comorbidity. We see it with depression, we see it with anxiety, we see it with temper, impulse control. And make sure you screen for it.

Nurse Judd: Yes. And I would say for me, anxiety and ADHD or what go hand-in-hand almost all the time. And so people are coming in for a question of anxiety, and I end up finding out that it's actually more of an ADHD issue than anxiety.

Greg Mattingly, MD, is a physician and principal investigator in clinical trials for Midwest Research Group. He is also a founding partner of St. Charles Psychiatric Associates where he treats children, adolescents, and adults. A St Louis native, he earned his medical degree and received a Fulbright scholarship while attending Washington University. He is an associate clinical professor at Washington University where he teaches psychopharmacology courses for third year medical students. Dr Mattingly currently serves as the President-Elect for APSARD-The American Professional Society of ADHD and Related Disorders.

Elizabeth Judd, NP, MHS, specializes in ADHD, anxiety, depression, mood disorders, and autism spectrum disorders. She received her undergraduate degree from Washington University and her graduate degree from St. Louis University. She is trained in the evidenced-based PEERS social skills intervention for youth and adults with social challenges related to autism, ADHD, and anxiety. Elizabeth serves as an ADHD advisory board member and is very active in the ADHD community. Elizabeth currently has her own private practice in St. Louis.