This is part 2 of an excerpt from Dr. Frank Barnhill’s book, Mistaken for ADHD and the chapter called How To Diagnose ADHD The Wrong Way.

Part 1 of the article is here.

He continues  to talk about the many things that can mimic ADHD and how easy it can be to overlook these “zebras”.  This is why ADHD cannot be diagnosed or treated in just a few minutes.

It is a diagnosis of exclusion first since there is no one specific medical test to diagnose ADHD.

…Brain disorders (seizures, post-concussion syndrome), psychological disorders (depression, manic depression, generalized anxiety disorder), integrative disorders (learning disorders, autism spectrum disorders).

Of the more than forty zebras that may mimic or look just like ADHD, I think the most interesting is the normal child-gifted child!

What about your other question? “Why can’t we just go ahead and try some medicine without doing expensive tests?” Because …  hypothyroidism, seizures, sleep apnea, depression, and anemia will all initially improve with use of stimulants and cause you to believe all is okay, when it’s really not.

That’s right; several diseases that act like or mimic ADHD will actually temporarily improve on ADHD stimulant drug therapy! If your child has one of these zebras, it means your doctor will miss the real diagnosis because both you and he will feel that ADHD is the correct diagnosis,  since the condition seems to be improving.

ADHDI call this phenomenon “a false partial response to medication.” We’ll discuss this novel concept further when you learn of Jason’s struggle with sleep apnea in the chapter “Sleep Disorders.”

It’s important to keep this axiom firmly in mind as we continue:

ADHD is a diagnosis of exclusion first, then inclusion, based on guidelines specific to the disorder.

This means that together, you and your doctor need to rule out all the zebras or things that can look just like or act just like ADHD. These things must be excluded before your doctor uses DSM-IV guidelines to make an accurate ADHD diagnosis.

Now that we’ve cleared up any confusion about the wrong ways to make an ADHD diagnosis, in the next chapter we’ll discuss how to make an accurate ADHD diagnosis.

Dr. Frank Barnhill Frank Barnhill, M.D. is the author of Mistaken for ADHD and founder of the blog Mistaken For ADHD.  He is a family physician who specializes in diagnosing and treating ADHD and determining whether an ADHD diagnosis your child may have already received is a mistake.

Dr. Barnhill is also’s Official Expert on ADHD and will reply to your questions when you ask them via our contact button at the bottom of this page or in your comments below this article.  We answer all your questions on our blog about ADHD.  Here is Dr. Barnhill’s expert page on ADHD.

Related articles on ADHD:  How To Diagnose ADHD The Wrong Way, Part 1

Seven Natural Things To Help ADHD Behavior Without Drugs

Does Your Child Really Have ADHD