[thomastjeffery]

Only difficult because the criteria are misaligned. We diagnose school children more consistently, because we subject school children to strict measured criteria (school), and can point to the data (grades/homework) as objective evidence.

Why do we care so much about objective evidence? Because of prohibition. Prescribing stimulants isn't illegal because it is difficult to diagnose ADHD. It's difficult to diagnose ADHD for the very same reason it's illegal to prescribe stimulants: our society values prohibition of drugs over actual healthcare. An ADHD diagnosis implies a compromise of prohibition, so our society has structured the means to that diagnosis accordingly.

Experts in the field estimate a very high incidence of undiagnosed ADHD in adults. During the height of the COVID-19 epidemic, telehealth services were made significantly more available, which lead to a huge spike in adult ADHD diagnoses. Instead of reacting to that by making healthcare more ADHD accessible, our society backslid; lamenting telehealth providers as "pill mills", and generating a medication shortage out of thin air.

[roywiggins]

> Why do we care so much about objective evidence? Because of prohibition.

That may be true for ADHD, but autism diagnoses don't "unlock" any particularly sought-after prescription medication, so I don't think that can be the whole story. In kids, diagnoses do unlock accommodations in schools, but not so much for adults.

[thomastjeffery]

That's mostly true, but there is a huge overlap in ASD and ADHD diagnosis. It's very common to be diagnosed with both, and that expectation (from a healthcare provider's perspective) has implications.

[cootsnuck]

Very well said. I think it's hard for people to understand that ADHD is simultaneously over diagnosed and under diagnosed.