Lately the headlines say ADHD is an epidemic, that diagnoses are out of control, and that stimulants are being handed out too easily. I evaluate and treat only adults with ADHD, and I think that story gets part of this right and a lot of it wrong. Here is where I land on overdiagnosis, medication misuse, and what a broad crackdown could cost the patients who are doing well.
Is ADHD overdiagnosed?
I don't think it is. The modern diagnosis only took shape in 1980, and adults weren't explicitly recognized in the DSM until 2013. We also know ADHD is highly heritable. Twin studies put it at about 74 percent, which is comparable to height.
Add reduced stigma, more public awareness, and social media to that, and a rise in diagnoses is exactly what I would expect. We are catching people who were missed for decades, especially adults and women. In my own practice, I haven't seen real overdiagnosis from qualified professionals.
Where overdiagnosis really happens
It happens when the evaluation is poor. A fifteen-minute telehealth visit with a self-report quiz is not an ADHD evaluation, and it shouldn't be treated as evidence that ADHD is present. The same goes for online-only "neuropsychological" reports built on questionnaires and short answers, with no live interview, often sold for a fraction of the price of a real evaluation.
I don't accept those reports. If a patient comes to me with one, I require new testing, either with me or with an in-person neuropsychologist. That isn't gatekeeping. A diagnosis only helps if people can trust it.
What a thorough evaluation includes
A clinical interview of at least an hour, often using a structured tool like the DIVA-5
Collateral from a spouse, family member, or colleague
Rating scales such as the ASRS or CAARS
Sometimes a one-to-two-week symptom log and a continuous performance test (helpful, but not diagnostic on its own)
Ruling out look-alikes such as anxiety, sleep problems, and thyroid issues
All of it comes together in one cohesive report, whether through a neuropsychological evaluation or a skilled treating psychiatrist.
What is driving the surge in diagnoses?
Some of it is genuine. People are under more pressure from work, family, and social media, and many adults have always had ADHD, but with increased pressures and demands, they cannot mask it anymore. ADHD is now surfacing and impossible to ignore.
But there is also a commercial layer. Venture-backed telehealth companies saw a vulnerable population and marketed aggressively to it. And since 2020, temporary rules have allowed controlled substances, including ADHD stimulants, to be prescribed without an in-person visit. Those flexibilities have been extended repeatedly and, as of this writing in October 2026, run through December 31, 2026. In the hands of a careful clinician, telehealth expands access. Without that care, it makes rushed prescribing easy.
When it looks like ADHD but isn't
Stress, heavy workloads, and anxiety can look like ADHD. Trouble focusing and forgetting things can come from being stretched thin or from anxiety, and those problems need a different answer. A thorough evaluation sorts that out, which is one more reason I take the time to do one.
I want to offer treatment to patients with true ADHD, and help others understand that stress, heavy workloads, and anxiety can look like ADHD but need a different answer.
Are stimulants misused?
They can be. Misuse and diversion are real concerns, particularly among college students and young professionals looking for an academic or work edge. In my practice, I screen patients up front and set clear expectations. Prescriptions are limited to 30 days, each new prescription requires a follow-up visit, and the medication is only for the patient it is prescribed to.
Treatment is taking the medication as prescribed, within FDA-approved dosing. Misuse is taking more than prescribed. When that happens, I end the prescribing relationship and connect the patient with substance use treatment resources.
If you think you might have ADHD
My practice is self-pay and out-of-network, so here is what to expect. A full ADHD assessment with no prior testing is $2,000. If you already have an in-person neuropsychological report, the pathway is a $500 initial intake and $200 per follow-up. Initial evaluations are in person at my Edina office, and follow-up visits can be done by telehealth.
Whether you suspect you have ADHD, have been told you do, or simply want to understand your options, you are welcome to book a free consultation. There is no pressure and no obligation. We will talk through what you are experiencing, and if I am not the right fit, I will tell you honestly and point you in a better direction.
This post is general education and not medical advice.