如果我没有真正的多动症怎么办

您正在收听《成人ADHD诊断》第二季。本期节目将解答一个问题：如果实际上我并没有ADHD怎么办？我们将从两个角度探讨：如果我认为自己有ADHD但医生诊断说没有，该怎么办？反之，如果我被确诊ADHD却怀疑诊断准确性，又该如何应对？

You're listening to season two of ADHD Diagnosis in Adults. Today's episode answers the question, what if I don't really have ADHD? We're going to look at two sides of this question. What if I think I have ADHD but was told by a doctor that I don't have it? And the flip side, what if I got an ADHD diagnosis, but I'm not sure it's accurate?

我是Roberto Olivardia医生，作为一名临床心理学家，我在ADHD等病症评估领域拥有超过20年的经验。同时我也是数百万成年后被诊断为ADHD的群体之一。本期由我主持，旨在解答关于ADHD诊断最常见的问题。

My name is Doctor. Roberto Olivardia, and I'm a clinical psychologist with more than twenty years of experience evaluating people for things like ADHD. I'm also one of the millions of people who have been diagnosed with ADHD as an adult. I'll be your host. My goal here is to answer the most common questions about ADHD diagnosis.

通过本期内容，您将对ADHD有更全面的认识。接下来约十分钟内我们将高效探讨，现在开始吧。如果医生诊断我没有ADHD，我该怎么做？首先请思考是否接受了全面评估。建议您回顾本季前几期节目获取参考——

Along the way, you'll learn a lot about ADHD in general. We're going to do this quickly in the next ten or so minutes, so let's get to it. What do I do if my doctor told me I don't have ADHD? I want you to think about whether you got a thorough evaluation. To help with this, I recommend you go back and listen to a few episodes from earlier this season.

第二期可帮助判断您的评估医师是否具备资质，或是否需要寻求更擅长成人ADHD诊断的专业人士；第三期深入解析全面评估应包含的问题维度；若您接受过线上评估却怀疑其有效性，第四期内容将特别有用。假设您确实接受了全面评估，部分人未获ADHD诊断的原因可能是近期才在某些领域出现困难。

Episode two can help you think about whether you saw a qualified provider, or if you might want to go see someone who has more training in how to diagnose ADHD in adults. Episode three digs into the breadth and depth of the questions that a comprehensive evaluation should ask. And episode four is good to listen to if you got evaluated online and aren't sure if it was legit or not. Now let's say you did get a thorough evaluation. One reason some people don't qualify for an ADHD diagnosis is if they only started struggling in certain areas pretty recently.

仅此一点就可能导致评估者否决ADHD诊断，因为官方指南要求12岁前存在功能障碍证据。但成人ADHD患者未必在童年显现症状：可能成长于高度结构化的环境，或父母提供了大量支持；可能当时课业要求较低，无需如今这般组织规划能力；也可能幼时靠临场发挥就能考试满分，但大学或职场的高要求使得这种模式难以为继。

Many evaluators will disqualify an ADHD diagnosis for that reason alone, because the official diagnostic guidelines say there needs to be evidence of impairment or struggle before age 12. But there are a lot of reasons why adults with ADHD may not say we struggled as kids. Maybe you grew up in a highly structured environment, or your parents did a lot to help make things easier for you. Maybe you had a much less demanding schedule, and didn't need to use as much organization or time management skills as you do now. Maybe as a kid, you could ace all the tests without doing the homework, but you couldn't keep winging it when the demands got a lot harder in college or at work.

又或者童年时您是个与懒散完全相反的完美主义者——这现象在ADHD群体中出奇普遍。许多优秀孩子成年后陷入倦怠也不罕见。若这些情况与您吻合但未在评估中体现，建议联系原评估者或寻求二次诊断。另一个重要可能是：困扰您的实为其他问题。

Or maybe as a kid, you were a perfectionist, the complete opposite of a slacker. Perfectionism is surprisingly common among people with ADHD. It's also not unusual for high achieving kids to feel totally burnt out by the time they become adults. If any of these things sound like you, but maybe didn't get captured in your evaluation, you may wanna consider reaching back out to the evaluator or getting a second opinion. Another really important possibility to consider if you weren't diagnosed with ADHD is that you could be struggling for other reasons.

比如近期承受巨大压力（全球疫情就是典型），这种压力可能引发类似ADHD的症状。无论根源为何，您的困扰都值得重视，且总有改善方法。第六期提到的所有非药物疗法（制定应对策略、寻求社会支持、使用辅助技术、开始认知行为治疗等）对ADHD与非ADHD人群均有裨益。

For example, maybe you've been under a lot of stress recently. Hello, global pandemic. And that stress could be causing a lot of symptoms that look like ADHD. Whatever the source of your struggles, your concerns are still valid, and there are still plenty of things you can do to help. All of the non medication treatments that I talked about in episode six can help people who have ADHD and people who don't have ADHD.

若未获ADHD诊断是因存在情绪障碍、物质滥用或创伤等问题，明确这点对获得正确治疗至关重要。如果怀疑ADHD诊断不准确怎么办？这是常见疑问，建议从三个维度考量：评估是否全面、治疗方案是否有效、以及您本身的自我怀疑倾向。

Things like developing coping strategies, leaning on social supports, using assistive technology, starting cognitive behavioral therapy. CBT can help everyone. And if you didn't qualify for an ADHD diagnosis because you're struggling with something else, like a mood disorder, substance abuse problem, or trauma, that is super important to find out so you can start getting the right treatment. What if I don't think my ADHD diagnosis is accurate? This is a very common question, and I want you to think about three possible reasons you're doubting your diagnosis: how thorough your evaluation was, how effective your ADHD treatment plan has been, and how much you tend to doubt yourself in general.

首先聚焦评估环节。请结合第二、三、四期内容，判断是否由ADHD经验丰富的专家进行了全面评估。特别注意问题设置的广度——评估是仅针对ADHD，还是同时排查了共病情况（如学习障碍、焦虑、抑郁或强迫症等易与ADHD混淆的病症）？ADHD往往伴随其他病症，准确鉴别至关重要，因为有时被误诊为ADHD的实为其他问题。

Let's focus on any evaluation concerns first. I want you to look back at your evaluation and use all the info we discussed in episodes two, three, and four to help you think about whether you got a thorough evaluation by someone who has a lot of experience with ADHD. In particular, I want you to think about how narrow or broad the questions were. Did the testing only seem to ask about ADHD, or did the evaluator seem to consider whether you might have something in addition to ADHD, or something that can look a lot like ADHD, like a learning disability, anxiety, depression, or obsessive compulsive disorder. ADHD rarely travels alone, so chances are that another condition or diagnosis will be present alongside the ADHD.

其次思考是否因治疗效果不佳产生怀疑。若服用ADHD药物，请重温第五期关于与处方医生密切合作调整药物剂量的内容——这必然是个试错过程。请注意，无论采用何种治疗方式，改善都可能是渐进式的。

But this is important to tease out since there can be overlapping symptoms, and sometimes people get an ADHD diagnosis when it's not ADHD at all. Next, I want you to think about whether you're doubting your diagnosis because your ADHD treatment doesn't seem to be helping. If you're taking ADHD medication, go back and listen to episode five, where I talk a lot about the importance of partnering closely with your prescriber to find the right medication and dosage. This is definitely a trial and error process. Keep in mind that regardless of whether you're treating your ADHD with or without medication, your progress can be gradual.

这并非像拨动开关那么简单。如果发现你除了ADHD还有其他症状，可能需要优先治疗其他问题，ADHD次之。另外要考虑的是，作为成年人，即使确诊ADHD，你也可以自主选择是否采取行动。无需告知他人。你可以将评估报告锁进抽屉，慢慢消化自己的感受。

It's not like flipping a switch. And if it turns out that you have another condition in addition to ADHD, then you may need to focus on treating that first, and your ADHD second. One other thing to consider here is that as an adult, you can choose what to do or not do if you're diagnosed with ADHD. No one else has to know. You can put your evaluation report in a drawer and wait to see how you feel about it.

诊断结果不会强求你做出任何改变，除非你自愿利用它。不妨将诊断视为一把钥匙——它能为你开启支持服务的通道，但何时使用、如何使用、甚至是否使用这把钥匙，完全由你决定。最后，请思考你是否常有自我怀疑倾向。许多ADHD患者都擅长自我否定。建议回听第七期节目，那里探讨了ADHD与冒名顶替综合征的关系。

A diagnosis requires nothing of you unless you choose to do something with it. Think of your diagnosis as a key that can unlock access to services and supports if you want them, but you get to decide when or how or if you wanna use that key. And lastly, I want you to think about whether you tend to doubt yourself a lot in general. Many people with ADHD are very good at doubting ourselves. Go back and listen to episode seven, which talks about ADHD and imposter syndrome.

ADHD或任何诊断都不应成为借口，而是帮助我们理解现状，从而制定改善方案的工具。理想的诊断结果应引发自我关怀，但现实是许多ADHD患者常对自己过于严苛。与其用'我真蠢'否定一切，不如接纳更精准的认知：'我有ADHD，这导致我难以按时完成任务，因此需要特定支持来确保事情完成'。若质疑诊断准确性，随时可以寻求二次评估。与医生坦诚沟通疑虑，共同制定让你对治疗计划更有信心的方案。

ADHD, or any diagnosis for that matter, isn't meant to be an excuse, but rather an understanding of what's going on that then guides you to treatment or a plan to make things better. Ideally, a diagnosis will lead to self compassion, but let's face it, many people with ADHD can be really harsh on themselves about a lot of things. So instead of dismissing everything with a quick, I'm an idiot, try to make room for more accurate thoughts like, I have ADHD, and that makes it hard to get things done on time, so I need certain supports to make sure I can finish what I need to finish. Bottom line, if you're doubting the accuracy of your ADHD diagnosis, you can always get a second opinion. Talk with your doctor or therapist about why you're concerned, and together you can come up with next steps to help you feel more confident about your treatment plan.

最后补充两点：首先，准确诊断不仅利于你，也惠及身边人。无论是ADHD还是其他问题，正确治疗能让你成为更好的自己，从而改善所有社会关系。其次，ADHD具有家族遗传性，焦虑抑郁等心理健康问题同样如此。

There are two last things I want to mention. First, getting an accurate diagnosis can not only help you, it can also help the people around you. Whether it's ADHD and or something else, getting the right treatment can help you be a better version of yourself, which can help in all of your relationships, and at home, and at work, etcetera. Second, ADHD tends to run-in families. The same is true for other mental health issues like anxiety and depression.

你越了解自己，就越能理解和支持家人。听众朋友们，第八期核心要点是：任何努力自我认知并寻求帮助的人都值得掌声。你们理应获得幸福健康，而恰当的支持能助你抵达彼岸。

So the more you understand yourself, the more you can understand and support other members of your family. Okay, listeners. That's it for episode eight. The key takeaway I'm hoping sticks with you from this episode is that I applaud anyone who is trying to understand themselves better and get the help they need. You deserve to be happy and healthy, and with the right support, you can get there.

感谢收听。欢迎继续关注特别番外篇，我们将分享多位成年人确诊ADHD的真实经历，包括我的故事。您正在收听的是Understood播客网络《Understood解读》第二季。更多本期相关内容请查看节目注释。

Thanks for listening. I hope you'll join me for a special bonus episode where you'll hear from several folks about their experiences getting diagnosed with ADHD as an adult. I'll share my story too. You've been listening to season two of Understood Explains from the Understood Podcast Network. If you want to learn more about the topics we covered today, check out the show notes for this episode.

我们提供了延伸资源及节目中提及的所有链接。重要声明：本人不开具ADHD药物处方，与制药公司无利益关联，Understood机构亦然。本播客仅作信息参考，不能替代专业诊断或医疗建议。医疗决策前请咨询医疗提供者。本期节目由朱莉·拉和科迪·尼尔森制作并剪辑。

We include more resources as well as links to anything we've mentioned in the episode. One important note, I don't prescribe ADHD medication and I don't have any affiliation with pharmaceutical companies and neither does Understood. This podcast is intended solely for informational purposes and is not a substitute for a professional diagnosis or for medical advice or treatment. Talk with your healthcare provider before making any medical decisions. Understood Explains is produced by Julie Ra and Cody Nelson, who also edited the show.

布丽安娜·贝里担任制片总监，主题音乐由兼混音师的贾斯汀·D·赖特创作。Understood播客网络团队中，拉拉·凯任编辑总监，斯科特·科希尔为创意总监，塞思·梅尔尼克是执行制片人。Understood作为非营利组织，致力于帮助学习与思维差异人群发掘潜能。详情请访问understood.org/mission。

Brianna Berry is our production director. Our theme music was written by Justin D Wright, who also mixes the show. For the Understood Podcast Network, Lara Key is our editorial director, Scott Koshier is our creative director, and Seth Melnick is our executive producer. Understood is a nonprofit organization dedicated to helping people who learn and think differently discover their potential and thrive. Learn more at understood.org/mission.