Clinician handoff
ADHD
Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.
Why this still fits
I want to evaluate whether ADHD is contributing to my brain fog and to separate that baseline pattern from sleep problems, depression, bipolar II, autism overlap, medication effects, thyroid issues, and low ferritin or B12.
What would weaken it
- -No childhood or long-term pattern of distractibility, executive dysfunction, or time blindness before the recent fog began.
- -Fog is constant across all tasks instead of clearly worse with boring, repetitive, or low-interest work.
- -Sleep disruption, thyroid disease, iron deficiency, medication effects, or concussion explain the picture more cleanly.
Key points to communicate
- •I want to separate a lifelong ADHD-style pattern from a newer fog state that only looks similar on bad days.
- •Please tell me what history would make ADHD stronger and what would make it less likely.
- •If ADHD stays on the table, I want to know what medical mimics still need ruling out first.
Bring this to the visit
- •School or work performance records showing a pattern across years, not just a bad stretch.
- •A completed ASRS-v1.1 self-report screener, available free online.
- •Medication list including stimulants, caffeine intake, and any supplements.
- •Examples of executive function failures: missed deadlines, lost items, unfinished tasks.
Useful screening structure
- -ASRS-v1.1 (Adult ADHD Self-Report Scale) as a structured starting point.
- -WURS-25 (Wender Utah Rating Scale) for childhood symptom recall if late-diagnosed.
- -PHQ-9 to screen for co-occurring depression, which overlaps heavily with ADHD fog.
Tests and measurements to discuss
ASRS-v1.1 screening + full clinical evaluation using DSM-5 criteria + collateral history
What this helps clarify: Patient-facing ADHD screener route matching the ASRS-v1.1 wording used in results cards and clinician conversations.
Range context
0-6 screener context
How to use the result
Save the result with date and symptoms from the same week.
DIVA-5 interview if the clinic uses it
What this helps clarify: Structured adult ADHD interview used when a clinic wants a full question-by-question diagnostic history instead of relying on a quick screener alone.
WURS or another childhood-symptom tool if early history is unclear
What this helps clarify: Retrospective childhood-symptom tool that helps show whether the pattern was present long before adult stress, burnout, or sleep disruption entered the picture.
TSH + Free T4, ferritin, B12, vitamin D, fasting glucose or HbA1c as indicated
What this helps clarify: Higher fasting glucose impairs executive function
Range context
70–85 mg/dL (optimal)
How to use the result
Save the result with date and symptoms from the same week.
Sleep apnea screening or sleep study if snoring, gasping, or unrefreshing sleep are part of the story
What this helps clarify: Overnight polysomnography explainer framed around the patient-facing 'sleep study' language most people actually search.
Range context
Sleep report
How to use the result
Ask whether the goal is to rule in sleep apnea, UARS, or another sleep-disruption pattern.
TSH + Free T4, ferritin, B12, vitamin D, fasting glucose/HbA1c as indicated
Rules out common medical overlaps or mimics.
What this helps clarify: Higher fasting glucose impairs executive function
Range context
70–85 mg/dL (optimal)
How to use the result
Save the result with date and symptoms from the same week.
Questions to ask directly
- •Does this look like lifelong ADHD, or could an acquired cause explain the cognitive pattern better?
- •Should we screen for co-occurring conditions like anxiety, sleep disorders, or autism?
- •If ADHD is likely, what is the first-line medication approach and how will we measure response?
- •Would neuropsychological testing add clarity, or is the clinical picture clear enough to trial treatment?
Functional impact snapshot
- -Rate work/school impairment: missed deadlines, error rates, task switching difficulty.
- -Track which times of day function is worst - morning inertia vs afternoon crash vs evening.
- -Note whether hyperfocus on interests is preserved while routine tasks are impossible.
Escalate instead of self-managing if
- •Sudden cognitive decline rather than a lifelong pattern - this suggests an acquired cause, not ADHD.
- •New focal neurological symptoms, seizures, or severe headaches alongside attention problems.
- •Severe depression, suicidal ideation, or self-harm that needs immediate attention before ADHD evaluation.
Peer-reviewed references