ADHD, Burnout or Something Else – How Do I Know What’s What?

Have you just completed or started a diagnostic ADHD assessment and feel like you have no energy left? Do you suddenly feel extra exhausted as if you're heading straight for burnout? Isn’t it a bit strange that right now, when you are so close to what you have believed in and hoped for, you feel so incredibly tired – that no amount of rest in the world seems to make you feel better?

Is it wise to continue an ADHD evaluation or start ADHD medication if there is a chance that your symptoms are actually due to burnout or something else?

These are common and important questions – for both patients and healthcare professionals.

Understanding the overlap

First of all, it’s not unusual for symptoms and fatigue to catch up with you when starting an ADHD evaluation. 

For many, the assessment process is an emotionally intense experience. 

One that involves revisiting their entire life and confronting difficult and painful events.

Fortunately, an ADHD diagnosis is never based solely on symptoms a person exhibits at a given moment. 

A diagnosis requires a history of symptoms and difficulties with concentration, energy regulation and impulsivity that began before the age of 12.

A thousand reasons for being tired

There are countless reasons why someone might experience exactly the symptoms they are currently describing. 

For example:

Severe fatigue, increased sleep needs, and exhaustion despite rest can sometimes be traced to low iron levels, especially in young women with heavy periods. 

Persistent tiredness may also be a symptom of low-grade depression. Especially in those who have been under prolonged stress at work or live in an unsustainable relationship. 

Extreme exhaustion is also common after a serious infection, even months after recovery.

In addition, sleep disturbances, brain fog, unexplained dizziness and cold sweats are frequent symptoms in perimenopausal women. Women that also often describe forgetting words, names, phone numbers and important codes, as well as experiencing mood swings similar to those of teenagers. 

These exact symptoms are also seen in young people who use cannabis. And in individuals with long-term excessive alcohol consumption.

The importance of a thorough assessment

This is why it’s crucial that a diagnostic ADHD assessment thoroughly considers – and rules out – other possible explanations besides ADHD. 

This is particularly important for women, as knowledge about the impact of hormonal fluctuations (such as PMS/PMDD and declining estrogen levels in perimenopause) is still relatively low in many healthcare settings. 

As a result, women who seem to meet the symptom criteria for ADHD may be misdiagnosed and treated for ADHD, when in fact their issues are hormonal in nature.

However, if you have ensured that your diagnostic team has the clinical experience and knowledge about the different conditions that could explain your current symptoms. And that they follow proper diagnostic guidelines. Then, you should not worry about receiving an incorrect diagnosis. 

After a broad and thorough clinical assessment, you should not fear being prescribed ADHD medication when you actually need support to prevent burnout, hormonal treatment for menopausal symptoms, or iron supplements to correct anemia.

The Bottom Line

If your symptoms are new or have worsened recently. And especially if you are nearing menopause, have had heavy periods, struggle with addiction or a physical condition or have been under chronic psychosocial stress.

Then, it’s wise to discuss these factors with your healthcare provider before making any decisions about ADHD diagnosis or treatment. 

A serious assessment should always consider the whole picture, ensuring that you receive the right explanation – and the right treatment – for what is affecting you.

Lotta Borg Skoglund

MD PhD & Letterlife Medgrundare