Question: Thank you for doing this AMA.
  
  Would you say that "high performers" or other atypical cases usually have a different response to medication or otherwise require different treatment to typical cases? 
  
  How common do you think misdiagnosis is, e.g. a depressed adult being diagnosed with ADHD? Do you think ADHD is generally overdiagnosed or underdiagnosed? 
  
  (I admit I'm asking because of my specific case -- high performer until college/work, responding very little to medication, worried that doctors settled on ADHD too quickly -- but I understand that your responses can only be broad and every case has its nuances.)
Answer: The treatment for atypical cases is  the same as for typical ADHD.  
  
  Misdiagnosis does occur for all sorts of reasons.  In the US, many primary care doctors know a lot about depression but not much about ADHD.  So they are more likely to diagnose depression and not realize that the patient also has ADHD.     Although ADHD diagnoses are usually correct, some cases of misdiagnosis occur although it is not as bad as one reads about in the media.   If someone diagnosed with ADHD doesn't respond to medication, then it is possible that the diagnosis was not correct.  But one would want to be sure that the medication was dosed correctly and that different types of medication were tried.  Sometimes, expert consultation is needed.
content: Q: Thank you for doing this AMA.
  
  Would you say that "high performers" or other atypical cases usually have a different response to medication or otherwise require different treatment to typical cases? 
  
  How common do you think misdiagnosis is, e.g. a depressed adult being diagnosed with ADHD? Do you think ADHD is generally overdiagnosed or underdiagnosed? 
  
  (I admit I'm asking because of my specific case -- high performer until college/work, responding very little to medication, worried that doctors settled on ADHD too quickly -- but I understand that your responses can only be broad and every case has its nuances.)
   Ans: The treatment for atypical cases is  the same as for typical ADHD.  
  
  Misdiagnosis does occur for all sorts of reasons.  In the US, many primary care doctors know a lot about depression but not much about ADHD.  So they are more likely to diagnose depression and not realize that the patient also has ADHD.     Although ADHD diagnoses are usually correct, some cases of misdiagnosis occur although it is not as bad as one reads about in the media.   If someone diagnosed with ADHD doesn't respond to medication, then it is possible that the diagnosis was not correct.  But one would want to be sure that the medication was dosed correctly and that different types of medication were tried.  Sometimes, expert consultation is needed.