*I am not a doctor or healthcare professional, I am a teacher and adult with ADHD and this post is based on information I have taken from the NHS website and my own experience. This post is for information only and anyone seeking an ADHD diagnosis should ALWAYS contact their GP.
Yesterday I posted about the ADHD diagnosis procedure for children and adolescents and today I am going to talk about the diagnosis procedure for adults. As per yesterday’s post I will include the NHS information about diagnosis, but there is a lot more to be said about adult ADHD diagnosis than is written on any one website.
This was potentially the most challenging post of the whole 31 in this project- on a personal level- and the version you are reading is the eighth draft! It was challenging because I have been torn about how much of my diagnosis story and medical history to share without giving too much of myself away. Thankfully, there is so much to talk about, that I was forced to keep my experience brief- less this blog post turn into a ‘War and Peace’ style epic!
Before my ADHD diagnosis I had a long history of visits to the GP for; ‘behaviour issues,’ eating disorders, self-harm, stress, anxiety and chronic sleep difficulties (all very common symptoms of teenage girls with undiagnosed ADHD). After many years of visiting the doctor, mostly for reasons related to anxiety, a period of stress moved me to ask for a referral to Adult Mental Health Services and after one month I saw a wonderful Psychiatrist and was diagnosed with ADHD.
Obviously, that is a very brief summary of the first 30 years of my life, but it gives you the gist. As a result of these frequent trips to the doctors, I had been referred for therapy several times and prescribed everything from antidepressants to help with anxiety, beta blockers to get me through driving lessons and had investigated every single medical and herbal remedy known to man to help me sleep. So, by the time it came to my diagnosis, the Psychiatrist had a few decades worth of evidence in my medical notes to work with.
My GP practice is excellent and over the five years I have been registered there I have seen three GPs, for various reasons, all of whom have been really wonderful, knowledgeable and understanding. I was also lucky to be referred to a fantastic Psychiatrist who understood me almost instantly and get a quick appointment.
Unfortunately, this is not always the case with adult ADHD diagnoses and in fact is quite uncommon amongst my ADHD family. Many adults have struggled to find GPs who believe that ADHD exists in adults and when they do, they have sometimes struggled to find Psychiatrists who are on board with adult ADHD- one told a friend of mine that she couldn’t possibly have ADHD because she has a degree!
The diagnosis process for some can be just as long and arduous as I described for children yesterday- if not longer- and for some people I know it has involved changing GP practices, moving to a new house or paying for a private diagnosis. Even with a private diagnosis, there have often been difficulties in obtaining ‘Shared Care’ agreements between the private practitioner and the NHS.
With all that said I’d like to reiterate my point from yesterday, our GPs and healthcare workers are limited to their training and experience and if they have not come across something before, it is natural for them to be cautious.
If you want to know more about the official guidance on ADHD, a good place to start is to look at the The Scottish Intercollegiate Guidelines Network (SIGN) guidelines. SIGN’s objective is to improve the quality of health care for patients in Scotland by reducing variation in practice and outcome (Sign, 2017). Or if you are in England and Wales, The National Institute for Health and Clinical Excellence (NICE) which provides national guidance on treatments and care for people using the NHS (NICE, 2017). The specific links to what they say about ADHD can be found here:
But if you want more generalised information, what I have posted below from the NHS is very similar to what I posted yesterday- aimed at adults.
From the NHS (altered to take out the parts about children)
Your GP can’t formally diagnose ADHD, but they can discuss your concerns with you and refer you for a specialist assessment, if necessary.
When you see your GP, they may ask you:
- about your symptoms
- when these symptoms started
- where the symptoms occur – for example, at home or at work
- whether the symptoms affect your day-to-day life – for example, if they make socialising difficult
- if there have been any recent significant events in your life such as a death or divorce in the family
- if there’s a family history of ADHD
- about any other problems or symptoms of different health conditions you or may have
For adults with possible ADHD, your GP will assess your symptoms and may refer you for an assessment if:
- you weren’t diagnosed with ADHD as a child, but your symptoms began during childhood and have been ongoing since then
- your symptoms can’t be explained by a mental health condition
- your symptoms have a significant impact on your day-to-day life – for example, if you’re underachieving at work or find intimate relationships difficult
You may also be referred to a specialist if you had ADHD as a child or young person, and your symptoms are now causing moderate or severe functional impairment.
There are a number of different specialists that you may be referred to for a formal assessment, including:
- an adult psychiatrist
- a learning disability specialist, social worker or occupational therapist with expertise in ADHD
Who you’re referred to depends on your age and what’s available in your local area.
There’s no simple test to determine whether you have ADHD, but your specialist can make an accurate diagnosis after a detailed assessment that may include:
- a physical examination, which can help rule out other possible causes for the symptoms
- a series of interviews
- interviews or reports from other significant people, such as partners, parents and looking at school reports
Diagnosis in adults:
Diagnosing ADHD in adults is more difficult because there’s some disagreement about whether the list of symptoms used to diagnose children and teenagers also applies to adults.
In some cases, an adult may be diagnosed with ADHD if they have five or more symptoms of inattentiveness, or five or more symptoms of hyperactivity and impulsiveness, that are listed in diagnostic criteria for children with ADHD.
As part of your assessment, the specialist will ask about your present symptoms. However, under current diagnostic guidelines, a diagnosis of ADHD in adults can’t be confirmed unless your symptoms have been present from childhood.
If you find it difficult to remember whether you had problems as a child, or you weren’t diagnosed with ADHD when you were younger, your specialist may wish to see your old school records or talk to your parents, teachers or anyone else who knew you well when you were a child.
For an adult to be diagnosed with ADHD, their symptoms should also have a moderate impact on different areas of their life, such as:
- underachieving at work or in education
- driving dangerously
- difficultly making or keeping friends
- difficulty in relationships with partners
If your problems are recent and didn’t occur regularly in the past, you’re not considered to have ADHD. This is because it’s currently not thought that ADHD can develop for the first time in adults.
Despite my late diagnosis, it feels like my journey with ADHD has just begun and I’m still learning a lot about myself and how some of the challenges I have faced relate to ADHD.
I can honestly say that I am not unhappy about having ADHD, quite the opposite. My non-typical neurology has made me the person that I am today and I’m quite fond of myself really! ADHD explains many of my habits, personality traits, my chronically poor sleeping and my other quirks and eccentricities. I wouldn’t change my lot in life, though do wish I knew about it when I was younger as the road may have been less bumpy.
I hope you found this post interesting, if you do please share and leave constructive feedback!
Tomorrow I will be giving you the chance to take a peak inside the mind of someone with ADHD.
NICE (2017) ‘What We Do’ [online at] https://www.nice.org.uk/about/what-we-do Accessed 28th September 2017
NHS (2017) ‘Attention Deficit Hyperactivity Diadnosis (ADHD)- Diagnosis’ [online at] http://www.nhs.uk/Conditions/Attention-deficit-hyperactivity-disorder/Pages/Diagnosis.aspx Accessed 28th September 2017
SIGN (2017) ‘Who We Are’ [online at] http://www.sign.ac.uk/who-we-are.html Accessed 28th September 2017