Diagnosis of ADHD in adults

One in forty adults have ADHD. It could even be more than that. Yet despite this growing awareness, many adults struggle to get a diagnosis. After the recent pandemic, anecdotal reports of more people seeking diagnosis has appeared, and celebrities have been talking openly about being diagnosed. So if you think you have ADHD, how do you go about getting a diagnosis in the UK?

Diagnosis of ADHD

Unfortunately, getting a diagnosis of ADHD as an adult can be difficult, time-consuming or expensive. Diagnosing ADHD in adults is quite difficult as there are no ‘objective tests, just ‘subjective’ tests. An adult can only be diagnosed with ADHD if they have 5 or more out of the 9 symptoms of inattentiveness, or 5 or more out of the 9 symptoms of hyperactivity/impulsiveness. In addition to that, a diagnosis of ADHD in adults cannot be confirmed unless your symptoms have been present from childhood. This is because it is currently thought that ADHD cannot develop in adult brains. This often involves asking your parents/siblings questions about you as a child or showing old school reports.

Importantly, symptoms also have to have a moderate effect on different areas of your life. This could include difficulty in your relationships, difficulty at work etc.

Frustratingly, there are inadequate resources available in the UK’s National Health Service (NHS) for ADHD assessment. This has led to reports of some people waiting up to five years for a diagnosis and post-diagnosis, waiting 12 months to start treatment. These delays, along with a lack of public awareness, mean there are likely to be many undiagnosed ADHD adults living with the condition.

There are currently two routes to a diagnosis in the UK but both require a specialist psychiatrist. You can use the NHS services or pay to go private. There are relative merits but also drawbacks for both of these routes.

Using the NHS

Using the NHS

Your GP cannot formally diagnose ADHD, but they can discuss your concerns with you and refer you for a specialist assessment if they agree that you need one. Your GP will likely ask you about your symptoms, when these symptoms started, whether the symptoms affect your day-to-day life and if there’s a family history of ADHD. It is best to be prepared for these questions. You can fill in an ADHD symptom scoring test to show your GP. Once the GP is satisfied, they can refer you to specialist services. Sadly, this process can take several years depending on where you are geographically. This is the major downside of using the NHS.

Right To Choose

There is a middle route for adults in England, which is to ask for a ‘Right to Choose’ referral to a private clinic, where the diagnosis is generally faster than using the NHS but many GPs are unaware of this system, and some may be resistant. At the time of writing, there are two Right To Choose Approved clinics, Psychiatry UK and ADHD360. Using this service will likely speed up the time to diagnosis and not cost anything.

Private Diagnosis

Getting a diagnosis of ADHD through a private clinic is much faster than the NHS (you can expect to be diagnosed in some cases in less than 2 weeks) but has significant costs attached. You can be expected to pay for the initial consultation, the cost of a nurse prescribing your medication and checking your response, the cost of medication at the pharmacy (it will be prescribed privately so you cannot pick it up like an NHS prescription), and the cost of a discharge consultation. This in total can exceed £1500. You also have to first check that your GP is willing to accept the ‘Shared Care Agreement‘ that your private psychiatrist will pass to them, and some GPs are not well versed in these agreements. There are reports that even private healthcare services are overwhelmed at the time of writing.

Whether you choose a diagnosis route or not, the evidence suggests that treatment for Adult ADHD is a major factor in living healthily with this condition.

Author: James Brown PhD.

Editor: Alex Conner PhD.