Navigating the process of receiving an ADHD diagnosis as an adult can be overwhelming. Here’s a comprehensive, step-by-step guide to help you through the process, with additional information that may help along the way.
Start by Keeping a Symptom Log
Before speaking to your GP, it’s important to keep a detailed symptom log. This log should document how your symptoms affect various aspects of your life, including work, home, and social situations. The log will help provide evidence of your challenges and allow your healthcare provider to get a clearer picture of your condition.
For women and men, ADHD can present differently, which makes tracking symptoms important. Women, for example, may display more inattentive symptoms, leading to issues being overlooked. Recording these patterns will help the healthcare professional understand your specific experiences. Include examples like:
At Work: Struggling to stay focused in meetings, difficulty managing deadlines, or trouble prioritising tasks.
At Home: Forgetfulness about daily chores, trouble maintaining routines, or misplacing items.
In Relationships: Difficulty paying attention during conversations, feeling emotionally reactive, or becoming easily frustrated.
This log helps your GP gain a clearer understanding of how ADHD affects you across different areas of life.
Step 1: Talk to Your GP About ADHD
Once you’ve prepared your symptom log, schedule a visit with your GP. Share why you believe you might have ADHD and discuss any other mental health concerns. Your GP will want to know about long-standing issues, so reflect on challenges from childhood through adulthood, such as difficulties at school, work, or in relationships.
For many adults, ADHD symptoms become more noticeable later in life due to increased responsibilities at work, prolonged levels of stress, or significant life events, such as starting a family. These pressures can make it harder to manage symptoms like time management, organisation, and attention, bringing ADHD to the forefront. Following this conversation, your GP may refer you for an ADHD assessment.
Step 2: What to Do If Your GP Refuses a Referral
If your GP refuses to refer you for an ADHD assessment, you have other options:
Seek a Second Opinion: You can formally request a second opinion through your GP practice or book an appointment with another GP. Make sure to mention that you’ve already discussed this with a GP.
Private Assessment: If you can afford it, consider a private assessment. Always ensure the clinician is registered with the General Medical Council to ensure you’re receiving professional care.
Step 3: What to Expect During the ADHD Assessment
Once referred for an assessment, healthcare professionals will evaluate your symptoms based on the criteria laid out in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition). Understanding this process will help you feel more prepared.
Categories of Symptoms
ADHD symptoms fall into two categories: inattention and hyperactivity/impulsivity. Adults need to show at least five symptoms from either category for six months or longer to be considered for a diagnosis. These are some of the common symptoms assessed:
Inattention:
- Difficulty focusing on tasks
- Easily distracted
- Avoiding tasks that require sustained effort
- Frequently losing things
- Forgetting appointments or important tasks
Hyperactivity/Impulsivity:
- Restlessness or inability to stay seated
- Frequently interrupting others
- Talking excessively
- Impulsively acting or making decisions
Additional Criteria
Symptoms Since Childhood: To meet the diagnostic criteria, these symptoms must have been present before the age of 12, even if they were not diagnosed at the time.
Multiple Settings: Symptoms need to be evident in at least two different places, such as at home and at work, to rule out situational behaviour.
Significant Impact: The symptoms should cause significant disruption in daily life, including at work or in personal relationships.
Ruling Out Other Conditions: The clinician will rule out other conditions, such as anxiety or depression, to ensure that ADHD is the primary diagnosis.
Step 4: NHS ADHD Assessment, Right to Choose, or Private Assessments
NHS ADHD Assessment
Once referred, you’ll undergo a specialist NHS assessment, usually lasting 45 to 90 minutes. A psychiatrist or another qualified professional will assess your ADHD symptoms and any other mental health conditions, in line with NICE guidelines. After the assessment, your clinician will discuss diagnosis and treatment options.
Right to Choose (NHS England)
In England, you have the Right to Choose your healthcare provider if NHS waiting times are too long. This allows you to choose an alternative provider for your ADHD assessment. For more details, visit the ADHD UK Right to Choose guide.
Private Assessments
Many opt for private assessments due to long NHS waiting times. Though private assessments can be costly, they often offer quicker access to diagnosis and care. Always ensure your clinician is registered with the General Medical Council.
Step 5: Shared Care or GP Care
After diagnosis, your care plan will be discussed. You may continue with specialist mental health services, or transition to shared care, where your GP manages your treatment in collaboration with the specialist team. Shared care is the most common approach, with your GP overseeing medication and treatment while receiving guidance from specialists when necessary.
Gender Bias in Referrals
ADHD is often missed in women due to subtler symptoms. If you believe your symptoms are being overlooked, be proactive in discussing your experiences with your GP. Highlight long-standing attention difficulties, emotional regulation issues, and how they’ve affected your life.
Keeping a symptom log can help you make a stronger case during your consultation. This is a valuable tool for both men and women, but it’s especially important for women, whose symptoms may be less apparent due to common stereotypes or biases in healthcare.
Additional Considerations
Coexisting Conditions
Many adults with ADHD also experience other mental health issues, such as anxiety or depression. A thorough assessment should consider these coexisting conditions, as treating them alongside ADHD can greatly improve your quality of life
Workplace Accommodations
After diagnosis, you may be eligible for workplace accommodations through the Access to Work Grant, which helps cover ADHD coaching, adaptive software, and workplace training. For more details, check out our free downloadable guide on applying for the grant here
Long-Term Care
Managing ADHD doesn’t end with diagnosis. Treatment may include medication, therapy (such as Cognitive-Behavioural Therapy), and lifestyle adjustments like exercise and diet. Establishing routines and using organisational tools can significantly help manage symptoms.
By following these steps, you’ll be well on your way to navigating an ADHD diagnosis and finding the support you need. Remember, you’re not alone, and it’s okay to take things one step at a time. With the right tools and guidance, managing ADHD becomes much more achievable. If you need more information or support, feel free to explore our resources here. We’re here to help.