ADHD diagnoses are on the rise.
Yet, it can still be hard for people to know if they are among the 2.6million people in Britain with the behavioural condition.
For decades, attention deficit hyperactivity disorder (ADHD) has been stereotypically associated with the naughty 10-year-old boy who can’t sit still in class.
But now, it is understood to be far more complex.
Struggling to finish tasks, misplacing things and driving dangerously are just some of the many signs NHS doctors look out for when assessing suspected patients.
A new think tank report has revealed that increased awareness of the condition has left people in the UK waiting up to two years for an assessment.
ADHD can be categorised into two main types – inattentiveness and hyperactivity.
While most people show symptoms of both, this isn’t always true.
In adults, hyperactivity is less common, and symptoms are more subtle, making them tougher to identify, for example.
What is the test?
After seeing a GP and getting a referral, psychiatrists use assessment tools to help diagnose ADHD.
The NHS says: “Diagnosing ADHD in children depends on a set of strict criteria.
“To be diagnosed with ADHD, your child must have six or more symptoms of inattentiveness, or six or more symptoms of hyperactivity and impulsiveness.”
Examples include: “having difficulty organising tasks”, “excessive talking”, and “making careless mistakes”.
These symptoms must have started showing before the age of 12 and have been ongoing for at least six months.
Adults must only have five of the listed signs to receive a diagnosis.
In adults, the symptoms of ADHD are more difficult to define. This is largely due to a lack of research into adults with ADHD and the fact symptoms tend to become far more subtle as people get older.
For both adults and children, the supposed ADHD symptoms must have made their lives considerably more challenging.
But this criteria is not the only tool used by psychiatrists – and therefore, people cannot self-diagnose using it.
Interviews with friends, family, and teachers of the suspected patient are usually also conducted to gauge the severity of symptoms.
A physical examination, which can help rule out other possible causes for the symptoms, could also be done.
The test – children and teenagers
The symptoms of ADHD in children and teenagers are well-defined, and they’re usually noticeable before the age of six.
Your child must have six or more symptoms of inattentiveness, or six or more symptoms of hyperactivity and impulsiveness, the NHS says.
Inattentiveness (difficulty concentrating and focusing)
The main signs of inattentiveness are:
- Having a short attention span and being easily distracted
- Making careless mistakes – for example, in schoolwork
- Appearing forgetful or losing things
- Being unable to stick to tasks that are tedious or time-consuming
- Appearing to be unable to listen to or carry out instructions
- Constantly changing activity or task
- Having difficulty organising tasks
Hyperactivity and impulsiveness
The main signs of hyperactivity and impulsiveness are:
- Being unable to sit still, especially in calm or quiet surroundings
- Constantly fidgeting
- Being unable to concentrate on tasks
- Excessive physical movement
- Excessive talking
- Being unable to wait their turn
- Acting without thinking
- Interrupting conversations
- Little or no sense of danger
The test – adults
Adults must only have five of the listed signs to receive a diagnosis.
Some specialists have suggested the following as a list of symptoms associated with ADHD in adults:
- Carelessness and lack of attention to detail
- Continually starting new tasks before finishing old ones
- Poor organisational skills
- Inability to focus or prioritise
- Continually losing or misplacing things
- Forgetfulness
- Restlessness and edginess
- Difficulty keeping quiet and speaking out of turn
- Blurting out responses and often interrupting others
- Mood swings, irritability and a quick temper
- Inability to deal with stress
- Extreme impatience
- Taking risks in activities, often with little or no regard for personal safety or the safety of others – for example, driving dangerously
What is ADHD?
ADHD is a behavioural condition defined by inattentiveness, hyperactivity and impulsiveness.
It affects around 2.6 million people in the UK – including 708 million children.
Symptoms typically appear at an early age and become more noticeable as a child grows
Most cases are diagnosed between six and 12 years old. Adults can also suffer, but there is less research into this.
ADHD’s exact cause is unclear but is thought to involve genetic mutations that affect a person’s brain function and structure.
Premature babies and those with epilepsy or brain damage are more at risk.
ADHD is also linked to anxiety, depression, insomnia, Tourette’s and epilepsy.
There is no cure.
A combination of medication and therapy is usually recommended to relieve symptoms and make day-to-day life easier.
Long waits for assessments
A report by the Nuffield Trust said 24 per cent of patients referred for ADHD in England had to wait one to two years for an assessment.
The think tank’s report also revealed a 51 per cent increase in prescriptions for ADHD medication.
In the Autumn of 2023, the NHS announced there was a national shortage of the drugs due to “excessive increases in demand”.
The charity ADHD UK told the Sun in October it had seen a surge in calls from families needing help.
Thea Stein, chief executive of the Nuffield Trust, said: “The extraordinary, unpredicted and unprecedented rise in demand” has “completely overtaken the NHS’s capacity”.
“It is frankly impossible to imagine how the system can grow fast enough to fulfil this demand,” she said.
“We shouldn’t underestimate what this means for children in particular: many schools expect an assessment and formal diagnosis to access support – and children and their families suffer whilst they wait.”
What should you do if you think you have ADHD?
First, visit your GP and tell them why you think you might have ADHD.
They will refer you to a specialist for an NHS assessment.
If your GP refuses to send you on for an assessment you can get a second opinion.
You can also speak to your child’s teacher or the school’s special education needs coordinator (SENCO).
However, waiting lists are lengthy on the NHS and, in many cases, getting worse.
Many opt for a private assessment, but many private clinics also have long waiting lists.
If you do choose to go private, make sure you choose a clinician is a recognised member of the General Medical Council. You can search the register here.
Following your assessment, your clinician will let you know what the next stage is.
One option is a diagnosis of ADHD, with a discussion on whether you want to consider medication options and a referral back to your GP for shared management.
For more information on the ADHA diagnosis process, head to ADHD UK’s website.
Sarah Carter is a health and wellness expert residing in the UK. With a background in healthcare, she offers evidence-based advice on fitness, nutrition, and mental well-being, promoting healthier living for readers.
