Assessment, Diagnosis & Treatment
Questions About Diagnosis
In order to get a diagnosis, you need to satisfy 5 questions:
- You have sufficient symptoms.
- You have had the symptoms since childhood.
- You have had the symptoms for at least 6 months as an adult.
- Your symptoms are causing a moderate impact on more than1 area of your life (i.e. work, relationships, education).
- There is no other obvious psychiatric disorder that could cause your symptoms.
There are some additional resources that you can explore to find out more:
- We have a self-test and information on gaining diagnosis for ADHD on our webpages. This gives info on diagnosis: https://www.adhdadult.uk/diagnosis.
- There are resources to help with diagnosis: https://www.adhdadult.uk/resources.
- A more detailed FAQs: https://www.adhdadult.uk/faq.
- We have a podcast which may also help answer some questions: https://theadhdadults.uk.
- Our online community is where you can speak to other people who may be struggling with the same things as you: https://discord.com/invite/458smEgfUS
- There is also an online magazine with evidence-based articles: https://focusmag.uk.
Right to Choose
You can find details on how to go about getting a diagnosis for ADHD on the diagnosis (https://www.adhdadult.uk/diagnosis) and FAQ (https://www.adhdadult.uk/faq) sections of our website. There is also information about Right to Choose (https://www.adhdadult.uk/right-to-choose).
The current waiting times for Psychiatry-UK are 6 months and you can find more information on getting referred to them here (https://psychiatry-uk.com/right-to-choose/?nowprocket=1). From their website you can access:
- Instructions for your GP.
- The ASRS form and,
- The letter recommended by Psychiatry UK.
Once your GP agrees to refer you,we recommend that you follow up with a medical secretary to ensure that the correct paperwork has been sent by your GP.
Should I Go Private?
Before you decide seek diagnosis privately, speak to your GP and ask whether they will agree to sign a shared care agreement to agree to take on prescribing any medication on the NHS. As GPs are not legally obliged to do so. We would hate to see you waste money paying privately and then have this refused, unless you are prepared to continue to pay privately for anty prescribed treatment.
It is important to check what is included in the private clinic fees and what additional charges may be applied for follow up consultations or titration. The NHS generally will not accept shared care if you are not fully titrated onto medication.
Beyond this, there are many private clinics that offer what is essentially a similar service; diagnosis, titration, and letter of discharge to your GP. We do not specifically recommend an clinics. Our advice would be to google ‘private ADHD clinic’, have a look at what clinics offer in terms of price, look at whether or not they are regulated by the CQC and try to find some reviews and/or customer feedback.
Worries about Private Clinics
We understand that people may be concerned however they are likely to be making sure that their processes are robust after being under scrutiny.
In our podcast episode #107 on the 18th May 2023, we expressed our view that there will be the odd psychiatrist here and there that is not doing a good job (both privately and in the NHS) but that should not tar everyone with the same brush. We do not know a lot about that particular company but we would always recommend reaching out to them for reassurance if you are worried about any aspect of their care.
Diagnosed as a Child
Unfortunately, even if you were diagnosed as a child, your GP will usually send you for diagnosis again as an adult if you are not currently being treated under the care of a psychiatrist for ADHD.
- There are resources to help with diagnosis here: https://www.adhdadult.uk/resources.
- We also have an FAQ page here: https://www.adhdadult.uk/faq.
- We have a podcast which may also help answer some questions here: https://theadhdadults.uk, and an online community where you can speak to other people who may be struggling with the same things as you here: https://discord.com/invite/458smEgfUS.
What Evidence is Needed from Childhood?
As undiagnosed adults we often do not have the physical evidence or parental input that is requested from childhood, and you will not be the only one who doesn’t have this. At my assessment they were happy to accept my recollections from childhood, so a good piece of advice is to have a look at the symptoms of ADHD and have specific examples prepared for both childhood and adulthood so that you can talk about them.
If you do have anyone close to you who you could ask to give any examples, that could be useful, but most assessors will understand that not all adults have access to this.
Making notes beforehand is useful. Our website has lots of resources to help you prepare for your assessment
- Here is our resource page: https://www.adhdadult.uk/resources.
- This link has information to help with diagnosis: https://www.adhdadult.uk/diagnosis.
If you scroll down to “A guide to diagnostic assessments” you will find advice on evidencing your symptoms.
GP Refusing Shared Care
I’m so sorry you’re going through this. Unfortunately there is no obligation for your GP to take on a shared care agreement but there are some things that you can try.
It is worth asking your private provider if they have any advice or if they can do anything to help as they will come across this all the time.
If you have more than one GP at your practice it is worth trying another and, if not, speak to the practice manager. Emphasise how much you are struggling.
If they still refuse them ask them for details of their complaint procedure and to provide their reasons for refusing the shared care agreement in writing.
If it comes to it, there is guidance on making a complaint here: https://www.nhs.uk/using-the-nhs/about-the-nhs/how-to-complain-to-the-nhs.
GPs vary drastically even within the same practice, so it is also worth trying another practice if you do not have any luck with this one.
Discharged to GP Without Titration
There are usually 3 options after you are diagnosed privately:
- Continue with private care.
- A shared care agreement between your psychiatrist and your GP so your titration is monitored by your psychiatrist, but medication is provided through your GP on the NHS.
- Discharged to your GP without a shared care agreement in place and without a plan for titration.
It sounds as though the third option has happened in your case. Of course, a private assessment by a GMC registered psychiatrist should be just as valid as an NHS ADHD assessment and many GPs are happy to recognise this, but unfortunately it is at the GP’s discretion as to whether they accept a private diagnosis.
Sometimes GPs will agree as a compromise to take on shared care with your psychiatrist so that you can access treatment while you wait for your referral on the NHS pathway but again, this is at their discretion.
The other options you have are to complain to your GP practice manager or move to another GP.
At present we do not have any particular courses to recommend (although this is something that we are looking at in the future). Non-directive coaching works best for ADHD along with learning as much as possible about the condition.
- We have resources that can help with the knowledge side on our website: https://www.adhdadult.uk.
- We have a podcast which may also help answer some questions: https://theadhdadults.uk.
- We also have an online magazine with evidence-based articles: https://focusmag.uk.
Wanting 1 to 1 Support?
We are a very new charity and at present there are just a few volunteers that deal with the charity admin, all the social media platforms, our online community platform, creating the podcast, making sure we have up to date information on the website and producing the evidence-based online magazine. We all work full time and do all of this in our spare time and at present we do not have the volunteers or resources needed to provide one-to-one support. It would be great to be able to do this in the future though, so I’ll add this to our possible future plans.
In the meantime getting to know more about ADHD can really help.
- We have lots of information on our website https://www.adhdadult.uk.
- We have a podcast which may also help https://theadhdadults.uk.
- A supportive online community https://discord.com/invite/458smEgfUS.
- We also have an online magazine with evidence-based articles here: https://focusmag.uk.
Do Supplements Work for ADHD?
Some people report that supplements help them but unfortunately there is no robust evidence to back this up.
Remember that all medications, whether they are natural or pharmaceutical are chemicals, and all have side effects whether natural or not. The difference between them is that pharmaceutical drugs have been tested extensively so all side effects and benefits are well-known and listed.
I’m not saying that natural treatments are better or worse but there simply isn’t enough evidence to prove how effective they are and what the side effects are. Because James and Alex are devoted to providing evidence-based information they can only really advise on treatments that are evidence based and extensively tested.
If you think it might help you and it’s not expensive, it may be worth trying, because they do anecdotally work for some people, but we recommend that you monitor the benefits and side effects closely, just as a prescriber would if they prescribed ADHD medication for you.
Appeals, Complaints & Advocacy
Complaints to the NHS
Speak to your GP again to appeal to them and if they still refuse then ask how to make a complaint.
There are details on how to make a complaint here: https://www.nhs.uk/using-the-nhs/about-the-nhs/how.
Universities have an academic appeals procedure that allows students to appeal exceptional circumstances prior to receiving their results. The academic appeals procedure is usually available on the university’s website. If the result of an academic appeal is not in your favour you can also ask the Office of the Independent Adjudicator to review your case.
ADHD in the Workplace
We have guides (https://www.adhdadult.uk/adhd-in-the-workplace) on our website for employees and employers with guidance on reasonable adjustments that can be made to help employees with ADHD. You can give the guide for employers to your manager so that they can learn a little about ADHD and the sorts of adjustments that might be useful for you.
You are also able to get help through Access to Work https://www.gov.uk/access-to-work.
Disclosing ADHD at Work
You do not have to disclose that you have ADHD if you do not feel comfortable doing so, but if you do, you cannot be discriminated against because of your diagnosis and it would be illegal for them to do so. This is because ADHD is protected under the 2010 Equalities Act if it has a ‘substantial’ and ‘long-term’ negative effect on your ability to carry out normal day-to-day activities.
It is entirely up to you whether you choose to disclose it or not but if you do we have some info on our website that might help https://www.adhdadult.uk/adhd-in-the-workplace.
Looking for Advocacy?
I’m so sorry that you and your family are going through all this. Unfortunately we are a very new and small charity (there are just a few volunteers doing this in our spare time outside of our full time jobs) that do not have the resources to provide advocacy at this time, although this is something that we would like to offer in the future when we are able. This page gives a list of charities that can help and there are more links here:
Financial & Wellbeing Support
Debts and Housing Issues with ADHD
The Citizen’s Advice service will be able to help and advise you with the debt and housing issues. Contact them via telephone, online or by going into your local Citizen’s Advice centre. Details here: https://www.citizensadvice.org.uk/about-us/contact-us/contact-us/contact-us.
The Disability Law Service also provide free help. Contact them by phone or email. https://dls.org.uk/free-advice/by-phone-or-in-writing.
Getting to know more about ADHD can also really help and we have lots of information on our website: https://www.adhdadult.uk.
We have a podcast which may also help answer some questions https://theadhdadults.uk and an online community where you can speak to other people who may be struggling with the same things as you https://discord.com/invite/458smEgfUS.
Personal Independance Payment (PiP)
This website also gives advice on how to answer the questions:
The citizen’s advice service also offer help with filling out PIP forms on their website: https://www.citizensadvice.org.uk/benefits/sick-or-disabled-people-and-carers/pip/help-with-your-claim/fill-in-form-pip.
You can also speak to an adviser online, by phone or by going in to your local centre. More details can be found here https://www.citizensadvice.org.uk/about-us/contact-us/contact-us/contact-us.
I am Struggling. What can I do?
We would urge you to go back to your GP and tell them how you are feeling. There is help out there.
If you are working you can get coaching through access to work. You can find out more about this at https://www.gov.uk/access-to-work.
It may be worth finding out if there is a local ADHD support group in your area. A quick google search should find a group near you.
We also have an online community which may help: https://discord.com/invite/458smEgfUS.
We’re sorry that we can’t fix everything for you, but hope some of that helps and you don’t feel this way for much longer.
Talking about ADHD & Other Resources
How do I Explain ADHD to Others?
The key is understanding exactly what it is yourself so that you can explain it to others. We have recorded a podcast episode (https://theadhdadults.uk) on this which may help. James is doing some talks on ADHD for SeedTalks (https://www.adhdadult.uk/public-talks) and we frequently have people come up to say that they had brought their partners/friends/family along to help them understand more about them.
We also have a document to help explain ADHD to others on the ADHD guides (https://www.adhdadult.uk/adhd-guides) section on our website. Hopefully that will help! We have also had reports that listening to the podcast has helped partners and families better understand ADHD which has led to better relationships.
Links to Resources
- We have lots of information on our website: https://www.adhdadult.uk.
- We have a podcast which may also help: https://theadhdadults.uk.
- A supportive online community: https://discord.com/invite/458smEgfUS.
- An online magazine with evidence-based articles: https://focusmag.uk.
Thanks so much for your offer to help. We did put a call out for volunteers a while ago and have had hundreds of applications, but we haven’t had a chance to go through all of them and contact people yet. Because we are a charity we have to go through a process of vetting, interviewing and DBS checks, etc before we can let anyone help which is why it’s taking us so long because we can’t just say come and help. It’s a bit of a nightmare when we’ve all got ADHD!
It’s because we’re so busy answering messages and emails and doing social media and the podcast and the website and online magazine and all the talks etc that we haven’t got time to go through all the volunteers we desperately need to help with all the stuff that’s keeping us busy. Here is the volunteer form:
Let us know what your special skills are and how you can help and we’ll get back to you as soon as we possibly can.