Below are the answers to some frequently asked questions
1. What is ADHD?
Attention deficit hyperactivity disorder (ADHD) is a lifelong neurodevelopmental disorder in which the brain develops differently from typical brains. It is thought to affect between 2-4% of the population. It is associated with symptoms (below) and an increased risk of co-existing psychiatric conditions such as anxiety, mood disorders and eating disorders.
2. What are the symptoms of ADHD?
Symptoms of ‘Inattention’:
- Makes careless mistakes/lacks attention to detail
- Difficulty sustaining attention
- Does not seem to listen when spoken to directly
- Fails to follow through on tasks and instructions
- Exhibits poor organization
- Avoids/dislikes tasks requiring sustained mental effort
- Loses things necessary for tasks/activities
- Easily distracted (including unrelated thoughts)
- Is forgetful in daily activities
Symptoms of ‘Hyperactivity/Impulsivity’:
- Fidgets with or taps hands or feet, squirms in seat
- Leaves seat in situations when remaining seated is expected
- Experiences feelings of restlessness
- Has difficulty engaging in quiet, leisurely activities
- Is “on-the-go” or acts as if “driven by a motor”
- Talks excessively
- Blurts out answers
- Has difficulty waiting their turn
- Interrupts or intrudes on others
3. What is needed for a diagnosis of ADHD in an adult?
To get a diagnosis, the following need to be met:
- Positive for 5/9 symptoms of inattentiveness and/or hyperactivity/impulsivity
- Several symptoms (inattentive or hyperactive/impulsive) were present before the age of 12 years.
- Several symptoms (inattentive or hyperactive/impulsive) must be present in ≥2 settings (eg, at home, school, or work; with friends or relatives; in other activities).
- There is clear evidence that the symptoms interfere with or reduce the quality of social, academic, or occupational functioning.
- Symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder, and are not better explained by another mental disorder (eg, mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication, or withdrawal).
4. How can I test my symptoms before going further?
There is a test called the Adult ADHD Self-Report Scale (ASRSv1.1) which is over 90% sensitive/specific in detecting someone who may have ADHD. A link to the ASRS self-report symptom test can be found here.
5. How do I go about getting a diagnosis?
To get a fully NHS accepted diagnosis, a specialist psychiatrist has to make a decision based on an assessment. You can ask your GP to be referred for this assessment, based on reporting the symptoms as a child and adult, how your ADHD affects you now, and your ASRS scores from above.
6. What if I have other psychiatric issues?
Many psychiatrists will, at the point of diagnosing ADHD, focus on treating the most important issue first, therefore if you have a dual diagnosis of ADHD and a mood disorder, they will focus on treating the mood disorder first as this is more important. Equally, if you have a significant anxiety disorder and ADHD, this anxiety disorder may be focused on first.
7. What can I do if my GP says there are no services in my area or if the waiting list is many years?
If you are registered with a GP surgery in England, you have the legal right to choose the organisation (qualified provider) to whom you are referred, as long as that organisation is providing that service in another part of England. There are several approved suppliers, such as Psychiatry-UK, ADHD360, Clinical Partners and others, whose waiting times may be significantly lower than most NHS community teams. Information on ‘Right to Choose’ can be found here.
8. Going private for an ADHD diagnosis.
Many private clinics offer ADHD assessments and drug titration (if needed), and this route can be significantly quicker than NHS assessments. It is important that before you undergo this process, and the expense associated with it, you check with your GP first that they would be happy to sign a ‘shared care agreement’ to take over your care under the NHS. Some GPs will refuse to sign this, and there is no obligation for them to do so, and this would then leave you with a diagnosis but costly monthly bills for medication. We hear every week of people who get a private ADHD diagnosis without drug titration, whose GP refuses to sign the shared care agreement and essentially refers them to the back of the queue to get an NHS assessment.
9. Do I have to tell the DVLA that I have ADHD?
Although many people are told that they have to, you only have to inform the DVLA about your ADHD if your ADHD or your ADHD medication affects your ability to drive safely. Guidance from the DVLA can be found here.
10. ADHD in the workplace
If you have a diagnosis of ADHD then you are protected by the 2010 equalities act, as ADHD is a protected disability if it impairs your ability to work. What this means in practical terms is that you are entitled to an occupational health assessment which should take into account how ADHD affect your ability to work and which should produce a set of suggestions for reasonable adjustments that your employer must consider making to give you a fair chance to be successful at work. The term ‘reasonable adjustment’ is open to interpretation, and this means that employers or not obliged to accept all the recommendations of an occupational health report, but they should justify why they decide not to enforce a reasonable adjustment this is their decision.
Reasonable adjustments can normally include the following
- Noise-cancelling headphones.
- Flexible working hours.
- Software to support your organisation, such as Microsoft To Do, EndNote, Grammarly, Asana or Todoist.
- If working in an office or other building (as opposed to working from home), having a space where you can go if you feel overwhelmed provision of technology such as a Dictaphone or dictation software to allow you to communicate more effectively.
- Access to ‘disability leave’, a special type of leave which does not impact your sick leave or annual leave, allowing you to attend appointments that are specific to your disability.
To access these reasonable adjustments, you must report your ADHD diagnosis to your HR department. ACAS has some details of reasonable adjustments on their webpage here.
11. Access To Work (A2W)
Related to reasonable adjustments is the Department for Work and Pensions scheme known as ‘Access to Work’. Access to work is particularly helpful because it is a scheme which pays for between 80 and 100% of the cost of any reasonable adjustments. If you are self-employed or work for a small or medium size 100% of the cost will be met if you work for a larger organisation and 80% of the cost will be met. Employers are more willing to engage in providing reasonable adjustments met by the department for work and pensions. You can find details of the scheme here at the Department for Work and Pensions Access to Work page.
As with occupational health based reasonable adjustments, a diagnosis of ADHD is needed in order to use the Access to Work Scheme.
12. Will my ADHD affect my car or life insurance?
There is currently no Uk law demanding that you inform your car insurance provider about your ADHD or medication; however, you may want to speak to your Insurance Company, l as any medical condition is deemed notifiable and may protect you if involved in a claim.
Life insurance companies may refuse to insure your life if you have ADHD. It is often easier to find life insurance through a broker as they will be able to get multiple quotes for you.