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Do I have ADHD? Your guide to an adult diagnosis.

The effects of Attention Deficit Hyperactivity Disorder (ADHD) and ADD (without the hyperactivity) can have a significant and far-reaching impact on an individual's life. It’s estimated that between 3 and 4% of the adult population have this neurodevelopmental condition, and the majority of these cases are undiagnosed.

Despite this, research has focused primarily on the treatment of the condition in children, rather than adults. This stems, in part, from the outdated assumption that children outgrow ADHD in adolescence. We now know that ADHD doesn't go away; it simply manifests in different ways in adults.

The U.K. has seen a significant rise in diagnoses of ADHD in recent years, fuelled by greater social awareness of the condition and a number of high-profile sufferers speaking out about their experience.

As diagnostic research grows, what was once dismissed as a label for disruptive and underachieving boys is now regarded by some as super-power within the neurodivergent community.

What are the symptoms of ADHD/ADD in adults?

The majority of people who are diagnosed with ADHD can trace their symptoms back to their childhoods, but for some - especially those with high IQs - symptoms may emerge later in life, once the structure of home and school are left behind.

ADHD is a neurobiological disorder that disrupts the brain's self-management system. This affects our ability to focus, organise and plan, as well as our emotional regulation. There are three subtypes of ADHD: inattentive, hyperactive and impulsive, or a combination of the two.

Common symptoms of attention-deficit include:

  1. An inability to concentrate for sustained periods

  2. Carelessness; lack of attention to detail

  3. Continually starting new tasks before old ones have been finished

  4. Difficulties with time-management and organisation

  5. An inability to focus and listen during conversations or meetings

  6. Habitually losing or misplacing things

  7. Restlessness, difficulty relaxing, agitation

  8. Prone to impulsivity or recklessness

Common symptoms of hyperactivity include:

  1. Restlessness - both internal and external

  2. Low boredom threshold

  3. Difficulty keeping quiet

  4. Prone to sudden outbursts in both professional and social situations

  5. Constantly craving excitement

  6. Difficulties sustaining relationships

  7. Interrupting other people

  8. Extreme impatience

Why are adults with ADHD often misdiagnosed?

While much is known about children with ADHD, the medical community's understanding of adults with the condition is still comparatively limited - the earliest diagnostic framework for adults was only published as recently as 2013. Testing has evolved since then, but the difficulty in getting a diagnosis can be attributed to a number of factors.

Under current NHS guidelines, a diagnosis in adults cannot be confirmed unless symptoms have been present since childhood. This means that clinicians have had to rely on the testimony of patients' parents, peers, or even old school reports for evidence of attention-deficit and hyperactivity.

The first meaningful studies into the condition began in the 1980s, meaning there are many adults who were simply born before ADHD was on the radar of educational and medical establishments, and so a retrospective interview for childhood is the only way to confirm a diagnosis.

There is also a growing recognition that women and girls with ADHD have been disproportionately mis- or undiagnosed. Research suggests girls are more likely to fall into the inattentive subcategory, meaning they present with fewer obvious symptoms of hyperactivity. We’ll delve deeper into this issue later on.

Another crucial factor which can mean a diagnosis is missed is the prevalence of what's known as comorbid conditions. Put simply, this means the other mental health conditions that sufferers of ADHD often have. Studies have shown that between 66% - 75% of people with ADHD also experience other mood disorders, including anxiety, depression and bipolar, but these may be caused or exacerbated by the difficulties of living with ADHD. They may be treated for one condition, but the ADHD is often missed.

Untreated ADHD can also result in substance abuse disorders and addiction, as sufferers seek to self-medicate using drugs and alcohol which can make symptoms of ADHD worse. Many people with undiagnosed ADHD will have been prescribed medication for other conditions which present with similar symptoms.

Is ADHD less common in women than men?

More boys than girls receive a diagnosis of ADHD in childhood in the U.K. - four times as many, in fact. This gender disparity led to the misconception that ADHD only affects boys, when, in fact, research now suggests that girls are no less susceptible - they are just consistently under-diagnosed.

There are a couple of key reasons for this. ADHD manifests itself in one of three ways: inattentiveness, hyperactivity, or a combination of the two. Studies have shown that girls are more likely to present with the first of these, and the symptoms of this are often perceived as character traits, rather than a sign that they have a condition.

Girls with inattentive ADHD are often described as 'daydreamers', 'spacey' or 'forgetful', whereas boys who display more disruptive behaviour are identified more quickly by parents and teachers. Women whose symptoms were not recognised in childhood often describe their hyperactivity as being internalised - a racing mind that feels unmanageable - which may lead to anxiety and depression in later life.

The role of gender stereotypes also shouldn't be underestimated. Women are often still expected to be good at organising day-to-day schedules for themselves and their families - remembering birthdays; organising shopping and playdates; juggling a career with running a home. All things that someone with ADHD will find it difficult to manage - it's known as 'executive dysfunction'.

The feeling that they're struggling to meet society's expectations of them means many women with ADHD suffer with feelings of inadequacy, low self-esteem and chronic stress. These problems can be exacerbated when they turn to alcohol or other substances in an attempt to manage their emotions, often in response to lives that feel out-of-control or chaotic.

Another factor that affects adult women is their fluctuating hormones. ADHD is characterised by low levels of dopamine, the "feel-good" chemical that is linked to our ability to sustain attention and also to our inhibitions. Women with ADHD will find that their cycle often makes their symptoms much more difficult to manage, and there's evidence to suggest a surge in women seeking a diagnosis during the menopause in recent years.

ADHD: the entrepreneurs' superpower?

Despite the challenges of living with ADHD, many highly successful individuals credit the condition as being instrumental to their professional achievements.

Business mogul Sir Richard Branson, JetBlue founder David Neeleman and Ikea founder Ingvar Kamprad all cite their ADHD brains as being a help to their careers, rather than a hindrance. The ability to 'hyperfocus' on one particular task - often to the exclusion of all others - means people with ADHD can remain laser-focused on one idea, spending hours of time on something they are incredibly passionate about.

Creativity is another 'superpower'. A low boredom threshold means people with ADHD will often search quickly for new ideas and solutions while their peers trudge along towards a dead-end. They're often fast thinkers and fast talkers, and - providing there's someone else to write down their ideas and do the bookkeeping - they often make exceptional business leaders.

CEOs and Directors with ADHD are often able to think outside the box; they're naturally restless and are often very visual in their interpretations of the world. While they may have struggled at school or work in environments which were not built for neurodiverse brains, those with ADHD can flourish in situations where others would feel overwhelmed.

I think I may have ADHD... can Montrose help?

At Montrose, our expert team of qualified specialists can help you at every stage of your journey with ADHD. From expert diagnostic support to world-class psychiatric and therapeutic care, we can help you to navigate the challenges you face living with ADHD and equip you with the tools to make your professional and personal life more manageable.

Our clinicians understand that each guest's circumstances are unique, and are able to create a bespoke programme that centres on their individual needs.

If you are concerned that you or someone you love is struggling with the issues we've mentioned above, get in touch to see how we can help. We're just an email or a phone call away.

Photography by Cottonbro, Wallace Chuck and daniyuk at Pexels

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