I know that diagnosis is something that is really personal to each of us. I know people who know they have ADHD and don’t feel they want a formal diagnosis. I know people who question whether they have ADHD and hope they can find the answers they’re looking for with a formal diagnosis.
There’s no right or wrong decision, whatever feels right for you, is right.
I think it’s also important to recognise that there can be privilege involved in obtaining a diagnosis. It can be dependent on postcodes, availability of services, there can be barriers around gender, ethnicity, age and social backgrounds. I am aware that I have been very lucky to finally receive my diagnosis and appreciate this isn’t always the case for everyone.
For me, I was first diagnosed with depression at 13 years old and put on anti-depressants. What followed was nearly three decades of anxiety and depression that could never be ‘fixed’ by standard treatments. It leaves you feeling like there’s something so fundamentally wrong with you, that you’re just not trying hard enough and it’s frustrating and exhausting and eats away at your self esteem until you feel like there’s nothing left of you anymore. So, when I stumbled upon an article about ADHD by accident, it was unbelievable to be reading about something that sounded so much like me and I wanted to explore a diagnosis as, by this point, I was nearly 40 years old and desperate for an answer.
I hope that the below is helpful if you are considering diagnosis for yourself or a family member. I am based in England, UK so the details I share here are specific to the process currently available in England.
Routes to diagnosis
In the UK, there are three potential routes to diagnosis:
NHS referral This is a referral from your GP to an ADHD specialist service within the NHS. This service is free but waiting times can often be very long, usually at least two years, often longer.
Right to Choose This is a GP referral to an NHS funded private provider. Waiting times are usually quicker (around 3 - 6 months) but this option isn’t available in all areas of the UK.
Private diagnosis This is a self referral to a private provider. Waiting times are very quick (usually within weeks) but it can be expensive with costs anywhere between £1,000 - 3,000.
ADHD UK have an amazing resource which looks at each option in more detail here.
If you’re right at the start of your journey, a screening tool can be useful to look at your symptoms and start your exploration.
Here’s an ADHD one and an autism one.
I think it’s also important to say that the screening tools used for diagnosis don’t really take into account any nuance or intersectionality and definitely don’t account for the fact that we all present so differently so they are a good starting point but obviously not a one size fits all answer.
If you are looking for a formal diagnosis, your doctor should be your first port of call.
It might be useful to take some notes about your traits and experience so you can talk these through in more detail. Your doctor may then look to refer you to a specialist.
Things that might be helpful ahead of your referral/assessment
These are some things that can help for you to share with your doctor at your initial referral request or with your psychiatrist when you get to the assessment stage:
Start a list of the ways in which your traits present for you in different scenarios such as at home, at work and in social situations so that you have these ready to share
For ADHD, this will look like ways that you are hyperactive, impulsive or inattentive (aligning with the diagnostic criteria)
Hyperactive traits might look like needing lots of exercise, speaking very quickly, having a very active mind with thoughts that you can't 'switch off', stimming.
Impulsive traits might look like spending money without thinking, risk taking, interrupting, leaving your job impulsively or job hopping, addictive behaviours around alcohol, drugs or gambling.
Inattentive traits might look like being forgetful, finding it difficult to start or finish tasks, zoning out, making mistakes.
Other traits may include being very sensitive to rejection, being overwhelmed in social situations, struggling to make or keep friendships, sensory sensitivities like touch, smell or sound and physical issues including migraines, digestive issues, nausea.
You might also notice issues with your sleep.
You might also present with other co-existing conditions such as anxiety, depression, dysregulated eating.
The referral process
This may look different depending on the route that you choose but generally, assessment will look something like this:
Your doctor makes the referral either to a local NHS provider or via Right to Choose depending on your request or the provision available in your area.
Your provider will then get in touch and you may be asked to complete a number of questionnaires about your experiences.
You might also be asked to get someone who has known you since childhood to also complete a set of questionnaires to share what they know about you.
You will likely then be invited to attend an in person or online assessment to talk through your experiences in more detail.
The assessment may take place over one session or multiple sessions depending on the provider and how much detail you need to discuss.
You may be told at the end of the assessment if a diagnosis is appropriate or they may write to you with a report shortly afterwards.
Most providers are only able to assess for one option at a time so if you think you are also autistic or have another co-occuring condition, you may need to start the process again for a separate referral.
While you are waiting for your assessment
Find community that can support you, such as ADHD groups as it may help to be able to share and hear from others who have similar experiences
Listen to podcasts or read books to start to understand more about what ADHD is and how it might impact you, here are some that I have loved:
Books
ADHD Explained by Dr. Edward Hallowell
This book helped me to understand so much about how my brain worked and to start thinking about strategies that could help me. It's written in bite size chapters with lots of visual information so is really ADHD friendly.
A Radical Guide for Women with ADHD by Sari Solden and Michelle Frank
I love this book. It's part workbook, part ADHD guide and helps you to start thinking in a more compassionate and accepting way about yourself. Genuinely, one of my favourites.
Podcasts
The ADHD Women's Wellbeing Podcast hosted by Kate Moryoussef This is tailored specifically for women and considers the role of hormones, perimenopause, menopause etc. and the impact that this can have on ADHD. Kate also has guests who talk about a range of other co-existing conditions so it's fairly broad in terms of neurodiversity.
The ADHD Adults Podcast hosted by James Brown, Alex Connor and Sam Brown
This podcast considers a lot of the science around ADHD but is also very funny, hosted by two friends and one of their wives, who all have ADHD.
You may also want to think about ADHD coaching which can help you to understand your ADHD at a deeper level whilst helping you to identify your strengths and how to work with your brain. If you're thinking about coaching, you can find more information that here.
I hope this is helpful if you are looking into a diagnosis. I'm always happy to share any information that I can about my experience so please feel free to drop me a message if you need any support.