Adult attention-deficit hyperactivity disorder (ADHD) has been in the spotlight lately, with comedian Em Rusciano detailing, at the National Press Club, her journey to diagnosis and how she now reflects on her younger self.
There has been a growing awareness of ADHD, a lifelong, neurodevelopmental condition that affects attention, activity levels and impulsivity. Perhaps you’ve read or watched something online about adult ADHD, or maybe another family member or friend has recently received a diagnosis.
If you think you have ADHD, getting a diagnosis can be a long, frustrating and often expensive process. So it’s important to decide what it might mean for you.
At 42, comedian Em Rusciano was diagnosed with ADHD. She says it triggered “enormous grief” for her younger self that ‘just wanted to be like everyone else’, but left her with a new understanding of who she is.
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What is ADHD? And how can it affect your life?
People with ADHD have difficulties with flexibly focusing their attention. This means it may be hard to focus and sustain their attention on tasks that are a priority.
Instead, they may spend time getting lost scrolling on their phone or doing unimportant tasks. They may procrastinate: not starting activities or getting distracted so they don’t finish tasks. They may be forgetful, disorganised and run late.
Those with impulsive symptoms may overshare, be impatient and say yes to things without thinking it through, often with negative consequences in the long-term.
Those with hyperactive symptoms will have a constantly busy mind, find it hard to sit still and relax, and may be a chatterbox. They may be constantly “on the go” seeking new and exciting stimulation, getting easily bored with hobbies, jobs and relationships.
Some people will have only inattentive symptoms, others only hyperactive-impulsive symptoms, and some will have both.
Inattentive, hyperactive and impulsive symptoms can impact achievement in studies and at work, negatively affect relationships, and result in feeling different to others and developing a negative sense of self.
The symptoms are neurobiological, resulting in differences in brain development. For most people symptoms persist throughout their lives.
Importantly, ADHD is not caused by “bad behaviour” or “laziness” and it is not a “character flaw”. ADHD symptoms can’t be changed through “putting in more effort” or “applying yourself”.
Sound familiar? So how do you get a diagnosis?
In Australia, this is not as easy as it should be. There are no adult public mental health services that can diagnose ADHD without cost.
Accessing private clinics and clinicians is the usual way adults can be assessed for ADHD in Australia.
If you are interested in accessing stimulant medication, the most effective treatment for ADHD, then seeing a psychiatrist who specialises in ADHD is usually the most efficient path.
A psychologist with expertise in ADHD can also conduct a diagnostic assessment for ADHD, they just can’t exclude possible medical causes or prescribe medication should the diagnosis be confirmed.
An adult ADHD assessment usually involves an ADHD-experienced psychiatrist or psychologist conducting a clinical interview with the person and often with a partner and parent(s).
This will include asking about your early development including developmental milestones, academic and social development, signs and symptoms of ADHD, and your mental health history. You will usually be asked to provide your school reports, so the clinician can look for any evidence of symptoms in childhood as reported by teachers.
As ADHD is a neurodevelopmental condition, evidence of the symptoms in childhood before age 12 is needed. You and your family, and sometimes a partner or close friend, will be asked to complete rating scales for ADHD symptoms, in both childhood and current symptoms as an adult.
There should be a thorough examination of other possible diagnoses that may account for apparent ADHD symptoms; and other common co-occurring conditions should also be explored and diagnosed if present.
Australia’s National Health and Medical Research Council has just approved an evidence-based clinical practice guideline for the diagnosis and treatment of ADHD in Australia, ahead of its release in October.
The guideline explains the diagnostic process and the most helpful treatments so clinicians can provide consistent and evidence-based assessments and treatment for people with ADHD. It’s hoped this will lead to easier access to diagnosis and support.
What might a diagnosis mean for you?
Finally receiving an ADHD diagnosis for many is a positive, life-changing experience. It can make sense of a lifetime of unexplained difficulties, often attributed incorrectly to being “lazy” or “incompetent”.
An awareness can result in a fuller understanding yourself and why your life may have taken a certain path. It can explain why certain things happened to you, why you experienced anxiety and depression but it didn’t go away with treatment, and why your trajectory has perhaps not been the norm.
It is not an easy process. Some experience a period of grief following a diagnosis when they reflect on how their life may have been different had they known and received support and understanding from an early age.
However, diagnosis can allow you to access medication which, for most people, is effective in reducing the core symptoms of ADHD and can result in clarity and focus.
You can also access psychological therapy, ADHD coaching and occupational therapy support to make changes in your life to minimise your symptoms and maximise your strengths.
An adult ADHD diagnosis can help you reject damaging self-beliefs. You may finally understand yourself as different, not defective, and see your strengths and value.
Psychologist and Research Associate in the Department of Paediatrics, Monash University