At BUSY Health, our AHPRA registered psychologists understand the factors that can affect attention and concentration for people living with Attention Deficit Hyperactivity Disorder (ADHD). We can help you adopt skills to reduce the impact ADHD has on your life.
With October being International ADHD Awareness Month we shine a light on a disorder that is often shrouded in opinion, including claims of overdiagnosis and ‘epidemics’.
What is ADHD?
The Diagnostic and Statistical Manual 5th Edition Text Revision (DSM-5-TR) defines Attention Deficit Hyperactivity Disorder (ADHD) as a neurodevelopmental disorder beginning in childhood that presents in a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.
There are 3 main subtypes of ADHD:
- Predominantly inattentive presentation
- Predominantly hyperactive/impulsive presentation
- Combined presentation
Behaviourally, inattention can be seen in wandering off task, failing to follow through on instructions or finishing work or chores, having difficulty sustaining focus or being disorganised where the behaviour is not attributable to defiance or lack of comprehension.
Hyperactivity refers to excessive motor activity (such as a child running about) when it is not appropriate, or excessive fidgeting, tapping, or talkativeness. In adults, hyperactivity may manifest as extreme restlessness or wearing others out with their activity.
Impulsivity refers to hasty actions that occur in the moment without forethought, which may have potential for harm to the individual (e.g., darting into the street without looking). Impulsivity may reflect a desire for immediate rewards or an inability to delay gratification. Impulsive behaviours can manifest in social intrusiveness (for example, interrupting others excessively) and/or as making important decisions without adequate foresight and consideration of consequences (e.g., taking on a pet without thinking of commitments inherent in doing so).
The DSM-5-TR sets out criteria related to diagnosis from the above set of symptoms, which requires comprehensive assessment, history taking and elimination of alternative causes which may better explain the symptoms and their onset.
Diagnosing ADHD
Whilst often being diagnosed in childhood, it is not uncommon for adults to recognise common behavioural symptoms in ADHD like procrastination, poor attention, disorganisation, distraction, or preoccupation with unimportant tasks like scrolling on their phone, prompting them to seek diagnosis and treatment.
While the negative impacts of the disorder can often be the focus when seeking assessment and diagnosis, it should also be said that ADHD can be associated with behaviours that are highly advantageous to individuals when well-leveraged. Some individuals experience intense hyper-focusing once engaged in a task. ADHD individuals are often described as inventive, imaginative, creative thinkers and problems solvers. They may also be noted for their energy, divergent thinking and ability to approach challenges in non-traditional ways.
Nevertheless, even potential upsides like hyper-focussing on particular tasks or creative problem solving can lead to challenges when inattentive, hyperactive or impulsive traits lead an individual to apply themselves in pursuits others would classify as ‘non-productive’ or ‘off-target’. This is where formal diagnosis and treatment can be helpful. So how does one go about diagnosis of ADHD as an adult?
The Pathway to Adult ADHD Diagnosis
In Australia, ADHD diagnosis isn’t always an easy nor cheap pathway. There are no adult public mental health services that can diagnose ADHD without cost.
If you’re open to the most effective treatment for ADHD, stimulant medication, typically your starting point would be a referral from your GP to see a psychiatrist who specialises in ADHD.
A psychiatrist will typically take a medical history via a clinical interview exploring your early development, age-related developmental milestones, social development, academic performance, your current and historically present signs and symptoms of ADHD as well as your mental health history. This may often involve seeking objective evidence like school reports and reports from those who knew you as a child to verify the presence of the disorder during childhood. The psychiatrist will also look to exclude other possible medical causes of such symptoms.
Formal diagnosis and treatment can be costly. Seeing a psychiatrist (psychiatrists are medically trained professionals with additional training in psychiatric medicine) for a diagnosis of ADHD can often cost between $1500 – $2000 (or more) before medication is prescribed.
BUSY Health psychologists can assist in diagnosis of ADHD by:
- identifying with you any clinically significant presenting symptoms consistent with ADHD diagnosis;
- providing ADHD screener assessments that can help identify the presence of ADHD consistent symptoms (these screeners may in some cases also be accepted by the psychiatrist as objective evidence of symptoms);
- comparing your symptomology with DSM-5-TR diagnostic criteria to give a realistic appraisal of the advantages or challenges in pursuing formal diagnosis;
- discussing and demystifying treatment options including medication (both stimulant and non-stimulant medication options) and non-medication pathways for treatment such as cognitive and behavioural strategies;
- identifying and implementing effective behavioural, cognitive and attentional management strategies that reduce the impact of symptoms consistent with ADHD;
- preparing you for navigating the diagnosis pathway and the potential personal impact of either diagnosis or non-diagnosis;
- supporting individuals with difficulties in social, academic, vocational or other settings impacted by ADHD; and
- helping partners, parents or loved ones understand helpful strategies, allowances and options for supporting someone with ADHD.
For a personal recollection of the ADHD diagnosis journey, check out journalist Gary Nunn’s enlightening story, or comedian and presenter Em Rusciano’s ADHD story on the AADPA website The AADPA website contains useful resources and research for Australians with ADHD.
We’re here to help!
If you would like further information regarding ADHD, contact BUSY Health. Our AHPRA accredited psychologists can assist you to navigate the pathway to diagnosis.
Find out more about ADHD Awareness Month
Article contributed by BUSY Health psychologist, Jamie Anderson.