Adult ADHD: An expert's guide

Adult ADHD is a neurodevelopmental condition that is becoming more and more prevalent. In his latest article, leading London-based psychiatrist Dr Stefan Ivantu explains this condition in detail, including its diagnosis, treatment and your future prospects if you are diganosed with ADHD. 

What is adult ADHD?

Adult ADHD, also known as attention deficit hyperactive disorder, is one of the most common neurodevelopmental mental health conditions. In simple terms, it is related to the development of the nervous system. It is a condition which is becoming more and more recognized, in particular in the United Kingdom. Depending on different studies, it is estimated that around 4.4 per cent of adults suffer from this condition.

Traditionally, the condition was more prevalent in males. However, the prevalence is very likely to change over the next decade.

What are the main symptoms of ADHD?

Some of the most common symptoms are fidgeting, talking excessively, being disorganized, interrupting, being distracted, being forgetful or unable to pay attention to details. Of course, everyone in the general population will exhibit these symptoms at some point in their life. However, people suffering from ADHD are different because they likely display these symptoms over a longer period.

People suffering from ADHD usually come to my attention with multiple diagnoses, such as depression, anxiety or substance abuse. My recommendation is that you make sure that you have a proper diagnosis, which should include:

• A preassessment.
• A minimal assessment of an hour and a half to two hours.
•  A comprehensive report that can be shared with your GP for you to be able to access medication in a sustainable way.

How is ADHD treated?

The treatment for ADHD is holistic in nature. We don’t just consider medication, but also behavioural therapy. Perhaps one of the most important aspects is the coaching, but also educational interventions if needed.

How common is it for children with ADHD to continue suffering from it in adulthood?

The prevalence of ADHD in children aged between 11 and 17 in the United States is now around 11%. As they transition into adult life, 40 to 60 per cent will continue to have this condition.

What is ASD?

ASD (autism spectrum disorder) is a neurodevelopmental condition caused by differences in the brain. People with ASD have problems with social communication and interaction and restrictive or repetitive behaviours or interests. People with ASD may also have different ways of learning, different ways of paying attention or different ways of expressing emotions and feelings.

Although there is no specific treatment for this condition, the diagnosis needs to be established as early as possible for the patient and the loved ones, so as not to miss important developmental opportunities in their life.

How are both of these conditions diagnosed?

The diagnosis pathway is quite similar. In my clinic, the journey to getting care for ADHD begins before attending the clinic. You will need to complete some questionnaires about the symptoms that you had during childhood and during your adult life.

These questionnaires are usually completed by yourself, but also your loved ones when they are available. We know it is sometimes difficult to receive feedback from your family members during the assessment.

We look in great detail into your personal life and journey through life, from when you were born, going through primary school, secondary school, and university.

We may also look into your career path and jobs or personal relationships. It is not necessarily a black-and-white decision. It is more about understanding what areas you struggle with the most and how we can target and address these problems.

But it's not just making your symptoms better. In some circumstances, we may be able to transform these weaknesses into strengths in terms of creativity, productivity, or choosing a career path.

How effective is medication?

If you decide to start medication, we start something called a titration process. Now, this takes a different amount of time from one case to another because people respond differently to medication. Usually, you're looking at a minimum of three follow-up appointments to find the right medication.

However, sometimes it may take longer than that, but once you are established on a certain medication, we are more than happy to support your case and to complete a shared care protocol with your GP.

The shared care protocol means you will have access to affordable prescriptions from your GP. In some situations, you may require additional documentation and support for your university, your employer or different bodies. I’m more than happy to help you with this.

If I have ADHD, what are my future prospects?

Neurodevelopmental conditions tend to get better as you get older. Half of patients diagnosed with ADHD in their childhood may not continue to have this condition in their adult life, or they may have fewer symptoms.

However, this doesn't mean that they need to stop taking medication, although the medication can be adjusted to a more comfortable level. The symptoms tend to be much more prevalent when you’re in your teens, twenties, and thirties. I can see in my clinic that when people reach their forties and fifties, the symptoms tend to decline in comparison with the other mental health conditions out there, such as schizophrenia. People suffering from these conditions tend to relapse and each relapse becomes more and more severe with time.

The key approach is to seek help at the right time, because even though we know the symptoms will get better, it is important in that specific period of time for you to be able to access the educational or career support that you need. This is why timing is crucial in getting help for ADHD.

Dr Stefan Ivantu is a leading psychiatrist, and an expert in adult ADHD and a range of other mental health conditions. If you have any mental health or psychiatric concerns, you can book a consultation with Dr Ivantu via his Top Doctors profile or his personal website.