ADHD in adults: symptoms, assessment and treatment in the UK

ADHD is described by the NHS as a condition in which the brain works differently from most people. It involves difficulty paying attention, high energy levels and trouble controlling impulses. The cause is not always known; it may involve genetic differences and often runs in families. Factors linked to it include premature birth (before 37 weeks), epilepsy, brain injury and being autistic.

Many adults are diagnosed after years of being told they were disorganised or unmotivated, often after a child is diagnosed or after work or study pressures expose difficulties that were previously compensated for.

Hyperactivity often looks different in adults than in children, with restlessness and a feeling of being driven rather than running about. The NHS gives these examples.

• Inattentive signs: easily distracted or forgetful, trouble organising time, difficulty following instructions or finishing tasks, often losing items such as keys, wallet or phone.

• Hyperactive and impulsive signs: a lot of energy or restlessness, being very talkative, interrupting conversations, making quick decisions without thinking through consequences.

• Frequent companions: depression, anxiety, addictions or learning difficulties such as dyslexia. Autism, Tourette's and anxiety can also produce overlapping symptoms, so clinicians consider them.

The NHS suggests booking a GP appointment if symptoms affect study, work or relationships. The GP asks about your symptoms and their impact and may consider other possible explanations before referring you to a mental health professional who specialises in ADHD. If you were diagnosed in childhood and still need help, ask your GP about a referral.

At the assessment an ADHD specialist such as a psychiatrist asks about the history of symptoms, especially those in childhood and at school, and looks at work and education, family and friends, and medical history including mental health. They may want to speak to someone who knows you well. NICE says the assessment of adults should cover personal, educational, occupational and social functioning and coexisting conditions.

The NHS says adult waits for ADHD specialist services vary and can run to several months or years. In England the Right to Choose scheme lets you ask your GP for an NHS-funded appointment at any clinic, including a private one, that provides ADHD services for the NHS. This is different from paying privately, where you fund the assessment yourself. The NHS describes the scheme in terms of NHS services in England, so check what applies if you live elsewhere in the UK.

The NHS says a GP can take over ADHD prescribing only under a shared care agreement with the specialist, so it is sensible to ask any provider, before you commit, how medicines would be started, monitored and prescribed afterwards.

Not everyone with ADHD needs or wants medicine. The NHS says ADHD can be managed through lifestyle changes, adjustments at work and medicines, depending on symptoms and their effect.

The NHS says you must tell the DVLA if ADHD or its medicine affects your driving. NICE adds that ADHD symptoms may impair driving and that medication may improve it.

People with ADHD are more likely to have anxiety or depression and are at higher risk of suicide, according to the NHS. If you are in distress, speak to someone urgently; help is available through NHS 111, and in an emergency 999.

Private ADHD assessments are widely available and can shorten the wait for a diagnosis. Check that the assessing clinician is suitably qualified and registered, that the report covers history from childhood, and what follow-up and prescribing arrangements are offered; NICE expects regular monitoring of pulse, blood pressure and weight once medicine is started.