I think I may be experiencing symptoms of ADHD…what next?

Attention Deficit Hyperactivity Disorder (ADHD) is a group of behavioural symptoms including hyperactivity, inattentiveness and impulsiveness which is normally recognised and treated in childhood (normally between the ages of 6-12) although there is increasing evidence that some symptoms can continue into adulthood and adults that may not have been identified as having the condition.

Assessment and Diagnosis

In order for us to be able to consider ADHD as a potential diagnosis there needs to be objective evidence of symptoms from an early age (before 12 years old) which are continuing into adult life (ADHD does not develop in adulthood).  This objective evidence may come from family members or school reports and should include evidence of the following

Signs of inattentiveness such as:

  • having a short attention span and being easily distracted
  • making careless mistakes – for example, in written work
  • appearing forgetful or losing things
  • being unable to stick at tasks that are tedious or time-consuming
  • appearing to be unable to listen to or carry out instructions
  • constantly changing activity or task
  • having difficulty organising tasks

Signs of hyperactivity and impulsiveness such as:

  • being unable to sit still, especially in calm or quiet surroundings
  • constantly fidgeting
  • being unable to concentrate on tasks
  • excessive physical movement
  • excessive talking
  • being unable to wait their turn
  • acting without thinking
  • interrupting conversations
  • little or no sense of danger

Online screening tools such as the Structured Adult ADHD Self Test (SAAST) or Adult ADHD Self Report Scale (ASRS) can be helpful guides to assessment of symptoms but in themselves are not sufficient to offer a formal diagnosis.

Assessment by Primary Care staff can include

  • when these symptoms started
  • where the symptoms occur for example, at home and/or in work
  • whether the symptoms affect your day-to-day life for example, if they make socialising difficult and how; if you’re underachieving at work or find intimate relationships difficult
  • if there’s a family history of ADHD
  • whether your symptoms can’t be explained by another mental health condition

 Although NHS Forth Valley is committed to supporting individuals who may be showing signs of ADHD there is currently no dedicated pathway for the assessment and treatment of this condition.  As a result of this and the extreme pressure being placed on health services, formal assessment is currently only available via Adult Mental Health Services for individuals who can evidence that they are experiencing a severe impairment to their daily lives because of associated symptoms. Whilst we work on this pathway we ask that you show patience with our Primary Care colleagues who will be happy to discuss ways to manage some of these symptoms without a formal diagnosis.  Some of our Adult Mental Health teams also request that guided self help skills are practised for a minimum of six months before a referral could be considered. These should be practised alongside the elimination of other factors which may be influencing your ability to maintain focus, concentration and control impulsivity such as

  • Caffeine
  • Alcohol
  • Non-prescribed medications
  • Illicit substances such as cannabis

Skills that can help manage symptoms may include

  • Learning to improve time management and organisational skills
  • Reducing impulsivity through distraction, exercise and planning
  • Learning more about our mood and anxiety and managing these more effectively
  • Practising skills which improve focus and reduce unhelpful external stimulation
  • Improving attention and memory through brain training exercises and games
  • Learning about the impact of our emotions and how to manage adverse emotions more effectively
  • Improving our daily routine and importance of managing our home environment
  • Improve problem solving skills
  • Managing our sleep pattern and importance of good sleep hygiene
  • Improve how we manage social relationships and expectations of these
  • Learning to manage workload and maintaining balance with social life

Your Primary Care Mental Health Nurse will be able to talk to you about a range of tools and resources that will help you achieve this including

  • The Decider Skills (a range of Cognitive Behavioural Therapy (CBT) and Dialectic Behavioural Therapy (DBT) basked skills which can help us manage our mood, anxiety, emotional regulation and relationships more effectively
  • Guided self help for anxiety management and low mood
  • Try Daylight programme for anxiety www.trydaylight.com/nhs
  • Sleep hygiene skills
  • Sleepio Programme www.sleepio.com/nhs
  • Referral to Silvercloud programme (Computerised CBT to help with anxiety and depression related problems) This can be done by the Primary Care Mental Health Nurse or GP
  • Safety & Stabilisation (programme which helps explain the impact of trauma and ways to manage the associated symptoms) you can access safety and stabilisation
  • Referral to Adult Psychological Services
  • NHS Lothian’s Self Help Resource Pack for People with Attention Deficit Hyperactivity Disorder Self Help Resource Pack for People with Attention Deficit Hyperactivity Disorder (nhslothian.scot)
  • Get Self Help Adult ADHD resource https://www.getselfhelp.co.uk/adhd-self-help/

Access the self-assessment question here