Want to skip the preamble? Scroll down to the “Step One” header below.
Since I started talking about ADHD, I’ve had a surprising number of people tell me that it’s opened their eyes to their own symptoms, and ask me what the best process is for getting a diagnosis. I’ve got a big bundle of information that I keep sending out to people, and every time, I think “hey, I should write another piece on Medium so I can just link people to it in future”.
It’s really not surprising that a lot of people have approached me about it. ADHD is a slippery thing; pretty much all of its symptoms are shared with other disorders, and most of them are found in neurotypical people as well. I’ve had a few occasions where I’ve explained ADHD to someone I’ve not seen for a while, and they’ve said “oh, yeah, I’m a bit like that — always losing things!”. To be clear, I’m not knocking people for saying that! Speaking as someone who usually empathises by emphasising common ground, I don’t blame them at all for doing the same. My point is, though, when someone with ADHD explains their symptoms, the majority of people listening will probably relate to at least some of them. If it’s more than a few, those people might feel the need to seek a diagnosis themselves.
There seems to have been a boom of ADHD self-discovery this past year. Maybe it’s a lockdown thing; people were forced to slow down and stop dashing about the place, and maybe that’s going to lead to some introspection and increased self-awareness. I’ve also seen it being discussed a lot more online, although that might just be me living out the Baader-Meinhof phenomenon.
Anyway. I’m rambling on! Again, no surprises there. (Hey, ADHD tip! I’m putting lots of links in this article. Open them in new tabs so you don’t forget you were reading this one.)
Point is, a lot of people are having the same discovery I had at the start of the year. I was very lucky; I happened to have a few friends who’d recently been diagnosed themselves, so I had people to turn to for advice. A lot of people won’t be so fortunate, but maybe they’ll see this and it’ll do the job.
If you think you might have ADHD, the rest of this article is my advice for what to do next. Disclaimer: I’m not a doctor, I’m not a psychiatrist, I’m not even someone with a huge amount of experience in the system. All of my advice is specific to my own experience as a 38-year-old white cis man living in the UK. Sad to say, your mileage may vary if you’re a woman or a person of colour.
Step One: Watch some Videos
Before I start recommending checklists and questionnaires, I recommend watching a couple of videos and seeing if they ring true. Put them on while you’re doing some housework, or something, or listen to them on a commute; I’m not expecting you to comfortably sit still and absorb something for half an hour. Of the people I’ve sent advice to, three or four have got to this stage, watched a video, and realised that ADHD doesn’t fit them as neatly as they thought. (Of course, if that’s you, it doesn’t mean you’re perfectly neurotypical and your inescapable quirks are just awful moral failings! As I said, ADHD shares symptoms with lots of other things, so it’s worth doing more research.)
Here are some videos that I found incredibly helpful in this regard.
Step 2: Fill in a Quick Form
If you watched those videos and things sound chillingly familiar (I found it incredibly eerie, seeing people describe my life and the nonsense I’ve dealt with over the years in such great detail), the next step is to complete a short questionnaire.
Here it is! It’s a downloadable pdf. It’s not editable, but if you don’t have access to a printer, you can just scribble your responses on a sheet of paper. (I’m doing my best to remove barriers here, which is a great tip for getting things done with ADHD. Here are more of them.)
I’m not entirely sure who created the form, or where it comes from; it was passed to me, and I’m passing it to you. From what I understand, it’s intended for use by doctors in the early stages of diagnosis. At the moment, with the NHS (and private) waiting lists being what they are, I 100% recommend doing this yourself, as a starting point. (Again, especially if you’re a member of a demographic that’s chronically underdiagnosed; evidence is gonna be your friend.)
Read the instructions, and go through the questions one at a time. Answer as honestly as you can. If possible, get a close friend, close relative, partner or housemate to help you; people with ADHD often underestimate the severity of their symptoms, so having an external perspective is incredibly helpful. When I ran through the DIVA 2.0 form (see below), I got my partner Sophie to go through it with me, and on more occasions than I’d like to admit I noted that something is hardly an issue, only to have her look utterly baffled and point out half a dozen examples from the past week.
Once you’ve answered all the questions, assess your results. If you’ve got four or more ticks in shaded boxes in Part A, it’s worth pushing on. (If not, it doesn’t mean you haven’t got ADHD, but there’s a good chance it might be something else instead.)
At this stage, you should also ask yourself two further questions:
- Do the symptoms have an impact on multiple areas of your life? Work / school, family / relationships, social life, hobbies?
- Have the symptoms been around since childhood?
An ADHD diagnosis is a lot more likely if both of those are true.
Step 3: A Much Longer Form
Oh no, paperwork!
This is an optional step, but the more work you put in before approaching a doctor, the more evidence you have to make the case for an ADHD assessment.
Side note: don’t be wary of self-diagnosis. It’s easy to fall into the trap of thinking “oh, I don’t want to be one of those people who tells a doctor what I think the problem is”, but think of it this way: if you started having chest pains, you’d go to the doctor and describe your symptoms. They’d be physical, so they’d be easy enough for you to identify. Mental symptoms are a bit harder to quantify (and as I said, ADHD is slippery, and if you’ve got it you’re a terrible judge of what counts as a symptom), so using a tool like like a checklist or questionnaire lets you make sure you’re including everything and not leaving things out. It would be very difficult to explain all of the symptoms of a mental disorder in a five minute GP appointment, even if you weren’t suffering with a mental disorder. Allow yourself to use some tools.
Anyway, on with the form!
The DIVA 2.0 is significantly longer than the last one. It goes into a lot more detail, prompts you to give examples, and talks about both adulthood and childhood. It took me about two hours in total; I sat down with Sophie again for the adulthood side, then sat with my mum to go through the childhood side, each of which was about an hour.
This one’s divided into three parts, plus a Summary. The first part looks at symptoms of inattentive-type ADHD, the second part at hyperactive-impulsive type (for more info on the types, go here), and the third part looks at the areas of your life that are impacted by your symptoms. If you answer “yes” to at least six questions in either (or both) of the first two parts, that indicates the possibility of one type of ADHD (or combined type), providing that the symptoms are present in both the adulthood and childhood parts, and are impacting multiple areas of your life.
Thing is, if you’ve got to the point of filling in this form — i.e. you already filled in the one in Step 2 and you got enough ticks in the right boxes — you probably already know whether you’re likely to have a possibility of diagnosis. What this form does, however, is give you a lot more context for what ADHD symptoms are, and gets you to gather examples. All of this is incredibly useful stuff for the next step.
Step 4: Approach a Professional
At this point, you need to book an appointment to see your GP. Take along the forms you’ve filled in, explain your situation, and go from there. (Also, see the notes below about Right to Choose.)
I’ve heard from several people who have got to this stage and stalled because they’re concerned their GP won’t take them seriously, or they don’t like seeing doctors face to face, or they don’t want to go to a surgery with COVID still lurking around. I totally get that, but did you know you can write to your doctor?
I contacted the surgery reception and asked for an email address to contact my doctor. They were more than happy to give it to me. I wrote a short email saying that I’d read about ADHD online and had spent the past month reading into it. I attached scans of the forms I’d filled in, and said that I felt there was sufficient evidence to request an assessment.
Also, I exercised my Right to Choose. This is a relatively new thing, and when I chased up the referral a week or two later, the reception team at the surgery didn’t know how to deal with it. So be warned, you might need to help them out a bit.
In short, the waiting list for an ADHD diagnosis through standard NHS channels is long. I’ve heard people describe three-year waits. Instead, you can ask to be referred to a specific private hospital or assessment unit, as long as they have an existing contract with the NHS to provide the service you’re after; this will be funded by the NHS, without you having to pay the provider (this is a slight edit — thanks to Mika for the correction!). The queues for private assessment are considerably shorter, although since my referral in Spring (which took about three months), the number of people following this process has grown massively. I requested to be referred to Psychiatry UK, who have been fantastic, but I hear their waiting list for assessment is around one year at the minute. They’ve been expanding their team, so this might change. I’ve been told you can find lists of approved providers by checking Adult ADHD UK Facebook groups — if you get hold of a list, I’d love it if you could post a link in the comments.
Step 5: Wait! (but don’t be idle)
Yeah, this is the tricky part. Knowing that you probably have ADHD, but not having it confirmed for months, is tough. Then, after getting an assessment, you’ll likely have to wait again for medication to commence (I was diagnosed in July, and started on methylphenidate two weeks ago). It can feel a bit like wandering the desert, knowing there’s water somewhere nearby, but not knowing how far.
That said, there’s a lot you can do. Diagnosis is a really good thing, but it’s not the full picture; it gives you access to medication and support, but nothing you get through diagnoses will magically cure your ADHD. You need to build a toolkit, take steps to become familiar with how your brain works, and unlearn an awful lot of learned behaviours. You can start working on that right away.
I really need to get on with my day, so I won’t go into details here; there’s probably a whole follow-up piece on tools and coping strategies! For now, I hope this has been helpful. Please feel free to share it if you know anyone who might find it useful.