Overview
Attention deficit hyperactivity disorder (ADHD) is a condition that affects people’s behaviour. People with ADHD can seem restless, may have trouble concentrating and may act on impulse.
ADHD is still very misunderstood. It is not a condition that develops over time, it is the one you are born with.
ADHD was initially called a hyperkinetic reaction of childhood. It wasn’twasn’t until the 1960s that the American Psychiatric Association (APA) formally recognised it as a mental disorder. In the 1980s, the diagnosis became known as” “attention deficit disorder with or without hyperactivity.”

It is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood.

Symptoms
It is normal for children to have trouble focusing and behaving at one time or another. However, children with ADHD do not just grow out of these behaviours and traits. The symptoms continue, can be severe, and cause difficulty at school, home, or with friends.

A wide range of behaviours is associated with ADHD. Some of the more common ones include:
having trouble focusing or concentrating on tasks
being forgetful about completing tasks
being easily distracted
having difficulty sitting still
interrupting people while they’re talking
Signs and symptoms can be specific to different aspects of ADHD, such as hyperactivity, impulsivity, or difficulty focusing.
A person who is experiencing hyperactivity and impulsivity may:
find it challenging to sit still or remain seated, for example, in class
have trouble playing or carrying out tasks quietly
talk excessively
find it hard to wait their turn
interrupt others when they’re speaking, playing, or carrying out a task.
Someone who is having difficulty focusing might:
make frequent mistakes or miss details when studying or working
find it hard to maintain focus when listening, reading, or holding a conversation
have trouble organising their daily tasks
lose items frequently
be easily distracted by small things happening around them
A child with ADHD might:
trouble focusing on activities and becoming easily distracted
low attention span while playing or doing schoolwork
fidgeting, squirming or otherwise having difficulty sitting still
constantly needing movement or frequently running around
engaging in activities loudly or disruptively
excess talking and interrupting other people
As children with ADHD get older, the symptoms they experience may change. In some cases, certain symptoms seen in childhood may become less problematic in adolescence, while new symptoms can arise amidst the changing responsibilities accompanying growing older.

In adolescents and teenagers with ADHD, other symptoms that may appear can include:
difficulty focusing on schoolwork or other work
frequently making mistakes while doing work
trouble finishing tasks, especially schoolwork or chores
trouble with task organisation and time management
frequently forgetting things or losing personal items
frequently avoiding mentally taxing tasks
experiencing increased frustration and emotional sensitivity
trouble navigating social and familial relationships
increased conflict with parents due to ADHD symptoms affecting the home life
It’s important to understand that while these symptoms of inattentiveness, hyperactivity, and impulsivity can sometimes cause adolescents and teenagers with this condition to appear “immature,” they are simply a part of ADHD and have nothing to do with a child’s maturity level.

Related conditions in children and teenagers with ADHD
Although not always the case, some children may also have signs of other problems or conditions alongside ADHD, such as:
anxiety disorder – which causes your child to worry and be nervous much of the time; it may also cause physical symptoms, such as a rapid heartbeat, sweating and dizziness
oppositional defiant disorder (ODD) – this is defined by negative and disruptive behaviour, particularly towards authority figures, such as parents and teachers
conduct disorder – this often involves a tendency towards highly antisocial behaviour, such as stealing, fighting, vandalism and harming people or animals
depression
sleep problems – finding it difficult to get to sleep at night, and having irregular sleeping patterns
autistic spectrum disorder (ASD) – this affects social interaction, communication, interests and behaviour
dyspraxia – a condition that affects physical co-ordination
epilepsy – a condition that affects the brain and causes repeated fits or seizures
Tourette’s syndrome – a condition of the nervous system, characterised by a combination of involuntary noises and movements (tics)
learning difficulties – such as dyslexia

Related conditions in adults with ADHD
As with ADHD in children and teenagers, ADHD in adults can occur alongside several related problems or conditions.
One of the most common is depression. Other conditions that adults may have alongside ADHD include:
personality disorders – conditions in which an individual differs significantly from the average person in terms of how they think, perceive, feel or relate to others
bipolar disorder – a condition affecting your mood, which can swing from one extreme to another
obsessive compulsive disorder (OCD) – a condition that causes obsessive thoughts and compulsive behaviour
The behavioural problems associated with ADHD can also cause problems such as difficulties with relationships and social interaction.

Causes

Symptoms can be diagnosed during childhood, particularly with feedback from teachers. But the more we research ADHD, the more people are being diagnosed in adulthood.
Research from the Center for Neurobehavioural Genetics at UCLA shows that up to 40% of people with ADHD also have a parent with ADHD and 20-25% chance of having a sibling with ADHD.

Despite how common ADHD is, doctors and researchers still aren’t sure what causes the condition. It’sIt’s believed to have neurological origins.
ADHD tends to run in families, and, in most cases, it’s thought the genes you inherit from your parents are a significant factor in developing the condition.
Research shows that parents and siblings of someone with ADHD are more likely to have ADHD themselves.
However, the way ADHD is inherited is likely to be complex and is not thought to be related to a single genetic fault.

Research has identified several possible differences in the brains of people with ADHD from those without the condition, although the exact significance of these is unclear.
For example, studies involving brain scans have suggested that certain areas of the brain may be smaller in people with ADHD, whereas other areas may be larger.
Other studies have suggested that people with ADHD may have an imbalance in the level of neurotransmitters in the brain or that these chemicals may not work properly.
Research suggests that a reduction in dopamine is a factor in ADHD. Dopamine is a chemical in the brain that helps move signals from one nerve to another. It plays a role in triggering emotional responses and movements.
Other research suggests a structural difference in the brain. Findings indicate that people with ADHD have less grey matter volume.

Certain people are also believed to be more at risk of ADHD, including people:
who were born prematurely (before the 37th week of pregnancy) or with a low birth weight
with epilepsy
with brain damage – which happened either in the womb or after a severe head injury later in life

Diagnosis
No single test can tell if you or your child has ADHD. The goal of getting a diagnosis is to be referred to for a formal ADHD assessment. In the UK, there are two routes to obtaining a diagnosis of ADHD; you can do it either via the NHS or pay for a private ADHD assessment. While going through the NHS is free, it can come with a lengthy waiting list. It’sIt’s not unusual to hear about estimated times of 2-3 years, and it depends on where you live, so a practical first step is to visit your GP and find out what the situation is like in your area. Your GP will advise you of your options. In any case, it is helpful for your GP to know that you may have ADHD and related problems.

Children Route
There are various ways to get a diagnosis. These can include:
the hospital or your health visitor referring you to a specialist or doctor
your child’s teacher or school referring you to an educational psychologist or a Special Educational Needs Coordinator (SENCO), which mostly every school have
visiting your GP because you’ve noticed your child showing symptoms or physical difficulties
The hospital and GP approach takes you directly through the NHS assessment route.
The GP cannot formally diagnose ADHD, but they can discuss your concerns with you and refer you for a specialist assessment if necessary.
When you see a GP, they may ask you:
about your symptoms or those of your child
when these symptoms started
where the symptoms occur – for example, at home, in school, college or university, or at work
whether the symptoms affect your or your child’s day-to-day life – for example, if they make socialising difficult
if there have been any recent significant events in your or your child’s life, such as a death or divorce in the family
if there’s a family history of ADHD
about any other problems or symptoms of different health conditions you or your child may have
If the GP thinks your child may have ADHD, they may first suggest a period of “watchful waiting” (around 10 weeks) – to see if your child’s symptoms improve, stay the same or get worse.
They may also suggest starting a group-based, ADHD-focused parent training or education programme. Being offered a parent training and education programme does not mean you have been a bad parent – it aims to teach you ways of helping yourself and your child.
If your child’s behaviour does not improve, and both you and the GP believe it’s affecting their day-to-day life, the GP should refer you and your child to a specialist for a formal assessment.

If you decide to start the assessment route through school, you need to talk to the teacher or the SEN coordinator (SENCO). SENCos cannot diagnose any conditions, including dyslexia, ADHD and autism, but can refer children for assessments based on the signs they are trained to look out for.
SENCo can make the whole assessment process smoother and support parents or carers of the child to obtain their permission to start the appropriate referral processes. They will do this by speaking to various parties to obtain relevant advice and support, including health visitors, paediatricians and GPs. It can even take less time to wait for a formal assessment as the school already will have a record on your child and will be able to push to get documents from GP, who often take more time to submit paper works plus, SENCO will help with filling all the necessary forms. Following a diagnosis, they will work with parents/carers and specialists to establish the correct support programme for that child.
After all the paperwork goes through, you will receive a letter with an approximate assessment date.

An ADHD specialist will conduct a detailed assessment which may include a physical examination, a series of interviews with the child, and interviews or reports from parents, carers, and teachers.

In order for a child to be diagnosed with ADHD, they must display 6 or more symptoms of inattentiveness, or 6 or more symptoms of hyperactivity and impulsiveness. The child must also have been displaying ADHD symptoms continuously for at least 6 months and must have started to show symptoms before age 12. Children must also show ADHD symptoms in at least two different settings, for example, both at home and at school. This is to rule out the behaviour being related to one particular setting, for example, as a reaction to being at school.

As with an adult ADHD diagnosis, in order to diagnose ADHD in a child, it must be clear that the child’s symptoms make their day-to-day lives more difficult (for example, the child may struggle in education or find it hard to form friendships).

Adult Route
Unfortunately, getting a diagnosis of ADHD as an adult can be difficult and time-consuming.
The process requires an ADHD specialist psychiatrist to diagnose after a detailed assessment.
In the UK, adults can only be diagnosed with ADHD if they have >5 or more out of the 9 symptoms of inattentiveness or 5 or more out of the 9 symptoms of hyperactivity/impulsiveness. Whilst a specialist psychiatrist will always enquire about present symptoms, an adult cannot be diagnosed with ADHD based on present symptoms alone. Under current diagnostic guidelines, a diagnosis of ADHD can not be confirmed unless the symptoms have been present from childhood. This is because it is currently thought that ADHD cannot develop in adult brains, so if an individual’s symptoms did not occur in the past, they would not be diagnosed with ADHD. The research will often need to be conducted into the patient’s history, including speaking to parents/siblings about the patient as a child or looking through old-school reports.
Another area that an ADHD specialist will consider when diagnosing ADHD in an adult is the extent to which symptoms affect their day-to-day life. In order for an individual to be diagnosed with ADHD, their symptoms should have at least a moderate effect on areas such as work, relationships, friendships, or driving.
The first step to obtaining an ADHD diagnosis via the NHS is to speak to your GP and explain why you think you may have ADHD. Your GP cannot diagnose ADHD – whatever route you take, you will need to see a specialist psychologist to obtain a diagnosis. However, your GP may decide to refer you for an NHS ADHD Assessment if they feel that you need one (if your GP refuses to provide a referral, you may decide to get a second opinion from another GP). Sadly, the referral process can take several years, depending on where you are geographically; this is the main downside of going through the NHS for an ADHD diagnosis. If your GP does offer you a referral, ask them to give you an idea of wait times- this may help you decide on your next course of action.
When eventually, you will have a specialist assessment with the NHS – it should cover your overall mental health, an assessment of if you have ADHD, and an assessment if you might have any other related or unrelated mental health conditions. This usually involves a 45-90 minute discussion that may include a number of checklists with a specialist psychiatrist, specialist nurse, or “other appropriately qualified healthcare professional”. Psychologists can assess ADHD but are unable to prescribe medication.

Your clinician will let you know the next stage after your assessment. One option is a diagnosis of ADHD, with a discussion on whether you want to consider medication options and a referral to your GP for shared management.

Many people opt for a private ADHD assessment to avoid the long wait and to start ADHD treatments sooner.
If you decide to book a private ADHD test and assessment, you can start by:
Asking your GP or anyone that you may know with the condition for recommendations
Conducting an internet search for ‘ADHD Testing Near Me” or “Private ADHD Assessment”. Make sure your doctor is a GMC registered Consultant Psychiatrist and has good experience treating the condition.
ADHD can only be formally assessed by a UK registered psychiatrist, a specialist ADHD nurse, or “other appropriately qualified healthcare professional”.
A psychiatrist is a medically qualified doctor who specialises in psychiatry.
A specialist ADHD nurse is a qualified nurse with additional formal training and accreditation in ADHD. Specialist ADHD nurses undertake an additional 1-year program to be qualified in assessing for ADHD. They can undertake a further 1-year program to become qualified to prescribe ADHD medication.
“other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD” includes Psychologists. Psychologists can provide an assessment of ADHD; however, they are not able to prescribe ADHD medication.
Other mental health professionals, including counsellors, cannot provide a formally recognised diagnosis of ADHD. (Note: For children, a Pediatrician may also be able to diagnose ADHD) You need a recognised official diagnosis to access workplace protections. You need a psychiatrist or prescription-qualified specialist nurse to have medication as a treatment option.

You should always check that the person you are seeing is a member of the General Medical Council and on their specialist register.

Some links to private ADHD assesmnet:

Homepage

https://www.seikpsychiatry.com/
https://www.clinical-partners.co.uk/

Being diagnosed is the first step in helping yourself with ADHD and may unravel complex emotions. Many report that a diagnosis can be a relief to know what has been challenging them, but they also feel upset to know that they have a mental health condition. It is important to remember that nothing has changed because of a diagnosis – except that you are now empowered with the knowledge of it. What you now do with that insight into yourself is then up to you.

Treatment
Treatment for attention deficit hyperactivity disorder (ADHD) can help relieve the symptoms and make the condition much less of a problem in day-to-day life.

ADHD can be treated using medicine or therapy.
The two main types of medications used to treat ADHD are stimulants and non-stimulants.
Central nervous system (CNS) stimulants are the most commonly prescribed ADHD medications. These drugs work by increasing the amounts of the brain chemicals dopamine and norepinephrine.
If stimulants don’t work well or cause troublesome side effects for you or your child, your doctor may suggest a non-stimulant medication. Certain non-stimulant medications work by increasing levels of norepinephrine in the brain.
Treatment is usually arranged by a specialist, such as a paediatrician or a psychiatrist, although a GP may monitor the condition.

Here are some of the therapies that may be used.

Psychoeducation
Psychoeducation means you or your child will be encouraged to discuss ADHD and its effects. It can help children, teenagers and adults make sense of being diagnosed with ADHD, and can help you to cope and live with the condition.

Behaviour therapy
Behaviour therapy provides support for carers of children with ADHD and may involve teachers as well as parents. Behaviour therapy usually involves behaviour management, which uses a system of rewards to encourage your child to try to control their ADHD.
If your child has ADHD, you can identify types of behaviour you want to encourage, such as sitting at the table to eat. Your child is then given some sort of small reward for good behaviour.
For teachers, behaviour management involves learning how to plan and structure activities and to praise and encourage children for even very small amounts of progress.

Parent training and education programmes
If your child has ADHD, specially tailored parent training and education programmes can help you learn specific ways of talking to your child, and playing and working with them to improve their attention and behaviour.
You may also be offered parent training before your child is formally diagnosed with ADHD.
These programmes are usually arranged in groups of around 10 to 12 parents. A programme usually consists of 10 to 16 meetings, lasting up to 2 hours each.
Being offered a parent training and education programme does not mean you have been a bad parent – it aims to teach parents and carers about behaviour management while increasing confidence in your ability to help your child and improve your relationship.

Social skills training
Social skills training involves your child taking part in role-play situations and aims to teach them how to behave in social situations by learning how their behaviour affects others.

Cognitive behavioural therapy (CBT)
CBT is a talking therapy that can help you manage your problems by changing the way you think and behave. A therapist would try to change how you or your child feels about a situation, which would, in turn, potentially change their behaviour.
CBT can be carried out with a therapist individually or in a group.

Other possible treatments
There are other ways of treating ADHD that some people find helpful, such as cutting out certain foods and taking supplements. However, there’s no strong evidence these work, and they should not be attempted without medical advice.

Diet
People with ADHD should eat a healthy, balanced diet. Do not cut out foods before seeking medical advice.
Some people may notice a link between types of food and worsening ADHD symptoms. If this is the case, keep a diary of what you eat and drink, and what behaviour follows. Discuss this with a GP, who may refer you to a dietitian (a healthcare professional who specialises in nutrition).

Supplements
Some studies have suggested that supplements of omega-3 and omega-6 fatty acids may be beneficial for people with ADHD, although the evidence supporting this is very limited.
It’s advisable to talk to a GP before using any supplements because some can react unpredictably with medicine or make it less effective.
You should also remember that some supplements should not be taken long-term, as they can reach dangerous levels in your body.

In addition to — or instead of — medication, several remedies have been suggested to help improve ADHD symptoms.
Making lifestyle changes may help you or your child manage ADHD symptoms. The Centers for Disease Control and Prevention (CDC)Trusted Source recommends the following:

eating a nutritious, balanced diet
getting at least 60 minutes of physical activity per day
getting plenty of sleep
limiting daily screen time from phones, computers, and TV
Studies have also shown that yoga, tai chi, and spending time outdoors can help calm overactive minds and may ease ADHD symptoms.

Mindfulness meditation is another option. Some research has suggested meditation might improve attention in people with ADHD.
Avoiding certain allergens and food additives can also help reduce ADHD symptoms.

Living with

Tips for Parents
If you’re the parent of a child with ADHD:
be sure your GP or specialist helps you understand the difference between ADHD and any other problems your child may have
think about who else needs to know about your child’s ADHD, such as their school or nursery
find out the side effects of any medicine your child takes and what you need to look out for
getting to know people at local support groups can stop you from feeling isolated and help you to cope

If you or your child has ADHD, a consistent schedule with structure and regular expectations may be helpful. For adults, some ways to help you stay organised are:
making lists
keeping a calendar
setting reminders
For children, it can be helpful to focus on writing down homework assignments and keeping everyday items, such as toys and backpacks, in assigned spots.

Symptoms of ADHD often labelled as negative, can be leveraged positively and celebrated as a strength.
People with ADHD are usually more successful when they can have many projects going on at one time. They enjoy multitasking, and it helps them to be more focused and to feel calmer. Performing well under pressure is another strength for many people with ADHD. Crises, emergencies, last minute deadlines give them high energy stimulations they chase.
Professional sports are another area where people with ADHD thrive, as physical exercise is a good outlet for high energy.

Being different is your biggest asset, and it will help you succeed. (Richard Branson).

Successful people with ADHD are Bill Gates, Richard Brenson, Walt Disney.

Did you know that having positive reinforcement from mentors and loved ones can help children with ADHD become successful in life? By focusing on your child’s strengths, you are not letting ADHD define your child.

Make a list of what you are/or your kid is good at.
With self-awareness and correct assessment, you can make your ADHD your superpower. Having a good support system that understands you, understanding your diagnosis will guide you to a much more fulfilling life.

Many children with ADHD achieve and behave well. The learner distress of these children often goes unnoticed – usually, until the academic rigours of secondary school and exam performance take their toll on their low emotional resilience (years 7 and 11 are tipping points).

The key to improving outcomes for children with ADHD is early identification of ADHD characteristics and the need to implement strategies to support their successful integration into classroom-based learning.

Sources:
ADHD (Attention Deficit Hyperactivity Disorder): What Is It? (healthline.com) https://www.healthline.com/health/adhd

Attention deficit hyperactivity disorder (ADHD) – Symptoms – NHS (www.nhs.uk) https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/symptoms/

ADHD Assessment and Testing Methods – The ADHD Centre https://www.adhdcentre.co.uk/a-complete-guide-to-adhd-assessment-and-testing-methods/

Getting a diagnosis | Disability charity Scope UK https://www.scope.org.uk/advice-and-support/getting-child-diagnosis/

Diagnosis Pathways | ADHD UK https://adhduk.co.uk/diagnosis-pathways/

Low Dopamine Function in Attention Deficit/Hyperactivity Disorder: Should Genotyping Signify Early Diagnosis in Children? – PMC (nih.gov) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4074363/

Regional Gray Matter Volume Differences Between Adolescents With ADHD and Typically Developing Controls: Further Evidence for Anterior Cingulate Involvement – PubMed (nih.gov) https://pubmed.ncbi.nlm.nih.gov/26748338/

https://www.theminiadhdcoach.com/blog/adhd-brain