Attention deficit hyperactivity disorder (ADHD) - adults

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition that affects approximately 5–8% of Australians. While it has previously been thought the condition affects mainly men, many girls and women are now being diagnosed as we understand more about the condition and the many different ways it can present.

Until recently it was also thought that children outgrew ADHD during adolescence, due to developmental changes in their brain. It is now recognised that 7 out of 10 children will continue to experience ADHD symptoms as adults. A person with ADHD typically experiences differences in attention regulation, impulse control, executive functioning and energy levels.

Symptoms of ADHD

A person with ADHD may:

• experience emotional dysregulation or rapid changes in mood
• make careless mistakes at work
• find it hard to sustain attention in work or leisure
• not seem to listen when spoken to directly
• not follow instructions or finish tasks
• find it hard to organise tasks and activities
• avoid sustained mental effort in work
• lose things like keys, paperwork and things needed for tasks
• be easily distracted by other stimuli
• be forgetful in daily activities
• fidget with hands or feet, or squirm in their seat
• find it hard to remain seated
• feel restless or driven to stay busy
• be impatient
• have trouble doing things quietly
• talk more than intended or find it difficult to regulate conversational flow
• blurt out things without thinking
• have trouble waiting their turn in queues and other such situations
• interrupt conversations or speak before others have finished
• have sleep difficulties.

ADHD and quality of life

ADHD can affect a person’s quality of life. People with ADHD may find it difficult to maintain relationships or keep a job. If their condition was undiagnosed and untreated in childhood, they may not have done well in school or developed meaningful relationships.

Living with unsupported ADHD can affect confidence, wellbeing and participation in everyday life. Co-occuring conditions can include anxiety, depression, sleep difficulties, learning differences, and autism. On the other hand, being neurodivergent can also have its advantages. Adults who receive appropriate support are often highly productive, skilled in their chosen endeavours, and often show great imagination and creative flair.

Causes of ADHD

ADHD is considered to be a neurodevelopmental disorder, with possible links to genetics, neurobiology, prenatal factors, and environmental influences affecting symptom expression. While we do not yet know exactly what causes ADHD, we do know that diet and parenting approaches are not linked.

Diagnosis of ADHD

It is important to obtain an accurate diagnosis of ADHD so that appropriate therapies and supports can be accessed.

There is currently no single medical, laboratory or brain imaging test that can diagnose ADHD. Diagnosis currently involves a comprehensive assessment by a suitably qualified healthcare professional.

Diagnosis may include:

• ruling out psychological conditions that have similar presentations to ADHD
• ruling out alcohol or drug use that might be contributing to challenges you may be having
• investigating the impact of symptoms on your relationships, work, and other domains
• obtaining a comprehensive medical and family history
• interviewing your partner, family, friends, and others.

Read more about diagnosis of ADHD in children.

Treatment for ADHD

ADHD is a lifelong neurodevelopmental condition, but support and treatment can help you to:

• better understand your strengths and challenges
• develop practical strategies to improve participation in work, study, relationships and daily life.

Treatment should be tailored to the individual and may involve a combination of approaches.

Treatment for ADHD may include:

• Education and psychoeducation – to help you understand ADHD, how it affects you, and the supports available.
• Lifestyle strategies – such as regular physical activity, healthy sleep habits, balanced nutrition, and reducing alcohol and other drug use where appropriate.
• Medication – stimulant and non-stimulant medications can help improve attention, reduce impulsivity and support executive functioning for some people.
• Psychological support – including therapies that help with emotional regulation, self-esteem, anxiety, depression, stress management and coping skills.
• Cognitive behavioural therapy (CBT) – to help develop practical strategies for managing everyday challenges associated with ADHD.
• Coaching and skills-based supports – to assist with organisation, time management, planning, prioritisation, goal setting and maintaining routines.
• Workplace or study supports – including environmental modifications, assistive technology, flexible work practices, reasonable adjustments, and strategies to support productivity and wellbeing.
• Vocational support – to help identify career pathways, workplace strengths and strategies for success in employment.
• Family or relationship support – to help partners, family members and support networks understand ADHD and develop effective communication and support strategies.
• Peer support groups – which can provide opportunities to share experiences, learn from others and reduce feelings of isolation.

Emerging research is also helping healthcare professionals better understand the different ways ADHD affects individuals. This may lead to more personalised approaches to treatment and support in the future.

Expanded access to ADHD care

A group of GPs have completed specialised training in ADHD assessment and diagnosis to enable them to safely diagnose, treat and prescribe medication for ADHD in both adults and children 6 years and over.

These changes are part of statewide reforms to improve access ADHD care.

Short-term emergency prescriptions for ADHD medication are available through the Virtual Emergency Department. This service is free and available to children and adults who meet eligibility criteria, have an existing ADHD diagnosis, are unable to access a prescription through their regular treating doctor and require urgent access to their medication.

This service is intended as a short-term emergency measure and does not replace ongoing ADHD prescribing and management by a person's regular treating doctor.

What to expect when you see an ADHD trained GP

An ADHD assessment usually takes place over more than one appointment, giving your GP time to understand your symptoms, health history and individual circumstances. The aim is to understand what may be contributing to your symptoms and identify the care and support that is right for you.

An assessment does not always result in a diagnosis. Difficulties with attention, concentration, organisation or managing your emotions can have a range of causes. Whatever the outcome, your assessment can help identify the most appropriate next steps for your care. This may include further assessment or referrals to a psychiatrist or paediatrician. You can also seek a second opinion if you wish.

If you are diagnosed with ADHD, it is often managed over time through regular follow-up appointments, treatment reviews and ongoing support tailored to your needs.

ADHD assessment fees and out-of-pocket costs

The cost of ADHD care may vary between general practices because each practice sets its own fees. Before your appointment, you should ask the practice about their fees and any out-of-pocket costs you may need to pay.

ADHD assessments usually involve more than one appointment. This allows your GP time to understand your symptoms, health history and individual circumstance, gather the information needed for a thorough assessment, and discuss the most appropriate care and support with you.

Wait times to see an ADHD trained GP

Demand for ADHD assessments is high across Victoria, which means there may be a wait to see an ADHD trained GP. Availability will vary and appointments may not be immediately available in all areas.

ADHD treatment after diagnosis

If you are diagnosed with ADHD, your ADHD trained GP will work with you to decide on the most appropriate treatment and support for your needs. ADHD can be managed in different ways, and stimulant medication is one of several treatment options that may be considered.

Who can diagnose ADHD and prescribe stimulant medication

Only an ADHD trained GP, psychiatrist or paediatrician can diagnose ADHD for the purpose of starting stimulant medication.

Once a diagnosis has been made, another GP may be able to prescribe a stimulant medication as part of your ongoing care, where they have received treatment instructions In certain circumstances your GP may also need a permit before they can prescribe a stimulant medication.

Where to get help

• Your GP (doctor)
• An ADHD trained GP
• Psychiatrist
• Psychologist
• Virtual Emergency Department – for urgent short-term ADHD medication prescription
• ADHD Australia
• Aboriginal and Torres Strait Islander peoples may wish to access support through an Aboriginal Community Controlled Health Organisation or a healthcare provider experienced in delivering culturally safe ADHD assessment, treatment and support.