Adult ADHD (Attention Deficit Hyperactivity Disorder)

Perception of ADHD

THIS IS A SPECIALISED FIELD AND IS ONLY OFFERED BY CERTAIN DOCTORS IN THE CLINIC. Ideally prepare for the appointment by reading through this page and watching the YouTube videos linked below. If you are already on a program, you are at higher risk and may have had this page recommended to you.

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Introductory videos to watch

There are a lot of online resources. These will start your exploration.

ADHD is not necessarily a bad thing

She has also done a really good TED talk.

Is this you?

You can also check out his website: Totally ADD

or ADHD Australia

or, for a more formal website: National Institute of Mental Health

More information from Mayo Clinic

How to know if you have ADHD - funny


You can try the quick screening tool below and, if positive, see the doctor.

Quick screening tool



Background

Studies have shown that up to 5% of the population has ADHD, and this risk is much higher (10-46%) in people with SUD. SUD patients with a comorbid diagnosis of adult ADHD have poorer treatment outcome and higher risk of relapse than SUD patients without ADHD.

Medication is not always required - education and coping strategies are often sufficient.

Some interesting points about ADHD in Australia:

  • ADHD is common, with an Australian prevalence rate of around 5%
  • Girls are diagnosed less often than boys and may be missed as they have fewer hyperactivity symptoms
  • Adolescent girls with inattentive ADHD can be misdiagnosed with depression or anxiety, which is secondary to the ADHD
  • The ADHD symptoms of hyperactivity decrease in adolescence, but the inattention persists, leading to premature withdrawal of treatment
  • ADHD persisting into adulthood needs ongoing treatment
  • ADHD can severely disadvantage adults who development psychiatric comorbidity/substance abuse, family problems, job loss and trouble with the law
  • ADHD is estimated to cost the Australian economy $20 billion annually

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Diagnostic process

The first step will be to assess whether you may have ADHD and the best way forward. Medication is not necessarily required and, if used, needs to be prescribed within a supportive framework including

  • PsychoEducation
  • ADHD Coaching
  • Couples Therapy
  • Mindfulness Practices

You will be given some tests including some homework which you can do with other people's help, if necessary.

  • ASRS
  • Jasper Goldberg rating scale
  • DIVA-5

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First steps

The first steps may be to sort out other underlying issues, including sleep and mood. It is important to avoid escalation of addictive medications such as benzodiazepines. There are several options, including melatonin, clonidine, quetiapine, gabapentin, suvorexant or zopiclone. Stabilising mood is important. Lamotrigine may be considered, although antidepressants such as venlafaxine and duloxetine can have multiple benefits.

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Psychostimulant medications / Cognitive enhancers

Stimulants or cognitive enhancers may be appropriate. These need to be prescribed in cooperation with a psychiatrist as they are strictly controlled due to being "legal speed". There are short and long acting variants of methylphenidate (Ritalin) and dexamphetamine (dexamfetamine / Vyvanse), atomoxetine (Strattera - mostly used in young people) or modafinil.

ADHD is a chronic condition. If these medications seem appropriate, you will need to see a psychiatrist for at least one detailed initial assessment, and, for ongoing treatment, every 2 years. You will also need a set of blood tests to rule out other medical conditions. If you are over 40, an ECG will generally be required.

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