Adult ADHD (Attention Deficit Hyperactivity Disorder)
Please also note our Website Disclaimer Updated 8/5/2022
Jump to section:
THIS IS A SPECIALISED FIELD AND IS ONLY OFFERED BY CERTAIN DOCTORS IN THE CLINIC. 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. YOU WILL STILL NEED TO SEE A PSYCHIATRIST FOR THE FORMAL DIAGNOSIS, as we are GPs. We will try to facilitate the referral but there will still be out-of-pocket costs involved as the psychiatrists have a gap fee in excess of $200 for the complex appointment and required paperwork. But it could turn your life around.
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, 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.
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
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
- 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.
- Jasper Goldberg rating scale
You will then be referred to a psychiatrist. If the psychiatrist supports the diagnosis, your GP will obtain a government permit and be able to prescribe the appropriate medications. Without the preparatory workup, the psychiatrist would need 2-3 visits which would be even more expensive, and many psychiatrists don't even accept patients with ADHD due to the complexity involved.
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.
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.