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‘I can’t believe he’s late again,” my friend said, texting to complain about a colleague. “You’ve got ADHD, too, and you seem fine!” I thought smugly: “Ah yes,” as I prepared to pull another all-nighter to hit a deadline, “that could never be me.”
I was diagnosed with attention deficit hyperactivity disorder (ADHD) at 14, which, at its worst, feels like having a million YouTube tabs simultaneously playing in my brain. Extreme procrastination and restlessness are some of my most noticeable traits. If you meet me, I’m most probably discreetly tapping my big toe to expel the nervous energy that rips through me on a daily basis. And while I’m hardly ever late these days, that’s only because I’ve jerry-rigged an elaborate system of calendar alarms to alert me to any upcoming event.
Almost everyone treated my diagnosis like a behavioural problem that only affected young, hyperactive boys. These days, things couldn’t be more different. On TikTok alone, videos tagged #ADHD have received 2bn views in the UK over the last year. But misinformation is also rife:one study determined that 52% of the clips on the platform contained misleading information. Here, a team of medical professionals and ADHD experts unpack what you need to know.
What is ADHD and what causes it?
ADHD is a neurodevelopmental disorder that affects the brain and nervous system, with symptoms of inattentiveness and/or impulsivity and hyperactivity that arise in childhood and may persist well into adulthood. It’s believed to be the result of a complex combination of genetics and environmental factors. The condition is highly heritable.
“It’s thought to affect around 5% of children and around 3% of the adult population in the UK,” says Prof Philip Asherson, the emeritus professor of neurodevelopmental psychiatry at King’s College London. It’s one of the most common disorders, alongside autism spectrum disorder (ASD), and can be classed as a disability under the Equality Act if it is severe enough to impair day-to-day life and work.
The term “deficit” can be slightly misleading. “People think that people can’t concentrate at all, which is not true,” says Prof Amanda Kirby, the chair of ADHD Foundation. “Often children and adults can hyperfocus on the things of high interest.”
Is ADHD being overdiagnosed?
“It’s absolutely not overdiagnosed,” says Henry Shelford, the co-founder and CEO of ADHD UK. Though experts estimate that there are 2.6 million people with ADHD in the UK, based on Lancet and National Insitute for Health and Care Excellence (Nice) incidence rates, only about 350,000 to 500,000 have received a formal diagnosis – which leaves two million out in the cold.
What are some common symptoms of ADHD?
Hyperactivity and impulsivity are the most obvious symptoms of ADHD to those on the outside. “I have to hold myself still, and as I do so it feels like a volcano building in me,” Shelford explains. Children might fidget constantly, talk excessively, get up to move around or bother their classmates. Adults may find more socially acceptable ways of channelling that restlessness, such as repeatedly touching their hair.
People with ADHD can often make careless mistakes, regularly losing things and failing to pay close attention to details or following instructions. They often find it impossible to focus on certain tasks. They may lose hours to intense focus or have problems with managing their time. This time blindness could make them late for important occasions or fail to make deadlines. Conversely, it could also make them turn up incredibly early for occasions, as they can’t accurately estimate how long it takes to do something.
Doesn’t everyone get a little distracted sometimes?
“Two things mark out what might be potentially diagnosable from what is everyday,” says Dr Max Davie, the co-founder of ADHD UK and co-host of the ADHD Science podcast. “One is that symptoms are present in all settings, and the other is that they’re severe enough to cause functional impairment.”
If you are highly distractible all the time – not just when you’re bored at work – and your symptoms are persistent and severe enough to impair your life, you may very well meet the clinical threshold for a diagnosis. If a child struggles to consistently listen or pay attention at school and home despite their best efforts and intentions, it may be a sign that they have ADHD.
I saw on TikTok that sleeping like a ‘flamingo’ or a ‘T rex’ could be a good indicator you have ADHD
TikTok has been hugely influential in spreading awareness of the condition but it certainly shouldn’t be relied on as a formal diagnosis, especially given the widespread misinformation about symptoms. For instance, sleeping on your side with one leg curled up like a flamingo, or sleeping with your hands curled under your chin (“T rex arms”, as content creators call it) are widely claimed to be telltale signs – even though there is little to no scientific evidence that this is true. “Social media has some absolutely brilliant insight and some absolute nonsense,” Shelford says. “But it can start a learning journey where people look up more information about ADHD and go, ‘That explains so much.’ That enlightenment is to be celebrated.” Resources such as ADHD Foundation, ADDISS, AADD-UK and ADHD UK can help those looking for accurate and up-to-date information about the condition.
Does ADHD present differently depending on your sex?
Girls under the age of 18 with ADHD are three times less likely to be diagnosed, as they tend to present more inattentive and less hyperactive traits, and are therefore perceived as less disruptive. (The girl fidgeting subtly in the back of class doesn’t get half as much attention as a boy who feels the urge to run out of school.) Experts emphasise there is still plenty of overlap between the two, though. “People may not realise that you don’t have to be badly behaved to have ADHD,” says Asherson. “I like to remind people that there are lots of boys who fit that female criterion as well.”
Women’s symptoms may vary depending on their menstrual cycle. In the week before their period, “aligned with PMS, or possibly premenstrual dysphoric disorder (PMDD) if it’s really severe, women’s ADHD will worsen”, says Dr James Kustow, a consultant psychiatrist and the author of How to Thrive With Adult ADHD. Symptoms may also worsen during perimenopause and menopause, prompting some to seek help for the first time. Scientists believe this may have to do with declining oestrogen levels, though this remains an understudied topic.
Women also tend to be better at hiding or “masking” their symptoms, which may lead to a misdiagnosis of anxiety or depression. Asherson says: “Then they’re presenting later and often not necessarily saying, ‘I’ve got ADHD,’ but rather, ‘I’m worrying all the time.’ Part of that could just be their thoughts jumping and flitting, thinking about all the difficulties in their life – that looks a lot like anxiety.”
I don’t think I had ADHD as a kid, but I’m really struggling now. What’s happened?
Depending on the severity of your symptoms, you may have slipped under the radar of your parents or teachers and were able to cobble together habits to help you cope and get by. But any major life event or upheaval – such as the pandemic or a high-pressure job – can undermine that internal scaffolding. For instance, Kustow sees many people asking for help at the end of first year of university. Becoming a parent might also be “really destabilising for someone who struggles with executive function issues” as they are unable to cope with the baby’s unpredictable schedule.
Others may start having debilitating issues with focus where they might not have before, as well as sleep problems and racing thoughts – which can often be misattributed to mental health issues like anxiety, depression or even bipolar disorder.
How do I get a diagnosis if I think my child or I has ADHD?
You can check your suspicions with a reputable online screening test, like this one on the ADHD UK website. “But ultimately, the only way to really know is to have a formal assessment,” Shelford says. Talk to your GP about getting a referral for an adult assessment. If you suspect your child has ADHD, you should speak to their GP, as well as to their school about getting a referral to a specialist service.
Shelford adds: “If you’re in England, you’ve got the option of Right to Choose, which is designed to help people escape the postcode lottery if they have a poor service in their local area.” This means that you are legally entitled to an alternative provider. “It’s an NHS assessment, it goes on the NHS record, you get NHS prescriptions. Anyone in England can access that right,” Shelford adds.
The waiting list in my area is too long. What do I need to know about going private?
“It’s a little bit cowboy country at the moment, with private services popping up,” says Kirby. So the best thing you can do is your homework: talk to other people about their experiences, contact organisations like the ADHD Foundation and ADHD UK, speak to your local NHS trust for recommendations, and make sure your medical professional is registered with the General Medical Council (GMC).
If you are getting your child privately assessed, make sure the psychologist is registered with the British Psychological Society (BPS). “Without that, the diagnosis or report will not be outstanding,” emphasises Prof Barry Carpenter, the UK’s first professor of mental health in education. This is important because you may want to submit evidence that your child’s school needs to provide an Education, Health and Care plan (EHC), which legally entitles them to further support.
What kind of treatment is available for ADHD?
Stimulant medications such as methylphenidate and lisdexamfetamine are the most commonly prescribed for children and adults, but treating ADHD need not begin and end with medication. Sleeping well, having a good diet and regular exercise can help. Sticking to a nighttime routine is important, and there is some evidence to suggest that taking low doses of melatonin is beneficial.
“Understanding what makes you work will make a difference,” Kirby advises. She has fidget toys on her desk, sets automated reminders for important tasks and recommends headphones to cut noise.
How to Thrive With Adult ADHD includes tips such as immediately diarising all appointments as they pop up and having a 10 to 20-minute daily planning session to review everything you need to do. ADHD UK also has a discovery platform containing useful strategies.
How do I support my child or partner with ADHD?
Davie advises parents to look ahead and make their child’s day more predictable. Similarly, if a big life change is coming up, try to plan for the potential upheaval well in advance. Reaching out to a school or employer to get as much information and support ahead of time can be useful.
“No partner is perfect,” Kirby says. “Working together as a partnership, you might realise that one person might be more organised, whereas another might have different sets of skills. I come from a very neurodivergent family and I’ve always said, ‘If you find somebody organised, marry them quickly.’”
What if I’m managing someone in the workplace with it?
“The first thing is recognising that you’ve got people in your workplace already who have ADHD,” Kirby says. “Retaining talent and allowing people to thrive and use their talents is important.”
Employees with ADHD may be protected under the Equality Act, which means they have a legal right to reasonable adjustments at their work. For instance, you could optimise their work environment by offering quiet spaces to reduce distraction or provide equipment such as noise-cancelling headphones, standing desks or fidget toys.
Staying focused on meetings and keeping track of detailed tasks can be hard for those with ADHD – managers can break down an individual request into steps, offer more regular check-ins to keep on top of work, and provide breaks during long calls or tasks. Providing bullet-point takeaways and key steps after meetings can help, too. ADHD Adult UK and ADHD Foundation have helpful resources for employers who want to support those with ADHD.
Kirby also encourages managers to check any neurodivergent biases – someone fidgeting or looking away repeatedly may not be a sign that they aren’t paying attention, for instance. Shelford emphasises that you cannot fire someone because of their ADHD – that would be illegal – “but if someone can’t do the job, then obviously it’s bad for both that individual and the employer for them to stay in it.”
All the experts note that ADHD doesn’t have to mean you’re doomed to do badly in life. “Managed well, it can become a major asset to some people,” Kustow says. “That disinhibition also underpins creativity, because thoughts and ideas that are left to run a little while often get you to interesting places.” Being able to hyperfocus can also help people excel in the right environment. “You see that particularly in sports people,” Shelford adds, “the biggest examples being Michael Phelps and Simone Biles – two of the most successful Olympic athletes of all time.”
