To consider proper ADHD assessment for myself, age 52; will it change much?

@AGlessandahalf I was assessed by McKeown Psychology Associates Ltd in Brighton. An extremely thorough process lasting several hours/days and one of the only places I could find that look at the entire neurodevelopmental picture. I am also under an NHS psychiatrist, again they were /are very thorough.

My NHS one was through and they used my ASC diagnosis which they’d done too. I think it has been recognised that the NHS wait lists need to be sorted.

www.england.nhs.uk/long-read/report-of-the-independent-adhd-taskforce-part-1/

@Opinionsprettyplease it’s pretty focused on your childhood so do be prepared. But they will want questionnaires about your childhood filled in by parents and friend too

Can anyone recommend a robust private diagnosis for someone in their 50s?

14 members of my family, ranging from ages 9 to 77, have been diagnosed with ADHD in recent years and are all on medication.

They all think it's fantastic.

Got to be honest - I think for at least some of them it's just a fashionable badge of honour, but maybe it will work for you.

I'm not sure about the pathway for children. My son was diagnosed with autism through CAMHS as the school said that the local authorities won't always accept a private diagnosis. There may well be long wait lists now, others would be able to advise better.

There is some advice here. ((ADHD Diagnosis Pathways (Children) - ADHD UK

That’s why people voice feeling disheartened about it - most people want a robust assessment process so they can have confidence in the diagnosis they’re given

That is bad. But surely someone must know their diagnosis isn’t necessarily proper if they’ve just had a short zoom interview? Surely they’d want to know if they really have it or not?

No. It’s pointless.

Plenty of ADHD assessments aren’t rigorous though - you only need to be in some ADHD groups to hear about how many people were disheartened by how short and shoddy their assessments were - some assessors even telling people what they needed to say if they wanted the ADHD diagnosis.

It’s a personal choice. I have many of the traits but I’m in my late 40s and I manage them perfectly well. I wouldn’t take medication for it, so it seems rather pointless getting a formal diagnosis. I appreciate others will view it differently.

I get quite annoyed at the 'Everyone wants an ADHD diagnosis these days' trope. I can't speak for every clinic, but the assessment process for most, is very long, stringent and has to be evidence based. People don't get given a diagnosis easily and it comes after all other mental health possibilities are considered by a team of clinical psychologists. I wouldn't have considered going through it if not for massively declining mental and physical health during the menopause. HRT did not solve this and actually made things worse.

Op I was lucky to have all my school reports, as I didn't want to involve my elderly parents, one of whom has dementia. Is there a family member who can help you with the questionnaires?

And I agree it is especially important for women to get diagnosed because women who have ADHD can be much more sensitive to hormone fluctuations that can come from different life stages and are much more susceptible than neurotypical women to develop conditions like PMDD which can be absolutely harrowing.

But sure it's definitely just a trendy quirky label

This is atrocious advice.

I wasn't interested in a diagnosis at all and was very reluctant to even do screening, but my therapist who I see for a sudden severe increase of anxiety and depression took me through the process.

It is extremely relevant to the correct treatment of mental health conditions to understand neurodivergence, and especially for the treatment of anxiety and depression. Why on earth would you genuinely want someone to forgo understanding their own minds, and take unnecessary or inappropriate medications that have masses of side effects, when it would be more beneficial to develop coping mechanisms through understanding their ADHD? What sort of chip do you have on your shoulder?

OP, I'm in Ireland too. Am nearly 100% I have ADHD and possibly autism, I'm not sure about that. I tend to take things literally which is why I never thought I had ADHD. Did I find school boring and it hard to focus - no, I loved school and loved learning new things. Didn't realise the questionnaires mean the boring stuff, which made my skin crawl... Do I constantly lose stuff - no, I never lose anything. Didn't realise questionnaires mean do you misplace stuff - yes, constantly to the point of it being comical. Do you find it hard to focus - no I have amazing ability to concentrate/focus - hyperfocus after weeks/days/hours of procrastination.

Anyway the cost is off putting for me and due to my self diagnosis I'm managing myself better. I've learned that delayed gratification doesn't work for me, I need the rewards first. Completing leisure tasks ups my dopamine a bit, so if I fool around doing stuff like wordle on my phone I can get things done afterwards. If somebody else starts doing something I can finish it, even if what they've done is completely stupid. I don't seem to mind redoing. Perhaps fixing things raises dopamine, I'm not sure. Anyway I beat myself up less about the way I need to operate and that makes life better.

Also lack of hormones made my ADHD traits a lot worse so if you're not on HRT get that sorted. Incidentally there is some evidence that ADHD women don't get on with progesterone. Oestrogen is a stimulant.

I was diagnosed on the NHS at 56. It’s been massively helpful. I did an NHS psychotherapy group course for several weeks which they offered, was also offered individual therapy but not doing that yet and tried medication.

Just getting answers had helped massively as has the techniques I learnt on the group course. I’m too scared to continue with medication atm.

8 months is amazing! I waited over 6 years!

Yes, with many of the private assessments it's "pay for a diagnosis" rather than "pay for assessment." So even if they say you have ADHD, will it actually stop you wondering if it's that or lifestyle or menopause or etc?

Just saw this - and wanted to say that you may not get that closure, not least because your mind may be in a constant battle between the need for certainty and the urge to constantly question and revisit, which is central to ND experience.

And it can also 100% be a combination of all those things. The idea that there is one and only one cause of how we function in the world is seductive but also reductive.

But you’re not imagining the differences and difficulties. I work in mental health and I work with mostly ND people. When occasionally an NT person crosses my path, their engagement with therapy and the way they talk about their life and their struggles is hugely, palpably different - even when they’re depressed, or traumatised, or deep in perimenopause brain fog. The best way I can describe it is there is more coherence and flexibility / adaptability. They don’t fall down cognitive trap-doors all the time. Time and space feel solid. There’s an ability to create a clear and concise narrative that connects different parts of their lives and experience, and weights each part appropriately. They generally get more out of talk therapy as they are more able to take what they need and leave the rest, rather than needing everything to make total logical sense, and provide conclusive answers or a watertight framework for everything, leaving no loose ends. More ability to tolerate unsolved problems and imperfection and life as work in progress. It sounds lovely, TBH!

Just as food for thought - somebody I know had their child diagnosed privately, and medication is two hundred pounds a month.... the child's is now thriving but in our area there is no shared care agreement so they are tied into this for the foreseeable. Not a reason not to pursue a diagnosis per se, but for some - including us - this cost is prohibitive...

To add, our child is on the diagnosis pathway, but the waiting time for nhs route is four years... don't think it's unusual, sadly!

I was diagnosed mod 40s. The private assessment I has was simple to the point I did kind of feel anyone could game it to get a diagnosis, which I didn’t feel great about.

Stimulant meds help me feel less overwhelmed, get things done faster & more efficiently, and help me initiate and complete tasks. They make me less likely to want to cry with boredom at the prospect of peeling a parsnip. They help me feel a lot less anxious. My resting heart rate came down, which you wouldn’t expect whole taking amphetamines, so that suggests its reducing my stress levels a lot.

But it’s not a magic bullet, and I do get very cranky in the evenings when the meds wear off. Sometimes I take a short acting tablet before bed, which paradoxically helps me sleep, and allows me to tidy the kitchen so I don’t come down to a mess in the morning.

I do have some concerns about the long term physical effects of stimulant use but I figure I’m less likely to die by my own carelessness if I’m on the meds, so it’s swings and roundabouts.

I was diagnosed in the UK, by means of some self-report questionnaires, one from my mum (but it’s not like they checked her ID or anything - anyone could have written it), and a 45-minute Zoom call.

We currently live in the US where my DC had a much more thorough evaluation, including tons of cognitive and psychological tests over 3 long days. As a result he was un diagnosed with ADHD, though kept his existing UK diagnosis of ASD.

The tests suggested DS’s attention is actually fine and his working memory is excellent, but he has extremely slow processing speed. He also has unusually high intelligence in one or two areas and solidly average intelligence in others - which makes school tough as he’s massively bored in some lessons, and massively frustrated and impatient in the lessons where he has to work harder with less reward.

He also has poor visual tracking (which is why he can never bloody find anything even when it’s right in front of him), and pragmatic language issues & perfectionism consistent with his ASD diagnosis.

All of which adds up to an executive function shitshow (in layman’s terms) that isn’t much helped by stimulant meds - apart from that they did help his frustration tolerance and mood management during the school day.

I found that all extremely interesting! But nobody has any suggestions for what could be done to help, apart from some eye exercises and extra time for tasks and exams.

I’d love to have similarly rigorous testing done on me - as I do think it really helps to have some understanding of why things are as hard as they are. But I can’t afford it, so I’ll just soldier on with my meds.

It depends on your GP practice, not all accept shared care.