Going to the GP about suspected ADHD or Autism as an adult?

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I'm in my 20s, have struggled my entire life with being very shy and quiet. Struggle to initiate conversations, only have a couple of friends, always feel like I'm trying to understand social rules, find myself observing people interact to try and learn how to have a good back-and-forth conversation. I've been going through cycles of burning out every 2ish years, where I will go from functioning to struggling to get myself washed and dressed, and things like making meals or washing my face feel like huge hurdles. I like routine (e.g. my morning routine has been perfected down to the minute, and if someone is a few minutes longer in the bathroom it really stresses me out), yet equally I'm bored by routine and like to do spontaneous things. As a child I was very shy and quiet, would day dream in class a lot but always had a good group of friends and was well-liked by my peers. I hit all my early years milestones on time, but was very clingy to my Mum and shy.

I feel like I have something. I seem to get overwhelmed very easily and get stressed out very easily. I'm currently going through yet another 'burn out' cycle and was signed off for 'anxiety' for 3 weeks in January, and I'm still struggling.

I did the AQ-10 (autistic screening tool) though and only got 4/10 which is below the 6/10 needed for referral, I don't resonate with the questions asked in the AQ-10... Then I did the ASRS (ADHD screening tool) and it said my symptoms are highly consistent with ADHD, but I just don't believe that as most of my issues are social in nature so I feel like that would be more like autism?

A GP can't diagnose either condition but they are the starting point for a referral. Both assessments are very long and in-depth. The GP can refer you to community mental health for a general mental health assessment and from there they can put you on the waiting list for an ADHD or Autism assessment depending on what the clinician thinks is the most likely (they will usually do one at a time). The process will usually take about 4 years per condition, because so many adults are trying to get ADHD/ASD diagnoses atm.

If you've funds, I'd look at private assessments. ADHD is a lot cheaper than ASD so funding that just to rule it out (or thinking about a dual diagnosis) could be a good idea, then get the Autism assessment later on.

Also think about what a diagnosis will actually achieve. ADHD is treatable with medication and there's nothing they can really do for ASD beyond lifestyle changes you could try for yourself at home without a diagnosis if you Google them, so you'll have a word to describe what's wrong, but nothing you can really do about it.

You could try the AQ50 which is more detailed. If you’re not scoring highly then it’s unlikely you have autism. Talk to your GP and just ask to be referred, but be aware you’ll be waiting for 4-5 years for an assessment.

Your GP will possibly refer you on to the waiting list for outpatient assessment but it depends how it impacts on your life. I'm on the waiting list because I have a DC with a diagnosis. My sister is very similar but, because it's not impacting her life in the same way (no spouse or DC) they wouldn't refer her.

The adult waiting list is 3+ years by the way, so even if you get referred, nothing's happening any time soon.

If it is autism or ADHD (or even if it's 'just' anxiety) it impacts my life everyday. I wake up with such an intense feeling of overwhelm and dread because everything feels overwhelming and too much. I was signed off for 3 weeks in January because of it, signed off for 3 months in 2022, etc. Took a 3 months break last year in between jobs. It's just not sustainable, but I don't know what's actually wrong with me or how to pull myself together. I struggle to walk around a supermarket as my head feels so foggy and confused. I can't drive despite having a car because I find it overwhelming. I struggle to interact with colleagues, and had a manager pull me aside for a meeting about my 'shyness'.

I'm currently at university and I think I can get help with costs for a private assessment, but I don't know whether to or not. I'm scared to be honest, but I know having an answer and a diagnosis would allow me to advocate for adjustments to help me,

I am autistic. Autism isn’t an overwhelming feeling of dread, and it’s not brain fog and confusion. That’s anxiety and depression. Not saying you don’t have autism but it doesn’t cause those feelings.

I recommend getting a diagnosis, because you can legally request reasonable adjustments and advocate for yourself. Also it helps you to look back at your life and put things into context, you realise how many things have actually been caused by autism you didn’t know you had. In a way it helps you make peace because you understand why these things happened.

But you need to seek support for your anxiety and depression, and that’s a lot faster to access than an autism diagnosis. By all means get put on the waiting list, but get separate help for your anxiety as well.

I am autistic. Autism isn’t an overwhelming feeling of dread, and it’s not brain fog and confusion. That’s anxiety and depression.

It perfectly describes my experience of my adhd.

I have adhd and autism. It is possible to be both. An awful lot of your comments resonate with me. Particularly about how much you need routine, yet you get very bored and need spontaneity and wandering around the supermarket in a fog. Get yourself on the waiting list, it's a very, very long wait so the sooner the better.

In the meantime, i would read up on how both conditions present in women, and how it looks if you have both. I would start living your life with the knowledge that you may have either or both, and look at coping mechanisms. Even if you don't have either, those coping mechanisms may help.

Just to add that, if you are considering a private assessment, you need to see whether your GP would sign up to a "shared care agreement" if you are diagnosed. Without one, the GP will not be able to prescribe medication and you will likely have to pay not only for your drugs (if you have them) but also for an "admin fee" to cover your private provider's costs of issuing a prescription. It can get expensive.

Good point. I did get agreement for shared care, then my GP went back on it so now I'm unmedicated. Cost me hundreds of pounds and i ran out of money.

Could you have social anxiety? Have you looked into that at all? Just given what you said about shyness etc it might be that you have social anxiety?
Or are you a highly sensitive person?
Just throwing some other ideas out there as might not necessarily be autism / adhd
Sorry you're struggling it does sound like somethings going on for you impacting on your wellbeing like you say

Your op describes my life pre diagnosis pretty well, especially the burnouts. I have ADHD. A combination of medication and ADHD coaching has turned my life around.

I also have an ASD diagnosis, but this feels less descriptive of my particular constellation of traits. I was diagnosed with ASD during a period of depression and burnout and I suspect that this influenced the way I presented during the diagnostic process.

It's possible I have both, I suppose...