Pros/cons and practicalities of seeking an ADHD assessment as an older adult?

[alltheevennumbers]

Interested in your experiences and reflections: my teen has received ASD and ADHD diagnoses in the last 18 months, and it's dawning on me that I may also have ADHD. I have done online screening questionnaires and get scores which suggest an assessment is indicated.

The context is that I am in my 50s and have had a decent career in roles where I have been able to use my strengths (creativity, whole systems thinking etc) to balance out the things I struggle with (holding any notion of time/schedule in my head, something approaching physical pain when having to pay sustained attention to fine detail or complete routine tasks, pathological procrastination).

I'm not sure what the pros and cons of seeking an assessment would be or if there are any downsides to a diagnosis (insurance? Other people's assumptions about implications for parenting capabilities etc etc?).

I am curious primarily for self-knowledge; to help work out what to do with the rest of my life, and perhaps to find a bit more self-acceptance of the things I struggle with (including household organisation😀). Doing an MPhil/PhD appeals, but I also know that I struggle so profoundly with procrastination that this would be a living hell. Although I ended up with a good first degree, it was a drawn out process, that I could not engage conventionally in, and it felt like it nearly killed me.

I'm also wondering about the best way of getting an assessment as an adult? TIA

I have experience of seeking Autism assessment in my late 40s - not ADHD but as no one has answered yet I thought this would serve the purpose of bumping and possibly being helpful.

I found the NHS a waste of time (and very stressful). I was told in my area that they prioritise children and they won't accept adult referrals at all where there is any history of anxiety/depression etc. Even for those accepted I understand the waiting list is very long - years, not months.

I sought a private assessment as the only option and I do now have an official diagnosis of Autism which has been a huge relief to me. The assessment I had was for all types of neurodivergence but Autism was what they found, which tied in with my own research. The provider also assesses on contract for the NHS as most of them do, now, I believe.

My experience going private was very good, but obviously it has cost me money I would rather not have had to spend in the current climate. I try to see it as an investment as I am hoping now that I can be sure of the support/intervention I need it will help me progress in my career or at least, hang on to the job I've got!

Best of luck whatever you decide, OP.

they won't accept adult referrals at all where there is any history of anxiety/depression etc

This is really common and should be unacceptable given that pretty much all adults (especially adult women) who are diagnosed with ADHD have some history of being misdiagnosed palmed off with anxiety and/of depression.

I had that experience of being told there was no point in an NHS referral etc. but here, have some sertraline instead. So I went private. It was a pretty straightforward process. Hard though - emotionally. Basically going through all the ways you struggle in life and the negative effects it’s had is tough. As is asking other people to fill in questionnaires about that.

I’d say it has been useful to get the diagnosis. It’s an explanation for various things and a reminder that I need to be kinder to myself. It’s also a starting point for trying to make improvements. Being able to identify some of the negative patterns earlier as aspects of ADHD means I can try to do something more useful to overcome paralysis or overwhelm and bypass the being pissed off at myself and feeling I should be better at life and able to do things (which makes everything worse).

This is really common and should be unacceptable given that pretty much all adults (especially adult women) who are diagnosed with ADHD have some history of being misdiagnosed palmed off with anxiety and/of depression

Exactly. If you have been living for many years with undiagnosed neurodivergence, it would be more surprising if you did not have some level of depression or anxiety. A lifetime of masking takes a heavy toll.

It absolutely does. The fact the NHS use it as a way of screening people out should be shocking. But it’s not, because services are so stretched and society doesn’t take neurodivergence properly seriously in people who have managed to just about get themselves through to middle age.

they won't accept adult referrals at all where there is any history of anxiety/depression etc.

I’ve never heard this before. That is beyond shocking! As has been said, these are surely people that are especially worthy of assessment.

Can anyone explain the rationale?? Other than an arbitrary way to reduce demand on services, why would you target this group??

I think the NHS is so overwhelmed that they'll do anything to reduce referrals. They don't want more people on their waiting lists because it will look bad for them.

But I was told by my GP that the 'policy' is to 'treat the symptoms' of anxiety/depression. In other words, to prescribe you whatever is the buzz drug of the moment - sertraline is their current favourite; before that, it was citalopram - and hope that fixes it. However, no medication has ever touched my anxiety or depression - if anything, medication seems to make it worse.

As Charlie says earlier, there's an air of 'if you've survived to middle age, you're coping well enough' - ignoring the fact that today's middle-aged people have another 20 years of work to get through, and the toll of coping/masking gets heavier and heavier, and then you have middle-aged health problems dragging you down as well, aches and pains, the effects of the menopause.

I do understand the importance of children being diagnosed - I am sure many of us who have only just been diagnosed in middle age will look back and think how much an earlier diagnosis would have spared us, and would absolutely wish to have ND children today to be spared the same pain with as early a diagnosis as possible.

But it seems grossly unfair to penalise people for being born in an era when there was very little awareness of ND conditions - certainly for an average working-class family like mine - when we have the added burden of having to 'adult' in the 21st century and bear all the responsibilities of running a home, working and/or parenting, and/or caring for elderly parents, etc. etc. etc.

Thank you so much for your replies. I've had a 5 year battle to get a child assessed so am shocked but not surprised by what you report.

Just to ask a couple of follow on questions, if I may: have you brought your diagnoses back onto the NHS books, or kept them private? Have you been referred by the NHS to private providers or gone direct? TIA