How to get a diagnosis of ADHD

• Diagnosis is based on a comprehensive psychiatric/clinical interview. This can be done remotely or in person.
• Collateral information from parents, partners, or family members can be helpful but is not essential. Parents may sometimes minimise symptoms due to guilt, normalisation, or because they share similar traits themselves. If accounts conflict, the patient’s lifelong experience usually takes precedence.
• Rating questionnaires and diagnostic tests can support diagnosis but do not replace the clinical interview.
• The official criteria require:
  • 5 out of 9 inattentive symptoms and/or 5 out of 9 hyperactive/impulsive symptoms.
  • Symptoms must be lifelong (present since childhood).
  • Symptoms must cause clear impairment in academic, occupational, or social functioning.
• These criteria are consistent across DSM-5 and ICD-11.

A good ADHD assessment is more than just a checklist of symptoms. It should cover all areas of your life to build a full picture. You can expect your clinician to ask about:

• ADHD symptoms: past and present, across home, school, work, and relationships.
• Mood and anxiety: whether there are signs of Depression, Anxiety, or emotional dysregulation.
• Sleep: bedtime routine, difficulty falling asleep, early waking, possible conditions such as sleep apnoea, restless legs syndrome, or REM sleep disturbances.
• Diet and eating patterns: binge eating, restrictive eating, or avoidant/restrictive food intake (ARFID).
• Family history: ADHD, mood disorders, anxiety, or related conditions.
• Medical and psychiatric history: past diagnoses, treatments, medications, therapy, and how effective they were.
• Childhood temperament and development: including schooling, learning style, and early behavioural patterns.
• History of trauma or adversity: and how it has shaped coping styles.
• Relationships: patterns of conflict, rejection sensitivity, attachment style, and support systems.
• Substance use: alcohol, cannabis, stimulants, or other substances.
• Occupational history: career path, job stability, and difficulties with admin or structure.
• Medical conditions: especially those linked to ADHD, such as cardiac problems, asthma, or connective tissue conditions like Ehlers–Danlos syndrome.

A thorough assessment may feel wide-ranging, but that’s because ADHD often overlaps with many other conditions. A good clinician will explore these areas sensitively and at a pace that feels manageable.

• NHS Pathway: In many areas, waiting lists are extremely long. Some regions use the “Right to Choose” pathway, where patients can be referred to approved private clinics at NHS expense.
• Private Clinics: These are increasingly common. It is best to choose one where:
  • Assessments are carried out by a psychiatrist.
  • Assessment and treatment are offered in the same clinic.
  • Prescriptions can be provided directly.
  • Autism assessments are also available (if needed).

• Assessment costs: Typically £500–£1,500 in the UK. Be cautious of very low advertised prices, as ongoing treatment costs can be higher.
• Follow-ups: Usually £100–£250. Psychiatrist follow-ups are preferred, as they can manage ADHD alongside other mental health issues.
• Titration: Adjusting medication dose usually takes 4–6 months (4–6 appointments). It may take longer if side effects or comorbidities are present.
• Shared Care Agreements (SCA): Before choosing a clinic, ask your GP if they will accept shared care. Some GPs refuse SCAs from private providers.

Some patients are diagnosed abroad. While these assessments may be valid, prescriptions are often difficult to transfer back to UK GPs.

To get the most out of your assessment:

• Read about ADHD and its impact on daily life.
• Write down examples of symptoms across childhood, adolescence, and adulthood.
• Consider how ADHD affects your work, relationships, mood, and self-esteem.
• Prepare questions about medication, titration, and shared care agreements.
• Read widely, including patient stories and experiences in forums or chatrooms. These can help you feel less alone and highlight real-world issues. However, be cautious: not everything you read online is accurate. Always compare information with authentic patient leaflets or bring it up with a professional for clarification.