ADHD in Adults: Signs, Diagnosis and How to Get Assessed

ADHD in adults usually shows up as ongoing trouble paying attention (being easily distracted, forgetful or disorganised), being restless or full of energy, and acting on impulse, such as interrupting or making quick decisions. Everyone has moments like this, but with ADHD they happen often, in many parts of life, and get in the way of work, study or relationships. Only an assessment by a specialist, such as a psychiatrist, can confirm a diagnosis.

What ADHD is

ADHD stands for attention deficit hyperactivity disorder. The NHS describes it as a condition that can affect how you focus, so you may have trouble with things like concentrating and sitting still.

The US National Institute of Mental Health (NIMH) calls ADHD a neurodevelopmental disorder, meaning it is linked to how the brain develops and works. Symptoms begin in childhood and usually continue into the teenage years and adulthood. Many adults only start to wonder about ADHD later in life, for example when the demands of a job, studies or a family make old difficulties harder to manage.

The cause is not always known. According to the NHS, ADHD may be caused by genetic differences and often runs in families. Other things linked to it include being born premature (before 37 weeks of pregnancy), epilepsy, a brain injury and being autistic. Some people with ADHD describe themselves as neurodivergent, a word for the range of different ways our brains work.

Signs of ADHD in adults

ADHD symptoms fall into two broad groups: inattention, and hyperactivity with impulsiveness. The NHS says most people with ADHD have symptoms of both types, while some only show signs of one. These symptoms usually start before the age of 12.

Inattention

According to the NHS, signs of being inattentive in adults include:

• being easily distracted or forgetful
• finding it hard to organise your time
• finding it hard to follow instructions or finish tasks
• losing things often, like your wallet, mobile or keys

NIMH adds difficulty keeping on task and staying organised.

Hyperactivity and impulsiveness

Signs of being hyperactive and impulsive include:

• having a lot of energy or feeling restless
• being very talkative or interrupting conversations
• making quick decisions without thinking about what might happen as a result
• having trouble waiting your turn, or intruding on others (NIMH)

How this can look in daily life

The NHS notes that ADHD is thought to be recognised less often in women than in men. This may be because women with ADHD more often have inattentive symptoms, which can be harder to spot than hyperactive ones. A quiet woman who is always "a bit scattered" can easily be overlooked.

NIMH also explains why this matters. For many people, symptoms make it hard to get things done, interfere with work or study, and strain relationships. Teens and adults with ADHD are more likely to take part in risky behaviours, such as substance use, and are at higher risk of poor job performance and money problems.

ADHD or everyday distraction?

Most of us lose our keys, forget a message or drift off in a dull meeting now and then, especially after a bad night's sleep or a stressful week. That alone is not ADHD.

NIMH explains that it is common for people to show these behaviours some of the time. The difference with ADHD is that the behaviours are:

• frequent, not just once in a while
• present in several settings, such as at home, at work, at school or with family and friends
• interfering with daily life, not just a small annoyance

The NHS page on ADHD in children makes a similar point: being easily distracted, impulsive and full of energy does not on its own mean ADHD, and could be a sign of something else, like being tired, anxious or stressed. The same common sense applies to adults. If your concentration has only become poor recently, for example during a hard period at work or at home, talk to a doctor about what else could be going on.

How ADHD is diagnosed

According to the NHS, the first step is usually an appointment with a GP (family doctor). The GP will ask about your symptoms and how they affect your life. They may also think about other conditions that could be causing your symptoms, such as autism, Tourette's or anxiety, so that you get the right care. The GP may then refer you for an assessment with a mental health professional who specialises in ADHD.

The assessment itself is with an ADHD specialist, such as a psychiatrist. The NHS says they will:

• ask about the history of your symptoms, particularly whether they started when you were a child, and how they affected you at school
• look at different areas of your life, including work and education, family and friends, and your medical history, including any mental health issues
• possibly contact someone who knows you well, such as a family member or close friend

If you are diagnosed, the specialist will explain what it means and what happens next, including the help and support available. If you were already diagnosed as a child and need help again as an adult, the NHS advises talking to your GP about a referral.

Why an online quiz cannot diagnose ADHD

Online quizzes and social media videos about ADHD are everywhere. A self-screening questionnaire can be a useful prompt to think about your symptoms and to take notes for your doctor, but it cannot tell you whether you have ADHD. A quiz cannot:

• check whether your symptoms began in childhood
• see how much they affect your work, studies and relationships
• talk to someone who has known you for years
• rule out other conditions that can look similar

These are exactly the things a specialist looks at in a proper assessment.

Conditions that can look similar or come along with ADHD

ADHD often does not travel alone. According to the NHS, people with ADHD often have other conditions too, such as depression, anxiety or addictions, or a learning difficulty such as dyslexia. NIMH lists disruptive behaviour, learning disorders, sleep problems, anxiety and depression as conditions that often occur alongside ADHD, which can make everything harder to diagnose and treat.

Some conditions can also cause symptoms that look like ADHD. The NHS mentions that a GP may consider autism, Tourette's or anxiety when deciding what is behind your symptoms. If worry is a big part of your day, our guide on normal worry versus an anxiety disorder may also help.

The NHS also points out that people with ADHD may be more likely to have mental health problems such as anxiety and depression, and are at higher risk of suicide. This is one more reason to get a proper assessment rather than struggling alone.

Treatment, support and everyday coping

The NHS says ADHD can be managed in many ways, including lifestyle changes, changes at work and medicines. What helps depends on your symptoms and how they affect you. Not everyone needs or wants to take medicine.

Medicines and therapy

• Medicines: According to the NHS, ADHD medicines must be started and monitored by an ADHD specialist. You may need to try more than one medicine to find what works for you. Never start, stop or share ADHD medicine without your specialist's advice.
• Talking therapies: The NHS says talking therapies, such as cognitive behavioural therapy (CBT) or mindfulness, may be recommended for adults with ADHD. NIMH also lists medication and psychosocial treatments, such as CBT, as standard treatments.

Practical things you can do

The NHS suggests these self-help steps:

• Move your body. Make time for physical activities you enjoy. Exercise can be a good focus for your energy and also helps reduce symptoms of anxiety and depression, which can make ADHD symptoms worse.
• Protect your sleep. Keep a regular bedtime and a quiet, dark bedroom. Try to avoid screens, caffeine, sugar and alcohol close to bedtime. That late-night cup of chai and scrolling on your phone in bed can both get in the way.
• Eat regularly. Aim for a healthy, balanced diet and regular mealtimes.
• Talk about it. You may find it helpful to talk to friends and family about your ADHD.

Help at work or university

The NHS describes changes that can help at work or in study, such as:

• a personal work space in a quiet area
• written instructions as well as spoken ones
• help from another person to plan and structure your tasks

In Pakistan these are not always formal policies, but many managers and teachers are willing to help once they understand what makes a difference for you.

When to see a doctor and how to ask for an assessment in Pakistan

The NHS advises making an appointment if your ADHD symptoms are affecting your studies, work or relationships. You should also see a doctor if your concentration or mood has changed recently, since other problems can cause similar difficulties.

In Pakistan, a simple way to start is:

• See a GP or family physician at a clinic you trust. Explain what you have noticed, how long it has been going on, and how it affects your life. They can consider other causes and advise whether you should see a specialist.
• Or book a psychiatrist directly. A psychiatrist is the type of specialist the NHS names for adult ADHD assessments.
• Prepare before the visit. Write down examples from work, home and relationships. Because the specialist will ask about your childhood and school years, it helps to ask a parent, older sibling or close family member what you were like as a child, or to bring them along if you are comfortable with that.
• Mention other problems too, such as low mood, worry, sleep problems or alcohol and drug use, so the doctor sees the full picture.

Get help urgently if you are having thoughts of harming yourself or ending your life. The NHS says it is important to tell someone. Talk to a family member or friend you trust, see a doctor the same day, or call 1122 in an emergency.

You can find PMDC-verified doctors by city and specialty and book a visit on SehatDoc Booking.

Sources

• NHS — ADHD in adults
• NHS — ADHD in children and young people
• NIMH — Attention-Deficit/Hyperactivity Disorder (ADHD)

Medical note: This guide is for general information and is not a substitute for advice from a doctor who can examine you.