Two million people in the UK could have undiagnosed ADHD — here are the signs

There are three types of ADHD

Lisa Salmon
Monday 30 September 2024 12:56 BST
Difficulties with focus and regulating attention can be signs of ADHD (Alamy/PA)
Difficulties with focus and regulating attention can be signs of ADHD (Alamy/PA)

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It’s thought more than 80% of people with ADHD (short for attention deficit hyperactivity disorder) in the UK remain undiagnosed.

Millions of people in the UK have the disorder, including a host of celebrities such as Ant McPartlin, Ben Fogle, Zoe Ball, Lily Allen and Richard Branson.

October is ADHD Awareness Month, which aims to educate more people about the condition and help those with undiagnosed ADHD spot the signs and seek a diagnosis.

As ADHD UK points out, people with ADHD show ‘a persistent pattern of inattention and/or hyperactivity–impulsivity that interferes with day-to-day functioning and/or development’.

Dr Selina Warlow, a psychologist specialising in ADHD and autism at The Nook Clinic in Surrey, says: “ADHD affects an estimated 2.5-4% of adults, though this may be an underestimation. It’s common for adults to have undiagnosed ADHD, particularly women.

“Many people misunderstand the condition, thinking ADHD always involves hyperactivity, but it can also present as inattentiveness, impulsivity, or a combination of both,” she adds. “ADHD is one of the most talked about, and misunderstood conditions today.”

Consultant psychiatrist Dr Shyamal Mashru, an ADHD specialist at the ADHD Health Clinic in London, points out that people with ADHD may struggle with organisation, time management and emotional regulation, leading to difficulties in academics, work, and relationships.

“ADHD can significantly impact a person’s life, extending far beyond the core symptoms of inattention and hyperactivity-impulsivity,” Mashru says. “These challenges can lead to feelings of frustration, low self-esteem and anxiety, impacting their overall wellbeing and quality of life.”

He explains that there are three types of ADHD: 70-80% have a combined presentation, where they experience both inattentive and hyperactive-impulsive symptoms to a significant degree; 10-15% have a predominantly inattentive presentation, where inattentive symptoms are more pronounced and hyperactive-impulsive symptoms are less evident, while the final type, predominantly hyperactive-impulsive presentation, is rare.

Exactly how ADHD affects people can vary from person to person. However, ADHD UK points out that to diagnose ADHD in adults and adolescents aged 17 or older, at least five symptoms will be needed. And they will need to be things that happen in consistent patterns, rather than being an occasional experience.

So, what are they? Here, the experts outline signs of ADHD in adults…

Difficulty focusing

If you have a lot of trouble focusing and sustaining attention on tasks, it may be linked to ADHD, says Mashru.

Forgetfulness

Mashru says adults with ADHD may be frequently forgetful and misplace things. However, Warlow points out that the official criteria for the diagnosis of ADHD says it’s forgetfulness that interferes with functioning or development, and stresses: “This really differentiates day-to-day difficulties – for example, forgetting where you left your keys or forgetting a one-off appointment = with a formal diagnosis.”

Easily distracted

Having ADHD can lead to adults becoming  distracted by other things, instead of concentrating on the task at hand. “They may be easily distracted by external stimuli,” says Mashru.

Difficulties with focus and regulating attention can be signs of ADHD (Alamy/PA)
Difficulties with focus and regulating attention can be signs of ADHD (Alamy/PA)

Not following instructions

Difficulty following instructions and completing tasks on time can be a sign of ADHD, says Mashru.

Daydreaming

Someone who’s frequently got their head in the clouds and daydreams excessively could be displaying a symptom of ADHD, warns Mashru.

Impulsive symptoms…

Acting without thinking

Adults with ADHD may act without thinking about the consequences. “This might look like interrupting conversations, making hasty decisions, or needing help with waiting for their turn,” explains Warlow.

Mashru adds: “There may be a tendency to blurt out responses before fully thinking them through.”

Restlessness

Restlessness and fidgeting can be a sign of ADHD. Warlow says people who have the condition may have difficulty sitting still for extended periods, and adds: “This is more noticeable in children, who might seem like they’re always on the go, but adults can experience it too, often in the form of inner restlessness.”

An accurate ADHD diagnosis means people can get the correct advice and support (Alamy/PA)
An accurate ADHD diagnosis means people can get the correct advice and support (Alamy/PA)

Talking a lot

Excessive talking and difficulty taking turns in conversations can be another symptom of ADHD, says Mashru.

Risky behaviour

Mashru says the impulsivity linked to some types of ADHD may lead to people taking unnecessary risks, or engaging in impulsive actions.

 The World Health Organisation and the Workgroup on Adult ADHD have developed an Adult ADHD Self-Screening Tool to indicate whether someone might have ADHD and would benefit from further clinical analysis. Only a clinician can accurately diagnose ADHD. Visit adhduk.co.uk

Has your behaviour existed since childhood?

Adults who think they may have ADHD should think back to their childhood behaviour, suggests Warlow.

“It may be helpful for them to speak to their parents or think back to their childhood to look at if these have been ongoing difficulties,” she says. “As ADHD is a neurodevelopmental condition, we’d expect some of the difficulties to be historical.”

Get a professional assessment

Both experts advise adults who suspect they may have ADHD to seek a professional assessment. The Royal College of Psychiatrists says people who think they have ADHD which is having a negative effect on their life should speak to their GP, who can refer them to an appropriate service, such as a community mental health service. However, waiting times for referrals can currently be very long. Private assessments are also available.

Warlow explains that a clinical psychologist or psychiatrist will complete a formal assessment and then tailor support for each individual. “This may include behavioural strategies to support day-to-day, or medication can be helpful for some people,” she says.

Mashru adds: “Accurately identifying the type of ADHD allows for personalised treatment plans. Medication, therapy and behavioural strategies can be tailored to address the specific challenges faced by each individual.”

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