ADHD
Comprehensive services of the highest quality in the heart of the Melbourne CBD.
What is ADHD?
Attention Deficit/Hyperactivity Disorder, ADHD, is a neuroatypical condition of impaired attention regulation.
It is estimated that ADHD affects approximately 4-6% of the community.
It is present in more boys than girls in ratio of 3:1.
There are three key aspects to ADHD:
- Inattention
- Poor impulse control
- Hyperactivity
In adulthood, impaired attention regulation is the most disruptive symptom of ADHD that impacts domains in everyday life.
Healthcare on Collins provides various forms of healthcare support to individuals with ADHD.
How Can ADHD Affect Everyday Life?
If untreated, people living with ADHD primarily report underachieving in life.
In academic or professional endeavours, these individuals report stagnated careers and abandoned tertiary and sometimes secondary studies.
In social situation, ADHD affects relationship, friendships and supportive social networks leading to loneliness and isolation.
Untreated ADHD can also lead to secondary disorders such as mood disorders, sleep disorders, drug and alcohol disorders, gaming and gambling disorders and binge eating behaviour.
How Can Your GP Help?
For ADHD, a GP has two key roles:
1. Conduct an initial assessment and (if applicable) referral to a specialist for an official diagnosis.
2. Manage safe and effective prescribing of psychostimulants and navigate the legislative and PBS requirements in prescribing Schedule 8 substances.
3. Co-ordinate and refer to allied health professionals for ADHD informed psychological therapy and dietetics.
ADHD Diagnosis
Based on current legislation, only psychiatrists and paediatricians are considered to be eligible medical specialties who can make a formal diagnosis of ADHD.
This is based on a detailed clinical assessment and extensive psychometric evaluation.
A GP, being a delegate of a psychiatrist or a paediatrician, can then take over the management of ADHD and work within the federal and state laws that govern the stimulant prescribing.
PBS subsidy is available for those patients where it is possible to ascertain the retrospectivity of the diagnosis, based on evidence like school reports or a collateral history from a relative.
When Is ADHD Diagnosed?
ADHD diagnosis can be made at any time.
The benefit is many orders of magnitude greater when the diagnosis is made early as it allows early intervention and protects the individual against the compounded negative impacts of untreated ADHD.
Symptoms of ADHD start to be observed in a pre-schooler but typically present to the attention of medical professional during primary school when they are observed to have “learning difficulties”.
When the diagnosis is missed during school years, the young adults would typically initiate their own assessment to assist them with managing their cognitive, executive and behavioural difficulties.
Infrequently, mature adults will also present for ADHD assessment either referred by their children or other family members or seek their own diagnosis to understand and validate the difficulties that they have experienced in their lives.
ADHD is a chronic condition of neurodiversity.
However, it is reported that one quarter of those diagnosed in childhood would grow out of it by the time of adolescence and nearly half would grow out of it by adulthood.
ADHD Has Been Historically Underdiagnosed
Historically (over 25 years ago) ADHD has been underdiagnosed, particularly in women, who present slightly differently and are less disruptive in school environments (thus are less likely to be diagnosed as their symptoms interfere less with their teachers and peers).
While girls with ADHD might tend towards verbal overexpression in the classroom, boys with ADHD may exhibit more overt physical manifestations, such as restlessness or fidgeting, which can disrupt the learning environment for both themselves and their peers.
Recognising the historical underdiagnosis of ADHD highlights the importance of understanding diverse presentations of the condition to ensure accurate identification and support.
Impact of Technology
Additionally, the digital revolution has exacerbated and unmasked ADHD symptoms in some individuals. Push notifications and engagement algorithms reinforce sporadic attention, amplifying challenges related to focus and concentration.
ADHD Supports Available
✔Initial Supports
If a GP suspects a patient, whether adult or child, may have ADHD, they will conduct an assessment to determine if they meet the clear criteria for the condition and if there are any associated mood disorders. If signs of a mood disorder are present, the GP will address this first.
✔Referrals
If symptoms of ADHD persist after treating the mood disorder, the GP will refer the patient to a suitable psychiatrist for confirmation of the diagnosis.
✔Treatment
Once ADHD is confirmed, the GP will discuss available treatment options and help create a personalised plan, which may involve collaboration with specialists. Medication is a common treatment option for ADHD, potentially resulting in improvement of symptoms by up to 80% in some cases. It is particularly effective for managing addictive or impulsive behaviours that frequently coexist with ADHD.
Another treatment avenue is referral to a psychologist trained in ADHD-informed psychological therapy.
✔Management Timeline
After an initial ADHD diagnosis, you will typically have appointments with your GP until your condition is stabilised (minimal disruption to day-to-day life and mood disorder treated).
Following this, once treatment is optimised, consults may decrease in frequency to once every 3-4 months.
Booking GP Services at Healthcare on Collins
It’s important to acknowledge the historical underdiagnosis of ADHD.
Currently, a minority of GPs specialise in ADHD diagnosis and treatment, estimated at around 20%. This highlights the importance of seeking specialised care if you suspect ADHD.
Understanding that treatment effectiveness varies, with approximately 40% experiencing significant improvement, around 30% seeing moderate improvement, and 25-30% showing little to no improvement due to misdiagnosis or comorbidities, reinforcing the need for accurate diagnosis and tailored treatment plans.
Therefore, it’s advisable to consult with healthcare professionals experienced in ADHD for comprehensive assessment and management.
