Attention deficit hyperactivity disorder (ADHD) in adults

Our approach to treating ADHD: What is ADHD? How frequent is ADHD? What are the symptoms of ADHD?

If you are reading this, you might suspect you have attention-deficit hyperactivity disorder (ADHD), or someone may have told you that they think you have it.

ADHD can be a difficult condition to grasp because everyone can have a tendency towards some ADHD traits on occasion. ADHD is often used as a throw-away term to describe anyone who may appear too energetic, talkative, scatter-brained or even lazy. However, the diagnosis carries many more positive and negative features that can have a profound impact on a person’s life. The key to working out if you have ADHD, or are just simply a little scatty or excitable, is to consider how often and to what extent these features affect your life. After all, who doesn’t procrastinate, struggle to concentrate or act impulsively at times?

People with ADHD might feel different from their friends or colleagues and wonder why no one else seems to struggle with the same issues that they do. Over time, these feelings can become internalised and people believe they are personal faults or failures, which could lead to anxiety or depression.

Our ADHD psychiatrists in London have significant expertise in diagnosing and treating ADHD and can provide you or your loved one with expert guidance and a private ADHD assessment. 

Our approach to treating ADHD

The first step in treating ADHD is receiving a diagnosis to understand what type of symptoms are causing the most difficulty.

We believe that psychoeducation should always be the first approach in treating symptoms, regardless of severity, as per the guidelines set out by England’s National Institute for Health and Care Excellence (NICE). Psychoeducation involves your psychiatrist providing information about your specific ADHD symptoms so that you can better understand and cope with them.

We will also recommend talking therapy as a way to better understand and take control of many symptoms of ADHD. Therapy for ADHD can be incredibly effective for many people, and its results are often long-lasting.

If you have been diagnosed with ADHD, your London-based psychiatrist will discuss with you the possibility of taking medication. Taking medication for ADHD is completely optional, and the role of the psychiatrist is to provide professional advice while taking into account your personal preferences to help you through your journey.

We take the view that some lifestyle interventions, such as stress relief techniques, nutrition or exercise, can be very helpful for a lot of people with ADHD and we take these into account when developing your personalised treatment plan.

What is ADHD?

Attention-deficit hyperactivity disorder (ADHD) is a condition that can affect people’s behaviour in many different ways. Somebody with ADHD may experience any of the following issues:

  • Finding it hard to focus on tasks that they dislike, and avoiding them
  • On the other hand, being able to hyperfocus and spend lots of time on tasks that they Enjoy (to the point of often overdoing it)
  • Making careless mistakes unless they are deliberately paying a lot of attention
  • Having a tendency to start tasks and not finish them, because they are easily sidetracked
  • Difficulty finishing schoolwork, chores, or duties in the workplace or start tasks due to a loss of focus
  • Struggling with organisation or failing to keep a diary
  • Leaving things to the last minute
  • Procrastinating
  • Being easily distracted (for example by their own thoughts)
  • Problems organising tasks and activities, such as what to do in sequence
  • Keeping materials and belongings in order, having messy work and poor time management
  • Failing to meet deadlines
  • Finding it hard to pay attention in conversations
  • Feeling restless inside (too much mind wandering)
  • Fidgeting or finding it hard to sit still for long periods of time (tendency to move around more than other people)
  • Feeling a need to be constantly “doing something” (even if it is just checking the phone)
  • Talking most of the time, interrupting other people or finishing their sentences
  • Being quite impatient, finding it hard to wait for their turn

Testimonials

After 45 years of believing I was "just an anxious person", Dr Pertusa recognized quickly that I had ADHD. I found the assessment actually quite helpful to understand how my ADHD manifests. Dr Pertusa nicely walked me through the different treatments and medications available in the UK at the time. He did not push medication at all, but I am glad that he encouraged me to try it for a few days to see if it made a difference… it did! Thanks Dr P. for having been so instrumental to my growth as an individual and creating a safe environment that also helped me unpack past and current trauma. After 18 months of brilliant care, my quality of life has grown abundantly and I'm hopeful for the future as a person and mother.

Mei, 45 (San Diego)
Talk to us to discuss treatment options

How frequent is ADHD?

ADHD is surprisingly common in adults. In the UK alone, 1.5 million adults are estimated to have ADHD, yet only 200,000 are officially diagnosed.

The number of adults who receive treatment for their ADHD symptoms is even less. So even though it is a common condition it is widely underdiagnosed, especially in females.

Can I have ADHD even if I’m high-functioning?

Many people with ADHD are very high-functioning, which means they may have developed strategies to mask their symptoms, or they might be able to perform very well in their careers despite struggling with their symptoms.

Even if you are high-functioning, you will likely still benefit from an official diagnosis such as a private ADHD assessment and further support so that you can better understand the reason for any difficulties.

What are the symptoms of ADHD?

Symptoms of ADHD typically fall under three main categories of hyperactivity, impulsiveness and inattention. Although everyone demonstrates this behaviour on occasion, people with ADHD will constantly struggle with these tendencies despite their best intentions.

ADHD is a condition that exists across a spectrum or continuum in the general population. This means that while many people will display some of these tendencies, people with ADHD will display the extreme of these tendencies.

If others aren’t aware of your symptoms, they may think you are lazy or unfocused. This can lead to arguments and fights, or people might perceive your behaviour as ‘inconsiderate’ or ‘rude’ at times.

People with undiagnosed ADHD may feel frustrated and ashamed of their symptoms, which can sometimes lead to anxiety, depression or addiction problems if untreated. ADHD symptoms fall under several broad categories.

Inattention

Difficulty concentrating, listening or following instructions, becoming distracted quickly, procrastinate easily, struggling to meet deadlines, zoning out of conversations or daydreaming often, having to start a task multiple times before you can finish it, and difficulty planning ahead and organising your time.

Physical hyperactivity

Fidgeting, being unable to sit still, feeling restless, always moving around. You might struggle in environments that require you to sit still for long periods of time without disturbing others (such as libraries, offices and during flights).

Brain hyperactivity

Feeling either completely uninterested or completely obsessed with a topic. These extremes will influence whether you struggle to concentrate on something or whether you become completely focused on it, either because you find it interesting or because you are trying to cram for a deadline.

Impulsiveness

Not thinking about consequences or risks, impatient or snappy with people, impulsive purchases, reckless decisions that you later regret, interrupting conversations or completing other people’s sentences.

These symptoms can become problematic if they occur very often and interfere with your ability to maintain relationships or meet deadlines. If you feel that your ADHD symptoms negatively impact your career or academic performance, it’s appropriate to seek help and support by first getting a private ADHD assessment.

Is ADHD associated with sleep problems?

Insomnia is not a specific symptom of ADHD, but many people with ADHD suffer from sleep-onset insomnia. Generally, they tend to be night owls and function best at night when there are no interruptions, no distractions, or when they have an upcoming deadline. At nighttime, they may struggle to relax and fall asleep because their brains do not stop thinking about all sorts of stuff – sometimes just random things.

Many people with ADHD have developed coping mechanisms to deal with their sleeping problems. Some take alcohol or sleeping tablets, while others find that if they keep their brains entertained by watching TV, listening to a podcast or an audiobook they find it easier to relax and fall asleep. Often they might fall asleep with the TV on!

What are the different types of ADHD?

There are three main subtypes of ADHD that are classified according to the person’s symptoms:

Inattentive ADD

Predominantly characterised by problems with attention and concentration (which is actually known as Attention Deficit Disorder).

Hyperactive-impulsive ADHD

Predominantly characterised by problems with impulsive behaviour and hyperactivity.

Combined ADHD

This is the most frequent type and involves problems with attention/concentrations and problems with impulsive behaviour/hyperactivity. Symptoms of combined ADHD are usually more severe than the two other subtypes.

What conditions are associated with ADHD?

People with ADHD may also have other coexisting mental health conditions. Common issues that typically co-occur with ADHD include:

  • Addiction
  • Anxiety
  • Depression
  • Borderline Personality Disorder (BPD)
  • Sleep problems
  • Physical health conditions (epilepsy, allergies, gastrointestinal problems)

 

The reason for this is that the genes that increase the risk for ADHD also increase the risk for these other mental conditions, mainly depression, anxiety and Borderline Personality Disorder.

While the presence of these other conditions can make it more challenging to diagnose and treat ADHD, we often find that a holistic treatment approach can make an enormously positive impact. Once other conditions are treated, the symptoms of ADHD become much more manageable.

Is ADHD genetic?

ADHD is a complex neurodevelopmental disorder that is caused by a combination of genetic, environmental and biological factors. The heritability of ADHD is relatively high, at 74%, meaning that someone’s genetics will significantly influence whether they develop ADHD or not.

However, it’s not a simple case of genetic inheritance. Researchers have identified that the genetic risk comes from small mutations in thousands of different genes, with each of these genes contributing a small amount of risk (known as polygenic risk). Due to the vast number of genes involved, scientists still don’t understand precisely why some people develop ADHD, while others don’t.

Some environmental factors can increase the risk for ADHD, including smoking, alcohol or drug use in pregnancy, exposure to environmental toxins and premature birth. These environmental factors can place a degree of biological stress on the individual, which then increases their risk of developing ADHD, particularly if they already have an increased genetic risk

Does inflammation cause ADHD?

Several biological factors could be associated with ADHD, such as inflammation. Specifically, people with ADHD can have lower amounts of the anti-inflammatory hormone cortisol. Cortisol helps our body to absorb nutrients and is involved in regulating cognitive function and reward-seeking behaviour.

Neuroimaging studies have also shown that people with ADHD have altered patterns of brain activity, compared to people without ADHD.

Although it might be scary to learn about these biological factors involved with ADHD, the good news is that many of the treatments for ADHD help to regulate these biological mechanisms (such as cortisol and brain activity). Receiving a diagnosis and treatment for ADHD often leads to a considerable reduction in stress as you understand there is a concrete reason for your symptoms and difficulties. Stress reduction leads to a host of positive health benefits, from reducing inflammation to improving cognition. By focusing on your overall health holistically, this could even lead to an improvement in your ADHD symptoms!

Can ADHD cause addiction?

People with ADHD are at an increased risk of developing a drug addiction, as the genes that underlie the risk for developing ADHD are very similar to the genes underlying the risk for drug addiction. People with ADHD might have used or developed a drug addiction at a much younger age compared with their friends.

New genetic studies show that people with ADHD have a particularly strong predisposition to cannabis use. Meaning that the same genes that increase the risk for ADHD also increase the risk that someone will use cannabis. The study used a technique called Mendelian randomisation, which essentially demonstrated that it was the underlying genetic risk that was associated with ADHD and cannabis use, rather than the ADHD itself causing the cannabis use.

Nearly half of the risk associated with being a regular cannabis user is explained by our genetic make-up. Many of the genes are also involved in ADHD, which explains why people with ADHD are more likely to also smoke or vape cannabis.

Untreated ADHD can, in some cases, lead to serious problems later in life as it is associated with a high risk of addiction and other impulsive behaviours.

As ADHD can underlie many addictions, you should have a private ADHD assessment before treatment for any addiction begins.

While ADHD symptoms may not require targeted treatment itself, a diagnosis will be crucial for designing an effective addiction treatment.

How do you treat ADHD?

Every individual will have a unique set of symptoms and circumstances contributing to their ADHD symptoms. Once ADHD is diagnosed, as well as any other potential conditions, we will develop a personalised treatment plan specifically for you. We will develop this with your input, based on your needs and unique circumstances.

A treatment plan for ADHD may combine any of the following evidence-based approaches:

Psychotherapy (psychological therapy or talking therapies)

  • Cognitive behavioural therapy (CBT)
  • Psychodynamic therapy
  • Interpersonal therapy
  • Mindfulness-based cognitive therapy

 

Psychoeducation

  • Information and support so that you can better understand and cope with your ADHD symptoms.

 

Medication (if required)

  • Commonly prescribed ADHD medications include Ritalin, Adderall, Concerta, Medikinet, Elvanse, Dexamfetamine, Modafinil (Provigil), Atomoxetine (Strattera), Guanfacine (Intuniv)

 

Stress reduction approaches

  • Mindfulness techniques
  • Mind-body exercises

 

Diet and lifestyle interventions

  • Exercise
  • Nutritional and dietary changes
  • Supplements
  • Sleep therapy
Our Doctors

Here to help you with ADHD

Dr Srinivas Lanka

Dr Alberto Pertusa

Dr Nagore Benito

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Gemma Luke

My name is Dr Gemma Luke, a consultant clinical psychologist. I have been working in the field of mental health for over 20 years, and as a qualified clinical psychologist since 2011.

Conditions I treat:
Self-HarmAddictions AnxietyBDDBipolar disorderBehaviour problemsDepression Eating DisordersOCDPanic AttacksPersonality DisordersTrauma & PTSDOffending behaviour (domestic, violent, and sexual abuse)Behavioural issues

I am passionate about promoting positive mental health and strive to work holistically with both mind and body to help my clients achieve lasting change.

Fees

Initial consultations: £245 (1 hour)

Follow-up consultations: £245 (1 hour)

Alexandra Madureira

I’m a Clinical Psychologist who thinks outside the box. I have a creative and passionate approach that focuses on healing emotions while also considering life situations and neurobiological mechanisms.

Conditions I treat:
ADHDAddictions AnxietyBDDBipolar disorderBrain inuryBehaviour problemsChronic painDepression Eating DisordersFibromyalgiaMemory problemsOCDPanic AttacksPersonality DisordersTrauma & PTSD

I believe feeling safe is a prerequisite for change and therefore I focus on making people feel comfortable, so they can gain the courage to face and break unhelpful psychological patterns.

Fees

Please contact us for more information

Dr Ana Tsakiri

My Trauma-informed practice and holistic therapeutic approach aims to support children during periods of acute crisis but also help them with long standing emotional and behavioural difficulties. I work with families to understand how adversity and trauma has impacted a child’s world causing emotional and mental health difficulties as well as physical symptoms. I am also a Consultant Psychiatrist specialised in Interventional Psychiatry with TMS therapy for young people with resistant emotional difficulties and severe depression.

Conditions I treat:
ADHDAnxietyAutismBehavioural problemsBDDBipolar disorderBrain inuryComplex TraumaDepression Eating DisordersEmotional Difficulties Family workInterpersonal relationship problemsOCDPanic AttacksParental Psychoeducation about Mental Health DisordersPersonality DisordersPhychosomatic symptomsPsychosisPTSDSleep problems

The aim is always for your child to overcome the negative influence of the experience, redefine how they feel and rebuild their confidence

Fees
First Consultation:
£395
(1 hour)
First Consultation:
£650
(1.5 hours)
First Consultation:
£790
(2 hours)
Follow-up consultations:
£245
(30 min)
Follow-up consultations:
£295
(40 min)
Follow-up consultations:
£395
(60 min)

Dr Jonathan Garabette

I am a Psychiatrist specialising in General Psychiatry and Medical Psychotherapy. I treat most mental health difficulties and offer a range of approaches including medication, psychological therapies and lifestyle modification.
Conditions I treat:
Depression and Dysthymia​Depression and Dysthymia​Depression and Dysthymia​

I always try to focus on understanding you as a whole person and how any symptoms, problems and diagnoses affect you, your life and what is important to you.

Fees
First Consultation:
£475
(1 hour)
First Consultation:
£720
(1.5 hours)
First Consultation:
£895
(2 hours)
Follow-up consultations:
£275
(30 minutes)
Follow-up consultations:
£320
(40 minutes)
Follow-up consultations:
£475
(60 minutes)

Lynn Gruwez

I’m a Clinical Psychologist with experience across a range of mental health conditions. My goal as a therapist is to see each person as someone unique and human. I seek to understand in depth the nature of any mental health symptoms so that I can flexibly and creatively adapt therapy to suit your circumstances.

Conditions I treat:
ADHDAddictions AnxietyBDDBipolar disorderBehaviour problemsChronic painDepression Eating DisordersFibromyalgiaOCDPanic AttacksSleep problemsTrauma & PTSD

I believe in a holistic, non-judgemental approach where clients have the space and freedom to share their fears without constraint. I have a strong interest and passion for Mindfulness.

Fees

Please contact us for more information

Dr Triveni Joshi

I am a Consultant Psychiatrist specialising in Child and Adolescent Psychiatry with over 15 years clinical experience. I treat a wide variety of mental health and emotional conditions with an emphasis on holistic treatment and working with parents/carers.

Conditions I treat:
ADHDAngerAnxietyAutismBDDBipolar disorderBehavioural difficultiesDepression Emerging Personality DisordersOCDPanic AttacksParentingPsychosisSleep problemsTrauma & PTSD

I love to work with children. I wholeheartedly believe that early intervention is one of the best ways to successfully manage long term mental health problems.

Fees
First Consultation:
£475
(1 hour)
First Consultation:
£720
(1.5 hours)
First Consultation:
£895
(2 hours)
Follow-up consultations:
£320
(40 min)
Follow-up consultations:
£475
(60 min)

Dr Regina Sala

I am a caring and approachable medical doctor specializing in cognitive, behavioural and emotional well-being in children, adolescents, adults and their families. My ethos is to offer excellence of care based on evidence-based research with respect and compassion.

Conditions I treat:
ADHDAutismAddictions AnxietyAttachment difficultiesBDDBehaviour problemsBereavement, grief and lossBipolar disorderBrain injuryChronic painDepressionEating DisordersFamily TherapyFibromyalgiaIntellectual disabilityMedically unexplained symptomsOCDPanic AttacksPersonality DisordersPsychosisPsychosomatic symptomsSleep problemsSocial communication disorderSpecific learning disordersTics and Tourette’s syndromeTrauma & PTSD

I see my patients as human beings and aim to foster a sincere and relaxed environment so that we can build trust during our sessions. I believe in a positive body-mind integration with neuroscience’s principles to empower self-awareness, resilience and personal growth

Fees
First Consultation:
£475
(1 hour)
First Consultation:
£720
(1.5 hours)
First Consultation:
£895
(2 hours)
Follow-up consultations:
£320
(40 min)
Follow-up consultations:
£475
(60 min)

Dr Maria M. Herves

I am a General Psychiatrist with great interest in childhood and adolescence psychiatry. I have been working specifically in this field over the last 10 years. I believe that supporting mental health at early stages in life can prevent it from developing further into more persistent difficulties in adulthood.

Conditions I treat:
ADHDAnxietyAutismBehaviour problemsBipolar disorderChronic painComplex trauma and PTSDDBT(Dialectical behaviour therapyDepressionEmotional DysregulationFamily workFibromyalgiaMemory problemsOCDPanic AttacksParentingPersonality DisordersPsychosisPsychosomaticSchool bullying and cyberbullyingSleep problems

I regard the patient as the product, not the problem. They are a result of their environmental, genetic and social influences, all of which can be addressed and supported with professional help.

Fees
First Consultation:
£475
(1 hour)
First Consultation:
£720
(1.5 hours)
First Consultation:
£895
(2 hours)
Follow-up consultations:
£250
(30 min)
Follow-up consultations:
£320
(40 min)
Follow-up consultations:
£475
(60 min)

Dr Iyas Assalman

I am a Consultant Psychiatrist specialised in General Adult Psychiatry. I treat a wide variety of mental health and emotional conditions and I have an expertise in treating Adults with ADHD.

Conditions I treat:
ADHDAnxietyBDDBehaviour problemsBipolar disorderDepressionMemory problemsOCDPanic AttacksPsychosisSleep problemsTrauma and PTSD

Rather than seeing you as a diagnosis or trying to change your personality, I want to understand my patients as a whole person.

Fees
First Consultation:
£495
(1 hour)
First Consultation:
£745
(1.5 hours)
First Consultation:
£980
(2 hours)
Follow-up consultations:
£290
(30 min)
Follow-up consultations:
£385
(40 min)
Follow-up consultations:
£495
(60 min)

Dr Luis Alameda

I am a General Adult Psychiatrist and a Neuroscience Researcher. I specialise in severe mental conditions including trauma. I offer an individualised intervention integrating psychotherapy and medical approaches.

Conditions I treat:
AnxietyBorderline Personality DisorderBipolar disorderBrain inuryBehaviour problemsChronic painDepression Dissociative disordersNarcissistic Personality DisorderOCDPanic AttacksPersonality DisordersPsychosisReactions to acute stressSchizophreniaSchizoaffective DisorderSleep problemsTrauma & PTSD

I believe that difficulties in managing mental health are a normal part of life and far more common than you might think. They present an opportunity to understand the problem, become more self-aware and progress on your journey.

Fees
First Consultation:
£395
(1 hour)
Follow-up consultations:
£220
(30 min)
Follow-up consultations:
£330
(45 min)

Dr Lara Lavadiño

I am a General Adult Psychiatrist specialised in Adult, Child and Adolescent Psychiatry. I have specialist expertise in managing complex and long term conditions. I am an EMDR (Eye Movement Desensitization and Reprocessing) certified psychotherapist also integrating Cognitive-Behavioural Therapy (CBT), Systemic Therapy and Psychodynamic Psychotherapy principles.

Conditions I treat:
ADHDAnxietyAutismBDDBehaviour problemsBrain injuryChronic fatigueChronic painDepressionDissociationFibromyalgiaLearning DisabilityOCDPanic AttacksPanic/AgoraphobiaParentingPerformance anxiety in Music, Acting and SportsPerinatal PsychiatryPersonality DisordersPsychosisSleep problemsSocial phobiaTinnitus and VertigoTrauma & PTSD

I believe in a positive psychiatry approach, empowering both children and adults to overcome any difficulties by providing education and support on their condition, along with a holistic and personalised treatment plan.

Fees
First Consultation:
£475
(1 hour)
First Consultation:
£720
(1.5 hours)
First Consultation:
£895
(2 hours)
Follow-up consultations:
£320
(40 min)
Follow-up consultations:
£475
(60 min)

Dr Srinvas Lanka

I am a Consultant Psychiatrist specialising in Adult Psychiatry and Neuropsychiatry. I treat a wide variety of mental health and emotional conditions and have specialist expertise in managing complex and long term conditions.

Conditions I treat:
ADHDAutismAddictions AnxietyBDDBipolar disorderBrain inuryBehaviour problemsChronic painDepression Eating DisordersFibromyalgiaMemory problemsOCDPanic AttacksPersonality DisordersPsychosisSleep problemsTrauma & PTSD

I try to understand your treatment goals, values, limitations and preferences, so we can personalise your treatment using the best approach that gives you sustained recovery.

Fees
ADHD Initial Consultation:
£1160
(2 hours)
Initial Consultation:
£870
(1.5 hours)
Follow-up Consultation:
£290
(30 min)
Follow-up Consultation:
£580
(1 hour)

Dr Jonathan Garabette

I am a Psychiatrist specialising in General Psychiatry and Medical Psychotherapy.
I treat most mental health difficulties and offer a range of approaches including medication, psychological therapies and lifestyle modification.

Conditions I treat:
Addictions AnxietyBDDBipolar disorderBorderline Personality DisorderComplex TraumaDepersonalisationDepression Eating DisordersInsomniaOCDSleep problemsPanic AttacksPsychosisTrauma & PTSD

I always try to focus on understanding you as a whole person and how any symptoms, problems and diagnoses affect you, your life and what is important to you.

Fees
Initial Consultation:
£1160
(2 hours)
Initial Consultation:
£870
(1.5 hours)
Follow-up Consultation:
£580
(1 hour)
Follow-up Consultation:
£290
(30 min)

Dr Nagore Benito

I am a General Adult Psychiatrist with extensive experience in the diagnosis and treatment of most mental health conditions. I offer a person-centered and holistic approach.

Conditions I treat:
ADHDAnxietyBDDBipolar disorderDepression OCDPanic AttacksPsychosisSleep problemsTrauma & PTSD

The best six doctors anywhere, and no one can deny it are sunshine, water, rest, and air, exercise and diet. These six will gladly you attend If only you are willing Your mind they’ll ease Your will they’ll mend And charge you not a shilling
– Nursery rhyme quoted by Wayne Fields, What the River Knows, 1990

Dr Alberto Pertusa

I have a strong interest in behaviour modification, lifestyle optimisation and the use of self-quantification as a way to foster wellbeing and increase performance.

Conditions I treat:
ADHDAddictionsAnxietyBinge EatingOCDOrthorexiaSleep problems

I always strive to provide the highest standards of care to all my patients.
I endeavour to offer personalised and bespoke treatment in order to meet your specific needs