I’ve been diagnosed with ADHD at more dinner parties than I can remember.
It usually happens around dessert, by which time I’ve started several conversations and finished none. Most of my diagnosticians are psychiatrists, and a few have been ADHD experts, some of whom have produced proper rating scales. I score spectacularly. If there were medals for ADHD questionnaires, I’d have to find somewhere to put them.
Consulting room diagnosis is fussier. It wants to know whether this started in childhood and whether it actually affects my life. This is where it gets tricky: I’m not obviously impaired.
Except perhaps I am
When I was in Grade 6, one of my teachers called my parents in for a meeting. She had identified a problem. I wasn’t finishing tasks and was hopeless at organising myself.
Her solution was a diary, which quickly grew into a small multinational surveillance operation. My parents checked it morning and night. I had to consult it repeatedly during the school day. My teacher checked it too.
It worked.
And I never really stopped. I now have an electronic diary and still check it at least ten times a day. I sometimes set reminders for events half an hour away, because I know perfectly well that another thought may arrive between now and then and I’ll forget the appointment.
Perhaps I don’t have an impairment because I’ve been treating it for more than fifty years.
Symptoms aren’t diagnoses
ADHD is unusually easy to spot in yourself because its symptoms are things everyone does. Who doesn’t procrastinate, lose their keys or drift off in a boring meeting? Like most psychiatric traits, these traits run along a spectrum. You can be anxious without an anxiety disorder, obsessional without OCD and self-important without narcissistic personality disorder. Which is fortunate, because otherwise my diagnostic problems would extend well beyond ADHD.
The harder problem is compensation. Many people look perfectly functional because they’ve quietly built scaffolding around themselves: lists, alarms, routines, deadlines, a partner who reminds them, and a job that never sits still long enough to bore them. That makes my diary either evidence that I function perfectly well or a clue to why I do.
Psychiatry can be annoying like that.
Dr TikTok will see you now
Now imagine being 22. You’re struggling at university or in your first proper job, disorganised and behind on everything. Then your feed starts showing you ADHD content, and suddenly your whole life makes sense.
That can be genuinely helpful. Many adults were missed as children and only realise it later. But there’s a large gap between “This sounds like me” and “Therefore I have ADHD,” and the internet is not famous for minding the gap. One experiment found that ADHD misinformation could leave college students less informed yet more confident they understood ADHD, which is an impressively efficient psychological achievement.
In fairness, my profession has made assessment so slow and expensive that TikTok is the only clinic without a waiting list.
The Smart Drug Shortcut
Some years ago, a young trainee doctor told me that he and a few friends were thinking of taking ADHD stimulants to get ahead at work. The appeal was obvious: take a tablet, focus harder, work longer, get more done.
A normal person might have said, “Probably don’t.” I wrote them a briefing paper. It may be the least enjoyable document ever produced about amphetamines.
The evidence was not especially exciting. In people without ADHD, stimulants can increase alertness and motivation, but they don’t reliably make you smarter. They also come with real side effects, including, rarely, psychosis. The group told me they decided not to take them. I chose not to audit the outcome.
There is another trap here. If you take a stimulant and concentrate better, that does not prove you have ADHD. Stimulants can improve attention in people without ADHD too.
A treatment response is not always a reliable diagnostic test.
Exhibit A
So, do I have ADHD? Possibly. The problems started early and never entirely left. If I were ever properly assessed, the Grade 6 diary would be Exhibit A.
But I’ve never bothered to get a proper assessment because the treatment that works for me is the one I’ve used since primary school, and it doesn’t need a prescription. If your scaffolding holds and your life is working, I’d favour the ‘if it ain’t broke, don’t fix it’ approach. But if it keeps falling down, take it to someone who’ll ask about your childhood rather than your star sign.
As for me, I have to stop writing. My diary says I’m supposed to be doing something else, and I’ve checked three times.