ADHD DIAGNOSIS & THE NHS
As a result of the Richard Bacon ADHD interview that I mentioned in my blog about my background I started doing my homework and decided to see about getting my own diagnosis; I couldn’t ignore the way the traits reflected my own behaviours. After discussing it with Sam (my wife) I decided to contact my GP. We had the bog standard 10 minute consultation in which I explained my thoughts and backed them up with some examples. Throughout the conversation I felt utterly daft and worried that I wasting his time, but he listened. He sent me an ADHD questionnaire and agreed to refer me immediately to the regional team that deal with neurodiverse conditions.
At this point I felt quite confident that I was on to something, so I started to do my own research. Looking at various websites that were aimed at those with the condition, I very quickly started to focus my efforts towards UK based sites. I found the main American organisations were dealing with an audience that was much further down the line than ours. US diagnostic rates are roughly 50% higher and they have access to services, albeit paid, that we can only dream of at this time.
What I found was evidence of one of the worst service examples that I have seen in UK public healthcare provision; I worked in NHS performance management for 3 years, so I do have some understanding of this subject. It is not a political statement to say that our NHS has been struggling with funding issues for many years now, especially since the global financial crash around 2008. One of the main categories of care that this affects is mental health; it’s not that cuts over the years have damaged these particular services, it’s that there has never been adequate investment in that field in the first place.
So what else is out there?
I realised that I was probably going to have to wait at least 12 months just for an initial consultation through the NHS, and goodness knows how much longer before I could start the medication titration process. I had been living with this for 51 years and I didn’t want to waste another day if possible, so I looked at what was available privately.
In the UK GPs can’t diagnose ADHD so you must go to a psychiatrist. Sam came up with a recommendation quickly and the one she found for me was in London. It was not going to cheap, and it was not going to be a quick process, but I would be starting my journey earlier, so we decided that it was a no-brainer to invest some money in my long-term wellbeing.
Getting my ADHD diagnosis
I contacted the psychiatrist in late March 2022 and made an appointment for early in May (in the same year!). A few days before the appointment I received a questionnaire to complete and return (I did worry that this was a trap, and that by returning it in a timely manner I would show myself not to be ADHD enough!). The appointment itself was a video call and the outcome was a diagnosis of ADHD-C, or combined type, meaning that I have traits of both hyperactive-impulsive and inattentive types. The medication titration process would start straight away.
Medication titration phase
Titration: A titration is defined as ‘the process of determining the quantity of a substance A by adding measured increments of substance B, the titrant, with which it reacts until exact chemical equivalence is achieved (the equivalence point)’.
This process would be via private prescription until the right drug and right dose was found, then prescribing would be handed off to my GP. For the short term, while this narcotic nirvana was sought, it would cost me somewhere between £90 and £140 every 4 weeks. As I write this I am nearly there, a couple more weeks on Elvanse 70mg to go, and if all is well my GP will become my dealer and I can pay NHS rates from next month!
A twist in the tale
The consultation didn’t end there though, there was a bombshell to be dropped. The psychiatrist told me that he had picked up strong signs from me that we may be dealing with Asperger’s Syndrome as well. I was not expecting that! Apparently, e-mailing him a list of ADHD symptoms (which I had expanded to explain where I thought I showed traits) ahead of the consultation, is quite an Aspie thing to do!
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