ADHD in young people: signs, assessment and support

ADHD is not a mental health condition or a learning disability – it’s a neurodevelopmental condition. When people have ADHD, their brains work differently to the brains of people without ADHD.  

ADHD can affect the way people experience and understand the world, as well as the way they act. 

If someone has ADHD, they will always have ADHD – but here are ways to help manage the symptoms.  

People usually start showing signs of ADHD when they’re a child, but not everyone with ADHD is diagnosed straight away. Sometimes, people don’t realise they have ADHD (or get a diagnosis) until they’re an adult.  

Generally, the symptoms of ADHD are about finding it difficult to pay attention or focus on things (being inattentive), having high energy levels (being hyperactive), and finding it difficult to control urges to do or say things (being impulsive).  

Everyone can be inattentive, hyperactive, or impulsive sometimes. For people with ADHD, their inattention, hyperactivity, and/or impulsivity are stronger, and show up more often.  

Some people with ADHD have more symptoms around paying attention and focusing, while others have more symptoms around their energy levels or controlling their urges to do or say things – and some people have symptoms in all of these areas.  

The way ADHD affects someone’s life varies from person to person.  

A lot of people with ADHD find that it affects their executive functioning. Executive functioning describes the sorts of skills we use in our everyday lives to organise ourselves, plan things, make decisions, follow instructions, and stay focused.  

Struggling with executive functioning skills can mean people find it difficult at school, university, or work, for example, if they can’t figure out how to get started on a task, or if they don’t follow instructions because they can’t remember what they were. Being able to manage your emotions so that you can get a task done is also an example of an executive functioning skill that can be difficult for people with ADHD.  

People with ADHD sometimes talk about masking. This is when people put on a performance (or mask) for other people, which hides or minimises the symptoms of the ADHD.  

For example, some people might appear organised at school or work, while inside their head (and in other parts of their life) things are loud and chaotic. They might put a lot of effort and energy into sitting still during the day, or copy how other people talk or act to ‘fit in’ in conversations.  

Masking can have a big impact on people’s wellbeing. It doesn’t mean their ADHD symptoms go away – it just means they’re hidden. It can affect people’s self-esteem if they feel like they can’t be their ‘real’ self, and it can be exhausting too. It can also make it difficult for people with ADHD to connect with other people, with and without ADHD.  

Masking can also mean that people’s ADHD isn’t identified, or that they don’t get the support and adaptations they need in education or work. Navigating the world without the right support makes having ADHD much harder.  

Some people with ADHD find that they can be very impulsive with money, for example, they might spend lots of money on things they want as soon as they get paid, without thinking about bills they might need to pay towards the end of the month.  

While there are definitely ways in which ADHD can make life difficult, some people with ADHD also talk about their ADHD positively. They might feel that it’s linked to their creativity, helps them to solve problems, or makes them enthusiastic, or determined.  

ADHD is not a mental health condition, but having ADHD can affect someone’s mental health, and it’s possible to be diagnosed with a mental health condition as well as ADHD. In fact, some research suggests that people with ADHD might be more likely to develop a mental health condition like depression or anxiety.

Lots of people with ADHD find parts of their daily life overwhelming, and it can be difficult to explain why things are difficult if other people don’t know what ADHD is. It might affect your mood, or you might find that you worry a lot about your ADHD or how it affects you in different situations.

People with ADHD can often feel misunderstood, especially if adults are frustrated with them when they’re struggling, or if their ADHD is ‘missed’ and it takes a long time for them to get a diagnosis or the support they deserve.  

Girls and women can have ADHD.

In the past, people often said it was less common for girls and women to have ADHD, but now we understand that girls and women often experience (and show symptoms of) ADHD differently, which means their experiences were overlooked or misunderstood.

Part of the reason for this might also be that girls and women are more likely to mask symptoms of their ADHD. As girls are growing up, they are often taught to avoid conflict and to make sure other people are OK. As a result, they can end up masking symptoms of their ADHD to make other people more comfortable. This is not their fault and does not mean they need any less support.

You can only be diagnosed with ADHD by a psychiatrist (a medically qualified doctor who’s a specialist in mental health).

Psychiatrists diagnose people using diagnostic criteria – specific guidelines about the signs and symptoms that mean someone has ADHD, rather than any other neurodevelopmental or mental health condition.

To see a psychiatrist, you usually need to be referred by a GP or someone at your school. This means that the GP or person at school sends your details on to the service where the psychiatrist works, so they can contact you and offer you an appointment. Unfortunately, some people have to wait a long time for an ADHD assessment, but you should still get support while you’re waiting.

As part of an ADHD assessment, a psychiatrist (and other specialists, like a paediatrician – a doctor who specialises in looking after children and young people) might do a few different things to find out more about you and your experiences. The exact process is different for everyone, depending on their situation.

You and your parents might be asked to fill out some questionnaires, and they might talk to you and see what your behaviour is like. You might be asked to do some activities on a computer. They might also ask your parents or carers how things are at home (and at school or college) at the moment, or how things were when you were younger, and they might contact a teacher (or other staff member) from your school.

They will also think about how other things in your life might be affecting you, like your physical health, sleep patterns, and how things are at home.

Research suggests that at least part of the reason people have ADHD is genetic, which means it’s passed down from their biological parents.

We do not know exactly how people’s genes contribute to them having ADHD. It’s likely that it’s much more complex than one single gene causing ADHD.

Things in the world around us, like what happens in our family as we grow up, or our experiences of difficult life events, can also contribute to how our genes affect us.

We also know that being born premature (before 37 weeks of pregnancy), having epilepsy, and being autistic are linked to ADHD.

Treatments for ADHD aren’t about ‘getting rid of’ the condition. They’re about helping people with ADHD manage in a world that isn’t always designed for them.

Some people with ADHD take medication that helps with some of their symptoms, like not being able to concentrate.

Talking therapy can also help people with ADHD to understand themselves and how they think and feel and find strategies for coping. Mentoring or talking to a support worker can also help people find ways to manage their symptoms in everyday life, like using reminders to keep them on track.

Lots of people with ADHD find that they need to adapt their environment – for example, sitting near the front of a classroom to reduce distractions, or taking breaks during long meetings. At work, these are called reasonable adjustments.

There are also things you can do to take care of yourself, which might help you to manage your ADHD symptoms, like making sure you get enough sleep and finding movement or exercise that makes you feel good. You might have to adapt things to work for you – your sleep routine might be different to someone without ADHD, and that’s OK. Lots of people with ADHD find it helpful to build daily or weekly routines that can stick to.

If you think you may have ADHD (or have a diagnosis but are struggling to manage), the first step is to speak to an adult you trust. This might be a parent or carer, teacher, youth worker, or GP. Find out more about getting help from an NHS GP in England.

Together, you can make a plan so that you get the support you need to cope.

If you’re not sure where to start or want to practise talking about ADHD before you have a conversation with an adult in your life, you might find it helpful to contact NATTER.

If someone you care about has ADHD, it can be difficult to know how to support them. As well as being a good friend and including them in the things you do, there are some things you could try to help them.