What's being done to make assessments more affordable? How can I support someone with ADHD? Our experts answered all your burning questions about ADHD following Em Rusciano's National Press Club address.
Catch up on our expert Q&A with our blog.
Key events
- What's being done to make ADHD assessments more affordable?
- Should you ever tell your boss you have ADHD?
- Is there any point in seeking a diagnosis if I suspect I have ADHD?
- Em Rusciano on the grief of her ADHD diagnosis
- Why did so many people realise they might have ADHD during lockdown?
- 'For once in my life, I aced a test': Em Rusciano
- ADHD and the shame surrounding it
- Where can I watch Em Rusciano's National Press Club address?
- Time to meet our experts
Live updates
By Jessica Riga
This is where we'll wrap up our Q&A
Thank you so much for joining us today, and for all the questions you sent in! We wish we could get to them all, but we hope you found this expert Q&A useful.
Speaking of which, a huge thank you to all our experts, including Dr Madelyn Derrick, Professor Mark Bellgrove, Dr Tamara May and Dr Karuppiah Jagadheesan, who took time out of their day to answer your burning questions.
Looking for Em Rusciano's National Press Club address? You can watch it back in full here on the ABC News YouTube channel.
For now, I'll leave you with this snap of Em. See you next time!
By Jessica Riga
My son has ADHD. Will he one day be able to go off his medication?
My teenage son has adhd and has been taking medicine to help with school. How can he learn to be able to function without medication or will it be too difficult to be without it?
- M
Hi M, thanks for getting in touch.
We put your question to Dr Tamara May. She says:
The symptoms of ADHD are lifelong and ongoing treatment is very important as they symptoms are usually persistent. This includes long term use of medication.
There may be times in your son’s life where he may be able to cope without medication if his environment is optimal.
By Jessica Riga
What about some online resources?
Hi, I’m an adult female who has been looking into autism and ADHD for a little while now. I’m not a fan of self-diagnosis (though recognise it can be an important first step). Can you provide online resources for those of us who suspect we may be living with one or both of these conditions, and outline the process for a medical diagnosis in Australia? I live in Melbourne, work full-time, and have naturally/deliberately developed strategies for managing - but think I’m ready to take the next steps with the intent of properly treating the detrimental aspects. Thanks!
- Nuance is important
Hi there, thanks for writing in.
Here's what Dr Madelyn Derrick says:
If you are suspecting, then you are probably ready to seek an assessment. Get on waitlists, as it may take a while at this point, so don’t delay. You will need to go to your GP and request a referral to a psychiatrist (if interested in medication as a treatment option), and to a psychologist (with a mental health care plan).
You will want to search online to find which psychiatrists and psychologists have sufficient expertise with ADHD -if they mention it on their website then that is a good indicator. You could also join some online forums (e.g. facebook groups for neurodivergent people and ask for recommendations in your area).
Ultimately, regardless of whether it ends up being the psychiatrist doing the assessment for both, or whether the psychologist does some assessment as well, consideration of both medication and non-medication treatment options is best practice. Both referrals and waitlist spots are handy to have up your sleeve.
Here's what Dr Tamara May recommends:
To find a list of psychiatrists where you can select a specialisation such as ADHD or autism I would suggest Your Health in Mind.
Similarly for psychologists, Psychology.org or AAPI.
By Jessica Riga
What’s the best approach for undiagnosed peri-menopausal women with mounting ADHD symptoms to seek assessment?
What’s the best approach for undiagnosed peri-menopausal women with mounting ADHD symptoms to seek assessment? And what is it typically costing women to access help? Are there options for women with no private cover to find affordable help without waiting years? Thanks so much !
- Krish
Hi Krish, thanks for writing in.
Here's Dr Tamara May:
As an adult I would suggest seeing either a psychiatrist who specialises in adult ADHD; or a psychologist experienced in the diagnosis of ADHD. The important thing is to find one who has experience and knowledge of ADHD.
The costs of these assessments vary and there are some medicare rebates for seeing a psychiatrist for assessment. However, a rough estimate is that can range anywhere from around $600 to over $1000. This unfortunately makes it very hard for many to access treatment.
We need to work towards having ADHD assessments better funded by medicare or available without cost in the public health system.
And Dr Madelyn Derrick says:
To maximise the affordability of getting help, I would consider the following:
- 1.Join online groups (Facebook etc), read books about ADHD in women, and access as much online information and support as you can
- 2.Ensure you get a mental health care plan if going to see a psychologist, so that you have some Medicare rebate
- 3.Try calling the ADHD Foundation helpline to see if they are aware of any lower-fee charging psychiatrists, or psychologists for assessment and treatment options
- 4.Find out what your Medicare Safety Net is and see if you can afford the gap fees through to meeting your threshold. The gap fees would become much smaller for the rest of the calendar year from there
Chat to your GP about hormonal impacts here. It may be that an option to address hormonal fluctuations that are exacerbating ADHD symptoms is part of the solution.
By Jessica Riga
How do I start the process of diagnosis for ADHD?
Hi there, I’m 47 and think I have ADHD. My son has been diagnosed for some time and I display all his symptoms. I’m not sure how to start the process of diagnosis and am concerned for the stigma associated with diagnosis.
- James
Hi James, thanks for writing in. I think a lot of people reading along will be in a similar boat.
Professor Mark Bellgrove says "don't delay."
Things are definitely improving and conversations like this are a great way to build awareness and reduce stigma.
Your first point of contact is your GP who will then refer you to a psychologist or psychiatrists. It will take a while to get an appointment, but don’t despair. The destination will hopefully be worth the journey.
In the meantime, focus on keeping yourself fit, healthy and sleeping well.
By Jessica Riga
How can we normalise disclosure of disability to employers?
How can we normalise disclosure of disability to employers without fear of it impacting our job, and request fair accommodations without discrimination and with understanding?
- Jessica
Hi Jessica (great name), thanks for writing in.
Here's what Professor Mark Bellgrove has to say:
Great and important question. There was also a similar question previously.
I think this comes down to encouraging diversity and inclusion of all forms in the workplace. If people feel safe in knowing that their disability will be appropriately recognised and appreciated then this will help a lot.
Education within workplace setting about ADHD- the strengths and challenges that come with and how small accommodations can be made to boost productivity, are all important. Use of language that actively reduces stigma is critical.
By Jessica Riga
What can be done to make assessments more accessible?
What can be done to make assessments / diagnosis more accessible for adults?
- Kate
Hi Kate, thanks for writing in.
Professor Mark Bellgrove says:
Simply put we need more adult psychiatrists and psychologist trained in ADHD. We also need public health funded treatment of ADHD.
By Jessica Riga
What's being done to make ADHD assessments more affordable?
What's being done to make ADHD assessments more affordable?
Hi there, this is a common question.
Here's Professor Mark Bellgrove, who says:
This is a tricky situation for sure. In adulthood, almost all ADHD assessment is done within the private sector.
There are moves to get GPs upskilled in diagnosis but at this point that is rare.
There are also moves to encourage more public treatment of ADHD which would of course help to reduce costs.
By Jessica Riga
What is being done so medical and health professionals can recognise ADHD sooner?
What is being done to teach medical & health professionals about ADHD so it can be recognized & diagnosed sooner? – Kylie
Hi Kylie, thanks for writing in.
We put your question to Professor Mark Bellgrove, who says:
Another great question. Many of the professional colleges that are relevant here- such as those of Psychiatry and Paediatrics are certainly paying close attention to the training and are aware that more content specifically on ADHD in specialist training is desirable.
Psychology training courses– particularly clinical psychology- already deliver quite some training in assessment of ADHD but equally there is momentum building for this to increase. GPs are increasingly getting interested in ADHD and again there is a lot of interest in developing training courses for GPs. It’s a work in progress but at least its happening.
By Jessica Riga
How can we make the school system less stressful for kids with ADHD?
How do you think the school system can become less chronically stressing for kids with ADHD and perfectionism, who mask their dysregulation in the high-compliance culture?
- Anna
Hi Anna, thanks for asking.
Here's what Dr Tamara May says:
This is really tricky, as these young people may go under the radar in the education system because they are 'good' and achieving through their perfectionistic coping style.
Masking is exhausting as Em was noting in her speech, so it can lead people to burning out (repeatedly).
I hope as there is more awareness of this phenomenon that people will have more space to just be themselves and be safe to do so.
By Jessica Riga
Should you ever tell your boss you have ADHD?
Should you ever tell your boss? – Effie
Hi Effie, thanks for writing in. We put this question to multiple experts.
Dr Madelyn Derrick says:
If you are very confident that they understand ADHD, and if you feel you need to defend yourself (e.g. for performance management etc), you may wish to do this. Unfortunately there is a lot of misunderstanding around ADHD, and there are some risks with telling your boss. These risks include:
- Having your abilities underestimated moving forward
- Being viewed through a ‘lens’ with your boss noticing the ADHD impacts more than they would have if they didn’t know
- Your boss believing you’re using ADHD as an excuse
You can still get the adjustments you need at work without needing to disclose. For example, saying something like “I find I work better if I can be uninterrupted for a few hours at a time – is there somewhere I could do this?” “I want to make sure I remember all the details from our meetings… do you mind if I type notes as we talk?” (noting that everyone will be different in what actually works for them).
Professor Mark Bellgrove says:
This is a matter of personal choice, but many people do yes, and receive a positive response. Workplaces should be encouraging diversity and inclusion. They should also recognise some of the strengths that folks with ADHD can bring to the workplace (creativity, energy etc).
By Jessica Riga
Should postnatal mental health screening tests include questions about neurodivergency?
Neuro-divergent women are known to struggle with becoming mothers, often being (mis)diagnosed with anxiety and depression. Noting this, would it be appropriate for postnatal mental health screening tests to include questions related to neurodivergency? – Leah
Hi Leah, thanks for writing in.
Here's what Dr Karuppiah Jagadheesan says:
In general, a comprehensive process of psychiatric evaluation needs to include assessment of neurodiversity because anxiety and depression can be surface markers of issues related to neurodiversity.
In women, neurodiversity such as ADHD can intensify during perinatal period due to changes in biological, psychological and social areas.
So, it will be important to screen for neurodevelopmental disorders during mental health assessment.
By Jessica Riga
How do I support my partner who has ADHD?
How do I support a diagnosed partner when it’s frustrating that they forget events/shut themselves away and literally don’t show up for things that are important to me?
- Lisa
Hi Lisa, thank you for asking this question and sharing your experience with us.
Here's what Dr Tamara May says:
This can be very frustrating. Avoiding things is a coping mechanism that can help in the immediate term but not in the long term when it negatively impacts on one's relationships.
Providing a space to talk about what is going on for them, and what results in them avoiding, might be helpful. Forgetting is a core symptom of ADHD and people usually need strategies to support with that.
Couples counselling and education about ADHD can be extremely helpful when one partner has ADHD and the other doesn't.
By Jessica Riga
Is it ADHD or unrealistic expectations?
More than ever in our new world of hybrid and flexible work, people might be feeling pressure to maintain a 'superhuman' level of focus and concentration just to keep on top of their inbox, let alone maintain relationships, run a household and read books. Is there a risk that adults seeking ADHD diagnoses are medicalising problems that might have more to do with unrealistic social and self-imposed expectations than brain chemistry?
- Luke O
Hi Luke, thanks for your question.
We've put it to psychiatrist Dr Karuppiah Jagadheesan, who says:
Stress can affect cognitive functions including concentration. However, it is important to understand that ADHD is a neurodevelopmental disorder with clearly defined characteristics.
Often ADHD is underdiagnosed in adults and it is well known that undiagnosed ADHD can cause poor functioning. This would mean that an appropriate assessment process should differentiate ADHD from other causes.
We also put this question to Dr Madelyn Derrick who says:
Potentially, but they wouldn’t be diagnosed if being assessed by someone who has sufficient expertise. There are patterns that occur across the lifespan that assist with determining whether it’s ADHD, or just having an overly busy life and unrealistic expectations of yourself. And the experience of ADHD is so much more than this.
I would expect that the risk of medicalising these issues incorrectly is far less that the risk that an individual who genuinely has ADHD (undiagnosed) is beating themself for not being able to keep up with what others seem to achieve. In other words, more likely that someone will blame themselves for being insufficient somehow before they actually consider that ADHD may be an explanation for why they struggle.
And here's what Dr Tamara May says:
This is a good question andan appropriate ADHD assessment will be able to tease this out. If it is just due to today’s expectations then the person won’t have a developmental history that suggests ADHD and won’t have evidence of symptoms of ADHD in childhood/adolescence. ADHD is lifelong. There must be evidence that these symptoms were present before 12 years old, and that the symptoms cause clinically significant functioning across multiple domains.
By Jessica Riga
What's the best piece of advice I can give my son, as a 'neurotypical' mum?
Hi Em - thank you for a fantastic address. Wonderful to have your voice advocating for neuro divergents (and their carers). My question is, whats the best piece of advice I can give my son who is ADHD and 'Aspergers' as a "neurotypical" Mum who is also works black ops in his support.
- Lisa
Hi Lisa, agreed! Em Rusciano's speech was excellent, we're glad you enjoyed it too.
We're put your question to Dr Tamara May, here's what she said.
I would suggest them getting to thoroughly understand their ADHD and Asperger's symptoms and how they impact on them, both positively and negatively. Once they know this, they can work towards a life where their strengths are maximised in what they do day to day, and the things they find hard are minimised or they get support with. For example, finding a career where they thrive because it's linked to a special interest and the type of work and work environment fits with their ADHD brain.
By Jessica Riga
Are intrusive thoughts common for people with ADHD?
Are intrusive thoughts common for people with ADHD, particularly the inattentive type? Also, is being bored typically a challenge for people with ADHD? My 13 year old son really doesn't like being bored when off a screen and struggling to find something he wants to do and that occupies his hands and brain - he says this is when intrusive thoughts might appear
- Naomi Peters
Hi Naomi, thanks for your question.
We've put it to Dr Tamara May. Here's what she said:
People with ADHD can experience intrusive thoughts, and because of the core symptoms of ADHD such as difficulties with flexibly directing attention, they can find it harder to switch off from them.
Getting bored is a very common experience in ADHD. This can happen when there is not enough stimulation from an activity or it is no longer novel and exciting or engaging. At these times of boredom there can be many thoughts occurring in a busy ADHD brain, as there is no direction of attention. This could be when an intrusive thought comes up and then the mind can get stuck on it.
I would suggest talking to a health professional such as a psychologist if your son finds these distressing.
By Jessica Riga
Is there any point in seeking a diagnosis if I suspect I have ADHD?
Is there any point in seeking a diagnosis for ADHD if you are an adult and suspect you may have it? – Anne
Hi Anne, thanks for writing in. We've had a lot of questions similar to this.
Here's what Dr Karuppiah Jagadheesan says:
Undiagnosed and untreated ADHD in adulthood can contribute to poor psychological health and dysfunction affecting various aspects of life.
Like any other mental health problem, if an adults suspects to have ADHD, it is important to seek help.
We also asked Dr Madelyn Derrick. Here's what she said:
It's an individual decision. A major benefit of diagnosis is being able to understand yourself, with confidence - understand why some things are challenging, what expectations are fair to put on yourself, and understand your potential strengths.
Importantly, a diagnosis opens up options for intervention. This may include medication or may include non-pharmacological treatment that can help you to do the above, as well as help you develop strategies for challenges, heal any past hurts and self-esteem damage that has occurred, and set your life up to move forward in a more sustainable (less overwhelming!) way. Preventing anxiety and depression symptoms is often an outcome aswell.
By Jessica Riga
What's the test for ADHD?
When you talk about getting a diagnosis through brain and neurological test- what is that test? My ADHD is only getting worse and my medications are not working. This is so helpful!!!!
- LailaK
Hi there, thanks for your question.
Here's what Dr Karuppiah Jagadheesan says.
ADHD is a clinical diagnoses. There is no specific test to make this diagnosis. The reasons for lack of improvement in ADHD include inadequate medication doses, not on right medication, untreated co-existing other psychiatric disorders and psychosocial factors. A right therapeutic approach will take these factors into consideration to optimise treatment.
By Jessica Riga
What's been Em Rusciano's biggest revelation since getting her ADHD diagnosis?
What has been your biggest revelation or epiphany since diagnosis? – Kat
Here's Em Rusciano:
"That I am really good at hard things!
"And if there was ever a Zombie Apocalypse I would want an army of ADHD-ers behind me."
By Jessica Riga
How can the government best support private practice psychologists ?
How can the government best support private practice psychologists to be able to do the rigorous assessments needed for diagnosis, rather than relying on huge costs to the individual or family? (Full disclosure, I’m a child psychologist in private practice).
- Joan Caelli
Hi Joan, thanks for joining us today and for sending in your question.
Here's what Dr Madelyn Derrick says:
Funding for training, and for reimbursing and incentivising multi-disciplinary practice and collaboration in the private setting. The rigorous assessment process could become a lot more efficient with multiple sets of hands on deck (at different pay grades, and with different extent of demand). Current Medicare items don’t allow for this currently but some changes there would be likely to ease the bottle necks and be more cost effective to the public purse.
