ADHD treatment: what works for adults in the UK

Many adults get here after years of trying harder, with planners, apps and sheer willpower. You might be wondering whether treatment means taking tablets for the rest of your life. Our Clinical Director, Dr Darren O’Reilly, has ADHD and autism himself, and he reviewed this guide. Treatment doesn’t follow one set path. It’s a group of choices you make with someone who knows ADHD, and you can change them as you go.

What is ADHD treatment, and what is it for?

ADHD treatment is a plan to ease the way ADHD affects your daily life. NICE, which sets care standards for the NHS in England, says that plan should be shared between you and your clinicians [1]. It should cover your psychological, behavioural and work or study needs, as well as sleep, your goals and any other conditions [1]. So the aim is to lessen the day-to-day impact of ADHD, not to change who you are.

Before anything starts, the benefits and harms of each option, with and without medication, should be talked through with you [1]. Your own preferences and concerns are part of that conversation. There are also things you can do yourself to help manage your symptoms [2]. If you’re still getting to grips with the condition itself, read about what ADHD is first.

What does NICE recommend for adults with ADHD?

NICE sets out a clear order of care for adults with ADHD [1]. Changes to your surroundings come first, which means adjusting the space and routine around you to lessen the impact of ADHD. Medication comes next if symptoms still cause a significant problem in at least one area of life [1]. In practice, the first conversation often looks at what could change at home, at work or in study.

Medication isn’t the only route, though. Non-drug treatment is an option if you’ve chosen not to take medication or find it hard to keep taking [1]. The same applies when medication hasn’t worked, or causes problems you can’t tolerate. Non-drug treatment can also be added when medication has helped but symptoms still cause real difficulty [1]. You and your specialist choose the mix together, based on what matters most to you.

How does medication fit into ADHD treatment?

Medication is one option, and an ADHD specialist has to start and monitor it [2]. ADHD medication falls into two groups, called stimulants and non-stimulants. The first choices for adults are lisdexamfetamine or methylphenidate, according to NICE [1].

In a 2018 review of 133 trials, several ADHD medicines eased adults’ core symptoms more than a dummy pill [4]. Those results covered about 12 weeks, and some medicines were stopped more often than the dummy pill because of side effects [4]. So medication can help, but it doesn’t suit everyone. The same review found that long-term effects still need more research [4]. Our ADHD medication guide covers the medicines in more depth.

Which talking therapies and ADHD therapy options help adults?

At minimum, adults needing non-drug help should get structured psychological support focused on ADHD [1]. Regular follow-up, in person or by phone, comes with it [1]. In other words, you get a clear plan for ADHD and someone checking how it’s going. The support can include parts of CBT, or a full course of it [1]. CBT, or cognitive behavioural therapy, works on the link between your thoughts, feelings and actions.

Talking therapies such as CBT or mindfulness are among the options for adults with ADHD [2]. After a diagnosis, you should also get a structured talk about how ADHD could affect work, relationships and driving [1]. Psychoeducation is the name for that kind of conversation, and it feeds into your plan. Therapy is easier to stick with when you talk about the time it needs, including work between sessions [1].

What changes at work or study can help?

Changes at work or study are the practical layer of ADHD treatment. Examples include better seating, lighting and less noise, or headphones to cut distractions [1]. Shorter spells of focus with movement breaks help, as do written instructions alongside spoken ones [1]. You can try some of these on your own and ask for others. At work or college, the changes you ask for are called “reasonable adjustments” [2]. Your employer agrees the adjustments, and Access to Work decides on any grant.

Access to Work is a grant towards practical support at work, such as a job coach or support worker [3]. It can also give support with managing your mental health at work [3]. You need a paid job, or to be starting or returning to one, and you don’t pay the grant back [3]. The scheme covers England, Scotland and Wales, and Northern Ireland runs its own Access to Work (NI) [3] [5].

Where does coaching fit in ADHD support?

Coaching is practical support rather than a clinical treatment. ADHD coaching works on planning, routines and following through on the goals you choose. A coach isn’t a clinician, so a coach doesn’t diagnose ADHD or prescribe medication. Some adults use coaching alongside medication, and others choose it on its own.

You don’t need a diagnosis to start coaching with us. You can come to us if you were assessed elsewhere or have never been assessed. We accept Access to Work funding and insurance for coaching. So an Access to Work grant, if you’re awarded one, can go towards your coaching sessions. Sessions turn the goals you set with your coach into small, regular steps you can keep up.

What ADHD support helps day to day?

Exercise, sleep and peer support can all help alongside treatment. Exercise gives your energy a focus [2]. It also eases anxiety and low mood, which can otherwise make ADHD symptoms worse [2]. A healthy lifestyle, including exercise, belongs in your treatment discussion from the start [1]. Self-help sits beside treatment rather than replacing it. For better sleep, keep a regular bedtime and a quiet, dark bedroom [2]. Cutting screens, caffeine, sugar and alcohol close to bedtime helps too [2].

You don’t have to work it all out alone, either. Support groups for adults with ADHD meet locally and online [2], and the charity ADHD UK keeps a list of them. Some people also ask about supplements and other alternatives, which have their own guide.

What if you also have autism, anxiety or low mood?

If you’re autistic or anxious as well, your medication choices stay the same [1]. NICE says to consider slower dose changes, with more frequent checks, when autism, anxiety or another mental health condition is present [1]. Your prescriber can then spot any problems early and adjust the pace.

People with ADHD often have anxiety or depression too [2]. Low mood and anxiety can also make ADHD symptoms harder to manage, so they belong in the same treatment plan. AuDHD Psychiatry assesses ADHD and autism together when both seem to fit.

How do you get ADHD treatment as an adult?

You can start through your GP or through a private specialist service. A GP may refer you to a specialist ADHD service for an assessment [2].

Treatment with us may suit you if:

• you’re an adult living in the UK.
• you’ve been diagnosed with ADHD, or you think it explains long-standing problems at work, at home or with people.
• you want medication with regular reviews, or support that isn’t medication.

It might not be right today if:

• you need urgent help now. Call NHS 111 and choose the mental health option, or in Northern Ireland call Lifeline free on 0808 808 8000, any time. In an emergency, call 999 or go to A&E [6].
• you already have an NHS or private prescriber managing your ADHD medication.
• you mainly want a quick prescription without monitoring.

At AuDHD Psychiatry, medication follows an adult ADHD assessment with us. If you were diagnosed elsewhere, you can ask to transfer your care to us. Once your dose is stable, we ask your GP to take over prescribing. If your GP doesn’t accept shared care, we carry on prescribing privately. Our guide to what starting ADHD medication involves explains the early weeks.

Our free ADHD test gives you a quick screen, though it can’t diagnose ADHD. If autism may be part of it too, one assessment for ADHD and autism together looks at both. If you’d rather talk first, a free 15-minute call answers your questions, and it isn’t an assessment. Parents can read about ADHD medication for children, which follows its own pathway.

Questions people ask

In short

ADHD treatment is a set of choices you make with a specialist, and it’s reviewed as you go. Practical changes usually come first, with medication or talking therapy added where symptoms still get in the way. Support at work, coaching and steady daily habits can carry the rest of the load. When you feel ready, AuDHD Psychiatry can help you put together a plan that works for your life.