All across the world, the number of adults being diagnosed with attention deficit hyperactivity disorder (ADHD) is surging. It’s happening in Ireland too, at the same time as ADHD is now being spotted in children, where it may have been missed in the past.
Melanie May is one of them. She was diagnosed with ADHD when she was in her 20s.
“I had difficulty regulating my emotions, which is a sign of ADHD,” she says. “A couple of years back, I had an article due the next day which I only started in the evening, as I could not get myself to sit down at the computer. I’m freelance and find it can be hard to organise my time when working to deadline, but I am so organised in every other way.”
Focus can be a problem for people with ADHD but, on the flip side, they can also become hyper-focused, and May says that when she gets to work on a project, she can achieve great results.
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“I could sit there working till 4am, like a honey badger or Tasmanian devil. I don’t stop and never get tired, I am obsessed with learning for another master’s [degree]. I constantly look for new things and I don’t fear change, I embrace it. If I go on holiday, I see and do everything, I am a ball of energy.”
May’s embrace of change means that she has worked as a travel journalist and food writer, trained as a school teacher, is a sailing and windsurfing instructor, qualified open water diver and has an orange belt in kickboxing.
Many people with ADHD have so-called “co-morbidities”, where the condition occurs alongside other neurodiversity. May, for instance, is also dyslexic but says that spelling and grammar tools have been valuable to her as a writer and that dyslexia has helped her with creative writing, as she connects different phrases and concepts and picks up details that may otherwise be missed.
Colm McNamee, community initiatives senior associate at Salesforce, was diagnosed with ADHD in 2013 and has been on medication for it since last year. He says it has helped him with concentration.
McNamee is autistic, dyslexic and may also have dyspraxia. Many adults whose neurodiversity was never correctly identified in school were often written off as “stupid” “troublesome” or “bold”, and this was the case for McNamee, but he’s now been confirmed as intellectually gifted; this trajectory is not uncommon among adults and children with ADHD.
McNamee says the education system failed him in his formative years, although he has since undertaken a number of degrees.
“In school, I was refused reasonable accommodations because I ‘wasn’t bad enough’. When I did get support, I didn’t need extra time, I just needed a mechanism to get my thoughts and ideas out of my head and on to the paper. We are all different types of learners, and what we need is individualised learning set-ups for every child in the system, powered by artificial intelligence.
“I am doing well in Salesforce and have a lot to contribute, and so do other people with ADHD and other neurodiversities. The education system tries to bring everyone to the middle, including the most intelligent people.”
McNamee points out that teachers receive minimal training in supporting children with ADHD, despite making up at least 5 per cent of every classroom.
Once ADHD is identified and diagnosed, it is a condition that can bring challenges and opportunities.
Simply getting a diagnosis, however, can be a challenge in itself. The Irish Times is aware of several cases where parents are paying more than €500 for two consultations, a cost that excludes the price of medication. Even where parents are able to pay for a private consultation, there are long waiting lists. One seven-year-old boy with complex needs, referred for a consultation last April, was waiting nearly eight months for an appointment.
Parents and advocacy groups report particular difficulties securing an appointment with a psychiatrist, which is important in order to secure the medication that helps manage some of the more challenging symptoms of ADHD.
“At the moment, referrals go through the Child and Adolescent Mental Health Services (Camhs), and we have a list of clinicians who can do assessments for children,” says Ken Kilbride, chief executive of ADHD Ireland.
“This list normally includes psychiatrists but, at the moment, it only includes psychologists. We don’t know of psychiatrists who are taking on new children for assessment and treatment.”
While this does not necessarily mean that there are no psychiatrists offering assessments and treatment in Ireland, it indicates that they are, at least, relatively thin on the ground. Because psychologists cannot prescribe medication, parents who decide medication should be part of their child’s treatment, are often at a loss and have no choice but to join Camhs waiting lists, which can be up to two years long, depending on the part of the country.
“That’s two years of schooling that has not been optimised for a child,” says Kilbride.
Parents are often left scrambling for information, and most say that nothing comes easy. “It’s a fight from day one,” says one, and it’s a sentiment widely echoed.
Some are turning to telemedicine, and some admit to buying medication online. Some GPs will prescribe ADHD medication but, says Kilbride, many are reluctant to do so without instruction from the patient’s psychiatrist. ADHD Ireland is in talks with the Irish Council of General Practitioners
McNamee, meanwhile, urges parents “not to mourn the child you were expecting, but to embrace the child you were given and not to build any shame into them. Neurodiversity is like biodiversity, and if we had just one crop over the whole ecosystem, we’d have famine.”
May says that she has learned more about ADHD in recent years and it has helped her to understand herself and how she may have interacted with some people.
“ADHD and dyslexia are not necessarily disabilities or advantages: children need to know that their brain may just take a different, more scenic route to an answer. I’m not even sure if I like the term ‘neurodiverse’, as it makes you feel a bit different.”
What is ADHD, exactly?
For starters, it is a genetic and long-term condition that can affect learning and behaviour. It can take multiple forms but, in children, usually manifests in either problems paying attention, distractibility and short-term memory issues, or impulsivity and difficulties in self-monitoring behaviour.
But it often manifests in a combination of these behaviours, and it is sometimes easier to spot in boys than girls; this is because boys are somewhat more likely to act out, whereas girls are somewhat more likely to internalise, making them seem like a daydreamer.
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It is estimated that it affects between 100,000-150,000 adults in Ireland. It can also pose challenges; worryingly, research carried out by UCD, the HSE and ADHD Ireland show that one in five adults with ADHD has attempted to take their own lives in the past.
ADHD fits under the umbrella of neurodiversity which also includes autism, dyslexia, dyspraxia, Tourette’s syndrome and more. Indeed, ADHD often occurs alongside other neurodiversity.
ADHD, like most ways of thinking, has costs and benefits, and people with the condition — particularly where it occurs alongside autism — can have hyperfocus and work more efficiently when they are interested in what they’re working on.
They’re also quite resilient due to the challenges of processing the world around them, are more likely to be great conversationalists, and are renowned as great problem-solvers and creative thinkers.
