‘ADHD is more than a difficulty with concentration.’

What aspects of your work might surprise someone who only knows the headlines about ADHD?

When thinking of ADHD, many people still picture restless individuals who cannot concentrate. In clinical practice, however, I often see people who are professionally successful and function well on the outside. What remains unseen is how much effort this demands in their everyday lives. ADHD is truly far more than simply a problem with concentration.

Many people today recognise themselves in social media videos. What do you say to someone who comes to you with this suspicion?

I always take such thoughts seriously. Sometimes, these videos genuinely help people identify difficulties that have accompanied them for a long time. Yet not every instance of forgetfulness or restlessness points to ADHD. Similar experiences can also arise from stress, sleep difficulties, or other mental health conditions. That is why it is essential to look more closely and avoid reaching a premature diagnosis.

What does a thorough assessment involve, and why does it require time?

For me, a thorough ADHD assessment begins with a detailed conversation. I wish to understand the difficulties someone faces today, as well as their earlier experiences at school, within the family, or in daily life. This is complemented by questionnaires and, where available, previous school reports or information from relatives. It is also important to consider other possible causes and co-existing conditions. There is no single test that can definitively determine ADHD. A careful assessment therefore takes time.

Why is ADHD in women often only noticed in their thirties or forties?

Many women with ADHD did not particularly stand out as children. They may have been rather dreamy or quiet, or perhaps sought to compensate for their challenges through sheer diligence. This can work well for many years. When career, family, and further responsibilities later converge, these strategies often no longer suffice. Only then does it become evident how demanding daily life has truly always been.

High-functioning individuals with ADHD often compensate for years until they no longer can. How do you recognise in conversation that someone is compensating?

I often ask not only whether someone manages their daily routine, but how they manage it. Some people rely on countless lists, reminders, and strict control to ensure nothing is overlooked. Externally, everything proceeds smoothly, but internally, they experience constant tension and exhaustion. For me, it is therefore important to consider not just what someone achieves, but how much energy it requires of them.

How do you assess whether treatment is working, beyond simply ‘I can concentrate better’?

For me, meaningful progress is reflected primarily in daily life. Can someone cope more comfortably with their tasks? Is there less tension at home or at work? Do they still have energy left for themselves in the evening? The goal is not simply to achieve more. What matters most is that life as a whole feels more manageable.

Emotional dysregulation is not included in the diagnostic criteria, yet for many adults, it is a central concern. Do you view it as core to ADHD, and how do you address it?

Emotional dysregulation is a significant consideration for adults with ADHD. It can present in various ways, including emotional impulsivity. However, it is not specific to ADHD and can feature in other mental health conditions as well. Because it can be very distressing in day-to-day life, I devote particular attention to it throughout our work together.

Is there a subject that makes you lose track of time?

Yes, certainly. When a topic truly captures my interest and I become deeply engaged with it, time can easily slip away. This often happens during engaging professional discussions. I believe most people have experienced that feeling.