The number of people taking ADHD medication is at a record high – and the NHS is feeling the strain as it tries to diagnose and treat the condition.

Since 2015, the number of drugs prescribed to treat ADHD has almost tripled in England, and bbc research The suggestion is that it would take eight years to assess all the adults on the waiting list.

Last year, ADHD was the second most viewed condition on the NHS website. Concern about this increasing demand has prompted the NHS in England set up a task force,

So what’s going on and where will it end? Is ADHD (Attention Deficit Hyperactivity Disorder) Becoming More Common? Are we getting better at recognizing it? Or is it being over-diagnosed?

It turns out it’s not just you and I who are left wondering – the experts are surprised, too.

Dr Ulrich Muller-Sedgwick, an ADHD champion at the UK’s Royal College of Psychiatrists, says: “Nobody anticipated that demand would grow so massively in the last 15 years, and especially in the last three years.” He has been running adult ADHD clinics since 2007. He says that at that time, there were only a few of them.

ADHD is a fairly new condition – it’s only been 16 years since the National Institute for Health and Care Excellence (NICE) officially recognized it in adults. When considering whether it may continue to increase, Dr. Muller-Sedgwick argues that there are two different concepts to consider: prevalence and incidence.

Prevalence is the percentage of people with ADHD – Dr Muller-Sedgwick estimates it to be fairly stable at 3 to 4% of adults in the UK.

Incidence is the number of new cases – people getting diagnosed. This is where we are seeing growth. He explains: “What has changed is the number of patients we are diagnosing. It’s almost like the more we diagnose, the more the word spreads.”

Professor Emily Simonoff agrees. She is a child and adolescent psychiatrist at the King’s Maudsley Partnership for Children and Young People. She thinks around 5 to 7% of children in the UK have ADHD – and says: “It’s quite similar around the world, it’s remained consistent and hasn’t really increased.”

Professor Simonoff agrees that there has been a “sharp trend” in people coming forward for assessment since the pandemic – but says this comes after years of “long-term under-recognition”.

She points to statistics on ADHD medications. They expect that around 3 to 4% of children in the UK will need ADHD medication, but in reality, only 1 to 2% are actually using it. She thinks this shows that we are still underestimating the scale of the issue.

Professor Simonoff explains: “I think this is an important starting point when we say, ‘Oh my God, why are we seeing all these kids now – are we over-identifying with ADHD?’ We have under-diagnosed or under-recognized ADHD in the UK for many years.

In other words, we can expect more people to be diagnosed with ADHD now that services are working faster.

Thea Stein is the chief executive of the health think tank Nuffield Trust. He has his own explanation for the recent surge in demand: “The Hump”. She says: “The desire for diagnosis or diagnosis has increased because of knowledge and visibility – (it’s as simple as that).

According to Stein, the most immediate task is to get over the hump by assessing the huge backlog of people on the ADHD waiting list. Then, in the long term, she thinks society will become better at detecting ADHD in children early. They hope this will mean they get better support from an early age, and take some of the pressure off adult services.

She says: “I have real optimism that we will come out much better off as a society during this period. “I have no optimism that this is a quick fix.”

ADHD may be a new concept, but people having difficulty concentrating is an old problem.

In 1798, the Scottish doctor Sir Alexander Crichton wrote of a “disease of attention” accompanied by “an unnatural degree of mental restlessness”.

He explained: “When people are affected in this way… they say they have playfulness.”

However, ADHD goes beyond problems concentrating or being hyperactive. People suffering from this may struggle to control their emotions and impulses. It has also been linked to substance abuse and financial difficulties, as well as higher rates of crime and even car accidents.

Every expert I talk to strongly agrees on one thing: It is better for someone with ADHD to be diagnosed and treated as early as possible.

Dr. Mueller-Sedgwick says there’s a “risk of really bad outcomes.” But he perks up when he describes how diagnosis and treatment can change lives.

He says: “I have seen many patients get better, return to work or return to education. I have seen parents who were going through family court proceedings be able to become better parents.

“That’s why we work in this field, it’s a really rewarding part of mental health to work in.”

Currently, ADHD treatment revolves around medication and therapy, but there are other options on the horizon.

A patch worn on the forehead of children with ADHD during sleep – connected to a device that sends stimulating pulses to the brain – is on sale in the United States. It is not prescribed in the UK, but academics here and in the US are working on clinical trials on it.

Professor Katya Rubia is Professor of Cognitive Neuroscience at King’s College London – as she says, “My work over the last 30 years has basically been imaging ADHD, understanding what is different in the brain (of people with ADHD). “

She explains that some parts of the ADHD brain, including the frontal lobe, are slightly smaller and less active. Professor Rubia is trying to kickstart those areas of the brain, and is working on a study on the trigeminal nerve – it goes straight to the brain stem and can increase activity in the frontal lobe.

She says: “This is all very new. If we find an effect, we have a new treatment.” Although this has not yet been proven, she says: “If all goes well, it could be on the market in two years.”

So, hopefully, in the near future, there will be more ways to treat ADHD without medication. In the meantime, however, the challenge is to get over that “hump” of people waiting for assessment – ​​with the confidence that, over time, the increase in diagnoses should subside.

For support on ADHD issues visit the BBC Action Line

Read ADHD advice from the NHS

Top image: Getty Images

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