The waiting times for clarification about ADHD are getting longer – the reasons are complex

The waiting lists for an ADHD assessment interview are months long. The more people talk about the symptoms, the more adults suspect that they suffer from attention and concentration disorders.

Psychotherapist François Gremaud, specialized in the diagnosis and treatment of ADHD, also feels this increase. “More and more people are contacting me who have accidentally found out about the diagnosis – be it through (social) media or acquaintances,” says the psychotherapist. Some would be confronted with ADHD for the first time through an evaluation of their children – and recognize themselves in the symptoms.

For a long time, doctors and scientists assumed that only children suffered from ADHD and that the disorder developed during puberty. ADHD is now also recognized in adults and the fact that ADHD is not just a children’s problem is becoming increasingly aware in society.

“Many adults were not diagnosed with ADHD in childhood. These people have usually gone through a long period of suffering,” says Gremaud. In adulthood, the disorder is often accompanied by comorbidities such as depression or addiction. In many cases, ADHD is only recognized by comorbidity (one or more disorders or diseases that are associated with an underlying disease). In adults, ADHD is often overshadowed by secondary illnesses – and not properly treated.

Another reason for the long waiting times is the lack of trained specialists. “In the master’s program in psychology you learn how to treat psychological disorders such as schizophrenia or anxiety disorders. But ADHD is not integrated there. “Specialists are therefore not trained to diagnose and treat ADHD,” says Gremaud. You have to develop yourself as a professional.

According to Gremaud, this knowledge gap often leads to incorrect diagnoses and treatments. “The problem is especially evident with stimulant medication. Therapists, doctors or psychiatrists make their recommendations based on their personal attitude – and not as a professional.” In particular, drug treatment with the active substance methylphenidate (e.g. Ritalin) is often demonized – because the stimulant leads to dependence.

But this has been scientifically refuted. “Numerous studies show that concerns about medication or drug addiction associated with stimulant prescribing are unfounded. Some studies have shown that the risk even decreases,” says Gremaud. Methylphenidate is classified as a narcotic and requires a prescription. It helps increase activities in the brain related to concentration.

It is estimated that between 200,000 and 500,000 people in Switzerland suffer from ADHD. The number of unreported cases is likely high. ADHD is less apparent, especially in adults, than in hyperactive children or adolescents. ADHD is a neurological disorder. It can be assumed that ADHD is hereditary, like other mental health conditions.

In people with ADHD, the messenger substances dopamine and norepinephrine, which are responsible for transmitting stimuli in the nerve cells, are out of balance. This has a negative effect on information processing and concentration. In adulthood, ADHD mainly manifests itself in concentration problems, being easily distracted, forgetfulness and difficulty following conversations or keeping appointments.

Diagnosing ADHD is complex and not always immediately clear. “Depending on the dopamine level, ADHD patients can concentrate very well,” says Gremaud. This is due to the imbalance of messenger substances. Because the dysfunction in the brain disrupts the interaction between attention and motivation. Gremaud gives an example:

ADHD usually accompanies those affected throughout their lives and can be very stressful. It bothers Gremaud that the psychiatric disorder is still seen as a trendy diagnosis, even among therapists and doctors.

In the coming articles we will report on the different faces of ADD.