ADHD in Adults: Getting Assessed and Treated via Telehealth in Australia
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The image most people carry of ADHD is a hyperactive child bouncing off walls in a classroom. That image is not just incomplete; it actively prevents adults from recognising ADHD in themselves. Adult ADHD presents very differently from the childhood stereotype, and understanding those differences is the first step toward seeking assessment.
ADHD is a neurodevelopmental condition that affects the brain’s executive functions, the cognitive processes responsible for planning, prioritising, sustaining attention, regulating emotions, and managing impulses. In adults, these difficulties tend to manifest in ways that are less visible but no less disruptive. Symptoms must have been present since childhood to meet diagnostic criteria, but they may not have been identified at the time, particularly in individuals who developed compensatory strategies or who did not fit the expected profile.
The current diagnostic framework recognises three presentations of ADHD, and adults may identify with one or a combination.
Predominantly Inattentive Presentation
This is the presentation most commonly missed in childhood and most frequently identified in adults seeking assessment for the first time. It does not involve obvious hyperactivity and is sometimes still referred to informally as ADD, though that term is no longer used clinically.
Adults with the inattentive presentation often describe difficulty sustaining attention on tasks that are not immediately engaging, chronic disorganisation that persists despite repeated attempts to create systems, a tendency to lose track of time or underestimate how long tasks will take, and a pattern of starting projects with enthusiasm only to abandon them before completion. Many describe a sense of mental fog or an inability to marshal their thoughts when they need to. Work performance may be inconsistent, with periods of high output followed by stretches where even simple tasks feel overwhelming.
Predominantly Hyperactive-Impulsive Presentation
In adults, hyperactivity rarely looks like the physical restlessness seen in children. Instead, it tends to internalise. Adults may experience a persistent sense of inner restlessness, difficulty relaxing, a need to always be doing something, talking excessively or interrupting others in conversation, making impulsive decisions without fully considering consequences, and difficulty waiting in situations that require patience.
Impulsivity in adults can carry real consequences, from impulsive spending to abrupt career changes to patterns of saying things they later regret. The impulsive component is often what creates the most friction in daily life and relationships, yet it is frequently attributed to personality rather than recognised as a symptom.
Combined Presentation
Many adults meet criteria for the combined presentation, experiencing significant symptoms from both the inattentive and hyperactive-impulsive categories. The combination can create a particularly challenging experience where the person struggles to focus and plan while simultaneously battling impulses and restlessness. It is the most commonly diagnosed presentation overall.
One population deserves particular mention. Women with ADHD have been historically and significantly underdiagnosed. Research consistently shows that girls and women are more likely to present with the inattentive type, less likely to display the disruptive behaviours that prompt childhood referrals, and more likely to develop internalising symptoms such as anxiety and depression that mask the underlying ADHD. Many women are not assessed until adulthood, often after a child of theirs receives a diagnosis and they recognise the same patterns in themselves.
The rise in adult ADHD diagnoses is not a trend or a fad. It is a correction of decades of missed diagnoses, driven by several converging factors that have reshaped how the condition is understood and recognised.
The most visible driver has been the role of social media in raising awareness. Platforms like TikTok and Instagram have given adults with ADHD a space to share their lived experiences in ways that resonate with people who have never seen their own struggles reflected in clinical descriptions. While social media is not a diagnostic tool and content quality varies widely, its role in prompting adults to seek professional assessment is well documented.
Changes in diagnostic understanding have also played a significant role. The criteria for ADHD have evolved over successive editions of the Diagnostic and Statistical Manual of Mental Disorders, with increasing recognition that the condition persists into adulthood for the majority of those diagnosed in childhood and that many individuals are never identified as children at all.
The historical under-recognition of ADHD in women and in individuals who performed well academically has also contributed to the wave of adult diagnoses. High intelligence or strong compensatory strategies can mask ADHD for years, but the accumulated cost of constant compensation often becomes unsustainable. Major life transitions such as entering the workforce, becoming a parent, or taking on increased responsibilities can expose underlying executive function deficits that were previously managed through external structure.
The COVID-19 pandemic accelerated this pattern. The sudden loss of external structure and the shift to working from home exposed executive function difficulties that had previously been managed through routine and environmental cues. Clinicians reported a marked increase in adult ADHD referrals during and after the pandemic period.
None of this means ADHD is being overdiagnosed. The evidence suggests that it remains underdiagnosed in adults, particularly in women, older adults, and culturally and linguistically diverse populations. What is changing is that more people are recognising their experiences and taking the step of seeking professional assessment.
Understanding how adult ADHD assessment works in Australia is important because the pathway involves multiple steps and multiple professionals. It is not a single appointment or a single test. Knowing what to expect at each stage can help you prepare and navigate the process more effectively.
Step 1: GP Consultation
The journey begins with your GP. This is the appropriate and necessary starting point for anyone who suspects they may have ADHD. Your GP’s role at this stage is to listen to your concerns, conduct an initial clinical evaluation, and determine whether a specialist referral is warranted.
During this consultation, your GP will discuss the specific difficulties you are experiencing and how they affect your daily life, relationships, and work. They will ask about your developmental history, because ADHD symptoms must have been present since childhood even if they were not recognised at the time. They will also screen for other conditions that can mimic or coexist with ADHD, including anxiety, depression, sleep disorders, and thyroid conditions. This differential screening is a critical part of the process because many of these conditions share overlapping symptoms with ADHD.
Your GP may use preliminary screening tools such as the Adult ADHD Self-Report Scale (ASRS) to help structure the conversation, though a screening tool alone is not sufficient for diagnosis. What your GP can do at this stage is form a clinical impression and, if appropriate, write a referral to a specialist.
Step 2: Referral to a Specialist
If your GP considers a formal ADHD assessment appropriate, they will refer you to a psychiatrist or a clinical psychologist with specific expertise in ADHD. Not all mental health professionals have training or experience in assessing ADHD in adults, and your GP can help identify an appropriate specialist.
The referral letter from your GP is an important document. A thorough referral that includes your history, presenting concerns, and screening results helps the specialist prepare for your assessment and can contribute to a more efficient process.
It is worth being prepared for wait times at this stage. Demand for adult ADHD assessment currently exceeds specialist availability in most parts of Australia. Wait times of six to twelve months are common, and in some areas they are longer. Your GP can advise on specialists with shorter wait times or discuss interim strategies for managing symptoms while you wait.
Step 3: Specialist Assessment
The formal assessment is the most thorough stage of the process. It typically involves a detailed clinical interview covering your current symptoms, their severity, and their impact across multiple areas of your life. The specialist will explore your developmental history in depth, looking for evidence that symptoms were present in childhood, and may request collateral information from a family member or partner who can provide an external perspective on your behaviour and functioning.
Validated rating scales are used alongside the clinical interview. The specialist will also assess for comorbid conditions such as anxiety, depression, and sleep disorders, which frequently co-occur with ADHD and must be identified for effective treatment planning. The assessment may take place over one or more sessions depending on the specialist’s approach and the complexity of the presentation.
Step 4: Diagnosis and Treatment Planning
If the specialist determines that you meet the diagnostic criteria for ADHD, they will provide a formal diagnosis and develop a treatment plan in collaboration with you. This plan may include medication, psychological strategies, lifestyle modifications, or a combination. The specialist will explain the available options, discuss the evidence base for each, and help you make informed decisions about your care.
Step 5: Shared Care With Your GP
This is a critical step in the Australian ADHD pathway that is important to understand clearly. In Australia, stimulant medications used to treat ADHD must be initiated by a specialist, specifically a psychiatrist or paediatrician. Your GP cannot start you on stimulant medication independently. However, once a specialist has initiated treatment and established that the medication is appropriate and well-tolerated, your GP can continue prescribing and monitoring that medication under a shared care arrangement.
This shared care model means that you do not need to see a specialist for every prescription renewal. Your GP takes on the ongoing management, monitoring for side effects and making dosage adjustments within the parameters set by the specialist. Periodic reviews with the specialist may still be recommended, but the day-to-day management of your treatment sits with your GP. This arrangement is particularly important for patients in regional and remote areas where specialist access is limited.
Treatment for ADHD in adults is not a one-size-fits-all proposition. The most effective approach for most people is a combination of strategies tailored to their specific symptoms, circumstances, and goals. Medication is one part of the picture, but it is not the only part, and it is not mandatory.
Medication for ADHD falls into two broad classes. Stimulant medications are the most commonly prescribed and have the strongest evidence base for reducing core ADHD symptoms. Non-stimulant medications are an alternative for individuals who cannot tolerate stimulants, who have contraindications, or for whom stimulants are not effective. As outlined above, both classes require specialist initiation in Australia, with ongoing prescribing managed by your GP under shared care.
The decision to use medication is always made collaboratively between you and your treating clinicians. Your specialist will discuss the potential benefits, possible side effects, and monitoring requirements. Medication does not cure ADHD, but it can reduce the severity of symptoms sufficiently to allow other strategies to be more effective.
Psychological strategies play an important role in managing adult ADHD, and for some individuals they may be the primary treatment approach. Cognitive behavioural therapy adapted for ADHD focuses on developing practical skills for managing time, organisation, planning, and emotional regulation. ADHD coaching is another option that provides structured support for setting goals, building routines, and developing accountability systems. These approaches work on the skills and habits that ADHD makes difficult, and they can be effective both alongside medication and as standalone interventions.
Lifestyle factors deserve more attention than they typically receive. Regular physical exercise has a meaningful evidence base for improving executive function and reducing ADHD symptoms. Consistent sleep routines are important because sleep difficulties both worsen ADHD symptoms and are worsened by them, creating a cycle that structured sleep hygiene can help break. Building external structure through routines, visual reminders, and environmental design can compensate for the internal executive function difficulties that characterise the condition.
Treatment for adult ADHD is not about finding a single solution. It is about building a personalised combination of strategies that reduces the impact of symptoms on your life, shaped by your individual presentation and developed collaboratively with your clinicians.
Your GP is the starting point for the ADHD assessment pathway, and that consultation does not need to happen in a physical clinic. At Abby Health, you can see a GP via telehealth to discuss your concerns, complete an initial screening, and receive a referral to an appropriate specialist for formal assessment.
Your GP will take a detailed history, discuss your symptoms, screen for other conditions that may be contributing to your difficulties, and determine whether a specialist referral is the right next step. If it is, your GP prepares the referral and sends it electronically. You do not need to take time off work, drive to a clinic, or sit in a waiting room to start the process.
Where Abby Health becomes particularly valuable is in the ongoing management phase. Once a specialist has initiated treatment and established a shared care arrangement, your Abby GP can manage your ongoing prescriptions and monitoring. This is where continuity of care matters most. ADHD management is not a set-and-forget process. It involves regular check-ins, dosage adjustments, monitoring for side effects, and ongoing conversations about how treatment is working in the context of your actual life. Seeing a GP who already knows your history and understands your treatment plan makes those conversations more productive and more personal.
Abby Health’s care network includes over 300 clinicians available seven days a week. Consultations are bulk billed for eligible patients. Because Abby is built around the principle of long-term, continuous care, you are not starting from scratch every time you need to see your doctor. Follow-up appointments are genuinely that: follow-ups, not repeated intake conversations.
If you are also managing depression alongside ADHD, which is common, having a single GP who understands both conditions and how they interact is one of the most important things you can do for your overall care.
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