I took an ADHD test at 47. Here's what I found out

Telegraph

27-05-2025

The day begins in the usual fashion. As I frantically search the house for my car keys, I find them hiding under my handbag. On my drive to meet my friend I get distracted by the radio and overshoot the turn, arriving flustered, late – and without her birthday present. Last month my car insurance payments doubled since going (just) over the speed limit. It might not sound like much, but I make these sorts of mistakes on a regular basis, and they have become alarmingly common in the last few years.
After having two out of three of my children diagnosed as neurodivergent, one with autism in 2019 and one with ADHD in 2023, I began to wonder, might I also be neurodivergent? Or is it just the inevitable forgetfulness that comes with middle age?
I was also, however, aware, since starting hormone replacement therapy (HRT) in 2022, that I was in the grip of the perimenopause, so I put most of my symptoms – poor concentration and memory, insomnia and anxiety (to give the edited highlights) – down to that. It seems that I am not alone, and that at this stage of life (I'm 47) many women struggle to carry on 'masking' their ADHD and this is when the wheels start to come off.
Dr James Kustow, a psychiatrist and adult ADHD specialist at The Grove, a private psychotherapy practice in Harley St, says that the menopause can often be a time when ADHD hits its peak.
'We know that when oestrogen levels come down, dopamine levels also drop and that this can exacerbate and, in some cases, 'unmask' ADHD symptoms,' he notes.
Dr Kustow thinks, however, that it's about much more than just brain fog. 'We need to widen the lens further and start to see ADHD as a whole-body problem, and not just our brain and behaviour,' he says. 'ADHD impacts everything from the functioning of the body's main stress system, to our internal body-clock and ability to sleep.'
Could that, I wonder, explain why my insomnia has ramped up considerably? All of this has led me to finally seek some clarity on my situation, so I take the plunge and decide to seek a proper diagnosis.
I book in to see Dr Michaela Thomas, a clinical psychologist who specialises in working with women with ADHD. This is what happened next.
What to expect when going for an ADHD diagnosis
The process, Dr Thomas tells me, will involve completing pre-assessment forms and questionnaires, including one which looks at my medical history and another which looks at how often I feel anxious; a three-hour structured interview, and a call with my family to help provide a more detailed diagnostic overview.
Afterwards, Thomas tells me, I will receive a detailed report explaining her findings and including some recommendations and a personalised support plan, which may include therapy or medication referrals.
NHS waiting times for ADHD assessments can vary and may take over a year. Dr Thomas offers private assessments from £2,000.
What happens in my assessment
We start with a 'clarity call' where Dr Thomas and I chat through my current concerns and what has led me to get in touch with her.
I tell her that, like many women, I've found trying to juggle the demands of three children, my job, ageing parents and general day-to-day life, increasingly difficult in the last few years. Dr Thomas says she sees many women like me who have kept it all together for a time but started to crumble when perimenopause kicks in.
'This is when the perfectionism, or rather the self-criticism, starts to come in, and then the burnout,' Dr Thomas explains. She tells me perfectionism can manifest itself in many different ways, especially for women in their 40s who have been raised as people pleasers at a time when ADHD wasn't really recognised in girls.
'The pressures put on neurodivergent girls are often intensified because the expectations placed on us to fit in are heightened,' she explains. 'This can make us less forgiving later on when we make mistakes, because there is more onus on the mother to be the default parent and remember everything.'
I talk through my symptoms with Dr Thomas – forgetfulness, poor concentration, disorganisation, struggling with basic tasks and impulsivity – and my family history (my late mother was quite chaotic and my late brother had schizophrenia, which used to be known as childhood autism). We decide there is enough to go on for an assessment.
I am sent several forms including one which looks in detail at my childhood experiences and whether I've experienced any traumatic events, such as abuse (I haven't, thankfully) or a family bereavement, and a checklist which looks at day-to-day things, including how often I make careless mistakes (all the time).
These questions cover everything from my relationship with my parents; whether I had any difficulties at school; my work history; relationships and alcohol use. It takes several hours to fill in.
Dr Thomas then has a call with my father and sister to discuss my childhood and build a full picture of my life to date.
The in-person screening
I opt for the in-person retreat assessment at Dr Thomas's house where we have a structured interview documenting my life up until that point.
The screening looks at everything, from how often I avoid or delay tasks which involve lots of mental effort to how often I feel overly active and compelled to do things, as if driven by a motor.
We look in more detail at some things referenced in my pre-assessment questionnaires including how I was often described as a 'handful' as a child, with a need for constant stimulation and activity. My dad and sister described me as a 'fuzzy whirlwind' and Dr Thomas wants to know how that made me feel. I tell her it contributed to my sense of 'otherness' and sometimes made me feel ashamed as though there was something wrong with me.
She also asks more about my current day to day life, including how I organise myself. I tell her about the piles of paperwork dotted around my house and how I often struggle to think ahead to organise meal plans for the week.
She is alarmingly perceptive and picks up on me going off on tangents, constant fidgeting and intermittent daydreaming. It's quite emotional to feel so 'seen' and in such a non-judgemental way. Dr Thomas has ADHD herself and clearly recognises the same sort of traits in me.
We go through the diagnostic forms which look at my formative years at school and how I operate now, including avoiding queues, losing things and struggling to organise myself. This takes several more hours.
As the six-hour day comes to an end, Dr Thomas tells me that a detailed report will follow, but that I fit the profile of someone with combined hyperactivity and inattentive ADHD (a type of ADHD characterised primarily by difficulties with focus, attention, and organisation, rather than hyperactivity or impulsivity).
What the report tells me
A detailed report follows which documents my education (how I was bright but disorganised and frequently 'told off' at school); work (which is ruled by deadlines); and my ability to maintain long-term friendships.
It includes a better understanding of the ADHD condition and how it impacts me. The key findings in terms of a diagnosis show that I fall under the 'inattentive domain', which references an endless list which includes my difficulty sustaining attention, avoiding tasks that require sustained mental effort and how often I lose things.
Combined ADHD is the most common and accounts for between 50 to 75 per cent of all cases, according to the ADHD Foundation.
Using the DSM-5 criterion, an assessment tool which uses diagnostic criteria to assess mental health conditions, individuals over the age of 16 must have five or more symptoms of inattention and/or hyperactivity/impulsivity for a diagnosis of ADHD. I have an average of nine which puts me in the moderate category.
I also fall under the hyperactivity/impulsivity domain in terms of restlessness both internally and externally, always being on the go and blurting out answers without thinking.
The report then looks at the impact these ADHD traits have had across my life 'domains' including my erratic work schedule and pattern of over committing then becoming overwhelmed to struggling with simple life admin such as paying bills on time and replying to emails.
My initial thought is one of relief that there is an explanation. I also feel, having thought back to the times in my childhood when I was punished for forgetting things or not listening, quite emotional.
Dr Thomas tells me that a diagnosis is just the first step of the process. 'I always say to clients that they need to think about their next steps and the following six to 12 months and that there will probably be an element of grief too, for the child who wasn't given the right support.'
What the report advises
The report goes on to recommend a number of different support measures including access to visual learning resources (for example: mind maps, colour-coded notes and video-based content) to support my information retention.
I sign up to one called Mindgenius which pledges to 'visually organise my thought process' and help clarify my thoughts with images, colour-codes and shapes. As people with ADHD typically rely more on visual learning to help process and understand information, I try to use it to help brainstorm some feature ideas on Monday morning.
I start by writing a pitch idea but I get distracted by the mewing cat and then a work call. It also recommends using time management and organisation tools and ADHD-friendly task management apps, such as Todoist, Notion or Structured to assist with planning and reminders. In true ADHD fashion, I make a note of which ones to use and then procrastinate and, without the dopamine hit of instant gratification, delay.
I finally download the Todoist app which promises to help organise my life in 30 seconds. It gives me a number of helpful categories, work, personal and so on. I write a list of work deadlines and shopping (to save me writing one from scratch each week). It gives me the option to build my routine, from setting reminders to going for a walk every day and texting a friend. I can see how it could be useful, but I doubt it's something I'm going to use every day.
What are the next steps after diagnosis?
Dr Thomas recommends having regular follow-ups (such as coaching or check-ins) to track progress, adjust strategies and reinforce consistency. She suggests finding a community and some peer support and connecting with neuro-divergent spaces, such as Spark – The ADHD Club for late-diagnosed ADHD women or local support groups to reduce isolation and access shared experiences.
Dr Thomas also recommends resources including podcasts, books, and websites. These include the ADHD Foundation, a UK-based charity providing training, research, and resources for individuals with ADHD, families, and professionals.
So how do I feel at the end of it all? In the weeks after the diagnosis, I have mixed emotions. On the one hand, it's a relief to finally understand why my inner and outer worlds don't always align. For me, people always seem to be 'together' and organised, whereas under the surface I am constantly worried I'm going to drop the ball and make people angry by making mistakes.
It also explains why I find simple things, keeping on top of my invoices for example, so difficult whereas other people seem to glide through such things with ease. It helps explain that sense of 'otherness' I had at school and all the negative messages I received about being inconsistent, either too much or too little.
I don't feel the need to make it part of my identity, and even feel quite reluctant to share it with friends in case they think I'm just jumping on the ADHD bandwagon.
Ultimately, though, it has given me a greater sense of self-compassion and understanding. It's helped me overcome some of the shame about the parts of me most people don't see. And you can't put a price on knowing who you are, can you?