Commonly, adult ADHD is complicated by other secondary disorders especially substance use disorders, anxiety or depression, and impulse control disorders. There is a complex and not fully understood relationship between ADHD, autism spectrum disorders, and bipolar II disorder. It is important to be clear about whether a substance use disorder is producing attentional deficits and disruptive behaviour or whether true ADHD is present.

As the diagnosis becomes more accepted and widely known, more adults are being treated for this condition, but generally outside the publicly fundedmental health system although some coommunity mental health services have availability. 

In adults, the basics of treatment are to control the underlying attentional disorder, hyperactivity and impulsivity with medication, then apply cognitive behavioural strategies to assist the individual in repairing the personal damage (to self and others) from years of untreated disorder, and to assist them in developing more functional coping strategies to replace those which they have developed over the years to help them get by.

Support from a local organisation can be very helpful, including the ADHD Association and the online support group adhd.org.nz both for the affected individuals but also their friends and family. Also ADDitude Magazine is a useful resource, with this advice in booklet form developed y the ADHD Foundation in the UK generally applicable in New Zealand.

If you think that perhaps you have undiagnosed ADHD then we would suggest you complete this ADHD screen and discuss with your GP whether a referral would be indicated.

I am originally from Whakatane in the Bay of Plenty, attended Medical School in Auckland, and subsequently worked my House Officer years in Palmerston North, where amongst other attachments I was House Officer to Dr (now Sir) Mason Durie. Having returned to Auckland, initially at Carrington Hospital, for my psychiatry training, 18 months of this was spent in Liaison Psychiatry, including weekly clinics at the Concussion Clinic with Dorothy Gronwall and Philip Wrightson. I then worked for just over a year in Birmingham, UK, including Liaison Psychiatry and Neuropsychiatry attachments, but also laid the groundwork for an MA in the Philosophy and Ethics of Mental Health at Warwick University, subsequently completing requirements back in New Zealand.

From 1997 through 2017, my public practice at Auckland Hospital was dominated by Neuropsychiatry interests including especially Huntington’s Disease, Parkinson’s Disease and Epilepsy. Other neuropsychiatry activities included directing the Concussion Clinic from early 1998 after Mr Philip Wrightson retired, through to late 2005, and as the Senior Medical Officer in the Community Neurobehavioural Service from 1997 for five years.

From 2017 though 2019 I was working as a liaison psychiatrist at Waitemata DHB (North Shore and Waitakere Hospitals). Other public commitments have included as Clinical Director of Te Whetu Tawera from 2009 to 2015, as Director of Area Mental Health Services for Auckland DHB in 2008-9 and 2016-17, and from December 2018 to August 2022 as Service Clinical Director and DAMHS for Waitemata DHB. I am currently in full time private practice.

For most years since 1999 I have spent between one and 4 tenths in private practice, working largely with neuropsychiatric issues in traumatic brain injury, via an ACC contract; ADHD and ASD; Intellectual Disability with emotional and behavioural symptoms; and emotional and behavioural aspects of Movements Disorders and Epilepsy.  I have taught the psychiatry registrars on Movement Disorders and Epilepsy. For about 15 years I have been the New Zealand committee member on the Section of Neuropsychiatry of the RANZ College of Psychiatrists, and am a member of the International Neuropsychiatric Association as well as other organisations including the ILAE, IBIA, and Movement Disorder Society.