Therapy When You Have ADHD

How common ADHD is, and why the numbers disagree

We are going to give you two figures, because two exist and they do not agree.

NICE puts adult ADHD in the UK at around 3-4%. NHS England's own independent ADHD taskforce puts it at 2-3%. Nobody has reconciled them, so we will not pretend one is settled.

What both agree on is that recorded diagnosis sits far below either number. In 2024/25 in England, almost 2% of males and almost 1% of females had a recorded ADHD diagnosis. Since 2016/17 that has more than doubled for males and more than quadrupled for females.

In the 2023/4 national survey, almost 14% of English adults screened positive on a standard ADHD questionnaire. Under 2% reported a professional diagnosis.

A positive screen is not a diagnosis. It is a flag that says a conversation might be worthwhile. Anyone who tells you that 1 in 7 adults has ADHD has misread that number.

Sources: NICE: ADHD summary, NHS England PRN02031, NHS England Digital: OpenSAFELY ADHD, NHS England Digital: ADHD survey 2023

What talking therapy can do

We will be straight about this, because a lot of sites are not.

NICE says medication comes after changes to the environment have been tried and reviewed. It recommends offering it to adults only if symptoms still cause significant impairment after that. We cannot prescribe, we are not a clinical service, and a therapist cannot substitute for an assessment.

What therapy is good at is everything that has accumulated around the ADHD. That is usually the larger problem by the time someone reaches out.

• The belief that you are lazy or careless, built up over decades of evidence that felt convincing
• Anxiety about being found out at work, and the exhaustion of covering
• Relationships strained by forgotten things and unfinished conversations
• Shame after a late diagnosis, and grief for the years before it
• Practical work on the systems and structures that suit how you think

None of that requires a diagnosis, and none of it needs to wait for one.

If the exhaustion of covering has become the whole picture, masking and burnout has its own page.

Source: NICE NG87

Being diagnosed late

A late diagnosis often lands as relief and anger at the same time. Both are common and neither needs justifying.

Many people describe a period of looking back and rereading their own history. School reports. Jobs that ended badly.

A pattern that suddenly has a different explanation. That reappraisal is real work. Most people do it better with someone else in the room.

A diagnosis, and medication if you and your prescriber choose it, answers one question. It does not tell you what the years before mean. Talking therapy sits alongside medication, not in place of it.

What else often comes with ADHD

NICE names personality disorders, bipolar disorder, obsessive-compulsive disorder and substance misuse as common coexisting conditions in adults with ADHD.

Anxiety and depression are widely reported alongside ADHD too. We are not going to attach a percentage to that, because there is no reliable UK population figure for it. The numbers quoted elsewhere generally come from specialist clinics, where people are more unwell by definition.

Others come from outside the UK. Either way they do not describe the general population.

Some physical conditions also turn up more often alongside ADHD, from PMDD to hypermobility. We set out the studies on ADHD, autism and the body.

Source: NICE NG87

If things are difficult right now

A Danish study followed nearly three million people, the whole population. Suicidal behaviour was recorded around 4.7 times more often in people with ADHD. Where ADHD occurred on its own, without other conditions, it was 4.1 times.

If tonight is bad, please do not wait for an appointment or an assessment. Our crisis page lists free confidential helplines you can contact now.

You do not need a diagnosis to use any of them.

Source: Fitzgerald et al. 2019