Didn’t receive a positive diagnosis for ADHD? Here’s what to do first

Understand your assessment outcome

If your assessment concluded that it’s “Not ADHD”, it doesn’t mean that what you have is “Nothing”. 
The symptoms you’ve been experiencing are real, and they still deserve attention.
 
But there are a few possible reasons why you might not have received a positive diagnosis, including:

• Assessments aren’t perfect: Sometimes conditions like anxiety or autism can mask symptoms, or the assessment process itself might not capture “the full picture” of your symptoms. It’s also not uncommon for people with ADHD—especially adults—to have learned to mask their symptoms in order to fit in socially.

• Other conditions can better explain your symptoms: Sleep disorders, depression, autism, anxiety, dyslexia could be a closer match to what you're experiencing than ADHD.

• You don’t meet the criteria for an ADHD diagnosis: For a formal diagnosis as an adult, you need to exhibit at least 5 symptoms of inattention or hyperactivity-impulsivity, in multiple settings, over at least 6 months. It’s possible you simply don’t meet some or all of these criteria.

A negative diagnosis doesn’t invalidate your experiences. But it’s still important to discuss with your clinician to understand why they didn’t give you a positive diagnosis. If you’re not able to speak to them, read your ADHD assessment report carefully. This might also help you understand the reasons behind their decision.

Explore alternative explanations

So what now? After you find out why your ADHD assessment report said “Not ADHD”, but you still feel that your symptoms are impacting your life, there are a few things you can do next:

• Review your symptoms: Revisit the specific symptoms that led you to seek an ADHD assessment. You can keep a symptom journal for a few weeks to help you track what you're feeling, when your symptoms start, and what’s going on around you at the time. Then look for patterns or triggers:
• Do your symptoms worsen during periods of stress, poor sleep, or hormonal changes?
• Are certain environmental stressors, like noise or high pressure, making these symptoms worse?
• Consider other potential causes: Research the symptoms of other conditions and see if they resonate with your experiences. Many symptoms that look like ADHD can also be signs of other mental or physical health issues, like:
• Anxiety: constant worry can make it hard to focus.
• Depression: low mood, fatigue, and poor concentration are common signs of depression, and can look like ADHD.
• Autism Spectrum Disorder (ASD): social and sensory challenges can sometimes be mistaken for ADHD.
• Bipolar disorder: symptoms that are similar to those present in ADHD, like impulsivity and attention changes, may appear during mood episodes.
• Trauma or PTSD: chronic stress from past trauma can affect memory and attention.
• Sleep disorders: insomnia, sleep apnoea, or poor sleep hygiene can cause problems with focus and attention.
• Thyroid issues or hormonal imbalances: can influence energy, focus, and mood.
• Substance use, including caffeine or alcohol: can worsen attention and impulse control.
• Create a very detailed medical history for yourself: This will be very helpful for any medical professional you see in the future. You can include the following:
• Your symptoms: what they are, when they started, what makes them better or worse
• Any physical or mental conditions you’ve been diagnosed with in the past
• Major life events, like trauma, accidents, struggles at school
• Your childhood behaviour - it’s usually useful to talk to family members who’ve known you well as a child to gather information about this
• Medications or therapy you’ve tried and how they’ve affected you
• Family history of mental health and neurodevelopmental conditions
• Your lifestyle, including sleep habits, diet, physical activity, or substance use

H3: Should I get a second opinion?

If, after considering all of these factors, you still feel strongly that ADHD might be the cause of your symptoms, consider seeking a second opinion from another qualified professional.

You have several options:

If your GP said no to referring you to a specialist for a proper diagnosis, you have a couple of options. You can ask to see another GP at the same practice, or you can switch to a different practice entirely. Just make sure to let the new doctor know what the first one said and why you're asking for a second opinion.

Explain clearly why you think you might have ADHD, but keep an open mind. It shouldn’t be an “ADHD or not” discussion, but much wider than that. And keep in mind that the goal is to seek help for your symptoms, even if they’re better explained by other conditions.

If an NHS specialist, like a psychiatrist or a nurse practitioner, has told you that you don’t have ADHD after an assessment, you can consider booking a private assessment.

And if you received a diagnosis from a private clinic, you can always ask for a second opinion from another private clinic.

You can read more about this here: Told it’s not ADHD: What are my options now?