Local doctor spotlight: Adult ADHD takes centre stage in local healthcare
Dr Woon visiting his sister, Dr Sy Woon, in California as part of his Churchill Fellowship It’s been a whirlwind 18 months for Dr Wee-Sian Woon since joining Ochre Medical Centre Bruce last year. On top of settling into the practice, he spent six weeks undertaking research in Europe and the USA on a prestigious Churchill Fellowship from the Winston Churchill Trust as well as presenting a workshop at the recent WONCA (World Organisation of Family Doctors) Conference in Sydney – the largest conference of general practice ever held in Australia. Dr Woon’s recent activities have been focused on ADHD (Attention Deficit Hyperactivity Disorder) in adults - investigating models of care to increase the accessibility of diagnosis and management. His interest in ADHD was piqued when he observed an increase in adult patients seeking his help with diagnosis and management of the condition a few years ago. “I was quite sceptical at first about the number of patients coming in for diagnosis and management,” he says. “I’d had no formal education in medical school or GP training about ADHD in adults and didn’t know much about it. Coincidentally, at around the same time, my sister who practises as a veterinarian in the US, was diagnosed with ADHD. I saw how the diagnosis allowed her to understand herself better. She was able to recognise how her brain works and what aspects might contribute to her daily challenges or her strengths. On the one hand, people with ADHD
may find day-to-day activities challenging, whereas when given the right environment, they can flourish and be notoriously entrepreneurial as well as able to intensely hyperfocus on creative endeavours or special interests. While they may lack impulse control in ordinary conversations, they can be very effective communicators and public speakers, as shown in prominent figures such as Emma Watson, Jamie Oliver, Michael Phelps and Simone Bile. Knowing these strengths and building on them can be so empowering.” During his travels, Dr Woon observed similar issues with increased demand for diagnosis and treatment around the world. “I was able to meet with health planners, clinicians, and advocacy organisations. It is apparent that there aren’t sufficient specialists to cater for the prevalence of 2-5% of the adult population, causing lengthy waits and issues with affordability. It was interesting to see the different models being devised in Europe and the USA to cater for the demand. I saw services that were led by nurses, GPs, and psychiatrists, as well as different ways of delivering education to patients about ADHD. I also appreciated the importance of patient-centred care and managing co-occurring conditions such as other mental health issues and neurodiverse conditions.” Lack of knowledge about adult ADHD remains a key challenge.
“At the recent WONCA conference in Sydney, casual conversations during the conference highlighted that there’s still a lot of scepticism, misinformation and lack of knowledge about adult ADHD among GPs,” he says. At the conference, Dr Woon also ran a workshop on Gay men’s health. “The workshop was very well-received,” he says, “we had participants from all the regions around the world. They particularly enjoyed being able to discuss the situation in their own countries, share experiences and learn from each other. The discussion included access to PReP, a medication taken by people who do not have HIV to lower their risk of acquiring HIV. In Australia, you can just see your GP and you won’t pay a significant amount for the medication, but
in some other countries that’s not the case: you might have to visit a specialist clinic and pay a lot of money, or even travel to another country, to access PrEP.” Dr Woon would like to express his gratitude to the Winston Churchill Trust for the opportunity offered by his Fellowship. He is currently preparing his Fellowship Report, which will be published on the Trust’s website. He also made a submission to the recent Australian Senate Inquiry into assessment and support services for people with ADHD, with its November 2023 report now available online. Dr Woon is accepting new patients at Ochre Medical Centre Bruce. Bookings can be made via ochrehealth.com.au or by calling the practice on 6180 8500.
ADHD: THE FACTS • Untreated Adult ADHD has significant social and economic impacts, including more lost workdays, unemployment, increased reliance on mental health services, increased substance use disorders, and over-representation in the prison population. Deloitte estimated the total social and economic cost of ADHD in Australia to be $20.4 billion in 2019. • People with ADHD can easily be distracted in carrying out everyday tasks - they have a neurodevelopmental condition that can be managed to help them function more effectively and decrease the impairments caused by the condition. • Psycho-stimulant medications can be effective in managing ADHD symptoms. When used correctly in the right doses, they are a safe first line of management for people with ADHD. • A common myth is that people with ADHD can’t do well at school. Some people with ADHD do very well at school or work, particularly if it is an area that they are very interested in, but they may struggle in other areas of their lives, finding it difficult to function at their full potential. • There are also non-stimulant medications and nonpharmaceutical approaches such as cognitive behaviour therapy, exercise, and proper sleep, which can also improve symptoms.
ADHD TIPS • The main symptoms of ADHD are inattention and/or impulsivity and hyperactivity that are usually persistent and pervasive since childhood, resulting in significant impairments in work, school, home, and relationships. If you are finding these issues impact different aspects of your life, the first step is to talk to a GP with interest and experience in ADHD. They may recommend you take a screening test. • There are many valuable sources of ADHD information online, such as the American magazine ADDitude and ADHD Experts podcasts, however, be cautious of random Google sources and social media. While they may raise awareness, they also propagate a lot of misinformation, and a skilled clinician is required to make a proper diagnosis.