Key Workers and ADHD ... how a late diagnosis can be a blessing in disguise

Attention Deficit Hyperactivity Disorder (ADHD) and other forms of neurodivergence are prevalent among Key Workers, and yet Key Workers seem more reluctant than others to open up about it. ALICE HARGREAVES speaks to ZOE WATSON, who, like her, was diagnosed later in life, to find out what’s going on.

It was a warm summer day in 2022 when I heard the words I’d been expecting: “You have textbook ADHD”.

I was 32, and like a lot of women in the UK was receiving a diagnosis later in life. Through my business, SIC, which works to close the disability employment gap here in the UK, I was meeting women just like me. Women with ADHD.

My journey to diagnosis wasn’t straightforward; the diagnosis can take up to four years via the NHS.

I did my research and decided that a private pathway was right for me. Within a few months, I was able to book an appointment with the lead clinician for the ADHD Transitions Service in my region (Coventry & Warwickshire) through their private practice. It cost £450.

I spoke to Dr Hina Rehman, a Consultant Neurodevelopmental Psychiatrist in Manchester, to find out more about the different types of ADHD. She explained that there are three main areas where people with ADHD experience difficulties: attention, hyperactivity, and impulsive behaviour. Around 15% present with the hyperactive or impulsive type, 20 to 30% have the attention type, like me, and others experience a combination.

Those three difficulties are just the tip of the iceberg of ADHD symptoms which can also include emotional dysregulation, low selfesteem, sensory overload, communication difficulty, insomnia, and hyperfocus.

“There is a huge list of mental health problems that coexist with ADHD, including depression, anxiety, bipolar and autism. But the key to establishing this coexistence is thorough assessment,” Dr Rehman explained.

Boys are three times more likely than girls to be diagnosed with ADHD and a lot of this is down to how ADHD presents in males.

The more physical signs are less prevalent in young women, but in adulthood, the ratio moves to 1:1, which goes some way to explaining why it is common for women to be diagnosed later in life.

Dr Zoe Watson, a London-based GP and founder of Wellgood Wellbeing, was diagnosed at the age of 40.

She sought help after finding herself falling out of love with medicine.

“Consultations were ten times more exhausting than they should have been,” she said.

“People don’t realise how overwhelming being a GP is; I experienced a lot of sensory overload during my face-to-face appointments. There is so much human interaction and you have to do a lot of masking.

“As a profession, there’s a lot of shame associated with neurodivergence and we need to work together to shed that.”

She found that a creative outlet was the only way to ease her busy mind.

“Meditation just doesn’t work for my ADHD brain, my thoughts are just too loud,” she said. “So I created my own form of meditation, and started to make things.”

Zoe’s first business, Make and Create, allowed her to make and do whilst also removing barriers to creativity for others.

Wellgood Wellbeing evolved out of Make and Create, bringing together Zoe’s medical background and her creativity. Her aim was to offer a safe space for people struggling with mental health and provide access to medical professionals, traditional meditation, yoga, breathwork and exercise.

It’s a platform built with Key Workers in mind, with subsidised rates for people who fall into that category and free places for those on lower incomes.

“I entered medicine to help people, and with Wellgood Wellbeing I want to empower people with knowledge, understanding, and acceptance,” Zoe added.

Her platform has proved popular with those with ADHD, who have found that more conventional wellbeing pathways aren’t for them.

Zoe Watson

Like Zoe, for years my mind was an anxious one. I tried medications, speaking therapies, and Cognitive Behavioural Therapy to quieten my busy brain, but little seemed to work.

Now, following my diagnosis, I recognise that a lot of the symptoms I associated with my anxiety are actually my neurodiversity.

For instance, I have Rejection Sensitive Dysphoria, a common comorbidity with ADHD, which means that I struggle enormously with rejection, negative feedback, and self-confidence.

“70% of neurodivergent folk have a co-existing mental health condition, and as Key Workers, we are not immune to either,” added Zoe.

NHS England estimates that 3% of the population have ADHD and some research suggests it is more prevalent in Key Workers.

An April 2023 survey of 1,450 adults with ADHD found that 23% worked in healthcare with many citing the variety and sense of purpose as key drivers.

However, it seems that Key Workers are reluctant to admit to experiencing symptoms.

A 2020 British Medical Association report discovered that 19% of respondents to anonymous NHS staff surveys disclosed a disability (including neurodivergence), but only around 3% did so on their ESR (electronic staff record).

Only around 2% of the clinical workforce disclosed a disability, and disclosure rates decreased at later career stages.

This lack of disclosure is partly down to the varied perceptions of ADHD.

Sue Perkins, Denise Welch, Johnny Vegas, and Nadia Sawalha are all public figures who celebrated their diagnosis in 2022 and hoped that it would encourage people with ADHD to be more open about their experiences.

However, the BBC Panorama episode, Private ADHD Clinics Exposed and Steven Bartlett’s The Diary of a CEO episode, We’ve Got ADHD Wrong! Break Any Habit & Never Be Distracted! (both released in May 2023) tell a different story.

Both suggested that ADHD is over-diagnosed and that many people are being wrongly prescribed medicines that they do not need.

It’s also been hard to avoid articles with headlines blaming TikTok influencers for creating an ADHD trend. One concern is that the diagnoses some people receive privately are unsafe.

I asked Dr Rehman what a diagnosis should look like.

She explained:

“When we do these assessments we go into detail, exploring the neurodevelopmental history of a person right down to when their parent was pregnant, and in very early childhood.”

She said the NICE guidelines are very clear, that symptoms should be visible before the age of 12 and should be present in two or more settings: home, education, or the workplace.

There are two types of medication available to support people with ADHD, stimulants and non-stimulants, and both pose risks to people with pre-existing health conditions.

Dr Hina recommends Cognitive Behaviour Therapy (CBT) to help more holistically, with or without medication.

Waiting lists (even privately) are increasing but support is out there and anyone who believes they may have ADHD symptoms should seek help sooner rather than later.

Both Zoe and I spoke to our GP first and made decisions based on current waiting lists. For me the wait was too long, so I sought private advice, while Zoe found the “Right to Choose” route via the NHS was quicker in her region.

Your GP is the best place to start.

“I already knew I had ADHD by the time I had a diagnosis,” said Zoe, “But being able to own this identity was a huge relief”.

“The public sector needs to do more to support Key Workers who are struggling. As a sector, we have a lot of learning to do.”

For fellow Key Workers who think they may have ADHD, Zoe offers some reassurance: “Just because you haven’t met a Key Worker with ADHD, doesn’t mean there aren’t any, you’re certainly not alone.”

Dr Zoe Watson works remotely as a GP part-time and is the Founder of Wellgood Wellbeing. The organisation’s website can be found here.

Alice Hargreaves is a writer and is the Co-Founder and COO of SIC. The organisation’s website can be found here.