Adult ADHD: How To Get A Diagnosis in Singapore

Have you always found paying attention challenging, or have you experienced unexplained restlessness or impulsiveness? Attention-Deficit Hyperactivity Disorder (ADHD) can go undiagnosed well into adulthood. Read our Homage guide to find out how to get tested for adult ADHD in Singapore.

What is ADHD?

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Attention-Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders associated with childhood. Common symptoms associated with ADHD include impulsiveness, a short attention span, poor time management, as well as difficulties with concentration and executive function. However, ADHD can go undiagnosed in children and persist into an individual’s adulthood.

Are there different types of ADHD?

There are generally three different forms of ADHD:

1. Hyperactive
2. Inattentive
3. Hyperactive-Inattentive Combination 

1. Hyperactive ADHD

People with hyperactive ADHD typically feel like they are constantly moving. Fidgeting, squirming, and struggling to stay seated are common experiences. In children, this can appear like they are being “driven by a motor” and excessive running. Broadly across all age groups, hyperactive ADHD individuals may talk excessively, unintentionally interrupt others during conversation, and have trouble exercising self-control. This ADHD subtype is most recognisable and most often diagnosed in younger children, especially boys. 

2. Inattentive ADHD

Inattentive ADHD individuals instead find greater difficulty with sustaining their attention, following complicated or detailed instructions, and organizing activities and tasks in general. These symptoms are caused by a poorer working memory and an inclination to be distracted by stimuli. Inattentive ADHD individuals may also tend to lose their belongings, such as their mobile phones, wallets, and keys, easily. While hyperactive ADHD is most often diagnosed in men and boys, inattentive ADHD is more commonly diagnosed in adults and girls. 

3. Hyperactive-Inattentive Combination ADHD 

Hyper-Inattentive Combination individuals exhibit six or more symptoms of hyperactive ADHD and six or more symptoms of inattentive ADHD at the same time. 

What are the symptoms of adult ADHD?

Here are common struggles that adults with ADHD often face:

• Struggling to pay sufficient attention to detail, which may affect work performance 
• Difficulties with time management
• Finding it difficult to prioritise tasks or to break down bigger tasks into smaller ones
• Difficulties with following through with a task, especially if they require high amounts of preparation work or are challenging in nature
• An inclination to start new tasks and projects before finishing old ones
• Tendency to be forgetful
• Physical and mental restlessness – which can manifest as fidgeting, such as picking at nails or tapping hands and feet
• Unintentionally interrupting others in conversation
• Lower tolerance for stress
• Heightened sense of impatience – for example, being more restless than most people while waiting in line
• Taking risks in activities, often with little or no regard for personal safety or the safety of others – for example, driving recklessly

Many who remain undiagnosed until adulthood may have developed coping and compensation strategies to avoid being perceived negatively by those around them, such as their peers, family members, and even bosses. Some individuals with ADHD have imposed structured and detailed checklists and routines that they rely heavily on so that they do not miss out on critical steps while working, which may make it more difficult for them to identify the extent to which their ADHD impacts their lives.

Additionally, adult ADHD presents itself much more subtly than childhood ADHD. ADHD in adults is likely to manifest in an inattentive presentation rather than a hyperactive presentation as the pressures of adulthood encroach. 

On a practical level, inattentive and hyperactive ADHD symptoms can present themselves differently for adults in the following ways:

For inattentive ADHD, differences in presentation between children and adults are usually not as noticeable. Making careless mistakes and an inability to finish what one has started or pay attention to details are common to both children and adults with inattentive ADHD. While this can present in children as sloppy schoolwork or difficulty with chores and projects, things are different at the workplace. Adults with ADHD may find themselves bouncing between different job tasks without being able to finish them or have difficulty prioritising important tasks over trivial tasks. Chronic multitasking inevitably leads to lowered work performance as a result.

For hyperactive ADHD, differences in presentation between children and adults are starker. While children with hyperactive ADHD may be impatient and impulsive by skipping turns, blurting out responses to questions or attempting dangerous stunts without thinking things through, these have magnified repercussions for adults in social and work settings. Adults with hyperactive ADHD may similarly have difficulty controlling their instinctive responses during work meetings but more worryingly, may also be impulsive in spending patterns and engage in other risky behaviours such as speeding. In social settings, they may also interrupt conversations and end up monopolising them.

As such, although ADHD symptoms in children tend to be easily recognisable, adult ADHD symptoms can differ significantly in presentation and can manifest practically in a variety of ways that might not be very noticeable and are most likely to more obviously affect their work performance?

How ADHD manifests in women

While women and girls experience the same symptoms as men and boys, they are often expressed differently in behaviours than those observed in men and boys. These differences have traditionally led to the underdiagnosis of women and girls with ADHD. While medical practitioners often look for hyperactive ADHD symptoms in men and boys, they tend to overlook inattentive ADHD symptoms in women and girls, attributing them to other causes or cultural and social norms, due to gender bias. 

Yet, research and lived experience indicate that it is precisely inattentive ADHD symptoms that women and girls most often present with. These include: 

• Failure to pay close attention to detail and being prone to careless mistakes 
• Difficulty with maintaining sustained attention and listening 
• Struggling with following instructions
• Difficulty with organization, which can manifest in difficulties with paperwork, paying bills on time, managing money, and so forth
• Avoidance and dislike of mentally taxing tasks
• Being easily scatter-brained
• Easily distracted and forgetful when it comes to tasks and daily activities
• Overspending in adulthood

And when women and girls do display ‘internalised’ hyperactive ADHD symptoms and behaviours, they are mistaken for behaviours that have been culturally associated with female socialisation:

• Excessive talking
• Fidgeting and restlessness
• Impulsive acts and speaking
• Frantic thoughts internally and difficulty staying on track on one topic mentally
• Easily makes friends but has difficulty sustaining friendships
• Self-harming activities, or activities that require extreme and unhealthy self-discipline
• Working twice or thrice as hard as others to compensate for symptoms 

Women therefore often don’t realise that they have ADHD themselves until others surface it to them, as seen in this report by ChannelNewsAsia.

How and where you can get an adult ADHD diagnosis in Singapore

If you suspect that you or your loved ones may have adult ADHD, you can consider the following routes for getting a diagnosis:

How can you get help from a government-based hospital or clinic?

1. Get a Referral

For an immediate first step, you should head to your neighbourhood Polyclinic or General Practitioner to be evaluated and obtain a referral to a specialist at a restructured hospital or private healthcare institution if further diagnostic procedures are deemed necessary. 

2. Direct Consultation

You may also choose to opt for direct consultation at IMH or NUH. However, you may not be provided subsidised rates. For example, IMH patients need to have been referred by a polyclinic or a Community Health Assist Scheme (CHAS) GP clinic in order to receive treatment at subsidised rates. 

On the upside, non-subsidised patients generally have shorter waiting times to get an appointment. This may be a good option if you are not keen on waiting for your first visit. 

What about getting help from private clinics?

Private patients will have shorter waiting times for appointments, where you are able to choose your own doctor without requiring any referrals. A first consultation with a private specialist, however, can set you back by an estimated $200 to $300. Additional tests to confirm your ADHD diagnosis may also be charged separately. 

Here are some private clinics that you can consider: 

Ways to manage your adult ADHD symptoms

While ADHD cannot be cured, there are various ways to manage its symptoms. With medication, behavioural therapy, or a combination of the two, your ADHD symptoms can become less severe and disruptive.

• Stay physically active through exercise
• Eat a balanced diet
• Get sufficient rest at night
• Develop a day-to-day routine that you can fall back on

Are there subsidies or financial assistance for ADHD treatments?

Unfortunately, there are generally no subsidies and financial assistance for ADHD treatment in Singapore. Schemes that are available are often targeted towards children. 

Subsidies for consultation and diagnosis are available if you seek treatment at a public hospital via referral from a polyclinic or general practitioner. 

When coupled with the responsibilities and obligations you have to take on for your family and loved ones, as well as your duties at home and at work, being a caretaker to a loved one can be challenging if you have ADHD.

If you need help with taking care of a loved one, Homage Care Pros are here for you. Our range of home care services covers personal, respite and night care, allowing you to hire flexible, short-term care that can be tailored to your elderly loved ones’ needs and giving you more time and energy to cope with your other responsibilities.

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