There is a particular kind of appointment that has become far more common in general practice over the last few years. A patient in their thirties, forties or fifties sits down and says some version of the same thing: my child was assessed recently, and while I was reading about it, I recognised myself on every page.
Others arrive from a different direction. A promotion changed the shape of their work and the coping strategies that carried them for two decades stopped working. A relationship ended. They have been treated for anxiety for years with partial benefit and cannot escape the feeling that something underneath was never addressed.
The question they usually ask is the same. If this has been there my whole life, how did nobody notice?
It is a reasonable question, and the answer is not that anyone was careless. Adult ADHD is missed for reasons that are structural, historical and clinical.
Attention deficit hyperactivity disorder is a neurodevelopmental condition, which means the underlying differences are present from childhood even when the diagnosis arrives decades later. What changes across a lifetime is not the condition. It is the gap between demand and capacity.
Many undiagnosed adults have built an elaborate scaffolding without ever calling it that. Working late to compensate for a day lost to distraction. Choosing careers with high stimulation and constant deadlines, because urgency does what internal motivation will not. Relying on a partner who manages the calendar and the paperwork. Setting six alarms.
These strategies are effective, and that is precisely the problem. They hide the difficulty rather than resolving it, and they carry a cost in fatigue and self criticism that rarely shows from the outside.
The scaffolding then collapses when demand rises. Common tipping points include becoming a parent, especially a parent of more than one child. Moving into a management role where the work is planning and prioritising rather than executing. Losing an external structure, such as leaving a highly regimented workplace, moving into remote work, or retiring. Perimenopause is another, where hormonal change appears to affect attention and emotional regulation in ways many women describe as a sudden loss of capability.
Nothing new started. The margin simply disappeared.
Before it is recognised as ADHD, the experience is usually given a different name.
Anxiety is the most common. It is a genuinely confusing overlap, because unmanaged ADHD reliably generates anxiety. Missing deadlines, losing things and forgetting commitments produce entirely rational worry. Treatment aimed only at the anxiety often helps somewhat and then plateaus, because the driver underneath continues.
Depression is another, particularly where years of underperformance relative to your own sense of ability have accumulated into a settled belief that you are lazy or unreliable. Burnout is a third, and one that fits the story so neatly that it is rarely questioned.
Other explanations are not psychological at all. Poor sleep, thyroid disorder, iron deficiency, perimenopause, sleep apnoea and the effects of alcohol can each produce difficulty concentrating. A proper assessment considers these rather than assuming ADHD from the outset, which is one reason a GP led process has an advantage. Your GP can investigate the physical possibilities in the same setting.
Diagnosis in childhood historically depended on adults noticing a problem, and what adults noticed was disruption.
A child who cannot sit still and interrupts constantly gets referred. A child who is quiet, dreamy, disorganised and losing track in class does not, particularly if their marks are acceptable. The inattentive presentation of ADHD, without prominent hyperactivity, was largely invisible to a referral system driven by classroom behaviour, and it is more commonly recognised in girls and women.
Early diagnostic criteria and much of the early research were also built around hyperactive boys. Adults assessed today grew up under those criteria. Being clever compounded it further. Academic ability can carry a person through school and even university on capacity alone, and the difficulties only surface when the external structure of an institution is removed.
For the current Australian clinical position on assessment and diagnosis across the lifespan, the Australian Evidence Based Clinical Practice Guideline for ADHD is the reference used by clinicians here.
Access has been the practical barrier for many adults. Assessment traditionally required a psychiatrist, which for adults on the Gold Coast frequently meant long waits and significant out of pocket cost.
That has shifted. Since 1 December 2025, specialist general practitioners in Queensland holding FRACGP or FACRRM fellowship have been able to diagnose ADHD in adults aged 18 and over and to prescribe accordingly, making Queensland the first Australian state to move adult ADHD care into general practice in this way. Assessment can now begin with your GP rather than with a referral and a waiting list.
At Marketplace Medical and Skin Clinic, adult ADHD assessments are conducted by Dr Yasir Bashir through our ADHD Clinic. The process is structured rather than quick, and it is worth understanding what that means before booking.
An assessment involves reviewing your developmental history, because a diagnosis requires evidence that difficulties were present in childhood rather than beginning recently. Old school reports are genuinely useful if you can find them. It involves validated rating scales, and often information from someone who knows you well, such as a partner, parent or sibling. It involves considering and excluding other explanations, including the medical causes mentioned above. It involves in clinic attendance where diagnostic confirmation requires it, rather than being completed entirely at a distance.
It also involves an honest position on treatment. Medication is prescribed only where it is clinically appropriate, and it is one component of management rather than the whole of it. Where a diagnosis is confirmed, ongoing support may include care planning, strategies for structure and workload, and referral to our clinical psychology service where that would help. Where a diagnosis is not confirmed, the assessment still produces something valuable, which is a clearer explanation of what is actually driving the difficulty.
Being assessed later in life often brings a mixture of relief and grief. Relief at an explanation that fits, and grief for the years spent attributing a neurodevelopmental difference to a character flaw. Both reactions are common and neither is a reason to delay finding out.
Marketplace Medical and Skin Clinic is at 99 to 103 Broadwater Avenue, Hope Island QLD 4212, and we see patients from across the northern Gold Coast including Sanctuary Cove, Paradise Point, Helensvale, Coomera, Oxenford, Upper Coomera and Southport. We are a bulk billing practice for eligible Medicare patients. Some extended consultations and specific services may attract a fee where Medicare does not cover them fully, and reception will explain any cost before your appointment rather than after it.
If you have been wondering about this for a while, book an initial appointment online or call 07 5510 9222 to discuss whether an assessment is the right next step.
