Attention deficit hyperactivity disorder (ADHD)

What is ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a condition that affects how the brain works, making it harder for people to focus, sit still, and control impulses. It is a neurodevelopmental disorder, which means it starts in childhood and continues into adulthood for many people.  

Main Symptoms of ADHD  

ADHD symptoms are usually grouped into three main areas:  

1. Inattention: Difficulty focusing, becoming easily distracted, forgetting things, or struggling to follow instructions.  

2. Hyperactivity: Feeling restless, fidgeting, or moving around when it may not be appropriate.  

3. Impulsivity: Acting quickly without thinking, interrupting others, or finding it hard to wait for a turn.  

Who Can Have ADHD?  

ADHD affects both children and adults. While many people think of ADHD as being common in children, it can continue into adulthood and impact work, relationships, and daily life.  

What Causes ADHD?

ADHD is not caused by bad parenting or lack of discipline. It is linked to differences in how the brain develops and works. Research suggests that genetics play a major role, and other factors like premature birth or early life stress may contribute.  

How is ADHD Treated?  

There is no single cure for ADHD, but it can be managed with:  

Medication: Some people find medication (psychopharmacotherapy) helps with focus and impulse control. Medications include both stimulant and non-stimulant psychopharmacotherpies. 

Therapy & Coaching – Talking to a suitably qualified mental health clinician can help with managing emotions and behaviours.  

Lifestyle Changes: Regular exercise, good sleep, and structured routines can make daily life easier.  

Does ADHD Mean Someone is Less Intelligent?

No. People with ADHD can be just as intelligent as anyone else. Many are highly creative, energetic, and have unique strengths. ADHD just means their brain works differently, and they may need strategies to help them focus and stay organised.  

Getting Help

If you think you or your child might have ADHD, please contact our team who would be delighted to provide you with a more comprehensive overview of the services we offer. A comprehensive assessment can help find the best way to manage symptoms and support everyday life.  

We find the following description can be helpful in explaining ADHD to clients of all ages. Hopefully this explanation helps to explain ADHD as a concept and why/how medication might help with managing the symptoms.

Dopamine is like your brain’s notification system, it helps you stay focused, motivated, and interested in what you’re doing. It’s kind of like when you get notifications from Snapchat or Instagram, it keeps you engaged and paying attention.

In ADHD, the brain’s dopamine system doesn’t work as well as it should. Imagine if your notifications weren’t coming through properly, or they were delayed and all over the place. That’s what happens in ADHD, important signals about focus and motivation don’t always get to the right places at the right time. This makes it harder to concentrate, stay organised, and resist distractions.

This is where stimulant medication can sometimes help. Even though they’re called ‘stimulants,’ they don’t make you hyper. Instead, they help your brain’s dopamine work better, kind of like fixing a glitchy Wi-Fi connection so your notifications actually come through on time. When your brain gets the right signals, it’s easier to focus, complete tasks, and feel more in control.

Now, you might have heard that amphetamines (which some ADHD medications contain) can make people high. That happens when people take them in high doses or in ways that cause a big spike in dopamine, like snorting or injecting them. That flood of dopamine can create a rush of euphoria.

But ADHD medications are taken in much lower, controlled doses, usually as a slow-release tablet or capsule. This means they gently increase dopamine just enough to help with focus and attention, kind of like turning up the volume so you can hear better, rather than blasting music so loud it drowns everything else out. That’s why when taken as prescribed, ADHD meds can help balance brain function instead of creating a ‘high’.

Depsypher Mental Health Services believe in comprehensive assessment to ensure the most appropriate treatment can be instigated. We have a comprehensive policy which provides a clear pathway for assessment, diagnosis, and where indicated, treatment (either medication, psychology, or both).

We like to be upfront about cost and to set expectations. In the spirit of being upfront, coming for an ADHD assessment does not guarantee that you will be prescribed medication(s), nor does it guarantee a diagnosis of ADHD will be made. Our experienced clinicians will provide you with evidence-based and well-considered advice and follow up. 

Our ADHD policy is available by contacting reception@depsypher.com.au and requesting a copy, however a simplified version is below.

Process

1) Your details will be collected by our Practice Manager. These include your referral from your GP (if required), demographic information, payment details, and other important information. 

2) Once you have completed the consent form and fee agreement, you will be offered an appointment with one of our clinicians. Appointments are made for up to three hours and include a comprehensive psychiatric assessment (to determine if other disorders are evident) and completion of various ADHD screening questionnaires.

3) At the appointment with the Depsypher clinician you will undergo a comprehensive psychiatric assessment. They will complete ADHD screening questionnaires, which will complement the comprehensive assessment. The clinician may take your blood pressure, weight, and pulse rate, or refer you to your GP for this to be completed.

If the clinician considers it is likely you meet the diagnostic criteria for ADHD and stimulant medications (or other medications) may assist with managing your symptoms, they will refer you to the Depsypher psychiatrist. Please note this is not a guarantee the psychiatrist will prescribe medication as ultimately this is up to the psychiatrist to determine if medication is clinically indicated by using their clinical judgement and experience.

If proceeding to psychiatrist review, you will be asked to attend for pathology testing and for an electrocardiogram (ECG) to ensure there are no underlying issues which may contraindicate the prescribing of certain medications. 

If another disorder is evident, or you do not meet the diagnostic criteria for ADHD, or you are not eligible for prescription medication, the clinician will discuss alternate treatment options with you.

4) If you are referred to the Depsypher psychiatrist our Practice Manager will contact you to arrange the appointment. All appointments with our psychiatrist are conducted by telehealth. Around 45-60 minutes of clinical time is allocated to this appointment.

5) If prescribed medication (either stimulant or other), you will then enter the ADHD follow up protocol. Whilst this may be different depending on your response to treatment, typically you will be reviewed by the Depsypher clinicians every eight-weeks, and attend for a further review with the psychiatrist after six-months. Titrations to medication doses can be made in-between reviews with the psychiatrist, depending on symptoms and response. 

After the six month review, you will be followed up by the Depsypher clinician every three months. You will be reviewed by the Depsypher psychiatrist at the 12-month point and if you prefer, the prescribing will be handed over to your GP if clinically appropriate and consented to by both Depsypher Mental Health Services and you. This will conclude your follow up with our clinic, however you will be able to request reviews even after you have been discharged from our care, noting we reserve the right to decline to provide services at the discretion of our clinicians.

The above protocol is on the presumption that you are prescribed medication and there are no unexpected complications in your treatment for ADHD. Our clinicians have a duty of care to provide you with appropriate treatment and should you require additional follow up this can be arranged via the clinic, or may require a referral to other services, such as the public community mental health services, or other provider(s). We believe in transparency and will make all efforts to advise you of our clinical decision making and reasoning at all times. 

We are upfront with our costs. Please note the following costs only apply to ADHD assessments and treatment.

Initial assessment with Depsypher Mental Health Services clinician

Senior Clinician: $660

Director: $840

Initial assessment with Depsypher psychiatrist

$550 (Medicare rebates may apply as per Medicare Item 296)

Total cost for assessment (without rebate) = Between $1210 - $1390

* You will only be charged the psychiatrist fee if you are referred by the Depsypher clinician. So, for example, if you see the clinician and it is agreed you do not need to see the psychiatrist, you will only pay for the services you require, in this instance $660-$840

Follow up with Depsypher clinician: first six months

Senior Clinician: $220 per review. 3 reviews at $220 = $660 over six months

Director: $280 per review. 3 reviews at $280 = $840 over six months

Review by Psychiatrist: $450 (Medicare rebates may apply as per Medicare Item 304)

Total cost for six months follow up (without rebate) = Between $1110 - $1290

Follow up with Depsypher Mental Health Services: second six months

Senior Clinician: $220 per review. 2 reviews at $220 = $440 over six months

Director: $280 per review. 2 reviews at $280 = $560 over six months.

Review by Psychiatrist: $450 (Medicare rebates may apply as per Medicare Item 304)

Total cost for second six months follow up (without rebate) = Between $890 - $1010

Total fee estimate for 12-months of standard assessment, treatment and follow up of ADHD (without rebates) $3210 -  $3690 

The provide figures are estimates only and presume standard treatment only is provided. Additional costs may apply to external clinicians and services such as GPs, pathology and ECG. 

We believe you should know what you are going to be paying, up front. Accordingly we have provided a comprehensive breakdown of our fees. We have had feedback that this is confusing, and we have considered this feedback. In the absence of charging a flat fee, we feel it is important to be very upfront with our fee structure and we want to be clear we will not charge you for a service you do not need.

Additionally, we have received feedback from some clients who only want to see our psychiatrist and not be assessed by our clinicians. We have carefully considered this feedback and determined our model of care provides clients with gold-standard mental health treatment and we are not willing to compromise this by changing our current model. The Depsypher shared-care model allows our psychiatrist to be more available, reducing waiting times and providing timely access to psychiatrist follow up as clinically needed. Our clinicians provide the psychiatrist with comprehensive referral notes allowing our psychiatrist to focus on the important and significant issues. This saves our clients from extended waiting times and can result in cost savings.