More than 23,000 adults were waiting for an NHS neurodevelopmental assessment across the nine Scottish health boards that reported figures in March 2025, with median adult waits ranging from 24 to 146 weeks (Scottish Parliament SPICe briefing SB 25-25, June 2025).
You've read about adult ADHD and recognised yourself in more of it than feels comfortable. You've asked your GP, or you're about to, and then you hear the number: months, maybe years. The good news is that you don't have to wait for a piece of paper to start getting support.
Can you have therapy for ADHD without a diagnosis?
Yes. Therapy isn't an assessment, so a diagnosis isn't a requirement. ADHD therapy with me is open to adults who have a formal diagnosis, adults on a waiting list, and adults who simply recognise the patterns. Assessment and therapy do different jobs.
What an assessment does
A formal assessment by a suitably qualified clinician can confirm whether you meet the criteria for ADHD and open the door to NHS-prescribed medication. Many people also find the clarity deeply validating.
What therapy does
Therapy gives you a space to make sense of your experience as it is today: the exhaustion, the shame, the masking, the patterns that keep repeating. It doesn't need a label to begin, and it can't give you one, because I can't diagnose ADHD or any other condition. Our page on neuroaffirming therapy explains the approach.
Why so many adults are waiting
The wait isn't in your head. The latest official figures show a system under strain.
Where you live matters
Waits vary hugely by board, and the longest reported waits averaged around three and a half years. Adult pathways aren't available in many boards, and some have withdrawn adult assessment services (SPICe). In NHS Lothian, which covers Edinburgh, adults don't need to meet secondary mental health criteria to be referred, but the average adult wait reported for 2023/24 was 101 weeks.
Demand has surged
In four boards, the number of adults waiting for a neurodevelopmental assessment rose from 543 in 2020 to 12,974 in 2025. SPICe suggests this reflects growing awareness rather than more people being neurodivergent.
Experiences that bring people to ADHD therapy
These aren't a diagnostic checklist. They're experiences many adults describe, and most have more than one possible explanation.
Emotional
- Feeling "too much", or never quite enough
- Shame about forgotten tasks, missed deadlines or unfinished projects
- Exhaustion from holding it all together
Cognitive
- Knowing exactly what to do and still being unable to start
- Time slipping away, or being impossible to judge
- A busy, foggy or racing mind
Behavioural
- Masking: hiding your difficulties so you appear "fine"
- Cycles of over-committing and crashing
- Relying on last-minute pressure to get things done
Our piece on ADHD vs anxiety explains why these experiences are so often mistaken for anxiety.
Who tends to be missed?
Women and late-diagnosed adults
SPICe notes that ADHD often looks different in women: more inattentive and internal, and more likely to be masked, so it's frequently missed or mistaken for anxiety or depression. Our ADHD therapy page covers late diagnosis.
Students and young adults
Many people first struggle when external structure falls away, at university or in a first job. Our therapy for students page is built around this stage of life.
Adults treated for anxiety or low mood
If treatment for anxiety or low mood has never quite lifted, it can be worth asking your GP whether something else sits underneath.
Your options while you wait
Talk to your GP
In Scotland, NHS assessment usually starts with your GP, and the pathway differs by health board, so ask what's available locally. NHS inform has more on ADHD in adults.
Think carefully about a private assessment
Long waits mean more people are paying for one. It can bring clarity, but it costs money, and SPICe notes that in many areas GPs don't accept private diagnoses or enter shared-care agreements, so you may have to pay for medication yourself. Ask your GP how a private diagnosis would be handled before you commit. England's "Right to Choose" scheme doesn't apply in Scotland.
Look for support without a diagnosis
The Scottish Government has said support shouldn't depend on a diagnosis and should be available to people who are waiting or not seeking one. SPICe notes that many people still find it hard to access without one.
How therapy can help
Therapy won't shorten a waiting list, but it can make the wait more bearable and the years behind you easier to understand. As a person-centred, neuroaffirming psychotherapist in Edinburgh, I work in person and online across Scotland, including Glasgow, Aberdeen, Dundee and Stirling. Find out more about online therapy in Scotland.
We can look at the shame, the masking and the exhaustion, and at what you'd want from support whatever an assessment finds. If you decide to pursue one, I'm happy to talk through what that involves. No checklist, no diagnosis required.
"You don't have to wait for a diagnosis to start understanding yourself differently. Support can begin with the experiences you're living with right now."
— Amber FieldgateFrequently asked questions
Can I have therapy for ADHD without a diagnosis in Scotland?
Yes. Therapy isn't an assessment, so you don't need a diagnosis or a GP referral to start. Many people come while waiting for an assessment, or simply recognising themselves in what they've read.
Can a therapist diagnose ADHD?
No. A diagnosis comes from a formal assessment with a suitably qualified clinician. A therapist can support you before, during or after that process.
How do I get an NHS ADHD assessment in Scotland?
It usually starts with a GP referral, and the pathway and waiting times vary by health board. Ask your GP what's available locally.
Is it worth having therapy while I wait for an assessment?
Many people find it helpful. A Scottish Parliament research briefing notes that people report the wait itself causes significant stress and anxiety, and therapy gives you support in the meantime.
Key takeaways
- You don't need a diagnosis to start therapy. Therapy isn't an assessment and can't diagnose.
- NHS adult assessment waits in Scotland vary widely by health board, and over 23,000 adults were waiting in March 2025.
- A private assessment is an option, but it costs money and in many areas GPs won't enter shared-care agreements for it.
- ADHD is often missed in women and mistaken for anxiety or low mood.
- Therapy can make the wait more bearable and help you understand your experience, whatever an assessment finds.
Waiting for answers?
You don't have to put your life on hold until an assessment comes through. A free 20-minute intro call is a low-pressure place to start.
Get in touch →