‘I was diagnosed with ADHD at university — and everything made sense’

At school in Newcastle-upon-Tyne Rebecca Steele gained top grades without, she admits, “too much effort”. She studied developmental biology at the University of Manchester before returning home to complete a master’s in space law at Northumbria University, and in 2021, started postgraduate study in cardiovascular developmental genetics at Newcastle University.
Then, halfway through her PhD, Steele’s struggles with anxiety and obsessive compulsive disorder, including compulsive checking, rituals and intrusive thoughts, led her to the university’s Health and Wellbeing Service. She was referred to Newcastle University’s Neurodevelopmental Assessment Service (NDAS), the first of its kind in the country to assess and diagnose attention deficit hyperactivity disorder (ADHD) and autism on campus. Steele was diagnosed with both.
In an instant she felt validation and hope, as well a deep sense of relief. “I could never understand why I found it so difficult to process what was being talked about in lectures,” she says. “Now I know that I am a visual learner and have difficulties with auditory processing, but at the time I thought I was just bad at listening.” She hadn’t expected to also be diagnosed as autistic, “but, looking back, I’ve always felt different — it made sense”.
Now 26, she can see that her academic achievements masked her lifelong struggles with procrastination, time management and indecision. Steele admits she “found the transition to university study really hard.”
It is estimated that about one in seven people in the UK are neurodivergent, which means they absorb and process information differently. Steele describes brilliantly how it feels.
“At any given time in my head there are two or three songs playing, a playback of a conversation from a few days ago, a side serving of words in a different language, some maths and a couple of big ideas,” she says. “Behind all of this is a cartoon monkey crashing a big pair of cymbals whenever it sees fit. There is a lot of anxiety that comes with never being able to fully switch off.”
She is not alone. Last year more than 200 students approached NDAS for an assessment.
“Students have gotten this far without a formal diagnosis because they’re bright and they’ve had lots of help with planning at home and school,” Dr Fiona Gullon-Scott, a clinical psychologist who launched the service in 2022, says. “But at university, where there’s very little structure and they’re managing the minefield of new social situations as well as independent learning, they’ve found themselves unravelling.”
Professor Peter Hill, a London-based consultant psychiatrist and global expert in ADHD, says the majority of his patients are aged 18-30. “As well as difficulty following directions and staying on task, there is often a high degree of frustration and emotional dysregulation. They’ll struggle to balance work and social life, will overspend and often drink too much. Others can become overwhelmed and isolated. For those who have been really well scaffolded at home, the transition can be horrific.”
Students who are in crisis or at risk of dropping out are prioritised. The NDAS clinic runs one day a week on an annual budget of £1,000, with assessments carried out by students studying doctorates in clinical psychology, and a postdiagnostic group offering support and education about executive function (which includes working memory), time management, emotional control, sensory processing and managing anxiety. “It’s a win-win situation,” Gullon-Scott says. “Students wanting assessments avoid a two-year NHS waiting list and our PhD students get valuable experience.”
Two thirds of referrals are female or nonbinary. “Girls are more likely to mask at school and have all their problems written off as anxiety,” Gullon-Scott says. “It’s been eye-opening realising how desperate the situation is. In some cases they’re suicidal.”
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Valerie Ivens, an ADHD coach , and the founder of ADHD Richmond and Kingston — a support service for families that works with local authorities and Child and Adolescent Mental Health Services in southwest London — says the themes are always the same.
“By the end of the first year, they’ve started to struggle with the work/social balance, and shame and guilt can kick in,” she says. “Without the support we know can help — personal tutors who really understand ADHD and its impact on learning, and can step up and down as the students need — these students can go to some very dark places.”
She mentions two students who have dropped out of university (Bath, Nottingham) despite getting high A-level grades. Another three retook years repeatedly, their self-esteem tumbling with each retake.
Her advice? “These are super-bright kids who could thrive with some fairly small adjustments in the way universities provide education, primarily early and consistent one-to-one mentoring and coaching,” she says.
The pandemic did not help. Kelly Goodfellow, senior neurodiversity practitioner, at the University of the West of England (UWE), points out that the present cohort of students had their GCSEs and A-levels interrupted.
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“Some arrived at university with huge social and study skill challenges. For those with ADHD it was a disaster.” Pre-Covid she had 13 students accessing the service, post-Covid the department refers more than 600 students a year for screening. Nearly all those are for ADHD and autism, with more than 3,000 appointments taken up by neurodiverse students coming to workshops, study groups, and one-to-one support.
Like all universities, UWE has government funding for diagnostic assessments for specific learning difficulties (spLDs) such as dyslexia, dyscalculia and dyspraxia, but she says that ADHD has “taken over”.
“The reports we commission for ADHD don’t cover medication but they’re enough to get students support and DSA [Disabled Students Allowance, funded by the government through Student Finance England], which means extra time in exams, funding for specialist mentoring and reasonable adjustments to work deadlines.”
There is little available data on just how many students are receiving diagnoses for ADHD and other neurodiverse conditions at university, but a survey last year by Unite Students, an accommodation provider, found one in seven applicants described themselves as having ADHD or autism. While the Universities and Colleges Admissions Service (Ucas) report the number of applicants with specific learning difficulties or SpLD — a hypernym that includes dyspraxia, dyslexia and ADHD — increased 51 per cent last year, while mental health conditions are up 786 per cent.
But are more graduates paying for a diagnosis to gain extra support and longer time in the exam hall? Dr Jane Sedgwick-Müller, who set up the first ADHD service for students at the London School of Economics in 2006, believes such cynicism is unwarranted and that students with ADHD are among the most marginalised and disadvantaged group on campus.
“ADHD isn’t a learning difficulty, it’s a neurodevelopmental disorder, which hardly ever presents on its own,” she says. “We normally see it with dyslexia, autism, anxiety, mood disorders or other mental health conditions. It requires real understanding and its own specialist service so medical, psychosocial and academic support can be fast-tracked.”
“Right now, ADHD feels like dyslexia’s poor cousin. Both are categorised as SpLD, but unlike dyslexia, which is well catered for within the education system, once ADHD is identified, many students will join a long NHS waiting list for drug treatment. What do you do if you’re failing? Your needs are not recognised and you fall through the net.”
Sedgwick-Müller’s seminal research on the impact of ADHD in higher education, published in 2022, found that students who performed best had personalised one-to-one support. “A really good personal tutor will help, but it’s regular academic coaching that enables neurodivergent pupils to reach their potential,” she says.
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Professor Hill is also seeing more women than men being diagnosed for the first time at university. “Women get missed,” Hill says. “Because they often lack hyperactivity and are better at masking. Coming to university may be the first opportunity to have their difficulties recognised and characterised.”
Hill advises neurodivergent students to waive confidentiality, a strategy that some parents and students caution against. “Sign a bit of paper so academic tutors, disability services and GPs can contact your parents,” he says. “When that doesn’t happen, it’s chaos.” But isn’t the point of university to learn to be independent? “Remember the prefrontal cortex in young people with ADHD is visibly smaller than neurotypical students. They are functioning at least two years behind.”
It doesn’t help that even if targeted support is available on campus, it may not be easy for students to find it. Goodfellow acknowledges this is a problem, especially since students with ADHD are likely to switch into “avoidance mode” when overwhelmed, and not open their laptops. “All university students are inundated with information,” she says. “Everything is digital, their inbox is off the scale — 90 per cent of my study skill sessions involve helping students to navigate the systems and find the information they need.”
Sedgwick-Müller becomes emotional at the thought of the talent “lost by the university system that doesn’t recognise the disadvantage and discrimination it has created”.
“These students are so talented, so clever, so innovative, so bright, so driven. Once they get the right support they can thrive. It’s heartbreaking,” she says, “because it’s too late for those who have had to drop out. I could cry thinking about it.”
A combination of medication, coaching and coping strategies have made a big difference to Steele. “Despite finding auditory processing difficult, I can use my strong visual processing skills to my benefit instead,” she says. “My diagnosis has given me insight into myself and I have learnt tools to use when things feel overwhelming.”
Source: Valerie Ivens, ADHD coach and advocate
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