Adult ADHD assessment in Slovenia: where to turn and what to expect

It’s two in the morning. On the phone is a list of “twenty signs of ADHD in adults” that someone shared on social media. By sign seventeen it has stopped being funny. Lost keys, unfinished projects, that eternal “I’ll start tomorrow”, feelings that arrive like a wave. And then the question that keeps you awake: What now? Who do I even tell?

This post is meant for exactly that moment. I won’t tell you whether you have ADHD — nobody who hasn’t assessed you can, and as a psychotherapist I’m not permitted to. What I can do is explain how the road to an adult assessment works here in Slovenia, who carries it out, what happens during it, and how to prepare so you get as much out of it as possible.

One note at the start: procedures and the organisation of healthcare change, so I’m describing the general route here. For the details that apply to you, your GP is the best person to ask.

Why adults decide to seek an assessment

ADHD isn’t a “childhood” condition that disappears as you grow up. International expert consensus estimates that around 2.5% of adults have it (Faraone et al., 2021). Many of them weren’t recognised as children — because they were well behaved, because they got good grades, because they were dreamy rather than restless, or simply because nobody thought about ADHD back then. Why it goes unnoticed for so long in adults is described in ADHD in adults: signs we have put down to character for decades.

Adults most often decide to seek an assessment when something changes: a new job with more independent work, the birth of a child, studies that demand more self-organisation, or exhaustion after which the old strategies no longer work. Sometimes the trigger is a child who receives a diagnosis — and the parent recognises themselves in the description.

It helps to know that the diagnostic criteria for adults are not the same as for children. The American diagnostic manual DSM-5 requires at least five symptoms in one of two groups (inattention, or hyperactivity and impulsivity) for adolescents from age 17 and adults, compared with six for children. In addition, some symptoms must already have been present before age 12, they must show up in more than one setting, and they must significantly affect your life (American Psychiatric Association, 2013). This alone shows that an assessment isn’t just counting symptoms off a list.

Who can make a diagnosis

An adult ADHD diagnosis is made by a psychiatrist or a clinical psychologist. A psychiatrist is a medical specialist and can prescribe medication. A clinical psychologist carries out an in-depth psychological assessment but doesn’t prescribe. They often work together.

Who isn’t qualified: a psychotherapist, a coach, a teacher, a friend who has ADHD themselves, and of course any online test. A psychotherapist may notice patterns suggesting an assessment would make sense and encourage you to seek one — but doesn’t make the diagnosis. I explained the boundaries in more detail in Who may diagnose, who may prescribe, and who leads the process, and who’s who among professionals in Psychotherapist, psychologist, psychiatrist: who does what and where to go.

The first step: your GP

In the public healthcare system the first stop is, as a rule, your GP (in Slovenia, your osebni zdravnik). You talk to them about what you’ve noticed, and they decide whether to refer you to a psychiatrist or clinical psychologist and issue a referral (napotnica). It helps to come prepared: with a few concrete examples from daily life, not just a sense that “something isn’t right”.

The other option is a private, self-paid assessment with a psychiatrist or clinical psychologist in private practice, where a referral is generally not needed. How to choose between these routes and what each offers is something I described in Referral, waiting list or self-funded: how you actually get help here, so I won’t repeat it here. Whichever route you take, check whether the professional you’re seeing assesses adults and has experience with ADHD.

What an assessment involves

People often fear the assessment will be a short chat after which they’ll be sent away with “you’re perfectly fine”. Or the opposite — that it will be a test you can “fail”. A good assessment is neither. The European consensus on adult ADHD (Kooij et al., 2019) describes it as a clinical process that covers your whole life story.

It usually includes several parts:

• A clinical interview about what brought you, how the difficulties show up now and how they affect work, relationships and daily life.
• Questionnaires. Some are short screening tools, such as the ASRS, developed by a group working with the World Health Organization (Kessler et al., 2005). A screening questionnaire doesn’t make a diagnosis — it only tells you whether it’s worth looking further.
• A structured interview, in which the professional systematically checks each criterion, both now and in childhood.
• Information from other sources: a conversation with a parent, partner or someone who knows you well, old school reports, teachers’ comments.
• Checking other possible explanations — more on this below.

Whether the assessment takes one session or several, and which tools the professional uses, depends on them and on your story. It’s not unusual for it to take more than one visit. If you don’t understand something — why a particular question, what a questionnaire score means — you’re allowed to ask. An assessment is also a chance to learn something new about yourself, not just an exam to get through.

Why they’ll ask about your childhood

Many people are surprised by how many questions in an assessment are about childhood. The reason is simple: ADHD is a neurodevelopmental difference, which means it is present from the early years. If inattention only appeared at forty, it’s likely something else is going on — or that ADHD was there before but circumstances masked it.

A study by Sibley and colleagues (2018), which followed young people from age 10 to 25, showed that many cases that at first glance look like “adult-onset” ADHD turn out, on closer examination, to have another explanation — for example anxiety, depression or substance use. That’s why the professional looks for traces in the past.

Old documents and people who knew you as a child can help here. Teachers’ comments in school reports (“capable but doesn’t apply himself”, “daydreams in class”, “forgets homework”) are often more telling than the grades. Parents or older siblings may remember things you don’t. If these sources aren’t available — because your parents are no longer alive or you’re not in contact — that doesn’t mean an assessment isn’t possible. It just means the professional will look for more information elsewhere.

What else can explain similar difficulties

Attention problems are like a fever: a sign that can have many causes. The professional literature (Asherson et al., 2016; Kooij et al., 2019) lists the most common things that need to be considered in an assessment:

• anxiety — worry takes up attention and makes it hard to start tasks (ADHD and anxiety can look very similar at first glance);
• depression — slowed thinking, lack of energy and motivation;
• sleep disorders — chronic sleep deprivation looks a lot like inattention;
• physical causes, for example thyroid problems, which a doctor will assess;
• the after-effects of trauma and prolonged stress, including burnout;
• use of alcohol or other substances.

It’s important to understand that this isn’t either/or. ADHD in adults is often accompanied by other difficulties, such as anxiety or depression. A good assessment therefore doesn’t look for a single label, but for the picture that best explains your experience.

What it sounds like up close

The conversation below at a GP’s surgery is composed (a composite, not a real person). It shows how concrete examples can make the first step easier.

“I think I might have ADHD. I’ve read a few articles …”
“Tell me what you’ve noticed in yourself.”
“At work I start five things and finish none of them. Deadlines always slip away from me, even when I’ve written them down. Even at primary school teachers wrote that I was bright but scatty.”
“How have your sleep and mood been over the last few months?”
“I sleep badly, but I always have. My mood’s fine — I’m just angry with myself.”
“All right. I’ll write you a referral so you can talk this through with a specialist who assesses ADHD in adults.”

Notice that the doctor also asks about sleep and mood. That isn’t doubting your story; it’s good practice — part of finding the picture that truly explains what’s going on.

Exercise: prepare for your appointment

Preparing won’t change the outcome of the assessment, but it helps you say what matters in a short time and not leave feeling you forgot half of it. Set aside one evening for it.

1. Write down five concrete examples from the last month when attention, organisation or impulsivity made your day genuinely harder. Be specific: what, when, and what the consequence was.
2. Look for traces from childhood: old school reports, exercise books, teachers’ comments. If you can, ask a parent or sibling what you were like as a child.
3. Note how the difficulties affect different areas — work, home, relationships, money, driving, health.
4. List what you already take and what you already know about your health: medication, sleep, any past diagnoses, alcohol use.
5. Write down three questions you want to ask — for example, what happens after the assessment, what support options there are, what if it isn’t ADHD.

The knowledge base also has a tool for this, preparing for a psychiatric appointment, which you can print and take with you.

After the assessment: report, medication and support

At the end of the assessment you receive a report and, ideally, a conversation about what it means. Whatever the outcome, it’s worth asking: what is the next step now?

If the finding is ADHD, several paths may open. Medication is decided by the psychiatrist together with you — for many adults it helps, but it doesn’t solve everything and isn’t right for everyone. Alongside that, psychoeducation (understanding how your brain works), practical adjustments at work and at home, and psychotherapy can all be useful — therapy that doesn’t treat ADHD as such, but what years without an explanation have left behind: shame, self-criticism, tension in relationships.

A late diagnosis often brings a mix of feelings: relief that the thing finally has a name, and grief for everything that could have been different. That’s the subject of Late ADHD diagnosis: relief and grief at once.

What I wrote in A diagnosis is a map, not a name for you also holds: a diagnosis tells you where the bends in the road are, not who you are. The term neurodivergence helps many people see a difference in functioning as a difference, not a defect.

If the finding isn’t ADHD, that doesn’t mean you made your difficulties up. It means the answer lies elsewhere — and that’s just as valuable to know. You don’t need a diagnosis for psychotherapy; more on that in Do I need a diagnosis to come to therapy?

Where this post has its limits

Not all distractibility is ADHD. We all sometimes forget our keys, procrastinate and lose the thread. Lists of symptoms on social media are often written so that almost everyone recognises themselves. It becomes ADHD only when the signs are persistent, present since childhood, show up in several settings and significantly get in the way of life.

Not everyone needs a diagnosis. Some people with ADHD traits live in an environment and with strategies that suit them, and don’t need an assessment. Deciding to seek one makes sense when you’re suffering, when a report would open access to help, or when the question weighs on you so much that you need an answer.

Self-diagnosis isn’t diagnosis. Recognising yourself in a description can be an important first step and is nothing to be ashamed of. But because similar signs have many causes, self-diagnosis can miss something that needs a different kind of help — depression or a sleep disorder, for example.

This post doesn’t replace a professional. The route I’ve described is general. If you’re struggling badly with your mood or having thoughts of harming yourself, don’t wait for an ADHD assessment: contact your GP, call the crisis line Klic v duševni stiski on 01 520 99 00 in Slovenia (every day from 7 pm to 7 am) or the Samaritans helpline (Zaupni telefon Samarijan) on 116 123 in Slovenia (24 hours), and in an emergency 112.

What to remember

• An adult ADHD diagnosis is made by a psychiatrist or clinical psychologist — not a psychotherapist and not an online test.
• In public healthcare the first step is, as a rule, your GP and a referral; the other option is a self-paid assessment.
• A good assessment covers the present, childhood, several areas of life and other possible reasons for the difficulties.
• Bring concrete examples, old school reports and, if you can, the memories of people close to you.
• Medication is the doctor’s decision; whatever the outcome, a diagnosis is a map, not your name.