Q&A with Dr Catherine Muyeba: Breaking barriers in ADHD and addiction psychiatry

I was born and raised in Lusaka, Zambia, where I grew up with a strong sense of community and an early desire to become a medical doctor. Moving to the UK was both a challenge and a blessing; it pushed me out of my comfort zone and gave me opportunities I could never have imagined. I started out in healthcare support roles before being encouraged by an African mentor to pursue full medical training. With determination and God’s grace, I passed the rigorous UK exams, trained as a junior doctor, and went on to specialise in psychiatry.

My career has taken me across hospitals, community services, and even prisons, where I developed a strong grounding in addiction psychiatry. Over time, I noticed how many people battling addictions also had undiagnosed or untreated ADHD. This overlap sparked my passion for understanding ADHD more deeply. Today, I work as a regional lead consultant/psychiatrist in Greater Manchester, and through my private work with The ADHD Centre, I specialise in adult ADHD, combining medical expertise with a lifestyle and coaching-based approach.

Addiction psychiatry taught me that no one develops struggles in isolation. There are often layers of life experiences, trauma, and unmet needs that shape behaviour. There is clear evidence that many individuals with ADHD use substances (including caffeine, nicotine, alcohol, and illicit drugs) as forms of self-medication in an effort to manage their symptoms, though this does not address the underlying problem and often leads to dependence.

In controlled studies, roughly 36% of young ADHD subjects reported self-medicating, while expert consensus continues to support self-medication as a significant risk factor for developing substance use issues when ADHD is unmanaged. That insight has made me very intentional in looking beyond the surface. Early and adequate diagnosis of ADHD is important to prevent later substance dependence.

When I assess an adult for ADHD, I’m not only asking about symptoms like inattention or impulsivity, I’m also exploring their life story, whether they’ve used substances to cope, struggled with employment, or carried shame for feeling “different.” This holistic lens ensures my patients feel understood, not judged. It also means I can integrate treatment strategies that address both ADHD and addictive vulnerabilities.

As a Black African woman myself, I know firsthand how cultural background shapes how mental health is experienced and discussed. Within African communities, stigma, spiritual interpretations, and lack of culturally aware services can create real barriers to care.

I bring cultural humility into every consultation. This means listening deeply, acknowledging cultural frameworks, and respecting the values my patients bring with them. It also means being proactive in advocacy, educating communities about ADHD, highlighting that it is not a moral failing or “laziness,” and empowering people to seek help without shame.

The workplace is often where ADHD difficulties become most visible. Adults with undiagnosed ADHD may be incredibly talented but struggle with time management, organisation, prioritisation, or coping with workplace stress. Without understanding why they operate differently, they may be labelled as underperforming or unmotivated. Over time, this can erode confidence and limit career progression.

On the flip side, when ADHD is recognised and supported, these same individuals often thrive, bringing creativity, problem-solving, and high energy to their roles.

At The ADHD Centre, we provide a comprehensive treatment pathway. This begins with a thorough diagnostic assessment based on DSM-5 criteria, followed by personalised treatment options. These include:

• Medication management with both stimulant and non-stimulant options
• Therapeutic interventions such as CBT and coaching
• Mindfulness and resilience training
• Lifestyle interventions - nutrition, exercise, sleep optimisation, and stress reduction
  
  

By integrating medical and lifestyle approaches, we aim not just to reduce symptoms, but to improve quality of life and empower long-term wellbeing.

The transition can be very difficult. Many children with ADHD receive good support in school, but once they enter adulthood, services often drop off or have stricter eligibility criteria. They can feel abandoned just as responsibilities, such as university studies, careers, relationships, are increasing. This service gap is one reason I focus on adult ADHD: to provide continuity, reassurance, and a pathway to thriving in adult life. I would like to see fewer people with ADHD coming to my addiction clinic.

Lifestyle Medicine is a cornerstone of my approach. I am a certified lifestyle medicine physician and developed the REAP & RISE programme, which incorporates CHEERS as a practical skill set to help sustain wellbeing while pursuing life goals. CHEERS is an acronym for the six pillars of Lifestyle Medicine and stands for:

• C – Connect Healthily
• H – Harm Reduction
• E – Eat Nutritiously
• E – Exercise
• R – Restful Sleep
• S – Stress Management

Each of these pillars is rooted in the science of lifestyle medicine and aligns with the six evidence-based domains championed by the British Society of Lifestyle Medicine: healthy eating, physical activity, restorative sleep, mental wellbeing, social connection, and reduction of harmful substances.

For my patients with ADHD, CHEERS becomes more than just a framework: it is a practical roadmap for daily living:

• Connect Healthily emphasises nurturing supportive relationships and healthy social bonds, reducing isolation and building a sense of belonging.
• Harm Reduction is crucial, especially for those with addictive vulnerabilities, and involves strategies to reduce or eliminate harmful substances and unhelpful coping mechanisms.
• Eat Nutritiously focuses on balanced, whole-food eating patterns that support energy, focus, and overall brain health.
• Exercise encourages regular physical activity, which has proven benefits for attention, mood regulation, and resilience.
• Restful Sleep addresses the common sleep difficulties in ADHD, ensuring patients create habits and environments that allow the brain to recharge effectively.
• Stress Management integrates mindfulness, relaxation techniques, and healthy coping strategies to manage the heightened stress reactivity often seen in ADHD.

By focusing on these six areas, patients not only manage their ADHD symptoms but also build sustainable habits that enhance wellbeing across every dimension of life. The CHEERS model empowers them to strengthen connections, improve nutrition, sleep better, manage stress more effectively, and reduce reliance on substances or self-destructive behaviours.

The transformation that comes from integrating CHEERS into daily life often extends far beyond the consultation room. Patients report feeling more resilient, more in control, and more aligned with their values and goals, a foundation not just for managing ADHD, but for thriving in every area of life.

Workplace assessments are powerful tools for levelling the playing field. Through The ADHD Centre, we collaborate with organisations to evaluate environments, recommend adjustments, and foster neurodiversity-friendly cultures. Employers who embrace these partnerships often see improved productivity, reduced turnover, and a more inclusive workforce.

The biggest misconception is that ADHD is a childhood disorder that people “grow out of.” Another is that it’s simply about being distracted or restless. In reality, ADHD persists into adulthood for many and affects executive functioning, emotional regulation, and daily life.

I challenge these misconceptions through education to raise awareness. I do this through speaking at conferences, training other professionals, publishing content, and consulting with workplaces. By normalising ADHD and highlighting its strengths as well as challenges, I aim to shift the narrative.