ADHD care that starts with a real diagnosis

Theodore Germanos, MDTriple board-certified — adult, child & adolescent, and addiction medicine

By the time most adults with ADHD reach a psychiatrist, they have spent years building scaffolding — lists, alarms, deadlines, caffeine, sheer will — and the scaffolding has finally stopped holding. The work demands grew, the structure of school disappeared, and what used to be manageable is now costing careers, relationships, and self-respect.

Diagnosis first — because plenty of things look like ADHD

Poor sleep looks like ADHD. Anxiety looks like ADHD. Depression, burnout, thyroid problems, and an impossible workload all look like ADHD. Autism can look like ADHD too — and the two frequently occur together, which is often missed in adults who were assessed for only one of them. That is why care here begins with a thorough evaluation rather than a symptom checklist: the diagnosis has to be right before any treatment decision is worth making. Sometimes the answer is ADHD. Sometimes it is ADHD plus something else. Sometimes it is something else entirely — and finding that out is a good outcome, not a failed appointment.

Treatment is more than a prescription

When ADHD is the diagnosis, medication is often genuinely transformative — stimulant and non-stimulant options both have strong evidence, and choosing between them is a clinical decision we make together based on your health, your history, and your work. But medication is half the treatment. The other half is structural: how you design your days, your sleep, and your commitments so the treatment has something to hold onto. High performers tend to be excellent at this part once the neurology is treated.

For individuals who trade, untreated ADHD interacts with markets in specific ways — I have written about ADHD, addiction risk, and the trading desk on Psychiatrade.

A note on stimulants, honestly

Because it needs saying: an evaluation here is a genuine evaluation, not a formality on the way to a stimulant prescription. If you are looking for guaranteed medication, this is the wrong practice. If you are looking for an accurate answer and the right treatment for it — whatever that turns out to be — you are in the right place.