Conditions we treat Adult ADHD

Adult ADHD assessment in Tempe, AZ

Losing time, losing threads, and being tired of apologizing for it. If you have spent years assuming this is a character problem, an assessment is the thing that tells you whether it is something else.

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Assessments are in person at our Tempe office, usually within 3 to 5 business days.

What it actually looks like in an adult

Most of what people know about ADHD comes from watching a nine-year-old boy who cannot sit still. That is one presentation, in one age group, and it is not the one that walks into an adult clinic.

In adults the hyperactivity usually moves inward. It becomes a motor that will not idle: the sense of being permanently slightly behind, about to be caught out, unable to rest even when there is nothing left to do. The visible part is not movement. It is the pile of half-finished things.

The emotional part surprises people most. Intensity is not a side effect of having had a hard time with ADHD. It is part of the condition, and it is one of the reasons the diagnosis gets missed for so long.

What people describe, almost word for word:

You can do the hard version of a task and not the boring version, and nobody believes you
You read a paragraph four times and take in none of it
You are either three hours early or twenty minutes late, with nothing in between
Admin sits undone for weeks, then gets done in one frantic evening
You lose the thread mid-sentence, in your own sentence
Small frustrations land far harder than they should, and pass quickly

Why something present since childhood goes unnamed for thirty years

ADHD is a developmental condition. By definition it was present in childhood, which means a diagnosis in adulthood is not a new arrival. It is a late identification. That raises the obvious question, and the answer is almost always the same: it was compensated for.

A child with enough intelligence, enough structure, or enough fear of disappointing someone can hold the shape of a functioning student for years. School supplies the scaffolding — fixed hours, external deadlines, an adult noticing. Then the scaffolding comes off. At university, at a first real job, or when a second child arrives, and the thing that was being managed becomes unmanageable at exactly the moment life stops providing structure for free.

It is missed more often in women, and in anyone whose presentation was inattentive rather than disruptive, because nobody sends a quiet child for assessment. Being the daydreamer costs a teacher nothing.

It is also missed because it rarely arrives alone. Long-standing anxiety and long stretches of low mood are the usual companions, and they are usually what gets treated first. Treating them is not a mistake. But if the attention difficulty underneath is never named, the anxiety keeps having something real to be anxious about, and the treatment keeps looking like it half-worked.

This is also why an assessment is worth doing even if you are fairly sure of the answer. Knowing which thing is driving which changes what to do about either.

What the assessment involves

What it covers

One appointment of about an hour, in person at our Tempe office, with a psychiatric provider. It is a structured clinical interview — not a test you can fail, and not a form you fill in by yourself in the waiting room.

It moves through five things. First, your developmental history going back to elementary school — old report cards are genuinely useful here, because teachers have written down the same handful of phrases for decades, and a parent or older sibling can often supply what paperwork cannot. Second, how the difficulty shows up in your life now, across separate settings such as work, home and money, because the criteria require interference in more than one and not just the hardest one. Third, standardized rating scales: these are not the diagnosis, but they give a measure of severity that can be compared over time. Fourth, your sleep in detail, because chronically short or broken sleep produces a picture almost indistinguishable from inattentive ADHD and is the most common reason an assessment reaches the wrong answer. Fifth, the alternatives that have to be considered and set aside — long-standing anxiety, a depressive episode, a physical cause worth a referral back to your primary care doctor, and the ordinary effects of a genuinely overloaded year. If you have no records and nobody left to ask, say so on the intake call; a large share of adults arrive with neither, and the interview is built to work from your own account alone.

What you leave with

A written summary stating whether the diagnostic criteria are met and, if they are, which presentation it is: predominantly inattentive, predominantly hyperactive-impulsive, or combined. The criteria are specific, and you are entitled to hear them — several symptoms present before age 12, showing up in at least two separate parts of your life, causing real interference rather than mild inconvenience, and not better explained by something else. Your clinician goes through which of those you meet and which you do not, out loud, in the appointment. You are free to disagree and say why, and that disagreement gets recorded.

If the criteria are not met, you get the same level of detail about that rather than a shrug. You leave knowing what the more likely explanation is — most often long-standing anxiety, disrupted sleep, a depressive episode, or the consequences of a period with far too much in it — and what the concrete next step for that would be, including who provides it and roughly what it costs. Arriving expecting one answer and leaving with a different one is common, and it is the reason this is a full hour with a clinician rather than an online questionnaire.

The plan itself is written down rather than described to you, and it names three things: what is being addressed first, what kind of support each part calls for — therapy, practical work on organization and time, accommodations at work or in study — and the date of your next appointment, booked before you leave the building. Nothing in it is decided by video: the assessment is in person at our Tempe office, and therapy or follow-up visits afterwards can be by video anywhere in Arizona.

Where people start

Psychiatric Evaluations

A sixty-minute appointment with a psychiatric provider at our Tempe office. You leave with a diagnosis, a plan, and the reasoning behind both.

60 min · At our Tempe office

See evaluations and cost

Individual Therapy

Sixty-minute sessions with the same clinician every time. Practical work on the parts that an assessment alone does not fix.

60 min · In person or video

See therapy and cost

Three questions we get about this

Can I have ADHD if I did well at school?

Yes, and it is one of the most common reasons an assessment gets delayed. Good grades are not evidence against ADHD; they are evidence that something was covering for it — intelligence, a rigid routine, a parent who checked the bag every night, or sheer dread of being told off. What matters for the criteria is not your results. It is what the results cost you to produce, and whether the difficulty shows up in more than one part of your life.

Do I need my childhood records?

They help and they are not required. Old report cards are useful because teachers write down the same six phrases for decades, and a parent or older sibling can often supply what the paperwork cannot. If nobody is available to ask, say so on the intake call. Plenty of adults arrive with no records and no living witnesses, and the assessment is built to work without them.

I have been anxious for years. Could that be all this is?

It could, and separating the two is a large part of what the appointment is for. Sustained anxiety damages concentration on its own, so the two pictures overlap heavily. The distinguishing question is usually about timing: whether the attention difficulty predates the worry by years, or arrived with it. That is a question about your history, which is why the history takes up most of the hour.

The hardest part is starting.

Thirty seconds now, a short phone call within one business day, and a real date on the calendar. You will know what it costs before you commit to anything.