ADHD Assessment & Treatment

Why ADHD Assessment Requires Medical Investigation

Difficulty concentrating, executive dysfunction, and attention issues have many possible causes beyond ADHD. Before assuming ADHD and starting stimulant medication, comprehensive assessment systematically investigates medical factors that commonly impair focus and executive function.

Research shows that thyroid dysfunction, iron deficiency, sleep disorders, anxiety, depression, and numerous other medical conditions can produce symptoms identical to ADHD. Without proper investigation, patients may receive ADHD treatment for years while the actual cause remains unaddressed.

Comprehensive ADHD Evaluation

Clinical Assessment

• Detailed symptom history across multiple life domains (work, relationships, daily function)

• Childhood symptom pattern assessment (ADHD typically present before age 12)

• Standardized ADHD rating scales and diagnostic questionnaires

• Executive function evaluation (planning, organization, time management, working memory)

• Impact assessment on occupational, academic, and social functioning

Medical Factors Investigation

Before diagnosing ADHD, systematic investigation of alternative causes:

• Iron Status: Ferritin below 30 ng/mL impairs dopamine synthesis and causes ADHD symptoms

• Thyroid Function: Even mild hypothyroidism causes cognitive slowing and attention issues

• Sleep Disorders: Sleep apnea, insomnia, and circadian rhythm disorders severely impair focus

• Nutritional Deficiencies: B12, folate, magnesium, and omega-3 fatty acids affect cognitive function

• Anxiety & Depression: Both conditions cause concentration impairment and executive dysfunction

• Medication Effects: Many medications impair attention and executive function

• Substance Use: Alcohol, cannabis, and other substances affect cognitive performance

Differential Diagnosis

Distinguishing ADHD from conditions that mimic ADHD symptoms requires systematic evaluation:

• Primary anxiety disorder with secondary attention impairment

• Depression with cognitive symptoms (concentration, decision-making, processing speed)

• Bipolar disorder (especially in cases of impulsivity and poor focus during mood episodes)

• Post-traumatic stress disorder (hypervigilance and concentration difficulties)

• Autism spectrum disorder with executive function challenges

• Learning disabilities misattributed to attention problems

ADHD Treatment Approaches

When ADHD Diagnosis Is Confirmed

If comprehensive assessment confirms ADHD after investigating medical causes, evidence-based treatment options include:

Medication Not Working

• Stimulant Medications: Methylphenidate and amphetamine-based options (first-line for most patients)

• Non-Stimulant Medications: Atomoxetine, bupropion, guanfacine for patients preferring non-stimulants

• Combination Approaches: Integrating medication with lifestyle optimization for best results

Lifestyle & Behavioral Optimization

• Executive function training and compensatory strategies

• Sleep hygiene optimization (ADHD and sleep issues commonly co-occur)

• Exercise protocols shown to improve ADHD symptoms

• Nutritional optimization supporting dopamine function

• Environmental modifications reducing distractibility

When Medical Factors Are Primary

If evaluation reveals that medical factors are causing attention symptoms, treatment focuses on addressing root causes:

• Iron supplementation when ferritin deficient (dramatic improvement often within 6-8 weeks)

• Thyroid optimization for subclinical hypothyroidism

• Sleep apnea treatment (CPAP, oral appliances, or surgical options)

• Anxiety or depression treatment when these are primary causes

• Medication adjustments when current medications impair focus

Adults with ADHD

Many high-functioning adults have compensated for undiagnosed ADHD through intelligence, structure, and sheer effort—but still operate below their potential. Comprehensive evaluation determines whether ADHD is present and whether treatment could help you move from "managing" to "thriving."

Adult ADHD assessment also considers workplace accommodations, career optimization, and relationship impacts that may not have been apparent in childhood but affect quality of life significantly.