Good mental health treatment begins with getting properly assessed and evaluated. This is especially true with a condition like ADHD that can have so many factors influencing it.
We offer ADHD evaluations and treatment in all of our locations in Raleigh, Chapel Hill, and Cary.
Written by Dr. Alexandra Spessott, Medical Director for the Triangle at AIM.
Getting an ADHD evaluation can feel daunting. Maybe you’ve been told your whole life that you’re “scattered” or “just need to try harder,” and you’re finally wondering if there’s something more going on. Or maybe a therapist has suggested you look into it.
Either way, knowing what the process looks like and what treatment actually involves can make the whole experience feel a lot less intimidating.
Here’s a look at how we approach ADHD diagnosis and treatment at AIM and what the science tells us about doing it well.
What Goes Into a Proper ADHD Evaluation
An ADHD evaluation has multiple steps, and I usually ask anybody who comes in for one to have an open mind and a fair amount of patience—because we’re going to take our time to get it right.
This can be frustrating for some patients, but mental health conditions can often get diagnosed and treated improperly. ADHD has a lot of contributing factors so gaining a thorough understanding of those factors are important.
The best outcomes are going to happen when treatment is based in an accurate diagnosis instead of just throwing medications at symptoms.
Step 1: A Comprehensive Diagnostic Interview
The first step is an extensive, really comprehensive diagnostic interview. We’re going to ask you in a structured way about different ADHD symptoms and how those symptoms have shown up for you—in your childhood and then in your adult life. This isn’t a quick screening; it’s a thorough conversation designed to understand your full history.
Step 2: Input From People in Your Life
We’re also going to get information from people close to you—not necessarily bringing them into the room, but gathering feedback from your spouse, your parents, maybe even your children or close friends. These are the people who can really speak to how you’re functioning in the world day to day. That outside perspective is a really important piece that helps us get the whole picture of what’s going on.
Step 3: Targeted Testing
Lastly, we can conduct certain tests that measure how you specifically perform certain tasks. These tests let us see a bit about how you process information and how you’re thinking. Now, these tests are not diagnostic on their own—they give us information that we interpret in combination with everything else we’ve gathered. It’s the full picture that leads to an accurate diagnosis.
And throughout this whole process, we’re also assessing for other conditions that can co-occur with ADHD or that can mimic it. We really want to make sure we get it right. Even if it takes a little longer, the evaluation process at AIM is by design intended to give us a comprehensive understanding of what’s going on.
Why Getting the Diagnosis Right Matters
We take diagnosing ADHD very seriously, and there’s a reason for that. Making an accurate diagnosis is the most important foundational component of this whole process. We have really rigorous diagnostic protocols because we want to make sure we’re not missing anything.
Symptoms that look like ADHD can actually be caused by other things—anxiety, cannabis use, sleep deprivation, stress. If we treat for ADHD when the real issue is something else, we’re not going to get results. And that’s not fair to the patient.
How We Approach ADHD Treatment at AIM
We are very invested in finding the appropriate treatment for the individual. Medication is an option—but it’s not the only option, and it’s not the right option for everybody. There can be dangers with ADHD medications and there are alternatives to things like Adderall that can carry risk.
Medications for ADHD: More than Just Stimulants
Stimulants are what we all hear about in the news—Adderall, Ritalin. They’re commonly used medications for treating ADHD, but they are controlled substances.
Not everyone with ADHD is an appropriate candidate for a stimulant, and that’s okay. The good news is that we also have non-stimulant medications that are quite effective. The science is continuously advancing in this area, and we’re getting more and more treatment options that are not stimulant-based.
But the most important thing to understand is that medication alone won’t fix everything. What it can do is make it easier for an individual to participate in the therapy that will help them work through the real challenges. That interplay between medication and psychotherapy is critical.
Therapy for ADHD: Individual and Group
Cognitive behavioral therapy has a very strong evidence base in the treatment of ADHD, and it’s one of the approaches we use at AIM. But we also place a strong emphasis on identifying the specific skills where an individual is feeling most challenged.
At the individual level, therapy is great because a person can really hone in on their specific challenges. On the other hand, we also offer something I’m particularly excited about: a group-centered ADHD treatment focused on executive functioning skills—the types of skills where people with ADHD tend to have the most difficulty.
In the group, individuals can self-evaluate how they’re doing on a number of different executive functioning skills. They learn things like how to initiate tasks, how to prioritize tasks, and how to tolerate the distress that happens when things don’t go as planned.
And there’s also the power of the group itself—sharing experiences, getting feedback from peers. What we’ve found is that these groups stay really cohesive and friendships are made, which is a wonderful bonus.
Many people elect to do both individual and group therapy, and that’s usually great. It’s one of the cornerstones of ADHD treatment here at AIM.
Addressing Sleep, Stress, and Lifestyle in ADHD
Lifestyle factors play a major role in how ADHD shows up in someone’s life. Sleep, stress, work demands, and how someone structures their day all strongly influence their ability to function with ADHD.
Sleep is foundational. It supports our ability to learn, consolidate information, regulate emotions, and process the world during the day. Sleep at night allows for functioning during the day. Without enough sleep, it becomes much harder to tolerate distress, focus, solve problems, and manage impulses. There is strong research supporting this across all brains—not just ADHD brains.
Our culture often glorifies functioning on little sleep, and I strongly disagree with that mindset. Sleep is one of the most important foundations of healthy living.
Stress and work demands also play a significant role. Someone with ADHD often has to be even more intentional about managing these factors. In a world full of distractions, learning how to protect and direct your attention is almost like a superpower.
If all of your mental energy is going toward daily stressors, it becomes much harder to focus on the things that truly matter. This is something we’ve written more about in our article on how to improve attention span.
When we look at the whole person, we consider all of these lifestyle factors. Instead of trying to change everything at once, we focus on small, realistic adjustments. Over time, those small changes can create meaningful and lasting improvements.
Why ADHD Often Comes With Anxiety and Depression
This is one of my favorite topics, and honestly, we could spend all day on it. We do know that there’s some genetic overlap between ADHD and other conditions like depression and anxiety. But we also know that living with ADHD can give rise to other psychiatric conditions over time.
For example, a child with untreated ADHD might miss certain social cues because they’re not paying attention to what’s happening in the friend group. That can make it hard for them to make friends. Going into the teenage years and adulthood, that individual may experience isolation and loneliness—and then that loneliness can lead to depression or anxiety. It’s really what we call in medicine “multifactorial.”
Studies say different things, but I’ve read research suggesting that up to 70% of individuals with ADHD have another psychiatric condition at some point in their lives. That’s a really high percentage. So we want to look out for that, make sure we’re treating the right things, and make sure we’re treating all the things.
It’s a big part of what makes our comprehensive approach to ADHD treatment at AIM so important.
ADHD Evaluations in Raleigh, Chapel Hill, and Cary
If you’ve been wondering whether ADHD might be playing a role in your life—or if you’ve already been diagnosed and aren’t getting the support you need—we’d love to talk.
We don’t rush the process. We take the time to understand you, get the diagnosis right, and build a treatment plan that fits your life.
Wherever you are in the Triangle, we have a team of ADHD specialists that can help with evaluations, proper diagnosis, medications, and therapy.
Learn more about our ADHD programs and evaluation process, or contact us today to schedule a consultation.
