From the Practice

Thinking Clearly About ADHD

Clinical perspectives on adult ADHD evaluation, treatment, and the patterns that get missed.
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Access to Care · October 20, 2026

ADHD Medication Shortage in Washington: What to Do When the Pharmacy Is Out

Partial fills, one-time pharmacy transfers, new prescriptions, and when switching medications is a clinical decision. What Washington law allows when your stimulant is out of stock.

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Access to Care · September 9, 2026

Can a PA Prescribe Adderall or ADHD Meds in Washington?

In Washington, a PA-C with DEA registration can diagnose ADHD and prescribe stimulants under physician collaboration. When that is enough, and when to see a psychiatrist.

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Treatment · September 9, 2026

Online ADHD Medication Management in Washington

What telehealth ADHD medication management actually includes: visits, typical medication trials, maintenance care, and who online prescribing is for.

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Misdiagnosis · September 9, 2026

I Thought It Was Depression.

Depression and adult ADHD overlap often. How the two travel together, how clinicians tell them apart, and what treatment sequencing usually means.

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Cost & Access · September 2, 2026

What Does an ADHD Evaluation Actually Cost in Washington?

The same words cover a $300 appointment and a $3,390 testing battery. What each one actually buys, what insurance does, and the recurring cost nobody quotes.

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Access to Care · September 2, 2026

You Moved to Washington. Your ADHD Prescription Did Not.

Your old prescriber says they can keep seeing you by video. Once you actually live here, Washington law usually says otherwise. How to plan the handover before you run out.

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Access to Care · September 2, 2026

Who Can Actually Diagnose and Treat ADHD in Washington?

Psychiatrist, psychologist, PA, ARNP, primary care. In Washington these are not interchangeable, and the split that matters is between who can diagnose and who can prescribe.

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Sleep · August 27, 2026

"I Get Eight Hours and Still Feel Wrecked."

About 60% of adults with ADHD screen positive for a sleep disorder. Delayed sleep phase, insomnia, restless legs, and what stimulants actually do to sleep.

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Diagnosis · August 27, 2026

"Can You Just Test Me for ADHD?"

Computerised attention tests measure real things. The evidence says they cannot diagnose ADHD on their own. What objective testing adds, and what it does not.

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Misdiagnosis · August 27, 2026

"I Was Told It Was Anxiety."

Anxiety is what adults with ADHD are most often diagnosed with first. What the overlap looks like, how the two are told apart, and which one to treat first.

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Access to Care · August 26, 2026

My Prescriber Closed Their Practice and I Have Two Weeks Left.

A Schedule II prescription cannot be refilled and no pharmacist can extend it. What to do when you lose your ADHD prescriber, starting with the records request.

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Misdiagnosis · August 23, 2026

Not Everything That Looks Like ADHD Is ADHD.

Sleep apnea, depression, thyroid dysfunction and chronic short sleep all produce inattention. Here is how a careful evaluation separates them, and why they so often coexist.

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Medication Management · August 7, 2026

"I Tried a Stimulant Once. It Wasn't for Me."

One medication trial is not a test of whether ADHD medication works. The drugs are not interchangeable, and nothing currently predicts which one will work for you.

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Medication Management · August 6, 2026

What If Stimulants Are Not an Option?

Non-stimulants are real treatments with real evidence, not a consolation prize. What the research supports for atomoxetine, viloxazine, guanfacine, and bupropion in adults.

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Misdiagnosis · July 29, 2026

"I Check the Stove Five Times." That Is Not Always OCD.

Rigid checking and organizing can look compulsive. In untreated ADHD it is often compensation for a working memory you cannot trust, and the treatment changes entirely.

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Medication Management · July 22, 2026

Why Did My ADHD Medication Stop Working?

Medication that helped for months can seem to stop working. The reasons are usually specific and addressable: tolerance, sleep, stress, hormones, timing, and dose.

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Telehealth · July 20, 2026

Yes, You Can Get an ADHD Diagnosis Through a Video Call. Here Is What That Actually Means.

"Can you actually diagnose ADHD through a video call?" The short answer is yes. The longer answer, covering what the law says and what a real evaluation involves, is worth understanding.

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Women & ADHD · June 10, 2026

"Too Much": Emotional Dysregulation in Women With ADHD

Women with ADHD are often told they're “too emotional.” What's actually happening is emotional dysregulation, a core feature of ADHD that gets misread as a personality flaw.

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Diagnosis · June 10, 2026

"You Can't Have ADHD. You Graduated College."

High achievement doesn't rule out ADHD. It often masks it. Here's what compensation actually costs, and who gets missed because they look like they're managing.

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Misdiagnosis · June 10, 2026

When the Diagnosis Doesn't Fit: ADHD and Bipolar Disorder

Mood swings that last hours, not days. Triggered by a slight, not arising on their own. One of the most common patterns I see is ADHD that has been carrying a bipolar diagnosis for years.

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Executive Function · June 10, 2026

"I Know What I Need to Do. I Just Can't Start."

Task initiation difficulty in adult ADHD isn't a discipline problem. It's a neurological one. Here's what's actually happening and why it matters for treatment.

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Treatment & Risk · July 6, 2026

ADHD Treatment Is Not Only About Focus. Sometimes It Is About Safety.

ADHD affects more than productivity. A 2017 JAMA Psychiatry study of 2.3 million people found crash risk was significantly lower during medicated months.

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Lifestyle & Treatment · June 22, 2026

Movement, Mindfulness, and ADHD: What the Evidence Actually Says

Exercise and meditation don't treat ADHD on their own, but they can be meaningful parts of ADHD care. Here's what the research actually shows.

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Recognize yourself in any of these? Let's talk about a structured, evidence-based path forward.

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