ADHD is a neurodevelopmental condition causing persistent inattention, impulsivity and sometimes hyperactivity that begins in childhood and often continues into adulthood. Diagnosis is clinical, based on a structured interview and rating scales. First-line treatment is stimulant medication (methylphenidate or amphetamine class), with non-stimulants such as atomoxetine, viloxazine and guanfacine as alternatives, plus skills-based therapy.
Stedfast Psychiatry evaluates and treats ADHD across the lifespan. Our evaluation separates ADHD from the conditions that mimic it, and our treatment plan combines medication (stimulant or non-stimulant) with practical skills training. We offer ADHD testing and treatment at all 13 offices and by telehealth throughout Florida and South Carolina.
Symptoms of ADHD
- Difficulty sustaining attention on tasks, reading or conversations
- Frequent careless mistakes and missed details
- Trouble organizing tasks, time and belongings
- Starting many projects and finishing few
- Losing keys, phone, paperwork or other essentials
- Avoiding tasks that require sustained mental effort
- Restlessness, fidgeting or feeling internally driven
- Interrupting, blurting out or difficulty waiting
- Impulsive decisions about spending, driving or commitments
- Chronic procrastination despite real consequences
Causes and risk factors
ADHD is one of the most heritable psychiatric conditions, with genetics explaining roughly 70 to 80 percent of risk. Prematurity, low birth weight and prenatal exposure to alcohol, tobacco or lead add to risk. The condition involves differences in dopamine and norepinephrine signaling in the prefrontal cortex and related networks, and in the brain's reward and timing systems, which is why both stimulant and non-stimulant medications act on those neurotransmitters. ADHD is not caused by sugar, screen time or parenting, although sleep deprivation, untreated anxiety and heavy screen use can make symptoms worse.
An estimated 7 million US children aged 3 to 17 (11.4 percent) have ever been diagnosed with ADHD.
Source: CDC, National Survey of Children's Health 2022
About 4.4 percent of US adults have ADHD, and fewer than one in five of them have been diagnosed and treated.
Source: NIMH, National Comorbidity Survey Replication
Stimulant medications produce a meaningful response in roughly 70 to 80 percent of people with ADHD.
Source: American Academy of Pediatrics and American Psychiatric Association clinical guidance
Roughly 60 to 70 percent of children with ADHD continue to have impairing symptoms in adulthood.
Source: Longitudinal studies summarized by the American Psychiatric Association
How we diagnose it at Stedfast Psychiatry
There is no single test for ADHD; the diagnosis is clinical. At Stedfast Psychiatry an ADHD evaluation includes a structured interview covering symptoms in childhood and today, functioning at work or school and at home, and a developmental, medical and family history. We use validated rating scales: the Adult ADHD Self-Report Scale (ASRS) and Conners or Vanderbilt scales for children and teens, with input from a parent, teacher or partner whenever possible. We screen for conditions that cause similar symptoms or coexist with ADHD, including anxiety, depression, bipolar disorder, sleep disorders, learning disabilities, substance use and thyroid disease. We ask about cardiovascular history, blood pressure and heart rate before prescribing stimulants, and request an EKG when there is a personal or family history of cardiac problems. For complex cases we can refer for formal neuropsychological testing.
Treatment options
Medication management
Stimulants are first-line for ADHD at every age and help 70 to 80 percent of people. The two families are methylphenidate (Ritalin, Concerta, Focalin) and amphetamine (Adderall, Vyvanse, Mydayis), each available in short and long-acting forms. We usually start with a long-acting formulation to cover the whole day and adjust the dose every one to two weeks until symptoms are controlled with acceptable side effects, typically within four to eight weeks. Non-stimulants are used when stimulants are not tolerated, when there is a history of substance misuse, when anxiety or tics are prominent, or by preference: atomoxetine (Strattera) and viloxazine (Qelbree) are norepinephrine reuptake inhibitors that take four to six weeks for full effect; guanfacine XR (Intuniv) and clonidine XR (Kapvay) are alpha-2 agonists that help impulsivity and hyperactivity and can be combined with a stimulant. Monitoring includes blood pressure, heart rate, weight, sleep and appetite at each visit, and growth tracking in children. Stimulants are controlled substances with specific prescribing rules, including for telehealth.
Psychotherapy and skills training
Medication improves attention, but it does not teach organization. CBT adapted for ADHD focuses on planning systems, time management, task initiation and managing the emotional fallout of years of missed deadlines. For children, parent behavior training and classroom accommodations (a 504 plan or IEP) are core treatments, and for young children under six behavior therapy comes before medication. ADHD coaching and executive-function skills training are useful adjuncts for adults and college students.
What to expect
The first visit is a 60-minute evaluation, in person or by video, that includes rating scales completed ahead of time. If ADHD is confirmed and medication is appropriate, a prescription is sent that day or after any needed cardiac screening. Follow-ups are every two to four weeks during dose titration, then every three months once stable, as required for controlled-substance prescribing. Telehealth follow-ups are available in Florida and South Carolina, within the current federal and state rules on prescribing stimulants by video.
When to seek help
Consider an evaluation if attention, organization or impulsivity problems have been present since childhood and are affecting your work, school, finances, driving or relationships, or if your child's teacher has raised concerns about focus, behavior or academic performance. Adults are often diagnosed after a child's evaluation prompts them to recognize the same patterns in themselves. ADHD is not an emergency, but untreated ADHD raises the risk of accidents, substance use and depression. If you have thoughts of harming yourself, call or text 988.
ADHD presentations
DSM-5-TR describes three presentations. Predominantly inattentive ADHD (what used to be called ADD) involves trouble focusing, following through and organizing without obvious hyperactivity; it is underdiagnosed, especially in girls and women, because it does not disrupt a classroom. Predominantly hyperactive-impulsive ADHD is more common in young children. Combined presentation, with both symptom clusters, is the most frequent diagnosis overall. Presentation can shift over time: hyperactivity often fades into an internal restlessness in adulthood while inattention persists.
Conditions that look like ADHD
Several conditions produce inattention and need to be ruled out or treated alongside ADHD. Anxiety and depression impair concentration. Bipolar disorder shares impulsivity and distractibility with ADHD, and stimulants can worsen mania if bipolar disorder is missed, so we screen for it. Sleep apnea and chronic sleep deprivation produce daytime inattention that resolves when sleep is fixed. Learning disabilities, autism spectrum disorder, hearing or vision problems, thyroid disease, and heavy cannabis use all belong on the list. ADHD rarely appears for the first time in adulthood, so symptoms that started after age 30 point to another cause.
ADHD in women
Women are diagnosed later than men, often in their 30s or 40s, and often after years of being treated for anxiety or depression. Hormonal shifts across the menstrual cycle, pregnancy and perimenopause change how ADHD symptoms feel and how well medication works; many women notice symptoms worsen in the week before their period and in perimenopause. We take this into account when timing and dosing medication.
Lifestyle and accommodations
Consistent sleep is the single most important non-medication factor; sleep loss can double ADHD symptom severity. Regular exercise improves attention for hours afterward. External structure (calendars with alerts, a single place for keys and wallet, breaking tasks into first steps, body-doubling) compensates for weak internal structure. Students are entitled to accommodations such as extended time and reduced-distraction testing under Section 504 or an IEP, and adults can request workplace accommodations under the ADA. We provide the documentation these require.
Long-term outlook
With treatment, most people with ADHD function well. Treated ADHD is associated with better academic and work outcomes, fewer car accidents, lower rates of substance use, and lower injury rates compared with untreated ADHD. Medication is often continued for years, with periodic reassessment, and some adults choose to use it only on workdays or during demanding periods. Skills learned in therapy persist. The goal is not to eliminate every symptom but to close the gap between your ability and your results.
Frequently asked questions
How do I get tested for ADHD as an adult?
Schedule an ADHD evaluation with a psychiatric provider. You will complete the ASRS screening scale, then have a structured interview that covers your childhood, current symptoms and how they affect your life. Old report cards or input from a parent or partner help but are not required. Most adults receive a diagnosis and treatment plan at the first visit; formal neuropsychological testing is only needed when the picture is unclear or when learning disabilities are suspected.
What are the non-stimulant options for ADHD?
Atomoxetine (Strattera) and viloxazine (Qelbree) are once-daily norepinephrine reuptake inhibitors that are not controlled substances and take four to six weeks to reach full effect. Guanfacine XR and clonidine XR help impulsivity, hyperactivity and sleep, and are often combined with a stimulant in children. Bupropion is used off-label in adults who also have depression. Non-stimulants are somewhat less effective on average than stimulants but are the right choice for many people.
Will ADHD medication change my personality?
At the right dose, stimulants make it easier to direct your attention and pause before acting; they do not change who you are. If you feel flat, irritable or like a different person, the dose is too high or the medication is the wrong fit, and we adjust it. Appetite suppression and difficulty sleeping are the most common side effects and are usually managed with timing and dose changes.
Can I get ADHD medication through telehealth?
Yes, within current rules. Federal and state regulations on prescribing controlled substances by telehealth have changed several times since 2020, and we follow the current requirements, which may include an initial in-person visit before stimulants are prescribed and periodic in-person follow-up. Non-stimulants such as atomoxetine, viloxazine and guanfacine can be prescribed by telehealth without restriction. Our staff will tell you exactly what applies in Florida or South Carolina when you schedule.
Does insurance cover ADHD testing and treatment?
An ADHD evaluation with a psychiatric provider is billed as a specialist visit and is covered by most commercial plans and Medicare. Our self-pay evaluation is $185. Generic stimulants and non-stimulants are inexpensive; brand-name long-acting formulations may need prior authorization. Separate neuropsychological testing, when needed, is billed differently and we will explain the cost before referring.
Is it ADHD or anxiety?
Both cause poor concentration, but for different reasons. Anxiety steals attention with worry; ADHD makes attention hard to direct regardless of mood. About half of adults with ADHD also have an anxiety disorder, often because years of missed deadlines produce chronic worry. We evaluate both and sequence treatment accordingly, since treating ADHD sometimes resolves the anxiety and treating anxiety first sometimes reveals the ADHD underneath.
At what age can a child be evaluated for ADHD?
ADHD can be diagnosed from age four, although we are cautious in preschoolers and recommend behavior therapy before medication in children under six. Most children are diagnosed between six and twelve when school demands make symptoms obvious. Our child and adolescent providers use parent and teacher rating scales and coordinate with the school on accommodations.
Are stimulants addictive?
Stimulants have abuse potential when misused, which is why they are controlled substances. Taken as prescribed for ADHD, they do not cause addiction, and long-term studies show that treating ADHD lowers the risk of later substance use disorders rather than raising it. We prescribe long-acting formulations, monitor refill patterns, and use non-stimulants when there is an active substance use problem.
Where to get treatment for ADHD
Evaluation and treatment for ADHD is available at every Stedfast Psychiatry office and by video across Florida and South Carolina.
Related conditions
If you are thinking about harming yourself, call or text 988 now, or go to the nearest emergency room. This page is educational and does not replace an evaluation. Clinical content reviewed by Dr. David Husted, board-certified psychiatrist.