Clinical overview
ADHD is a neurodevelopmental diagnosis. DSM-5-TR requires several symptoms present before age 12, impairment in more than one setting, and exclusion of better explanations (sleep apnea, anxiety, bipolar hypomania, substance use, TBI). A PMHNP-BC clinic can evaluate adolescents and adults. We do not treat preschool ADHD as a primary pediatric developmental program, and we do not diagnose ADHD from a viral checklist alone.
How we evaluate
History covers childhood school records when available, ASRS or similar scales, sleep, mood polarity, and cardiac risk before stimulants. Anxiety and trauma can mimic inattention. Oppositional patterns in adolescents are described, not automatically medicated as ADHD. Impulse-control complaints (anger, spending, risky sex) get a bipolar and substance screen before a stimulant is the answer.
Treatment stance
When ADHD criteria are met, options include methylphenidate or amphetamine salts, atomoxetine, viloxazine, or bupropion, plus executive-function coaching referral. Controlled-substance prescribing follows Florida law, PDMP review, and follow-up. We will not start a stimulant to treat untreated bipolar disorder, active cocaine use, or untreated severe sleep apnea.
When to seek care
Seek assessment when inattention, impulsivity, or restlessness has been impairing school or work across years, not only during a stressful month. Chest pain, fainting, or family sudden cardiac death history must be disclosed before stimulant therapy.