ADULT ADHD: Recognized, treated, and coached
Board-Certified Psychiatric Nurse Practitioner
Comprehensive Evaluation Not a 15-Min Refill Visit
Telehealth Sacramento + NorCal
Cash-Pay Superbill for Reimbursement
What ADHD actually looks like in adults
ADHD in adults rarely looks like the cartoon. It is a disorder of executive function: organization, follow-through, time management, emotional regulation. In practice that often shows up as starting ten things and finishing two. Chronic procrastination on tasks you genuinely care about. Feeling overwhelmed by things that "shouldn't" be overwhelming. A short fuse. Low frustration tolerance.
The line I hear most often from patients is, "I know exactly what I need to do, I just can't get myself to do it." That isn't laziness, and it isn't a character flaw. It's a brain-based regulation issue, and it responds well to the right treatment.
Why so many adults are diagnosed late
A lot of the adults I see have been compensating for years without realizing it. Smart, capable people build elaborate scaffolding around themselves to stay on top of work, family, and life. From the outside, the scaffolding looks like competence. From the inside it feels like running uphill on every task.
ADHD also doesn't present the same way in everyone. Women in particular often present with the more internal symptoms, distractibility, overwhelm, emotional dysregulation, rather than the hyperactivity people picture. Hormonal transitions like postpartum and perimenopause can unmask symptoms that were being held together by sheer effort. And the social expectation that women just "handle it all" means struggles get minimized, often by the patient herself, long before anyone asks the right question.
Part of my job is asking the right question. A surprising number of the adults I evaluate have lived with ADHD for decades without ever being told that what they were experiencing had a name.
How I work with ADHD
ADHD care at Blue Jay Psychiatry is more than a prescription. It's a three-part arc:
Identify it accurately. A thorough diagnostic conversation matters here, because adults with ADHD have usually been working around it for years and the symptoms hide behind anxiety, perfectionism, or burnout. I take a careful history and listen for the patterns that get missed in shorter visits.
Treat it well. When medication is the right call, I find the right tool and the right dose, then we iterate. Cash-pay visits are long enough that I can actually hear how a new prescription is landing and adjust accordingly, rather than guessing between rushed refills.
Coach you back into the life that's been waiting. Medication calms the noise, but the years of compensating leave habits and patterns that don't reset on their own. Within our visits I help you translate the new clarity into actual changes: how you plan a week, how you handle the inbox, how you decide what to commit to, how you talk to your partner about what's been hard. That coaching work is built into the visit, not a separate service.
ADHD rarely travels alone
Untreated ADHD and anxiety and depression are tangled together more than people realize. Chronic overwhelm becomes anxiety. Years of feeling like you're underperforming or letting people down turns into shame, and shame turns into depression. Sometimes the anxiety is the brain working overtime to compensate for the ADHD underneath, which is why treating only the anxiety often gets a patient part of the way and no further.
When I evaluate someone for ADHD, I'm also looking at the rest of the picture. If we treat the driver, the anxiety and the depression often improve dramatically on their own. If there's still work to do after that, we do it from a much steadier base.
What to expect
Free 20-minute chemistry check. A short conversation about what you're navigating and whether Blue Jay Psychiatry is the right fit. No medical advice, no commitment.
Initial consultation (60 min). Full history, current medications, and a careful diagnostic conversation. If ADHD looks like part of the picture, we'll talk through what treatment could look like for you.
Medication, dialed in over time. Cash-pay visits give us the time to find the right prescription and the right dose, then to keep adjusting as life changes.
Ongoing visits that include the coaching piece. Once medication is working, we use the visit time to translate the new clarity into how you actually live your week.
The initial consultation is a 60-minute visit. Ongoing medication management visits are 30 minutes. The general fee schedule is on the Services page. Blue Jay Psychiatry is cash-pay; on request I provide a Superbill so you can submit for out-of-network reimbursement.
Wondering whether ADHD is part of your picture?