ADHD evaluation and treatment done with the rigor it deserves.
ADHD in adults is frequently missed, frequently misdiagnosed, and frequently overtreated — sometimes all three at once. At Wave Psychiatric Group, our board-certified psychiatrists conduct thorough, multi-step ADHD assessments that meet the clinical standard required to make this diagnosis accurately, and provide ongoing treatment grounded in the same rigor.
Understanding ADHD in adults
Attention-deficit/hyperactivity disorder is a neurodevelopmental condition characterized by persistent patterns of inattention, hyperactivity, and impulsivity that are inconsistent with developmental level, present across multiple settings, and traceable to childhood — even when the diagnosis is not made until adulthood. It is not a condition that begins in adulthood, though it is frequently not recognized until then.
Adult ADHD is real, it is common, and it causes genuine functional impairment. It is also one of the most diagnostically complex conditions in outpatient psychiatry — not because the condition itself is obscure, but because its symptoms overlap substantially with depression, anxiety, trauma, bipolar disorder, sleep disorders, and the effects of chronic stress. Inattention, difficulty sustaining effort, poor working memory, emotional dysregulation, and executive dysfunction are not unique to ADHD. They are features of many psychiatric conditions, of inadequate sleep, of excessive cognitive load, and of the normal variation in human attention and temperament.
This means that accurate diagnosis requires more than a symptom checklist and a prescription. It requires a thorough clinical evaluation that establishes not just the presence of symptoms but their developmental origin, their pervasiveness across contexts, the degree to which they represent a change from baseline or a lifelong pattern, and whether an alternative explanation better accounts for the full clinical picture.
It also requires honesty. The threshold for ADHD diagnosis has been subject to significant diagnostic drift in recent years, driven in part by the rise of telehealth platforms that conduct rapid, checklist-based assessments with limited clinical rigor. Stimulant medications are effective for genuine ADHD — and carry real risks, including cardiovascular effects, abuse potential, and the possibility of precipitating or unmasking mood instability, for patients who do not have it. Our psychiatrists take both the diagnosis and the prescription seriously.
How ADHD presents differently in adults
ADHD in adults often looks different from the hyperactive, disruptive presentation that dominates popular conceptions of the disorder. In adults, hyperactivity frequently manifests as internal restlessness rather than observable motor overactivity — a sense of being unable to settle, of the mind running constantly, of difficulty relaxing even when the situation calls for it. Inattention in adults tends to show up as difficulty sustaining focus on tasks that are not inherently engaging, problems with organization and time management, chronic procrastination, forgetfulness in daily activities, and a pattern of starting projects without completing them.
The predominantly inattentive presentation — sometimes colloquially called ADD — is particularly common in adults and is frequently missed, especially in women, whose presentations tend to be less overtly disruptive than the hyperactive presentations more commonly identified in childhood. Many adults with inattentive ADHD spent years developing compensatory strategies that masked their difficulties until the demands of adult life — a more complex job, graduate school, parenthood, multiple competing responsibilities — exceeded those strategies' capacity.
Emotional dysregulation is increasingly recognized as a significant feature of ADHD in adults — the tendency toward intense, rapidly shifting emotional reactions, low frustration tolerance, and rejection sensitivity — though it is not currently a formal diagnostic criterion. It is a clinically important dimension that our psychiatrists assess and factor into both diagnosis and treatment planning.
Our ADHD assessment process
Wave's ADHD assessment is a structured, multi-step process designed to meet the clinical standard required to make this diagnosis accurately. We do not conduct checklist-based evaluations. Our process involves three components, typically completed over one to two appointments.
Step one: Clinical interview
Your psychiatrist will conduct a comprehensive clinical interview covering your current symptoms and their impact across work, relationships, and daily functioning; your developmental and educational history; your psychiatric and medical history; your family history of ADHD and other psychiatric conditions; and a careful assessment of alternative explanations for your presentation. A diagnosis is provided only when the full clinical criteria for ADHD are met — including evidence that symptoms were present in childhood and have persisted across the lifespan.
Step two: Developmental history
Because ADHD is a neurodevelopmental condition that by definition begins in childhood, corroborating developmental history from someone who knew you as a child is an important component of a rigorous evaluation. We request permission to speak briefly with a parent or primary caregiver who can speak to your childhood behavior, attention, and functioning. We recognize that this is not always possible — estrangement, loss, or other circumstances may make parental contact impractical. In those cases, a long-term partner or someone who has known you well over an extended period can serve as an informative alternative. Your psychiatrist will discuss this with you at your initial appointment.
Step three: Objective testing
You will complete an in-person computerized assessment of attention and impulsivity — an objective measure that provides data beyond self-report and contributes to a more complete clinical picture. This testing is conducted at our West Los Angeles office and is incorporated into the overall assessment alongside the clinical interview and developmental history.
If you already have an ADHD diagnosis
If you have been formally diagnosed with ADHD by a psychiatrist or psychologist through a thorough prior assessment — including neuropsychological testing or a process comparable to our own — you may not need to complete our full evaluation process. We ask that you have your prior records sent to our office for review before your first appointment. Records can be faxed to us at 323-389-4908.
If your prior records document a thorough assessment process, your psychiatrist may be able to proceed directly to medication management or ongoing treatment without repeating the full evaluation. This is determined on a case-by-case basis after review of your documentation.
A note on testing accommodations
If you are seeking an ADHD evaluation specifically to obtain formal documentation for testing accommodations — for the MCAT, LSAT, GMAT, bar exam, medical board exams, or similar high-stakes assessments — we recommend a neuropsychological evaluation with a psychologist rather than our assessment process.
Testing agencies and licensing bodies typically require detailed neuropsychological reports that include standardized cognitive and achievement testing, which our psychiatric evaluation does not provide. A neuropsychological evaluation conducted by a licensed psychologist is the appropriate pathway for accommodation documentation. We maintain a list of trusted psychologists in the Los Angeles area who conduct neuropsychological testing and are happy to provide referrals. Once your testing is complete, you are welcome to return to Wave for ongoing medication management or other psychiatric support.
Treatment — medication and beyond
Stimulant medications
Stimulant medications — methylphenidate-based and amphetamine-based formulations — are the most extensively studied pharmacological treatments for ADHD and have the strongest evidence base for symptom reduction and functional improvement. They work by modulating dopamine and norepinephrine signaling in prefrontal circuits involved in attention and executive function, and for patients with genuine ADHD, their effects can be meaningful and rapid.
They are also controlled substances, regulated by the DEA, with real considerations around cardiovascular safety, abuse potential, appetite suppression, sleep disruption, and the possibility of exacerbating underlying anxiety or mood instability. Our psychiatrists prescribe them when clinically indicated, with careful attention to these considerations and with ongoing monitoring.
Because stimulant medications are Schedule II controlled substances, we require a brief monthly check-in for patients on these medications. This is a clinical and regulatory requirement that we take seriously — not as a bureaucratic formality, but as an opportunity to monitor your response, assess for side effects, and ensure the medication continues to be appropriate for your situation.
Non-stimulant medications
For patients for whom stimulants are contraindicated, not tolerated, or not preferred, non-stimulant options including atomoxetine, viloxazine, guanfacine, and clonidine have meaningful evidence bases and are prescribed at Wave when clinically appropriate. These medications require more time to reach therapeutic effect but do not carry the same controlled substance considerations as stimulants.
Psychotherapy and skills-based approaches
Medication addresses the neurobiological substrate of ADHD but does not teach the organizational, time management, and emotional regulation skills that many adults with ADHD have never fully developed. CBT adapted for ADHD — which focuses on building practical executive function skills alongside addressing the cognitive patterns that maintain avoidance and procrastination — has a growing evidence base as an adjunct to medication and as a standalone treatment for patients who prefer not to use medication or for whom medication alone is insufficient.
Our psychiatrists incorporate skills-based and psychotherapeutic approaches into ADHD treatment plans where clinically appropriate, and provide referrals to therapists with specific ADHD expertise when indicated.
Integrative considerations
Sleep is particularly important in ADHD treatment. Sleep deprivation produces a symptom profile that closely mimics ADHD — inattention, impulsivity, emotional dysregulation, poor working memory — and inadequate sleep can both mimic the disorder and significantly worsen it in patients who genuinely have it. Our psychiatrists assess sleep carefully in every ADHD evaluation and address it as a treatment target where relevant.
Exercise has demonstrated cognitive benefits in ADHD, including improvements in attention, working memory, and executive function, with mechanisms involving dopamine and norepinephrine modulation in prefrontal circuits. It is a meaningful adjunctive recommendation that our psychiatrists discuss as part of comprehensive ADHD treatment planning.
ADHD rarely presents in isolation in adults. The majority of adults with ADHD have at least one comorbid psychiatric condition — most commonly anxiety disorders, depression, or both. Substance use disorders are significantly more prevalent in adults with ADHD than in the general population. Mood disorders, learning disorders, and sleep disorders co-occur with meaningful frequency.
These comorbidities complicate both diagnosis and treatment in important ways. Anxiety and depression can both cause inattention that mimics ADHD — and in many patients, treating the primary anxiety or depressive disorder produces significant improvement in attentional symptoms without any ADHD-specific treatment. In patients who do have both ADHD and a comorbid condition, the order and approach to treatment requires careful clinical judgment.
Our psychiatrists assess for comorbid conditions as a routine part of every ADHD evaluation and factor them explicitly into the treatment plan. A diagnosis of ADHD does not end the clinical formulation — it is one piece of a picture that may require attention to multiple conditions simultaneously.
ADHD and comorbidity
What to expect
Your ADHD assessment at Wave typically unfolds over three appointments. At your initial visit, your psychiatrist will conduct the clinical interview and discuss the developmental history process. If there are comorbid conditions present, a separate 50 minutes assessment appointment will likely be necessary specifically focused on ADHD. This may be soon after your initial visit, or later on once the other conditions are under better control.
Objective testing is scheduled at our West Los Angeles office.
Following completion of all three components, your psychiatrist will share their diagnostic impressions and, where a diagnosis of ADHD is established, discuss the full range of treatment options with you.
If you are transferring care from another provider with an existing ADHD diagnosis and medication regimen, please have your records sent to our office in advance. Records can be faxed to 323-389-4908.
Insurance and fees
Wave Psychiatric Group accepts Aetna, Optum / UnitedHealthcare Behavioral Health, Meritain Health, Oxford Health Plans, ComPsych, UC SHIP, and others for diagnostic assessment appointments. Self-pay rates are also available.
Call us at 323-688-6380 or complete our intake form and our team will verify your benefits before your first appointment.
Frequently Asked Questions
Can ADHD begin in adulthood?
By definition, no — ADHD is a neurodevelopmental condition that must have its onset in childhood, even when it is not recognized or diagnosed until adulthood. However, many adults are genuinely diagnosed for the first time in their thirties, forties, or later, having compensated for their difficulties through intelligence, structured environments, or sheer effort until the demands of adult life exceeded those compensations. A diagnosis in adulthood is entirely valid when the clinical history documents childhood onset — which is why the developmental history component of our evaluation is clinically important rather than administrative.
Why do you require speaking with a parent or partner?
ADHD is a lifelong condition that by definition was present in childhood. Corroborating history from someone who knew you as a child provides important clinical information that self-report alone cannot — including whether the patterns you describe have genuinely been present since childhood or represent a more recent change. This collateral history is a component of a thorough ADHD evaluation and is standard in well-conducted assessments. We understand that it is not always possible to obtain, and we will discuss alternatives with you if this presents a difficulty.
I was diagnosed with ADHD as a child but never treated. Do I need to go through the full assessment again?
Not necessarily. If you have documentation of a thorough prior evaluation — conducted by a psychiatrist or psychologist using a process comparable to our own, or including neuropsychological testing — your psychiatrist may be able to proceed with treatment without repeating the full assessment. Please have your records faxed to our office at 323-389-4908 before your first appointment so they can be reviewed in advance.
Can I get an ADHD evaluation via telehealth?
The clinical interview and developmental history components of our assessment are available via telehealth. The objective computerized testing component requires an in-person visit to our West Los Angeles office. Patients located outside of Los Angeles who are able to come in for testing are welcome to do so — the telehealth components can be completed remotely, with the in-person testing scheduled at your convenience.
What if I need documentation for testing accommodations?
If your primary goal is formal documentation for testing accommodations — for the MCAT, LSAT, GMAT, bar exam, medical boards, or similar assessments — a neuropsychological evaluation with a psychologist is the appropriate pathway. Testing agencies typically require detailed neuropsychological reports that our psychiatric evaluation does not provide. We maintain referral relationships with trusted psychologists in Los Angeles who conduct this type of testing and are happy to connect you with one.