Adult ADHD, treated integratively.

What this actually is

ADHD is a disorder of executive function — the systems responsible for attention, working memory, planning, task initiation, emotional regulation, and impulse control.

In adults, this may present as:

• Chronic procrastination
• Difficulty with time management
• Working memory lapses
• Emotional reactivity
• Sustained effort required for routine tasks

Many individuals — particularly women — are not diagnosed until adulthood.

Why the standard approach often falls short

Evaluation is often limited to symptom checklists followed by medication and infrequent follow-up.

This approach may overlook:

• Longstanding sleep disruption
• Trauma history
• Coexisting anxiety or depression
• Environmental and structural factors affecting performance

Without addressing these variables, treatment is often incomplete.

The Elevae approach

Treatment is structured across five domains:

Mind

Comprehensive diagnostic interview to confirm ADHD and identify coexisting conditions.

Biology

Review of history, validated rating scales, and screening for conditions that may mimic or worsen ADHD (e.g., thyroid dysfunction, sleep disorders, anemia). Pharmacogenomic testing when indicated.

Lifestyle

Sleep, nutrition (including protein intake), hydration, movement, screen exposure, and caffeine timing are addressed as factors that influence executive function.

Relationships

Development of external systems — calendars, reminders, and structured workflows — that support consistent execution.

Meaning

Many adults with ADHD have internalized years of self-criticism. Reframing symptoms as neurological, rather than personal, is an important part of treatment.

What treatment typically looks like

Care begins with a 60–90 minute intake focused on diagnostic clarity.

Within two weeks, you receive a structured treatment plan that may include:

• Therapy
• Medication, when indicated
• Targeted supplements
• Sleep and lifestyle interventions
• Pharmacogenomic testing, if appropriate

Follow-up visits are 45 minutes.

When medication helps — and when it doesn't

Medication can be an effective part of treatment when aligned with your specific presentation and needs.

It is less effective when coexisting conditions — such as anxiety, depression, or sleep disorders — remain unaddressed. Part of treatment is determining which factors are most relevant in your case.

Medication is used as one component of a broader, structured approach.

Lifestyle interventions that matter

• Sleep: insufficient or inconsistent sleep significantly worsens executive function
• Nutrition: adequate protein intake supports stable energy and neurotransmitter function
• Exercise: aerobic activity can improve attention and cognitive performance
• Caffeine timing: typically limited to earlier in the day
• Screen exposure: unstructured or high-frequency use can worsen attentional fragmentation
• External systems: structured supports improve consistency more reliably than effort alone

Pharmacogenomics and ADHD

Pharmacogenomic testing may be useful for a subset of patients — particularly those who have experienced significant side effects or limited benefit from multiple medication trials. Testing is used selectively to guide treatment decisions.

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