What to Expect During Your First ADHD Appointment with a Psychiatric Nurse Practitioner
A Guide from a Neurodivergent Mental Health Provider Who Gets It
If you're reading this, you're likely exhausted from trying to hold it all together while quietly wondering, “Is it supposed to be this hard for everyone else?” Maybe you’ve lived your life being labeled as lazy, disorganized, or emotional, when deep down you’ve always sensed that your brain just works differently. You’re not alone — and you're not broken.
Hi, I’m Molly, a Psychiatric Mental Health Nurse Practitioner (PMHNP) in San Diego (and online), and I specialize in diagnosing and supporting adults with ADHD. As someone who also has ADHD, I bring a personal and clinical understanding to the process. I know how daunting it can feel to make that first appointment — especially when you’ve spent a lifetime compensating, masking, or being misunderstood.
This guide is designed to walk you through what to expect during your first ADHD evaluation with someone like me — a provider who blends clinical expertise, lived experience, and affirming care to help you understand your brain and build a treatment plan that actually works for your life.
Before the Appointment: Preparation Matters
(But It Doesn’t Have to Be Perfect — You’re in the Right Place Already)
Taking the step to get evaluated is huge. You don’t need to have everything figured out before your first visit, but gathering a few pieces of information ahead of time can be helpful:
Report cards or teacher comments from childhood noting distractibility, fidgeting, or difficulty staying on task
Any prior mental health diagnoses or records mentioning focus, anxiety, or executive dysfunction
Work performance reviews that highlight struggles with deadlines, time management, or organization
A symptom journal (even just in your Notes app!) with real-life examples like “missed my appointment again even though I set 3 alarms”
Family history of ADHD or related mental health conditions — it often runs in families
These aren’t mandatory — they just help paint the picture. ADHD looks different in adults (especially women and marginalized populations), so your narrative matters just as much as the paperwork.
The Appointment Itself: What It’s Like to Be Seen and Heard
(No Tests You Can “Fail” — Just a Conversation That Makes Sense of It All)
During your first ADHD appointment, I’ll take the time to understand your story — not just your symptoms. We’ll cover:
Your childhood history, schooling, and early behavior
How ADHD shows up in your current daily life, work, relationships, and self-image
What’s worked (or hasn’t) in terms of organization, productivity, and mental wellness
Your strengths and how we can build on them
Any co-occurring conditions like anxiety, depression, trauma, or sleep issues
You’ll also complete standardized screening tools like the ASRS (Adult ADHD Self-Report Scale) or others. These help us gather more structured data to support the clinical picture.
And don't worry — I’m not here to invalidate your experience or check boxes. I’m here to listen and collaborate.
Additional Testing and Medical Screening: Ruling Out, Tuning In
(Because ADHD Doesn't Always Travel Alone)
In some cases, we may explore additional screening or testing to rule out other conditions that can mimic or overlap with ADHD. This is especially important when symptoms are complex, long-standing, or impacted by other factors.
Conditions that can appear similar to ADHD — or often co-occur — include:
Trauma and PTSD
Anxiety and depression
Autism spectrum conditions
Thyroid disorders or hormonal imbalances
Sleep disorders like insomnia or sleep apnea
Learning disorders
Sometimes, if the picture remains unclear or if there are multiple overlapping conditions, I may refer you out for a full neuropsychological evaluation. This is not to scare or overwhelm you — it's about making sure we get the right diagnosis so we can build the most effective treatment plan for you. ADHD diagnosis is not one-size-fits-all, and neither are brains.
Diagnosis Isn’t the End — It’s the Beginning of Understanding
(And Yes, There’s a Plan — Tailored to You)
If your symptoms meet the criteria for ADHD, I’ll talk you through your diagnosis clearly and without judgment. You’ll learn about:
The type of ADHD you may have: inattentive, hyperactive-impulsive, or combined
How ADHD manifests in adults and why it’s often missed — especially in high-functioning or people-pleasing individuals
What comes next in terms of support and treatment options
After the Evaluation: Understanding Results and Planning Treatment
(Because Clarity Is the First Step to Relief)
An ADHD diagnosis is based on a clinical decision-making process that considers everything we’ve discussed — your history, symptom profile, standardized measures, and the overall picture of how this impacts your life. There’s no single test that "proves" ADHD. That’s why taking the time to understand the whole you matters.
In many cases, a diagnosis can be made after the first visit. But in more complex or nuanced cases, the process may take 2–3 visits to complete — especially if there are overlapping conditions, trauma history, or uncertainty about when symptoms began. You’ll always be informed, involved, and respected throughout this process.
We’re here to make sure your diagnosis is accurate, affirming, and empowering — not rushed or reductive.
Treatment Options: More Than Just Medication
(Though Meds Can Help — and So Can a Lot of Other Things)
Treatment for ADHD is highly individual, and my approach is holistic and collaborative. Here’s what we might explore:
Medication management — If we decide medication is a good fit, we’ll start low and go slow. I prescribe both stimulant and non-stimulant options based on your goals, medical history, and concerns.
Therapeutic strategies — While I don’t provide traditional therapy, I use evidence-based tools like CBT techniques, ADHD coaching principles, and behavioral planning.
Supplements & lifestyle support — We may also look at things like sleep, movement, nutrition, and targeted supplements.
Referrals — If therapy, coaching, or additional evaluations are helpful, I’ll connect you with trusted professionals.
Support at work or school — Need help with accommodations or executive functioning hacks? I’ve got you.
Follow-Up and Monitoring: Support That Grows With You
(This Isn’t a One-and-Done Visit)
ADHD is dynamic — your treatment should be too. We’ll schedule regular follow-ups, especially if we’re trying new medications or strategies. I’ll check in on side effects, progress, and what’s working (or not), so we can pivot when needed.
My goal is to help you build a system that works with your brain, not against it — and to help you feel seen, understood, and empowered along the way.
Breaking the Stigma: Why Language and Lived Experience Matter
Unfortunately, ADHD is still widely misunderstood in the healthcare world. Many adults — especially women, BIPOC, LGBTQ+ folks, and those with high-functioning or masking behaviors — are often dismissed, misdiagnosed, or blamedfor their symptoms.
Here’s the truth:
ADHD is real. It’s neurobiological. And it doesn’t look the same in everyone.
In my practice, I work hard to break down the stigma surrounding ADHD by offering affirming care that validates your lived experience. That means:
I won’t shame you for being "disorganized" or "late again"
I understand that executive dysfunction is not laziness
I’ll never expect you to show up like a neurotypical brain
I’ll give you tools and support — not judgment
This is a space where you don’t have to "prove" your struggle. You deserve care that sees the full you — your story, your strengths, and your potential.
Final Thoughts: You’re Not “Too Much” — You’re Wired Differently
(And That Deserves Compassionate Care)
I know what it’s like to sit in your car after the appointment wondering if you said the right things — or second-guessing whether you “qualify” for a diagnosis. If you relate to these experiences and feel like ADHD might be part of your story, you deserve a provider who gets it and can walk alongside you with respect and understanding.
If you’re looking for ADHD care that’s grounded in clinical knowledge, lived experience, and affirming support, I’d be honored to work with you — whether you're in San Diego or anywhere in California.