Adult ADHD Evaluation and Treatment in Portland, OR
Many adults with ADHD have spent years wondering why everyday tasks feel harder for them than they seem to for everyone else. They may have been labelled as disorganised, forgetful, or unmotivated, or told they simply needed to try harder. In reality, many people reach adulthood with undiagnosed ADHD after years of challenges at work, in relationships, and at home that never had a clear explanation. Caroline Thiongo PMHNP-BC at Thrive Psychological Wellness provides comprehensive ADHD evaluation and personalised medication management for adolescents and adults at our Portland and Multnomah Village offices, with telehealth appointments available to patients anywhere in Oregon. Whether the primary concerns are focus, organisation, procrastination, impulsivity, or feeling consistently overwhelmed by daily responsibilities, the evaluation starts by understanding your specific history and symptoms rather than applying a standard checklist. Both stimulant and non-stimulant medication options are available, with ongoing follow-up to make sure the approach actually fits your life.
What We Evaluate and Treat
ADHD Inattentive Type
Difficulty focusing, following through, and staying organised without obvious hyperactivity.
ADHD Hyperactive-Impulsive
Restlessness, impulsivity, and difficulty staying still or waiting.
ADHD Combined Type
Both inattentive and hyperactive-impulsive symptoms present together.
Adult ADHD
ADHD that was undiagnosed in childhood or has become more prominent as responsibilities have grown.
ADHD with Co-Occurring Conditions
ADHD alongside anxiety, depression, sleep disorders, or substance use—all assessed and addressed together.
ADHD and Co-Occurring Conditions
ADHD commonly occurs alongside anxiety disorders, depressive disorders, sleep disturbances, learning disorders, and substance use disorders. Because the symptoms of these conditions can overlap with or mimic ADHD, a thorough evaluation is essential before any diagnosis or treatment decision is made.
Identifying co-occurring conditions is a central part of how Caroline Thiongo PMHNP-BC approaches ADHD assessment. Untreated anxiety, mood disorders, or sleep problems can contribute to difficulties with attention and daily functioning in ways that look like ADHD but require a different treatment approach. Stimulant medications are among the most effective treatments for ADHD, but in some individuals they can temporarily increase nervousness or anxiety, which makes careful assessment and individualised planning important from the start.
A comprehensive evaluation determines whether symptoms are primarily related to ADHD, another condition, or a combination of both, so that treatment recommendations are built around what is actually driving the difficulties rather than the most obvious presenting symptom.
Research on ADHD Co-Occurring Conditions
- Difficulty starting tasks, especially ones that feel boring or overwhelming
- Losing track of details or making careless mistakes at work or school
- Trouble following through on projects even when you understand what needs to be done
- Forgetting appointments, deadlines, or everyday tasks regularly
- Easily distracted by surrounding sounds, thoughts, or activity
- Restlessness or a feeling of internal urgency that is hard to settle
- Saying things impulsively or making quick decisions without thinking them through
- Difficulty sitting through meetings, long conversations, or anything that requires sustained attention
ADHD Presentations Evaluated and Treated at Thrive Psychological Wellness
ADHD is not the same in every person. The presentation, the age at diagnosis, and any co-occurring conditions all shape what effective treatment looks like.
ADHD Inattentive Type
The predominantly inattentive presentation involves difficulty sustaining attention, following through on tasks, and staying organised. Hyperactivity is minimal or absent. More common in women and frequently missed in childhood. Many adults receive this diagnosis for the first time in their thirties or forties.
ADHD Hyperactive-Impulsive
Excessive movement, difficulty staying seated, impulsive decisions, and trouble waiting. In adults, this often presents as internal restlessness and a tendency toward impulsive choices rather than obvious physical hyperactivity.
ADHD Combined Type
Both inattentive and hyperactive-impulsive symptoms present above the clinical threshold. The most commonly diagnosed type overall.
Adult ADHD
ADHD that was not identified in childhood or that has become more disruptive as life demands have increased. Adults often develop coping strategies that mask the condition until something breaks those strategies down.
ADHD with Co-Occurring Conditions
Anxiety, depression, sleep disorders, and substance use all occur alongside ADHD at elevated rates. The comprehensive evaluation assesses all of these. Getting the full picture is what allows treatment to actually work.
The ADHD Evaluation and Treatment Process at Thrive Psychological Wellness
Caroline Thiongo PMHNP-BC does not skip straight to a prescription. ADHD shares symptoms with anxiety, depression, trauma, and sleep disorders, and starting medication without a thorough evaluation first risks treating the wrong thing. Getting the diagnosis right at the start means the treatment that follows is far more likely to actually work.
Step 1: Full Evaluation
Review of your history including childhood symptoms, school and work patterns, current functioning, sleep, mood, and any prior treatment. Co-occurring conditions are screened at the same time.
Step 2: Diagnosis and Discussion
We confirm whether ADHD fits, identify the type, and explain what the diagnosis means in practical terms. You are part of every conversation about what treatment approach makes sense.
Step 3: Medication Management
For patients who want to try medication, we discuss stimulant and non-stimulant options based on your history, health, and preferences. We start conservatively and follow up regularly. Where co-occurring anxiety, mood, or sleep conditions are present, those are factored into medication decisions.
Step 4: Ongoing Monitoring
ADHD medication often needs adjustment in the first few months. We schedule follow-ups to check how things are going, manage any side effects, and confirm the dose is working.
Stimulant and Non-Stimulant Options for ADHD
Methylphenidate and amphetamine salts. The most effective medications for ADHD. Available in short and long-acting forms. Work quickly when the right dose is found. Note: in individuals with co-occurring anxiety, stimulants are introduced carefully and anxiety may need to be treated alongside ADHD.
Atomoxetine, guanfacine, and clonidine. Useful when stimulants are not tolerated, cause excessive anxiety, or when there is a history of substance use. They take longer to reach full effect but are not controlled substances.
Sometimes used when ADHD co-occurs with depression. Not a first choice for ADHD alone but can be helpful in the right clinical situation.
What to Expect When You Come In
Here is how the process runs from start to finish.
Book and Confirm Insurance
Contact us through the form, by phone, or as a telehealth request. We verify your insurance before your appointment.
Complete Intake Forms
Sent before your appointment. Cover your history, current symptoms, school and work patterns, medications, and prior treatment.
Your Evaluation
Your first appointment is a full evaluation. Robert Maina goes through your history carefully and asks how symptoms show up across different areas of your life. There is no rushing.
Leave With a Plan
A diagnosis, a treatment plan you have helped shape, and if medication is appropriate a prescription sent to your pharmacy the same day.
Why ADHD Rarely Shows Up on Its Own
Anxiety is the most common co-occurring condition with ADHD, and the combination can be difficult to untangle because the two share surface-level symptoms that look similar from the outside. Depression is also common in adults with ADHD, often developing as a secondary result of years of struggling without understanding why. Sleep problems are frequent too, partly because ADHD affects the ability to wind down at the end of the day in the way most people take for granted.
Caroline Thiongo PMHNP-BC builds treatment plans that account for everything present, not just the most obvious symptom. Prescribing a stimulant without first addressing underlying anxiety can make things worse rather than better, and sequencing matters as much as the choice of medication itself. The evaluation is where the right order and the right approach for your specific situation get worked out before anything is prescribed.
- ADHD and anxiety: both are common together and both need to be part of the treatment plan
- ADHD and depression: often secondary to years of undiagnosed ADHD and responds well when ADHD is treated
- ADHD and sleep disorders: difficulty winding down is common with ADHD and can affect how well medication works
- ADHD and learning disabilities: co-occurring and often require documentation for workplace or school accommodations
ADHD Evaluation and Treatment by Telehealth Across Oregon
We offer telehealth ADHD evaluations and medication management to patients anywhere in Oregon. Telehealth appointments work the same way as in-person for most ADHD care. Stimulant prescribing via telehealth is permitted under current regulations and we will explain the requirements when you book.
📍 Locations Served
In-Person Offices
Multnomah Village, OR (Primary)
Portland, OR (Secondary)
Regional Areas
SW Portland, Lake Oswego, Beaverton
Gresham, Milwaukie, Clackamas
Conditions That Often Come With ADHD
If any of these are part of your situation, we treat those too.
What Patients in Multnomah and Portland Say About ADHD Treatment
I spent my whole career assuming I just was not trying hard enough. Getting the ADHD diagnosis at 38 was genuinely life-changing. The medication made me feel like I was finally working with my brain instead of against it.
Portland ORAdult ADHD
Being able to do the evaluation and follow-ups by telehealth around my work schedule made this actually possible for me. The PMHNP took my history seriously and did not just hand me a prescription after ten minutes.
Salem ORTelehealth / ADHD
I had always been told my problems were anxiety. Turns out I had both. Treating them together made a difference I had not expected. I wish I had come in years earlier.
Multnomah Village ORADHD + Anxiety
Questions About ADHD Treatment at Thrive Psychological Wellness
Can a PMHNP diagnose and treat ADHD?
Yes. Caroline Thiongo PMHNP-BC is a board-certified Psychiatric Mental Health Nurse Practitioner and DEA-registered prescriber who evaluates and diagnoses ADHD and prescribes both stimulant and non-stimulant medications. Appointments are available at our Portland and Multnomah Village offices and through telehealth for patients anywhere in Oregon.
How is ADHD in adults different from ADHD in children?
In adults, hyperactivity often fades and inattentive symptoms become more prominent. The result is someone who appears organised enough on the surface but is constantly behind, missing details, and exhausted by how much effort it takes to function at a level that feels ordinary to others. Many adults with undiagnosed ADHD also carry significant anxiety from years of compensating without understanding why, which is one of the reasons a proper evaluation matters so much.
What is the difference between stimulant and non-stimulant ADHD medication?
Stimulants such as methylphenidate and amphetamine salts are generally the most effective option and work quickly. Non-stimulants such as atomoxetine and guanfacine take longer to reach full effect but are useful when stimulants cause excessive anxiety, are not well tolerated, or when there is a history of substance use. In some individuals stimulant medications can temporarily increase nervousness or anxiety, which is why careful assessment and monitoring are built into the treatment process from the start rather than added later if problems arise.
Can anxiety and ADHD be treated at the same time?
Yes, and treating both together often produces better outcomes than treating either in isolation. Research suggests that approximately 40 to 50 percent of adults with ADHD also have an anxiety disorder. When both are present, Caroline Thiongo PMHNP-BC builds a treatment plan that accounts for both conditions, including careful consideration of how medication choices interact with anxiety symptoms.
Can ADHD be treated through telehealth in Oregon?
Yes. Thrive Psychological Wellness offers secure, HIPAA-compliant telehealth appointments for ADHD evaluation and ongoing medication management, including stimulant medications under current telehealth regulations. Caroline will explain the current requirements for stimulant prescribing when you book your appointment.
How quickly can I get an ADHD appointment?
Thrive Psychological Wellness aims to schedule evaluations as quickly as possible. Same-day appointments may be available. Call the office or book online to check current availability.
Accepting New Patients for ADHD Treatment in Portland and Across Oregon
If attention, organisation, or impulsivity have been causing consistent problems in your work, relationships, or daily life, a proper evaluation is a reasonable next step. We take the time to get the diagnosis right and you are part of every decision about your care.
Crisis note below buttons: If you are in crisis, call or text 988. Cascadia Crisis Line: (503) 988-4888.