ADHD Care, Untangled.
Evaluation and integrative psychiatric care for ADHD at every age. Telehealth across NJ, NY, and MD.
ADHD is rarely just about focus.
Attention is shaped by sleep, hormones, thyroid, iron, stress, anxiety, and all the other things happening in your life. Not by dopamine alone. A ten minute visit and a quick script misses most of that.
ADHD often gets one of two responses. A rushed visit, a stimulant, a refill, and little else. Or a dismissal: you are just distracted, just anxious, just not trying hard enough. Neither one looks at the actual person in the room.
I do.
Untangling ADHD means looking at the whole thread. What is really going on with attention? What else is in the mix? What does the brain and body need? Those questions lead to treatment that works and lasts.
I bring more than three decades of clinical experience and a dual background in psychiatric medication and whole-body physiology to ADHD care. The goal is not just a prescription. It is to understand the whole picture, treat what is actually there, and build a plan you can live with.
ADHD does not stay in childhood
For years, ADHD was treated as a childhood condition that children outgrew. That assumption was mistaken, and many children grew into adults with unrecognized ADHD as a result. Many people spent years believing they were lazy, scattered, or not living up to their potential. The real explanation was undiagnosed ADHD. Girls were missed most often, dismissed as daydreamers rather than evaluated.
I evaluate and treat ADHD across the whole lifespan:
Children and teens, in close work with parents and schools
College students who hit demands that finally outpaced their old workarounds
Adults seeking a first evaluation, sometimes after a child's diagnosis made them recognize themselves
Adults treated for years who want a more careful, less piecemeal approach
ADHD and Hormones: the missing connection
As both a certified nurse midwife and a psychiatric nurse practitioner, I pay close attention to something most prescribers overlook: how hormones shape attention.
Puberty is an upheaval for every adolescent. Sleep slides later, school demands climb, emotions run hotter, and a medication dose that fit at age ten may not fit at age fourteen. For girls there is an added layer. ADHD is often missed in childhood, then surfaces or worsens once cycles begin and estrogen starts rising and falling each month. A girl who did well in elementary school can suddenly struggle in middle school, and too often it is waved off as hormones being hormones.
ADHD symptoms are not constant. They shift with the menstrual cycle, through pregnancy and postpartum, and especially through perimenopause, when falling estrogen can noticeably worsen focus, memory, and emotional regulation. Many women notice their ADHD intensify during these transitions and are told it is stress or menopause. It is none of that. It is real, it is physiological, and it is treatable.
I watch for all of it. My background means I am paying attention to exactly where development, hormones, and attention meet, at every age.
I look at the whole picture, not just the prescription pad
I am certified in integrative psychiatry, and that matters a great deal with ADHD. Both before and during prescribing medication, I look at sleep, nutrition, thyroid, iron, and stress. Often the answer is part medication and part “everything else”.
When medication is the right call, I do not assume it has to be a stimulant. I prescribe stimulants when they fit. I also have real depth with non-stimulant options, which matter for people with anxiety, a history of substance use, certain heart concerns, or a preference to start gentler. And I prescribe the way I always do: the lowest effective dose, the simplest plan that actually works.
What I treat and untangle
First time ADHD evaluations for children, teens, and adults
ADHD that overlaps with anxiety, depression, or a history of substance use
ADHD in women across hormonal transitions, including perimenopause
Medication that has grown complicated, with stimulants, sleep aids, and add-ons stacked on top of one another
Whether a non-stimulant is a better fit for you or your child