How do you find good ADHD care for professionals? Most psychiatrists will tell you they received about 45 minutes of training on ADHD. If they’re honest, they’ll also tell you most of that training was about kids.
What happens after that is self-directed — conferences, clinical experience, lived experience, the patients who show up and teach you what the textbooks couldn’t. Dr. Chanelle Ramsubick and I trained at the same institution, Mount Sinai in New York, and arrived at similar places through entirely different paths. She came through child and adolescent psychiatry, which gave her a neurodevelopmental foundation most adult psychiatrists simply don’t have. I came through decades of clinical work with professionals at the University of North Carolina, where the university kept sending their ADHD faculty and students because nobody else wanted to treat them.
We sat down together to compare notes — on assessment process, on what the workplace gets wrong, on the cognitive distortions that accumulate in people who spent decades not knowing how their brain worked, and on what it actually takes to help someone move from surviving to thriving.
Why ADHD training in psychiatry is still a problem.
Dr. Chanelle was candid about what she learned in residency: primarily that ADHD was something to be suspicious of. Patients asking for stimulants were drug-seeking. People with executive function difficulties were assumed to have other explanations. ADHD, to the extent it was discussed at all, was framed as a childhood diagnosis in hyperactive children — not something a high-functioning adult professional would have.
This is the training gap that shows up constantly in the clinical system and it directly impacts ADHD care for professionals. The professionals I work with have sat across from physicians who genuinely respect them and want to help — and were still sent home with the wrong answer, because the clinician didn’t have the framework to see what was in front of them.
Dr. Chanelle’s advantage was her child and adolescent training, which gave her a real understanding of neurodevelopmental conditions — how they present, how they evolve, how they interact with trauma and environment and life stage. She brought that lens to the adult patients who started flooding her Bay Area outpatient practice, and built her assessment approach from there.
The assessment process: what two thorough clinicians actually do.
Our approaches share a foundation and differ in the details — which is exactly how it should be in a field where the evidence base is still maturing and clinical judgment has to fill significant gaps.
Dr. Chanelle’s process starts with a comprehensive psychiatric assessment — understanding the full picture of how someone is functioning day-to-day before anything else. She reviews for co-occurring conditions: binge eating, substance use, anxiety, depression. She notes that untreated ADHD often drives persistent feelings of urgency and being behind that get misread as anxiety disorder rather than ADHD. On a second appointment, she uses the DIVA 2.0 to build a detailed ADHD narrative — working through childhood and adulthood presentations together to surface memories and patterns the patient may not have connected to ADHD on their own. On a third appointment, diagnoses are discussed and treatment options are mapped out honestly and realistically.
My process is designed around speed — because most people reaching out are looking for help urgently — and uses significant amounts of asynchronous intake so that by the time I’m sitting with someone, I already have a detailed history synthesized through clinical AI tools I’ve developed or helped develop. I add the Barkley Executive Function Rating Scale for adults, which captures real-world professional functioning in ways the DSM checklist doesn’t. And I add QB Check — a 20-minute computerized attention test that can be done at home, which is intentionally boring in a way that short screeners aren’t, and which I can use to track treatment response over time.
Both of us start with the medical picture before touching medication. And both of us have learned, from clinical experience, that not everything that looks like ADHD is ADHD.
Get the medical house in order first.
This is something I want people to hear clearly, because it doesn’t get said often enough: a good ADHD care for professionals requires a medical assessment.
Dr. Chanelle checks iron, vitamin D, vitamin B12. She screens for anemia. She reviews hydration, sleep, bowel function, social stress, work stress. She’s started ordering sleep studies regularly — obstructive sleep apnea is common in people with ADHD and causes cognitive symptoms that look indistinguishable from ADHD if you’re not looking for it. If any of these things are off and you go straight to stimulant medication, you’re building on an unstable foundation. She told me she’ll just keep having to go up and up on doses, getting less and less return, because the underlying issue hasn’t been addressed.
I’ve seen the same thing. Perimenopausal women with uncontrolled hormonal shifts presenting with symptoms that look exactly like ADHD — and the ADHD is sometimes real and sometimes not, but you can’t know until you look at the whole picture. Thyroid issues. Anemia. The cognitive fog of B12 deficiency. These are real, treatable, and regularly missed when a clinician goes straight to the checklist.
The cognitive distortions that accumulate over decades.
This was the part of our conversation I found most clinically important to name directly.
Dr. Chanelle described what she sees in late-diagnosed adults: deep, often unconscious beliefs that there is something inherently wrong with them. That they’re bad people. That they shouldn’t even try. A sense of not knowing who they are, what they like, what makes them happy — because so much cognitive energy has gone into compensating, masking, and surviving that the self underneath it all has been largely inaccessible.
These aren’t personality traits. They’re the accumulated residue of a brain that operated in the wrong environment for decades without understanding why. And medication doesn’t touch them. Coaching doesn’t always touch them. The cognitive distortion work — the actual examination of the beliefs that were formed when someone didn’t know what was happening in their own brain — is its own piece of the treatment picture.
I work on the vision side of this too. A lot of people who come to me have been surviving for so long that they can’t imagine what thriving might look like. They’ve lost access to what they want, what would make them happy, what a life designed for their brain might actually feel like. Helping people build that vision is part of the healing — because you can’t get somewhere you can’t see.
What the workplace needs to change — and why it hasn’t.
Dr. Chanelle’s ideal neuroaffirming workplace includes community walks instead of happy hours, healthy food available without requiring the executive function it takes to plan a meal, ERGs and peer groups where neurodivergent employees can talk to each other, and facilitators who can translate what they learn into environmental changes.
None of this is radical. Most of it would benefit everyone. I’ve never met a neurotypical person who didn’t want healthy food available at work or the option to take a walk during the day.
The reason workplaces haven’t made these changes isn’t that they’re impractical — it’s that the mental model of work itself was built on the Ford factory floor. Nine to five, widgets and workers, productivity measured in hours of physical presence. That model is so deeply embedded in how we think about professional life that departing from it feels risky even when the evidence points clearly in the other direction.
Dr. Chanelle does workshops in companies with large neurodivergent employee populations — and she finds that simply giving people a space to describe their lived experience creates a meaningful shift. People feel heard. And when people feel heard, the conversation about what would actually help them can finally start.
What to look for in a clinician when seeking ADHD care for professionals.
Dr. Chanelle’s closing message, and I’ll second it: find a clinician who will take the time to actually know you. ADHD presents differently in every person. A diagnosis is a starting point, not a complete answer. What matters is having someone who is genuinely curious about how your specific brain works and is willing to engage with the complexity of that picture.
Find someone who takes a strength-based approach. Because how a clinician understands ADHD shapes how treatment feels — and how you learn to understand yourself.
If you’re looking for an ADHD care for professionals, Constellation PLLC serves patients across 25 states. Reach out via the contact form at constellationpllc.com.
And if you’re in the Bay Area or California, Dr. Chanelle’s practice, ClearPath ADHD, is worth knowing about.
Grab your copy of ADHD in Professionals: Embrace Your Brain here.
📌 ClearPath ADHD — Dr. Chanelle Ramsubick: clearpathadhd.com
📌 Constellation PLLC — Dr. Jennie Byrne: constellationpllc.com
Dr. Jennie Byrne, MD, PhD is a neuroscientist, psychiatrist, and author whose work explores human behavior, mental health, and ADHD in high-achieving adults. In her latest book, “ADHD in Professionals: Embracing Your Brain,” she offers an honest, empowering look at how ADHD shows up in physicians, executives, entrepreneurs, and other professionals—and how they can better understand and work with their brains.
A board-certified psychiatrist with an MD/PhD in neuroscience, Dr. Byrne has built her career at the intersection of clinical care, leadership, and innovation. She is known for her clear, pragmatic voice on topics including ADHD, burnout, stigma, and the future of mental health care.
Dr. Byrne is also a sought-after speaker and thought leader committed to helping professionals navigate mental health with insight, candor, and compassion. Learn more at www.constellationpllc.com.