First, the boundary. I am not a prescriber. I do not give medical advice, recommend medications, or comment on what anyone should be taking or stopping. That is not modesty, it is scope, and it does not move.
What I can do is describe how the two kinds of help differ, because a lot of people are quietly choosing between them without ever being told they are not the same thing.
They work on different problems
Medication, when it works, tends to change the moment-to-moment experience: attention, restlessness, the ability to start. That is a real change and for many people a large one. What it does not do is undo twenty or forty years of being called lazy, careless or too much.
That second thing is most of what people bring into my room. The shame underneath the symptom. The sense that everyone else got a manual. The exhaustion of a person who has been trying much harder than the people around them, at things those people never had to think about.
You can be well-medicated and still carry all of that. You can also build good systems and still find that mornings are physically difficult. The two kinds of help are aimed at different targets, which is why people so often end up wanting both.
What the therapy half looks like
Practical, some of it: initiation and follow-through, time, transitions, sleep, the paperwork that never gets sent, the systems that survive a bad week rather than only a good one.
And the rest of it: rejection sensitivity, self-worth, the way an ADHD history reshapes what you believe about your own character. Parent coaching, where a child's difficulties are being read as attitude. Accommodation support for school or work, where the question is what is reasonable to ask for and how to ask.
Who to talk to about the other half
A prescriber. Your primary care doctor, a psychiatrist, or a psychiatric nurse practitioner, depending on what is available to you. They are the ones who can weigh your history, anything else you take, and what has or has not worked before.
If you are already working with a prescriber, therapy alongside it is common and the two do not compete. I will not be commenting on your prescription either way, which some people find a relief.
I also do not test for ADHD and do not diagnose it. If that is what you are after, ask on the free call and I will point you toward it.
