A proper ADHD diagnosis changes lives. For adults who have spent decades struggling with focus, disorganization, time management, and emotional regulation — wondering what’s wrong with them — getting an accurate diagnosis and an effective treatment plan can be genuinely transformative. Dr. Mark G. Agresti provides comprehensive ADHD evaluations in Palm Beach and via telehealth throughout Florida, bringing more than 30 years of psychiatric experience to a condition that is frequently missed, misdiagnosed, or inadequately treated in adults.
Do I Have ADHD? — Common Signs in Adults
Adult ADHD often looks quite different from the hyperactive child climbing the walls that most people picture. In adults, ADHD typically presents as a persistent pattern of:
- Inattention and distractibility: Difficulty sustaining focus on tasks that aren’t inherently stimulating, losing your train of thought mid-task, getting pulled off course by minor interruptions
- Disorganization: Chronic difficulty keeping your workspace, finances, email, or schedule organized — despite wanting to be organized and genuinely trying
- Time blindness: Consistently underestimating how long tasks take, losing track of time, chronic lateness, difficulty transitioning between activities
- Difficulty starting tasks: Procrastination and task initiation problems — especially for tasks that feel boring or overwhelming, even when they’re important
- Working memory failures: Forgetting what you were just about to do, losing track of conversations, re-reading the same paragraph multiple times without retaining it
- Hyperfocus: The counterintuitive flip side — an ability to intensely focus on something interesting or engaging to the point of losing track of hours
- Emotional dysregulation: Low frustration tolerance, quick temper, sensitivity to criticism, difficulty regulating emotional reactions in the moment
- Inner restlessness: Adults often learn to suppress overt hyperactivity but feel internally restless, always needing to be doing something
- Impulsivity: Interrupting others, making decisions without fully thinking them through, difficulty waiting
If several of these resonate — and have been present since childhood, even if you didn’t recognize them as ADHD at the time — a formal evaluation is worth pursuing.
ADHD in Women — Often Missed
ADHD is significantly underdiagnosed in girls and women. Many adult women are reaching their 30s, 40s, or even 50s before receiving a first diagnosis. Several factors contribute:
- Inattentive presentation is more common in females: Girls and women are more likely to have the inattentive subtype (formerly called ADD) rather than the hyperactive or combined type — less disruptive, and therefore less likely to be flagged for evaluation
- Compensatory strategies mask symptoms: Women often develop elaborate coping mechanisms — extensive lists, over-preparation, relying heavily on structure — that keep them functional while exhausting them
- Anxiety and depression get treated instead: The secondary consequences of unmanaged ADHD — anxiety, low self-esteem, chronic underperformance — are frequently treated as primary conditions while the underlying ADHD is never identified
- Hormonal influences: Estrogen modulates dopamine function, meaning ADHD symptoms often worsen premenstrually, during perimenopause, and postpartum — changes that may be incorrectly attributed to hormones alone rather than unmasking or worsening ADHD
If you’ve been told “you don’t seem like you have ADHD,” Dr. Agresti’s evaluation specifically screens for the ways ADHD presents in adult women.
The Evaluation Process
Not all ADHD evaluations are equivalent. A brief questionnaire scored by a staff member and followed by a prescription is not a psychiatric evaluation. Dr. Agresti’s comprehensive evaluation for adult ADHD includes:
- Detailed clinical interview: An unhurried conversation about your symptoms, when they first appeared, how they affect your work, relationships, and daily functioning, and what you’ve already tried
- Developmental history: ADHD is a neurodevelopmental condition — symptoms must have been present in some form since childhood. Dr. Agresti explores this history carefully, as adults often don’t recognize childhood symptoms without systematic prompting
- Validated rating scales: Standardized ADHD rating instruments provide objective data alongside the clinical interview
- Medical history review: Full medication history, sleep patterns, substance use, thyroid history, and cardiovascular history — all of which inform both the diagnosis and the treatment plan
- Differential diagnosis: This is critical and often skipped. Multiple conditions can mimic ADHD or co-occur with it: anxiety disorders, depression, bipolar disorder, sleep disorders (particularly sleep apnea), thyroid dysfunction, and trauma-related conditions. An evaluation that doesn’t actively screen for these alternatives is incomplete.
- Collateral information when available: Reports from partners, family members, or prior school records can add valuable historical perspective
This level of evaluation takes time — and Dr. Agresti allocates that time. The goal is not to check boxes; it’s to understand you well enough to make a genuinely accurate diagnosis and a thoughtful treatment recommendation.
What Makes Dr. Agresti’s Evaluation Different
Thirty years of clinical experience matters when evaluating adult ADHD. Dr. Agresti has assessed and treated hundreds of adults with ADHD and has seen the full spectrum of presentations — including cases that were missed or misdiagnosed elsewhere.
- He takes your concerns seriously: Adults who suspect they have ADHD have often already done significant research. Dr. Agresti engages with your self-assessment rather than dismissing it.
- He rules out the mimics first: Anxiety causes inattention. Depression impairs concentration. Sleep apnea creates cognitive fog. Thyroid problems affect focus and energy. Before diagnosing ADHD, Dr. Agresti systematically considers and rules out these alternatives.
- Calibrated accuracy: Some practices diagnose ADHD too quickly and broadly; others are reflexively skeptical of adult ADHD and under-diagnose. Dr. Agresti aims for accuracy over either direction.
- He thinks about the whole person: Co-occurring conditions are the rule in adult ADHD — anxiety, depression, substance use, sleep disorders, and relationship difficulties all co-occur frequently and must inform both diagnosis and treatment planning.
After Diagnosis — Treatment Options
If ADHD is confirmed, Dr. Agresti will discuss the full range of treatment options based on your specific symptom profile, preferences, medical history, and lifestyle. Stimulant medications remain the most effective first-line pharmacological treatment for most adults with ADHD:
- Adderall (amphetamine/dextroamphetamine) — immediate and extended release options
- Vyvanse (lisdexamfetamine) — smooth, long-acting amphetamine prodrug
- Ritalin and Concerta (methylphenidate) — a different stimulant class, preferred by many patients
For patients for whom stimulants aren’t appropriate or preferred: Non-stimulant ADHD options including Strattera, Wellbutrin, Qelbree, and Intuniv.
Beyond medication, Dr. Agresti may discuss behavioral strategies, lifestyle modifications, and referrals for ADHD-focused cognitive-behavioral therapy or coaching when appropriate.
Telehealth Evaluations Available
A complete ADHD evaluation can be conducted via telehealth video — no in-person visit required. Dr. Agresti provides telehealth psychiatric services to patients throughout Florida, including Miami, Fort Lauderdale, Boca Raton, West Palm Beach, Orlando, Tampa, Jacksonville, and beyond.
Under current DEA telemedicine flexibilities (extended through 2026), stimulant medications including Adderall and Vyvanse can be prescribed via telehealth following a video evaluation, without a prior in-person visit. Comprehensive ADHD care is accessible to Florida residents regardless of location.
Schedule Your Evaluation
If you’ve been wondering whether you have ADHD — or if you’re living with a diagnosis but not receiving the level of care and responsiveness you need — contact Dr. Agresti’s office to schedule a comprehensive evaluation.
Dr. Mark G. Agresti, M.D.
Board-Certified Psychiatrist | 30+ Years Experience
44 Cocoanut Row, Suite M-202, Palm Beach, FL 33480
Call or text to schedule: 561-760-4107
After-hours / emergency: 561-386-7743
Telehealth evaluations available for all Florida residents. Most new patients seen within one week.
Related: ADHD Treatment in Palm Beach | Adderall Treatment | Vyvanse Treatment | Non-Stimulant ADHD Options | Telehealth Psychiatry Florida