The evaluation process
Adult ADHD is among the most commonly missed psychiatric diagnoses in primary care. Symptoms in adults rarely look like the classroom-hyperactivity picture most people associate with the condition — they show up as chronic disorganization, procrastination that feels moral rather than neurological, relationship strain, stalled careers, and a persistent sense of underperforming relative to capability.
Our evaluation at the Salem office is built to pick up on these adult presentations. A full unhurried intakes covers developmental history (ADHD is a neurodevelopmental condition — we need the timeline), a structured symptom review anchored in DSM-5 criteria, and validated rating scales including the Adult ADHD Self-Report Scale (ASRS-v1.1). We also screen for the conditions that most often ride alongside or mimic ADHD: anxiety, depression, sleep disorders, substance use, and trauma.
A treatment plan is discussed before you leave. When the clinical picture is clear and medication is the right next step, a prescription may be sent that day; in many cases, though, we prefer to start after baseline labs, an EKG, or a brief focused follow-up — especially for new controlled-substance prescriptions. We aim for careful and unhurried, not rushed.
Medication options
Stimulants remain first-line for most adults with uncomplicated ADHD and are supported by the strongest evidence base. We prescribe both drug classes:
- Methylphenidate-based: Concerta, Ritalin LA, Focalin XR, Jornay PM
- Amphetamine-based: Adderall XR, Mydayis, Vyvanse, Xelstrym, Dyanavel
- Non-stimulant options: Atomoxetine (Strattera), guanfacine ER (Intuniv), viloxazine (Qelbree), bupropion — appropriate for patients with cardiac concerns, substance-use history, anxiety-predominant presentations, or stimulant intolerance
Starting doses are conservative. Once stable, follow-ups move to every 3 months — the Oregon-appropriate interval for ongoing controlled-substance monitoring.
Serving Salem and the Willamette Valley
Our Salem office at 401 Ratcliff Drive SE is three minutes off I-5 Exit 252, serving the South Salem, West Salem, and downtown corridors. Patients regularly drive in from Keizer, Independence, Monmouth, Dallas, Silverton, Turner, Stayton, and Woodburn — with some Corvallis and Albany patients splitting care between Salem and Oregon telehealth.
Salem has a deep base of adult patients whose ADHD went undiagnosed until work or caregiving demands finally outpaced their compensation strategies: state employees juggling legislative-session workloads, Salem Health and Salem Clinic staff, teachers in the Salem-Keizer district, Willamette University graduate students, and Oregon State Hospital personnel. We see a lot of first-time-in-adulthood evaluations — including patients who tried medication briefly in college and didn't stay on it.
Coordination with primary care is routine. We send a visit summary to your PCP at Salem Clinic, Kaiser, Salem Health, or Santiam Hospital within one business day when you request it.
Insurance & self-pay
We are in-network with ten major plans: Moda, PacificSource, Regence BlueCross BlueShield, Cigna / Evernorth, Aetna, Providence, Multiplan / Claritev, First Health, First Choice, and Optum. Most Salem patients pay a specialist copay ($20–$60 typical) per visit.
We do not accept Medicaid or Oregon Health Plan (OHP). Self-pay rates: $350 initial evaluation, $180 standard follow-up. Superbills available for out-of-network reimbursement. Good Faith Estimates provided before your first visit.
Frequently asked questions
How do I get tested for ADHD as an adult in Salem?
The evaluation is a comprehensive clinical interview using DSM-5 criteria and the Adult ADHD Self-Report Scale (ASRS). Psychological testing (neuropsych batteries) is occasionally ordered when the picture is unclear, but is not required for most straightforward adult ADHD cases.
Will I get a prescription at the first visit?
Not always. A first-visit prescription may be appropriate when the diagnosis is clear, there are no contraindications (uncontrolled hypertension, certain cardiac conditions, active substance use), and records are straightforward. In many cases we prefer to start medication after baseline labs, an EKG, a records review, or a brief focused follow-up — especially for new controlled-substance prescriptions. The goal is a careful, sustainable plan rather than a fast one.
Do I need to see someone in-person to get a stimulant in Oregon?
No. Current federal DEA telemedicine rules and Oregon Medical Board guidance permit stimulant prescribing by telehealth with an appropriate clinical evaluation. Many Salem patients do intake in-person and all follow-ups by video.
What if I've been told I have "ADHD plus anxiety" or "ADHD plus depression"?
Common — roughly half of adults with ADHD meet criteria for a comorbid condition. We treat both. Sequencing depends on which is more impairing: sometimes we stabilize depression first, sometimes ADHD treatment itself resolves secondary anxiety once daily function improves.