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RMC views Adult ADHD as a disorder of executive functioning and self regulation.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterised by persistent, developmentally inappropriate patterns of inattention and/or hyperactivity and/or impulsivity that cause functional impairment across settings. These symptoms are commonly associated with difficulties in executive functioning and self-regulation.

RMC understands this presentation as adults experiencing difficulties with  task irrelevant distractibility, managing concentration, sustained attention, and holding and using information in one’s  mind, for goal directed activities, in order to organise behaviour across time. 

We understand Executive Functioning challenges to include difficulty organising, planning and prioritising tasks and activities, and awareness of time. This extends to situation specific deficits with self motivation of initiating, sustaining and completing tasks. Our clinicians understand there may be very real historical and current challenges with self-restraint, or impulsivity, with verbal, cognitive, behavioural and emotional responses. Our clinicians have a deep appreciation of how rejection and injustice sensitivity and difficulty with self regulation of emotions are a core feature of ADHD. 

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RMC has a deep understanding of how ADHD may present in women and how their experiences may differ from those of men. Our clinicians recognise the impact that the late luteal phase of the menstrual cycle, perimenopause and menopause can have on ADHD symptoms. Our clinicians have a deep understanding that later life ADHD assessments may mean there is limited history, or none at all, from adolescence, and parents or caregivers may not be able to comment for multiple reasons. 

At RMC we deeply appreciate how so many women present with perfectionism, anxiety, burnout and may mask or camouflage their undiagnosed neurodiversity. 

Our knowing embraces how sensitivity to perceived or real rejection & injustice, emotional regulation difficulties, are significant aspects of neurodiversity.

Our prescribing clinicians have experience initiating and optimising ADHD stimulant medication, including reviewing treatment needs across the menstrual cycle and during perimenopause. RMC appreciates that the onset of perimenopause can vary significantly across the population.

RMC screens for possible autism but does not provide autism diagnoses. Our team also recognises the ways co-occurring autism and ADHD (AuDHD) may present with burnout, masking and camouflaging. 

A key specialism of Rainbow Mandala Clinic is the comprehensive assessment of physical health complexities relevant to adult ADHD medication. Our approach is underpinned by the principle that safe and effective ADHD prescribing in adults requires a thorough understanding of each person's physical, psychological, nutritional and social context, not just their neurodevelopmental symptoms.

The RMC approach to an assessment begins with a detailed history and examination that extends well beyond core ADHD symptomatology. We routinely evaluate complex medical and psychiatric comorbidities, lifestyle factors, nutritional status, sleep, and reproductive or hormonal considerations, all of which can significantly influence both mental and physical health outcomes.

Reproductive and hormonal considerations include menstrual cycle stages, perimenopause, menopause, pregnancy planning and breastfeeding.These findings inform individualised medication selection, careful dose titration and ongoing monitoring, supported by targeted investigations and coordination with GPs and other specialists where indicated. There are clinical situations where it is appropriate, and indeed essential, to defer or postpone the commencement of ADHD medication, while waiting upon results of further medical investigations.

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RMC clinicians understand that ADHD may present differently in late adolescence, early adulthood and midlife males. They also recognise that years of living with unrecognised or untreated ADHD may contribute to depression, low self-esteem and coping behaviours that are no longer helpful in men.

Difficulties regulating emotions and managing frustration can affect intimate relationships, family life, study and employment. These difficulties may include irritability, rapid frustration or anger, emotional fluctuations, and heightened sensitivity to criticism or perceived failure. Some people may also find it difficult to tolerate delays, boredom or waiting, cope with stress, or sustain motivation. Periods of low mood may occur alongside these challenges.

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AuDHD refers to the co-occurrence of Autism and ADHD. AuDHD is not currently established as a separate diagnostic disorder or a single, biologically distinct neurotype. Current evidence indicates that the two conditions have partially overlapping genetic and neurodevelopmental foundations while retaining distinct features. 

When they co-occur, executive, sensory, attentional, emotional and social-regulatory difficulties may combine or interact, sometimes producing greater functional impairment or apparently competing needs. 

RMC does screen for Autism traits, however we do not offer full diagnostic Autism Spectrum Disorder assessments. RMC has developed relationships with Psychologists who are highly skilled in the field of Neurodiversity.

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Extensive psychiatric knowledge, over 20 years each of both Doctors, of the diagnosis and long term medication management of the different presentations. The prescribing team are highly experienced in how this presentation can co-occur with ADHD and complexity of combination medication prescribing. 

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RMC is a specialist clinic for a Schedule 8 medication that is delivered either through intranasal or injectable methods specifically for use in Treatment Resistant Depression (TRD).This medication is delivered in our clinic under strictly controlled conditions, and is approved by the TGA in Australia for use in TRD.
Referrals are only accepted through a GP. 

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Our clinical team have an extensive experience in diagnosing PTSD and Complex PTSD in different adult population groups including Defence personnel. Psychiatric care for PTSD and complex PTSD involves

an individualised treatment plan, in combination with trauma-focused psychological therapy, and management of associated difficulties. 

RMC has collaborative relationships with Clinical Psychologists offering

 trauma focused interventions in ACT, NSW, QND and Victoria.

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RMC offers specialist Psychiatric medication reviews for chronic OCD and Anxiety Disorders where there is insufficient response. Psychiatric consultations explore medical history, interactions and tolerability, second line treatments and augmentation. GP’s are skilled in prescribing for early onset disorders. A stepped care approach is essential incorporating CBT evidence based interventions, which are routinely offered by Psychologists.