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Canberra Psychiatric Clinic offering:
Adult ADHD diagnosis & prescription of ADHD
stimulant medication
ADHD in Women specialisation
Diagnosis & prescribing of psychiatric medication
Updated: 1 October 2024
Now booking from : 15 April 2025
Our books will always stay open
Rainbow Mandala Clinic (RMC)
We are a Canberra based Psychiatric clinic with a specialisation in the diagnosis and medication
treatment of ADHD in adults (17+)
Rainbow Mandala Clinic is a safe space where lesbian, gay, bisexual, transgender and queer, other gender and bodily diverse clients are truly heard and understood.
Rainbow-Mandala
Rainbow Mandala Clinic (RMC)
We are a Canberra based Psychiatric clinic with a specialisation in the diagnosis and medication
treatment of ADHD in adults (17+)
Rainbow Mandala Clinic is a safe space where lesbian, gay, bisexual, transgender and queer, other gender and bodily diverse clients are truly heard and understood.
Rainbow-Mandala Clinic is :
Gender affirming
Queer affirming
Neurodiversity affirming
As a small clinic we pride ourselves on offering every client an in-depth and
neurodiverse affirming assessment and treatment.
Our expertise is in helping our clients find the right dose of ADHD medication.
RMC also has a specialisation in psychiatric treatment of;
PTSD & C-PTSD
Anxiety Disorders
Bipolar Mood Disorder
Treatment Resistant Depression
Premenstrual Dysphoric Disorder (PMDD)
Your GP has to refer you to RMC for an ADHD or Psychiatric Assessment
Our approach for ADHD is to undertake the diagnosis through a clinical assessment, prescribe the ADHD medication in the session with Dr Lewis,and support you in finding the correct dose.
RMC has a medication email help desk to help with any questions and Dr Lewis personally calls each client about 1 month into taking the medication to answer any questions or offer clinical guidance .
Dr Lewis has practised in Canberra since 2017 and spilts his time between RMC
and the crisis team at Canberra Hospital.
Dr Lewis has been treating clients with ADHD for 27 years and is a specialist in
Psychiatric disorders and prescribed psychiatric medication.
Our clinical director, Phil, has a special interest in ADHD in women and wrote his Masters Degree thesis on the under diagnosis and misdiagnosis of ADHD in women.
Phil has undertaken in excess of 300 ADHD clinical assessments with adults.
Consequently Phil brings a deep understanding and awareness of how ADHD presents in Women and the interplay with the menstrual cycle and stages of menopause.
Our psychiatric Nurse, Kelly, spent 20 years supporting patients
in ICU at Canberra Hospital and in the crisis team for Canberra .
Kelly is a highly experienced mental health Nurse and is very skilled in undertaking
psychiatric assessments for complex mental health disorders.
ADDitude website for everything ADHD
GP Referral
A GP referral is required for all ADHD assessments.
Please see your GP prior to contacting our clinic.
Your GP will send your referral directly to us.
Booking Approach
Text message confirmation within 48 hours of the clinic receiving your GP referral.
Phone call and text contact to book your appointment within 7 days of receiving your GP referral.
Physical Tests
A pathology visit is required where a brief ECG test on your heart and Urine Drug test will take place.
Blood Pressure reading
Obtained from any pharmacy
Appointment Location
Video appointments and at our clinic in Belconnen, 2617.
New ADHD Diagnosis and Treatment :
$1300
Medicare rebate $247.25
Fee $1052.75
This service comprises 3 aspects :
1. Clinical Assessment
2 to 3 hours with Mental Health Clinician
2. Psychiatric Consultation & Diagnosis
30 mins with Psychiatrist
3. Medication Support
phone call from Dr Lewis
email helpdesk
phone review
clinical support to help with finding the correct dose
Already Diagnosed ADHD
Transfers from a neurologist or paediatrian or psychiatrist
Diagnosed by a Clinical Psychologist and wishing to commence on ADHD medictation
$900
Medicare rebate $247.25
Fee $652.75
1. Clinical Assessment
Up to 1.5 hours with Mental Health Clinician
2. Psychiatric Consultation
30 mins with Psychiatrist
3. Medication Support
email helpdesk
phone review
clinical support to help with finding the correct dose
phone call from Dr Lewis if required
Duration
RMC practices a Neurodiverse Affirming assessment.
We allow 3 hours for this aspect, typically the average duration is about 2.5 hours.
This aspect is a relaxed and yet structured approach which allows clients the freedom to
engage in a conversation style assessment.
We encourage a partner or adult family members to be present in the clinical assessment, if the client wishes this to be so. Clients can also find it helpful when completing the self report electronic questionnaires to share the questions, for a perspective from another trusted adult.
Clients are encouraging to take a comfort break at any stage.
Our team are very aware that individuals with neurodiverse presentations may benefit from
movement and a comfort break from the assessment for a brief period.
For video consultations we encourage our Clients to be in a physical space where they feel safe and at peace.
This may be, for example, a certain chair, sofa, blanket and tea that allows an individual to be relaxed and talk freely.
The ADHD clinical assessment explores :
1. Executive Functioning
This investigation explores symptoms across Self Organisation, Self Restraint,
Self Motivation, Self Regulation of Emotions, & Self Management to Time.
Executive Functioning challenges encompasses:
Difficulty with focused and sustained attention
Hype-focusing , Distractability, Procrastination,
Verbal & cognitive impulsivity, Behavioural Impulsivity,
Difficulties with emotional regulation & Rejection sensitivity,
Planning & prioritisation, Time Blindness
Working Memory, Inner Restlessness, Insomnia & Sleep hygiene
The clinical assessment uses :
Barkley Deficits in Executive Functioning Scale (BDEFS)
Difficulties in Emotional Regulation Scale (DERS)
Rejection Sensitivity Questionnaire (RSQ)
2. Clinical Interview
This activity is conducted using the :
DIVA-5, The Diagnostic Interview for ADHD in adults
The Adult ADHD self-report Scale (ASRS)
Insomnia Severity Scale
3. Functional Impairment
Functional impairment is central to ADHD and consequences and difficulty functioning in certain areas of daily life are for the most part what triggers the request for an ADHD assessment.
This activity is explored using :
The WEISS Functional Impairment Rating Scale .
Impairment typically occurs across Family, Work, Education, Life Skills, Self Esteem ,Relationships
4. Mental Health Disorders
The symptoms of ADHD are common in other mental health disorders.
An evaluation will consider whether the symptoms belong to ADHD, another mental health condition,
another physical health condition, or if they represent more than one disorder.
ADHD can be present with other mental health disorders.
The clinical assessment uses the:
SCID-5, The Structured Clinical Interview for DSM-5.
Screening for Trauma, Autism, Bipolar Mood Disorder,
Borderline Personality Disorder, Anxiety & Depression.
A referral to a Clinical Psychologist may be required if the
Clinical team identify a possible Intellectual Disability.
Our diagnostic approach does not include the use of neuropsychological tests.
Further information
Psychiatrists are specialists in diagnosing, and treating the range of adult mental health and psychiatric disorders. See ADHD diagnostic frameworks.
The Psychiatrist confirms the diagnosis of ADHD.
Psychiatrists are trained in understanding how medication works on the brain and body and any interactions or potential complications between different medications.
Dr Lewis will collaboratively discuss ADHD medication:
Explanation of ADHD medication
Finding the correct dose
With stimulant medication is fundamental to gaining benefits of longer attention, less distractibility, greater focused attention, less difficulty with starting and finishing activities that are boring, long, tedious, repetitive, difficult, needing a lot of thought or preparation or do not offer an immediate reward.
The optimal dose
For ADHD medication is not determined by height or weight, but is determined by how efficiently the medication is metabolised in the GI tract, how efficiently the medication is metabolised and how efficiently the medication passes across the blood brain barrier.
The correct dose is specific to each person and one person may require a much higher dose to obtain the same benefits as another individual. Some people may experience mild physical side- effects, and so an approach of gradually testing out a gradually increased dose, incrementally, is required.
Dr Lewis has created a comprehensive Improvements & Side Effects Diary to help monitor your progress and decide on the most suitable dose of ADHD medication.
The easy to read diary includes explanations and answers to any common occurring side effects which sometimes present while a person in adapting to the medication at different doses.
Our approach follows an established approach of diluting medication in water, and by using a plastic syringe, gradually increasing the amount of the solution every three days.
Pathology Referral - ECG and Urine Drug Test
Emailed to you
Please print this form out & take to either:
Laverty Pathology
Capital Capital
Both have multiple clinics
Results sent directly to our clinic
ECG is a brief test that which monitors your heart.
This is required as ADHD can cause an increase in heart rate.
Further details found here
Urine drug test is to ensure that any prescribed ADHD medication does not
interact with any possible substances an individual is using.
Blood Pressure Reading
Any pharmacy offers a reading. It takes a few minutes and does not require an appointment.
Please take a picture on your smart device and email this directly to the clinic
Adults with attention-deficit/hyperactivity disorder (ADHD) have difficulty in self-management,
including organisation, planning, initiating and completing tasks on a timely basis, tracking
and shifting tasks, self-monitoring, and self-inhibition.
These are termed “executive functions” (EFs) which, can be viewed
as “those self-directed actions needed to choose goals and to create, enact,
and sustain actions toward those goals (Barkley, 2012).
This difficulty in self-regulation typically results in reduced productivity, inefficiency, missed deadlines,
poor planning, “careless” errors, and losing and forgetting things as a result of disorganistation.
In some (particularly those with the combined form of ADHD), reduced inhibitory control
may also lead to emotional dysregulation and inappropriate verbal and/or physical behavior in interpersonal interelationships. Over the lifetime of the individual, these difficulties contribute to failure to achieve goals—personally, academically, and occupationally. These failures in turn likely contribute to the high rates of anxiety and depression in adults with ADHD
The diagnostic clinical assessment is conducted using a semi-structured clinical interview, which explores the presentation as an Executive Functioning Deficits Disorder.
ADHD is a neurodevelopmental disorder that manifests in something called executive dysfunction.
Executive dysfunction causes your brain to have difficulty selecting and monitoring your
behavior to reach your goals.
It affects task management, scheduling, awareness of time, goal setting, and concentration.
A better way to think about and detect these symptoms are as problems with executive functioning (EF).
Executive Functioning encompasses working memory, self-inhibition, resistance to distraction,
attentional shifting, organising, planning, self-monitoring and time blindness.
The term “Attention Deficit“ is unhelpful and leads to confusion and misunderstanding of
exactly what this presentation is.
Hyperactivity is one of the many aspects of ADHD, however adults with ADHD are not hyperactive in the same way an 8 year boy is. This misunderstanding is what has lead to so many adults remaining undiagnosed for so long.
The term “hyperactivity ” current evidence shows, has no diagnostic validity in adults, and should be replaced with Impulsivity. Impulsivity has the potential to lead to significant negative consequences for adults in multiple areas of their life.
The most significant issue is that the current diagnostic criteria and terms used are wholly inadequate and discriminatory when considering how this disorder presents in Women and Adolescent girls.
Our diagnostic approach embraces ADHD as a broader Executive Functioning Self Regulation Deficit Disorder in Women which encompasses difficulty in emotional regulation and rejection sensitivity and cognitive and verbal and behavioural impulsivity.
Our diagnostic approach uses the Weiss Functional Impairment Rating Scale.
The WFIRS-S items collect the reporter’s perspective of their own functioning across seven domains:
Family (8 items), Work (11 items), School (10 items), Life Skills (12 items),
Self-Concept (5 items), Social (9 items) and Risk (14 items).
A functional impairment indicates that the available resources, comprised of internal resources eg, ability to concentrate, remember, and not be impulsive) and external resources (eg, support from parents and teachers), are inadequate to meet the environmental demands (eg, academic, occupational, financial, and social functions) that tend to increase in number, scope, and complexity with increasing age and level of independence.
As the numbers and levels of internal and external resources differ between individuals, functional impairments will emerge at different timepoints; some patients will demonstrate impairments early in childhood, whereas impairments may not emerge in others until later in life.
At RMC we explore your lived experience of your impairments and when they emerged for you and that may well be into your adult life.
Introduction to ADHD
By Dr Tracy Marks
Dr Russell Barkley YouTube Channel
Extensive videos explaining ADHD
Dr Tracy Marks YouTube Channel
Multiple videos on ADHD
Hormones , midlife, Women & ADHD
By Dr Carol Robbins
Vide
Procrastination & ADHD
By Dr Tracy Marks
Female Hormones & ADHD
By Dr Russell Barkley
ADHD & Caffeine
By Dr Russell Barkley
Executive Functioning
ADHD & Executive Functioning
By Dr Russell Barkley
Causes of ADHD
By Dr Russell Barkley
Why ADHD is so impairing
By Dr Russell Barkley
Rejection Sensitivity Dysphoria
ADHD & Rejection Sensitivity Dysphoria
By Dr Russell Barkley
An ADHD guide to Emotional Dysregulation &
Rejection Sensitivity Dysphoria
By Dr William Dodson
Rejection Sensitivity & Social Anxiety
By Dr Sharon Saline
Hyperfocusing
by Dr Russell Barkley
Perfectionism
By Dr Sharon Saline
Sleep
Sleep & ADHD
By Dr Russell Barkley
Hormones
Women & ADHD
By Dr Sandra Kooji
For a long time, it was thought that ADHD was primarily a condition in boys and some men. Research and lived experience have shown this is inaccurate, however. While women still receive fewer diagnoses for ADHD, the gap between women and men in overall prevalence has narrowed in recent years.
This means prevalenc
For a long time, it was thought that ADHD was primarily a condition in boys and some men. Research and lived experience have shown this is inaccurate, however. While women still receive fewer diagnoses for ADHD, the gap between women and men in overall prevalence has narrowed in recent years.
This means prevalence of ADHD in women is almost the same as the prevalence in men.
As boys dominate clinical samples of ADHD in childhood, female manifestations and gender differences have been relatively neglected in research as well as clinical practice [159–162].
In childhood ADHD is identified far more frequently in boys than girls with around a one in five ratio in most studies. However, the differences in prevalence and diagnostic rates according to gender become far less skewed with age, as more females are identified and become diagnosed in adulthood [17, 161, 163, 164];
and in some adult clinical series female cases may predominate.
Several factors may explain these observations. In childhood, girls may have less externalizing problems than boys: they suffer more from internalizing problems, chronic fatigue and inattention while boys may be more hyperactive and more aggressive [165, 166].
Girls show lower rates of hyperactivity and comorbid conduct disorder than males, and more frequently have the inattentive subtype of ADHD, with a later onset of impairment [162, 167].
For these reasons, general practitioners and health care professionals are less aware of ADHD in girls and they are thus less likely to be referred for treatment [168].
In adulthood, the higher prevalence of anxiety and depressive disorders in women may conceal underlying ADHD and influence diagnosis and treatment. As more women seek help from psychiatrists than men, the change in referral pattern may also contribute to the change in gender ratio within clinical populations [169].
Girls are diagnosed with ADHD at just under half the rate at which boys are diagnosed. This difference in diagnosis rate is made up for in adulthood, where women and men are diagnosed with ADHD at roughly the same rate.
The current ADHD prevalence for all adults is 4.4 percent.
Diagnosis of ADHD in girls and women:
ADHD symptoms continue to be overlooked in young girls and teens, even when they are struggling. Most experts conclude this is because girls more often exhibit the predominantly inattentive presentation of ADHD, while parents and professionals expect to see the predominantly hyperactive-impulsive presentation more often seen in boys.
Previously, it was assumed by some medical professionals that ADHD was a condition mainly found in boys, and they did not evaluate girls without the hyperactive-impulsive presentation for the disorder.Women experiencing ADHD symptoms may seek a mental health evaluation when they find themselves struggling with daily life. Since other mental health conditions, such as depression and anxiety, frequently co-occur with ADHD, a woman may be diagnosed with one of these conditions before the underlying ADHD is identified.
At Rainbow we have an in-depth understanding of how ADHD symptoms in adult females, both undiagnosed and diagnosed, really present and how and why these symptoms look different at different stages of life, menstrual cycle and peri-menopause, menopause and post-menopause.
Please see : Female-specific pharmacotherapy in ADHD: premenstrual ad
At Rainbow we have an in-depth understanding of how ADHD symptoms in adult females, both undiagnosed and diagnosed, really present and how and why these symptoms look different at different stages of life, menstrual cycle and peri-menopause, menopause and post-menopause.
Please see : Female-specific pharmacotherapy in ADHD: premenstrual adjustment
of psychostimulant dosage (Front. Psychiatry 14:1306194.)
Rejection sensitivity is not a formal diagnosis or disorder, but many women report that the inability to control their reactions to rejection is one of the most undermining aspects of their ADHD.
Impaired executive functions and emotional dysregulation increase the tendency to personalise ambiguous social interactions, interpret them negatively, and be unable to regulate an emotional reaction to the interaction that prompted it.
For too many years, women with ADHD have been routinely dismissed, disregarded, and misdiagnosed when they pursue evaluations and diagnoses for impairments like distractibility, executive dysfunction, and emotional dysregulation. Despite a growing canon of research on attention deficit hyperactivity disorder (ADHD or ADD) in girls and women, many clinicians continue to get it wrong — misattributing symptoms of ADHD in females to anxiety, mood disorder, or even hormones.
Many studies highlight the problem of rater/informant bias in parent and teacher reports. Some show that teachers are more likely to refer boys for ADHD treatment, even when such boys show equal or lower levels of impairment compared to female students.
Women and girls with ADHD have a distinct symptom presentation, with internalizing symptoms (eg, inattentiveness) being more prominent than externalizing symptoms (eg, impulsiveness and hyperactivity).
Their symptoms are more likely to be overlooked and they are less likely to be referred for diagnosis and treatment.
Females with ADHD may develop better coping strategies than males with ADHD and, as a result, can better mask or mitigate the impact of their ADHD symptoms.
ADHD Missed diagnosis of ADHD in women and girls may occur when anxiety or depression presents in association with ADHD because symptoms of ADHD may mistakenly be attributed to the coexisting condition.
The clinical assessment our Clinical Director, Phil, undertakes embraces all aspects covered in this discussion, and this is conducted in an informal, relaxed manner, while blending his extensive experience and knowledge of under diagnosis, misdiagnosis, emotional disregulation, rejection sensitivity, impulsivity and executive functioning and self regulation deficits that present with the disorder that is still named ADHD.
ADHD Missed diagnosis of ADHD in women and girls may occur when anxiety or depression presents in association with ADHD because symptoms of ADHD may mistakenly be attributed to the coexisting condition.
Significantly there are situations where Women have been misdiagnosed with Borderline Personality Disorder, or not accurately diagnosed
ADHD Missed diagnosis of ADHD in women and girls may occur when anxiety or depression presents in association with ADHD because symptoms of ADHD may mistakenly be attributed to the coexisting condition.
Significantly there are situations where Women have been misdiagnosed with Borderline Personality Disorder, or not accurately diagnosed with both disorder. Impulsivity and emotional disregulation are present in both disorders, however careful clinical assessment questions and a true understanding of both disorders can ensure Clients are clinically supported with different disorders. The same scenario historically has occurred with respect to Bipolar Mood Disorder and unfortunately is still occurring.
While there are many types of co-occurring conditions, researchers and clinicians tend to focus on several that more frequently affect women and girls.
Disordered eating and diagnosed eating disorders, alcohol and substance abuse, sleep difficulties, self-harm, mood disorders, and tic disorders can all co-occur with ADHD in girls and wome
While there are many types of co-occurring conditions, researchers and clinicians tend to focus on several that more frequently affect women and girls.
Disordered eating and diagnosed eating disorders, alcohol and substance abuse, sleep difficulties, self-harm, mood disorders, and tic disorders can all co-occur with ADHD in girls and women.
Additionally, fibromyalgia, chronic fatigue syndrome, and body dysmorphic disorder (an incorrect self-view of one’s body) have been noted as co-occurring conditions.
Most women who have ADHD report having a poorer self-image or lower self-esteem than their peers.
Depression and anxiety are often the most visible coexisting conditions experienced by women who have ADHD. Both conditions can be present as separate disorders or as the result of struggling with undiagnosed or poorly treated ADHD for a very long time.
The two conditions frequently prompt women to seek medical and mental health care and can lead to a diagnosis of ADHD.
When treating a woman or girl who has ADHD and a co-occurring condition, the clinician or treatment specialist needs to address the condition causing the most difficulty at that moment, especially conditions that can be life-threatening if untreated. However, many ADHD experts recommend treating both ADHD and the co-occurring condition together, because better management of ADHD symptoms can improve the treatment effectiveness for the co-occurring condition. Learn more about co-occurring conditions in Coexisting Conditions.
Dr Louise Newson
GP specialist on ADHD and Women’s health
Clinical implications of increased premenstrual
psychostimulant dosage
•
May help control premenstrual worsening of ADHD and mood
•
Consistent improvements in focus, energy, productivity and mood
•
Cycle awareness is essential: PMDD calendars or applications may help
•
Dosi
Dr Louise Newson
GP specialist on ADHD and Women’s health
Clinical implications of increased premenstrual
psychostimulant dosage
•
May help control premenstrual worsening of ADHD and mood
•
Consistent improvements in focus, energy, productivity and mood
•
Cycle awareness is essential: PMDD calendars or applications may help
•
Dosing and timing of increase should be individually determined
•
Monitoring and adjustments should be personalised
•
Appears to be valid for several types of psychostimulants
•
Additional side effects are minimal or absent
Further we understand clinically the significant challenges that can present when untreated ADHD and either PMS or PMDD are present. Research has not yet explained the disproportionate links between ADHD and both PMDD and postpartum mood disorders, and currently science does not know why women with ADHD appear more sensitive to the hormonal fluctuations of the menstrual cycle and the hormonal changes following childbirth
Telehealth Clinic
Monday I Tuesday I Thursday
I Fortnightly Saturday
Face to Face Clinic
Fortnightly Saturday
Weekly Tuesday
5/55 Lathlain Street
In Canberra Psychology Services
Belconnen
ACT, 2617
Open today | 09:00 am – 05:00 pm |
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