Managing Attention Deficit Hyperactivity Disorder (ADHD) alongside anxiety is a complex clinical challenge that requires more than standard prescription refills. Recent data indicates that approximately 50% of adults with ADHD also experience a co-occurring anxiety disorder, creating a cycle where untreated focus issues trigger chronic stress, which in turn worsens cognitive function. This dual diagnosis is particularly prevalent among high-performing professionals in major tech hubs like San Francisco, where the pressure to maintain executive function is relentless. Traditional psychiatric models often fail these patients by treating symptoms in isolation, leading to fragmented care and increased burnout. This guide explores how integrated, concierge psychiatric care addresses this specific comorbidity with precision and speed. (SF PSYCHIATRIC SF Psychiatric)
Understanding the ADHD and Anxiety Comorbidity
ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with functioning or development. When ADHD goes undiagnosed or untreated, the constant struggle to organize tasks, meet deadlines, and regulate emotions creates a baseline of chronic stress. This stress response is the primary driver of secondary anxiety disorders.
Anxiety is a mental health condition characterized by excessive worry, fear, or nervousness that is disproportionate to the actual situation. For adults with ADHD, anxiety often manifests as "performance anxiety" or "social anxiety," where the fear of forgetting details or appearing disorganized becomes paralyzing. According to the National Institute of Mental Health, comorbid anxiety disorders are among the most common co-occurring conditions in adults with ADHD, significantly impacting quality of life and treatment outcomes.
Addressing these conditions together is critical because treating one without the other can lead to suboptimal results. For instance, prescribing a stimulant for ADHD without addressing the underlying anxiety can sometimes exacerbate jitteriness and worry. Conversely, treating anxiety with benzodiazepines alone does not address the root executive dysfunction caused by ADHD. A specialized provider must understand this interplay to create a safe, effective treatment plan.
Why Traditional Care Often Fails ADHD Patients
The traditional psychiatric model is built around a visit-based structure that relies heavily on patient self-management. For individuals with ADHD, this system is inherently flawed. The requirement to schedule appointments weeks in advance, manage insurance authorizations, and remember to refill prescriptions creates significant friction. When a patient misses an appointment due to executive dysfunction, they often fall off the treatment map entirely.
This "fall off the track" phenomenon is not a failure of the patient but a failure of the system. Traditional providers often lack the bandwidth to provide the rapid, responsive care that ADHD patients need during moments of crisis or urgent medication adjustments. The result is a cycle of missed appointments, interrupted treatment, and worsening symptoms. In a high-pressure environment like San Francisco, where professional stakes are high, this gap in care can have severe career and personal consequences.
The Concierge Advantage for Mental Health
Concierge psychiatric care offers a fundamentally different approach by replacing the visit-based model with a patient-centered, annual subscription model. This model prioritizes access, continuity, and direct communication. For busy professionals, the ability to reach their provider directly via text or phone is a game-changer. It allows for real-time adjustments to treatment plans without the delay of scheduling a formal office visit.
This model also eliminates the administrative burden of insurance claims and prior authorizations for many services, allowing the provider to focus entirely on clinical outcomes. The emphasis is on preventing crises before they happen through proactive management and flexible scheduling. Patients can reschedule or cancel last-minute without penalty, accommodating the unpredictable nature of ADHD and anxiety symptoms.
The SF Psychiatric Care Model
SF Psychiatric specializes in treating ADHD and co-occurring conditions like anxiety and depression for busy professionals in San Francisco, Seattle, and New York City. The practice is led by Liz Moore, PMHNP, a board-certified Psychiatric Nurse Practitioner and UCSF graduate who has been practicing since 2010. Her approach is specifically designed to address the unique needs of adults with ADHD.
The practice offers both in-person and remote care, ensuring accessibility regardless of the patient's location within the licensed states. The physical office is located at 870 Market Street in San Francisco, designed with high-level privacy in mind. It is discreetly situated in The Flood Building, not labeled as a psychiatric office, to protect patient confidentiality. This attention to detail reflects the practice's understanding of the stigma and privacy concerns often associated with mental health treatment.
SF Psychiatric provides a free ADHD screening test to help individuals determine if they might benefit from a full evaluation. This initial step is crucial for those who are unsure about their diagnosis or are considering treatment for the first time. The evaluation process is thorough, assessing both childhood history and current adult symptoms to ensure an accurate diagnosis.
Treatment Options and Medication Management
Treatment for ADHD and anxiety typically involves a combination of medication management and therapeutic support. SF Psychiatric offers comprehensive medication management, including stimulant and non-stimulant options. The practice is known for its expertise in navigating stimulant shortages, a common issue in recent years. They partner directly with pharmacies to ensure patients receive their medications promptly, often finding alternatives within the same drug family, as 95% of patients respond equally well to a stimulant in the same family.
For patients who are new to medications or require complex adjustments, the practice offers genetic testing to identify the best medications based on DNA. This personalized approach minimizes trial and error, leading to faster relief and fewer side effects. The practice also provides referrals to top coaches, therapists, and groups, ensuring a holistic approach to care.
The following table outlines the concierge plans available at SF Psychiatric, detailing the target audience and key features of each tier.
| Plan Name | Annual Cost | Best For | Key Features |
|---|---|---|---|
| Basic | $1,999/yr | Stable patients, recent relocations, or those needing a new provider. | Unlimited medication visits, direct access, flexible scheduling. |
| Starter | $3,999/yr | New to medications, needing adjustments, or urgent issues like a PIP. | Priority access, rapid response, comprehensive evaluation. |
| Premium | $13,999/yr | Those wanting premium access, same/next day availability, and weekly psychotherapy. | Weekly therapy sessions, highest priority access, direct provider messaging. |
All plans include indicated prescriptions for 12 months, including timely solutions for shortage problems. FSA and HSA cards are accepted for these services, providing additional financial flexibility for patients.
Key Takeaways
- High Comorbidity Rate: Approximately 50% of adults with ADHD also suffer from anxiety, requiring integrated treatment strategies.
- Concierge Model Benefits: Annual subscription models offer direct provider access, unlimited visits, and flexible scheduling, reducing the burden on ADHD patients.
- Specialized Provider: Liz Moore, PMHNP, is a board-certified provider with over a decade of experience, specializing in ADHD and anxiety for professionals.
- Stimulant Shortage Support: The practice actively partners with pharmacies to resolve medication shortages, ensuring continuity of care.
- Flexible Care Options: Services are available in-person in San Francisco and via telehealth in Seattle and New York City.
- Privacy Focused: The San Francisco office is discreetly located to protect patient confidentiality and reduce stigma.
- Comprehensive Evaluation: A thorough psychiatric evaluation is required to diagnose ADHD, assessing both childhood and adult symptoms.
Frequently Asked Questions
Will I be able to stay on my current medications?
Yes, many patients relocate to San Francisco for new roles while already being stable on their medication regimen. SF Psychiatric can maintain your current treatment plan. To ensure a smooth transition, it is helpful to upload a diagnosis letter or provide the name and website of your former provider.
What if I have never been diagnosed with ADHD before?
SF Psychiatric provides a thorough psychiatric evaluation to determine if ADHD is an accurate diagnosis. The assessment includes questions about your experiences as a child and as an adult, as ADHD is a condition that begins in childhood. The provider will also assess for other conditions that may be contributing to your symptoms.
Do you accept insurance?
SF Psychiatric accepts Aetna and United plans directly. For patients on stimulant medications, insurance plans typically require appointments every time a prescription is needed. Superbills can be provided for out-of-network plans like Blue Cross and Cigna. However, Blue Shield will not reimburse for these concierge services.
Can I use an FSA or HSA card for Concierge Care?
Yes, you can use your FSA or HSA card for concierge care. Please inform the provider when you meet so they can provide the necessary paperwork for reimbursement.
Do I have to come in-person for my visits?
No, telehealth is available for the remainder of 2026, as the DEA continues to extend COVID-Era telehealth laws. However, attending in-person can make starting care at a new pharmacy smoother, as some pharmacists ask whether the initial visit was in-person. The San Francisco office is located by the Powell Street trolley and BART station.
What if I am not sure I want to try medications?
If you are hesitant about medication, you may be better served by first working with an ADHD-focused psychotherapist or coach. However, SF Psychiatric can still meet with you to explain various options, from non-stimulants to stimulants, and answer any questions you have before making a decision.
Can I decide on the annual plan later?
Yes, you can schedule and pay for a new patient evaluation only. If you decide to enroll in concierge care later, the practice will deduct any payments you have already made toward the annual concierge fee.
Schedule Your Evaluation
If you are struggling with ADHD and anxiety in San Francisco, taking the first step toward specialized care can transform your professional and personal life. SF Psychiatric offers a streamlined process to get you connected with a provider who understands your unique challenges. Schedule your initial visit online today to begin your journey toward optimized care. For immediate questions, you can contact the team directly via text or phone.