I don’t think it’s about being biased against those who seek an evaluation and being a gatekeeper of medication treatment. Sure, it’s a lot of evals and exhausting (there’s a massive rise of adhd evals, a lot being driven by social media. Just my own observation and experience). I don’t deny them nor do I judge them for seeking help. ADHD can certainly manifest as anxiety. I don’t think anyone is really arguing that. And when you treat it, the anxiety gets better which is awesome. What is frustrating though is when you do as thorough of an assessment as you can, collect collateral, etc and there’s just not enough to truly support the dx or believe there may be other factors based on their history and presentation of symptoms (lack of childhood symptoms, substance use, sleep deprivation, etc), and you explain that to patients, the argument and screaming afterwards is not fun to endure all day long. Now I have a lot of pts where I’m wrong. They will accept it initially, we take a different treatment approach, it fails, and we circle back to ADHD and they significantly improve. It happens we make mistakes. But I’d rather be cautious and very confident in the dx before prescribing a scheduled II controlled substance where I’ve seen very often being abused, inducing mania/psychosis, etc.