Welcome back to the Deep Dive. So if you're someone who's been trying to get answers about focus or maybe anxiety, you know the feeling. Oh, absolutely. You wait for an appointment, you finally get in and it's, what, a 15-minute chat, a quick checklist. And you walk away feeling like you barely scratched the surface. Exactly. You're here because you want real knowledge. Quick to get, sure, but it has to be thorough.

It has to be reliable. And that is precisely our mission today. We're doing a Deep Dive for anyone who is just done with surface-level answers and wants a real, medically-grounded diagnosis. Okay, so where's our source material from? We've been analyzing materials from a specialized psychiatric practice in Carmel, Indiana. They're focused entirely on comprehensive ADHD and anxiety diagnosis. And they have a specific process.

A very rigorous four-step protocol. They actually call it the most important tool for getting mental health clarity. And honestly, from what we've seen, they mean it. Okay, let's unpack that right away because the sources draw a really sharp line between that frustrating quick checklist and their method. They do. They seem to be focused on, you know, adults struggling at work, parents worried about their kids.

So what is that fundamental difference? It really comes down to time, depth, and the kind of data they're collecting. The whole critique in the source material is that people feel invalidated by a rushed checklist. Because it misses all the nuance. Exactly. So this practice, their entire belief, is that an accurate diagnosis is everything. The whole process shifts from just asking what your symptoms are to digging deep

into why you have them. So it's less about psychology and more about biology. That's a great way to put it. It moves from just observation to objective biology. Trying to find that root cause. So if you've been stuck in that cycle of, you know, check the boxes, get a diagnosis, try a treatment that doesn't quite work, and start all over. This is about breaking that cycle. By getting that rock-solid medical opinion

right at the start. Precisely. Because when you compare a 15-minute chat to a multi-step process designed to rule out other complex conditions, you see how seriously they take accuracy. Skipping steps isn't just inefficient, you can be really risky. Which brings us right to the core of it. Their four-step diagnostic protocol. They even call it the deep dive. They do. And this methodology is really what sets them apart.

It all starts, as it should, with the patient's own story. Step one is the clinical diagnostic interview. Right, but this is not just a quick chat about focus problems. No, not at all. The material really emphasizes this is an intensive history. They're looking at sleep patterns, anxiety, family history, developmental milestones, everything. They're casting a really wide net on purpose. The goal here is basically triage.

You have to rule out other conditions that can look almost exactly like ADHD. Like what? What's an example? Well, for instance, severe sleep deprivation or even some anxiety disorders can present just like inattentive ADHD. So if you skip the deep history... You might end up treating the wrong problem entirely. Yeah. They need that full picture, especially if there's, say, a family history of mood disorders or even subtle signs on the autism spectrum.

That makes sense. I mean, context is everything. Focus problems at age six are totally different than at 16 after a big life event. Right. So once they have that history, they go to step two. Standardized rating scales. I see they use tools like the Vanderbilt, Connors, or ASRS. Yeah, and these scales are crucial because they add a layer of objectivity. The Vanderbilt and Connors are mostly for kids and teens,

while the ASRS is for adults. But the key is how they use them. Exactly. It's about getting what we call a 360-degree view. A diagnosis can't just hang on one person's perception in one moment. So it's not enough for an adult patient to just fill out a form about themselves. Not nearly enough. The protocol gets data from multiple environments, home, school, work, and often from different people, like a spouse or a teacher.

What does it confirm for them? Two things. First, that the symptoms are happening everywhere, not just in one specific situation. And second, it makes sure the symptoms are actually impacting daily life across the board. Okay, now we get to what seems like the real game changer. Step three, biomarker and metabolic analysis. Most places stop with the scales, but they're doing advanced functional tests, specifically DTCH and OET tests.

This is where it moves beyond standard psychology and into functional medicine. For anyone not familiar, these tests look for biological root causes that can perfectly mimic mental health symptoms. Okay, let's break down those acronyms. DUTCH. The DUTCH test is a dried urine test for comprehensive hormones. It looks at sex hormones, but more importantly, it maps out your daily cortisol rhythm. Cortisol, the stress hormone.

Why does that matter for focus? Because if your cortisol rhythm is off, say it's high at night or too low in the morning, that directly messes with your sleep and your ability to think clearly. So low morning cortisol. Can feel like extreme brain fog, like you just can't get your engine started. It looks and feels just like inattentive ADHD. But the root cause isn't dopamine. It might be a problem with your HPA axis,

your body's stress response system. So you could give that person a stimulant, but if the real issue is hormonal, you're just putting a bandage on it. Precisely. Or you could even make their anxiety worse. And that brings us to the OAT. The Organic Acids Test. Right. This gives a window into your metabolism. It checks for nutrient deficiencies, how well your cells are making energy, and even flags things like gut health issues.

I see how that connects. Gut inflammation impacting the brain? The gut-brain axis is huge. The OAT can find things like B vitamin deficiencies. If your body can't make the raw materials for neurotransmitters, you're gonna have executive dysfunction. So this is why they do step three, to make sure they're not missing a physical cause. It moves the entire conversation from what's wrong with your focus to what's going on with your body's chemistry.

And that must completely change the treatment plan. It allows for a level of personalization that just isn't possible otherwise. Which brings us to the final step, step four, the results and feedback session. This seems like where it all comes together for the patient. Absolutely. All that data, the history, the scales, the lab work, it all gets woven into one clear story. The provider sits down and explains it all in plain English.

They actually tell you how your brain and body work. Yes. Linking the lab results from step three directly back to the symptoms you talked about in step one. And the outcome isn't just a label, it's a whole action plan. Correct. It might be medication, sure, but it could also be coaching, or nutritional changes based on those DUTCH and OAT results. It's a truly holistic approach. Now that level of detail obviously takes time,

which brings up some practical questions, especially with how high the demand is for mental health care. That's a huge point. The sources highlight a major advantage they offer, which is speed to answers, especially for people in that Carmel, Fishers, and Zionsville area. What's the contrast like? What are we talking about for wait times? Well, we've all heard the stories. Hospital systems in Indianapolis can have a six to 12 month wait list

for this kind of testing. Imagine struggling at work or with your child for a year just waiting for one appointment. This practice, in contrast, usually gets people in for an evaluation within one to two weeks. That's a massive difference. It can be life-changing. And just to be clear, they are serving people virtually statewide in Indiana too. Correct. Telehealth makes it accessible. Let's talk about complexity.

The sources say they focus on complex cases. When does ADHD become complex? It's complex when it doesn't exist on its own. They specialize in cases where ADHD overlaps with things like anxiety, autism symptoms, OCD, depression. All these things that can look like each other. Exactly. And that four-step deep dive is essential there because you have to treat the whole person, not just one symptom. Let's connect that back to safety.

You mentioned the danger of mistaking bipolar disorder for ADHD. Can you expand on that? Yeah, this is a critical safety point. If a patient has bipolar disorder but only gets diagnosed with ADHD, putting them on a stimulant medication can actually trigger a manic episode. Which is a serious medical event. A very serious outcome. That rigorous step one interview, plus the objective data from step three, helps them avoid that blind spot.

Safety really dictates the whole process. Okay, that makes total sense. Let's hit some quick logistical questions for anyone listening. Do you need a referral? Nope. A referral is not needed. You can schedule directly, which is part of why it's so much faster. What about insurance? This sounds incredibly thorough. So how does payment work? They're an out-of-network practice. And the reason they give for that is actually really interesting.

It is. It's to protect the process. It lets them do these longer, comprehensive evaluations without an insurance company dictating how long they can spend or which tests they can run. So they're not letting a third party turn their deep dive back into a quick checklist? That's the idea. To maintain that rigor, they operate outside those constraints. But what about reimbursement for the patient? Is there any option?

Yes, they provide what's called a super bill. It's basically a detailed receipt with all the right codes that you can then submit to your insurance for potential out-of-network reimbursement. Got it. And after the diagnosis, what's the follow-up like? How often are appointments? Once someone is stable, the goal is typically quarterly visits, so every three months. But, and this is key, if the case is complex and they're carefully adjusting medication.

To balance mood, anxiety, and focus. They will see that patient much more frequently until everything is stable. Safety and stability always come before a rigid schedule. Let's shift for a moment and connect this to the bigger picture. The current DEA telehealth rules are a hot topic. A very important topic for access. The context for Indiana is that under the current federal extension, practitioners can prescribe necessary ADHD medications

via telehealth without a prior in-person visit. And what's the timeline on that extension? That currently runs until December 31st, 2026. And there's a specific rule for Indiana, right? You can't just do a phone call. Correct. To be compliant in Indiana, the telehealth consultation has to be a real-time audio-visual session. That video component is required. Right, and just to put a pin in the map, their physical office is in Carmel

at 550 Congressional BLDD Suite 350. But again, they're serving the whole state virtually. And that ability to use telehealth within the current regulations is key to reaching people who are stuck on those long wait lists elsewhere in the state. So when we put this all together, what's the big takeaway for you, the listener? It really feels like a shift toward truly integrated care. It is. It's about combining those classic validated tools,

like the Vanderbilt scales, with cutting-edge functional biology from the DUTCH and OAT tests. To get an accurate diagnosis. And a treatment plan that's actually tailored to your unique body chemistry. It stops being about just managing symptoms. It starts being about treating the real underlying causes. It tells you not just that you have a problem, but why you have it. Exactly. And I think that point about flexibility

and follow-up appointments for complex cases, prioritizing stability over a standard schedule, that highlights a really important principle. It does. And for you, the informed learner, it brings up a bigger question that applies to any medical situation, really. When should a standardized schedule or cost concerns give way to what an individual's safety and complexity actually demand? And how do we know when an issue calls for a true deep dive,

not just a surface checklist? That's the question. A really critical thought to take with you. This has been a definitive deep dive into getting definitive answers. Absolutely. Until next time. We'll see you then.