An Interview with Psychiatrist Elizabeth Hersey
Elizabeth Hersey, MD is a psychiatrist at Seattle Anxiety Specialists, PLLC. Dr. Hersey specializes in the treatment and medication management of anxiety related disorders.
Rachel Kuras: Hello everyone, and thank you for joining us for this installment of the Seattle Psychiatrist Interview Series. My name is Dr. Rachel Kuras. I'm a psychotherapist at Seattle Anxiety Specialists, PLLC. We are a Seattle-based psychiatry, psychology and psychotherapy practice specializing in anxiety disorders. I'd like to welcome with us Dr. Elizabeth Hersey, a licensed psychiatrist who began working with Seattle Anxiety Specialists as a psychiatrist earlier this year. Dr. Hersey earned her medical degree and completed her psychiatric residency at the University of Washington where she earned a distinction as outstanding chief resident, served as a member of the Department of Psychiatry's Residency Admissions committee and was co-leader of the Perinatal Psychiatry Pathway. Welcome to the Interview Series, Elizabeth, thanks so much for joining me today. Before we dive in to the questions I have to ask you, will you tell our listeners a little bit about yourself?
Elizabeth Hersey: Yes. Hello. Thank you, Rachel for the introduction. I am Dr. Elizabeth Hersey, an adult psychiatrist here at Seattle Anxiety Specialists, and completed both my medical school training and residency training at the University of Washington where I had the privilege of working in a variety of different clinical sites around Seattle. My clinical focus includes mood and anxiety disorders, bipolar disorder, stress and burnout, ADHD and women's mental health, including perinatal psychiatry. I take a collaborative evidence-based approach to treatment and really enjoy helping people better understand themselves and their mental health and finding strategies to genuinely support their well-being. I live in Seattle with my husband and our dog and outside of work, I love photography and hosting dinner parties.
Rachel Kuras: Wonderful. Thanks for introducing yourself. I'm very excited. I have a lot of questions for you today. So what sparked your interest in becoming a psychiatrist? What led you to focus on diagnosing and treating ADHD in adults?
Elizabeth Hersey: Yeah. I've always been fascinated in the way people think, feel and how they relate to the people and world around them. Psychiatry felt like the perfect blend of medicine, neuroscience and human connection. Being a psychiatrist is deeply fulfilling. I strive to create a space where patients feel safe, truly heard, and are able to be vulnerable, and it is a great pleasure to be trusted with people's stories and experiences.
My interest in adult ADHD developed over time, particularly as I began working with high functioning professionals who have struggled for years, often feeling disorganized, overwhelmed, or emotionally reactive without understanding why, and many of them had been misdiagnosed or even dismissed when going to seek out help for some of these symptoms. When we finally name and acknowledge ADHD might be playing a role, it helps bring a huge sense of clarity and validation. From there, we can build a treatment plan, whether that's medication, therapy, a combination of lifestyle tools that actually supports their day-to-day lives. And helping people reclaim that sense of self-understanding is one of the most rewarding aspects of my work.
Rachel Kuras: Wonderful. It sounds like deeply meaningful and very much needed work. What are some of the common signs of ADHD in adults that people might not recognize?
Elizabeth Hersey: That's a great question. A lot of people associate ADHD with childhood hyperactivity, bouncing off the walls or being disruptive in class, but in adults it can look really different. Instead of physical hyperactivity, we are more likely to see things like chronic disorganization, forgetfulness, difficulty prioritizing tasks, constantly falling behind no matter how hard they try. And many adults describe ADHD as kind of a mental restlessness or sense that their brain is always on, but never quite focused.
There's also a really strong emotional component that's often overlooked. Adults with ADHD may experience intense frustration, anxiety, irritability, or even mood swings. They can be highly sensitive to criticism and rejection, and because ADHD coexists with anxiety and depression oftentimes, these conditions can sort of mask the underlying attention issues. That's why a lot of people do go underdiagnosed or undiagnosed for years, especially if they've developed coping strategies to help manage these symptoms. It's not uncommon for someone to come in after a major life event, like change or new job, graduating from school or even parenthood, where their old systems or strategies are just not enough anymore. Ultimately, many adults with ADHD spend years thinking about their struggles and feeling like they may be personal failings rather than symptoms of a really treatable condition. That's one of the most powerful shifts that I notice is realizing it's not a character flaw, it's a neurodevelopmental difference that we can work with and treat.
Rachel Kuras: Yeah, the symptoms of ADHD are often much more visible and external in childhood. Even then, there are those internal symptoms that are less easy to name and see. It sounds like a big part of what you do working with adults is naming the unnamed or the less visible symptoms that may be more likely to fall through the cracks.
Elizabeth Hersey: Absolutely.
Rachel Kuras: Yeah. I'm curious, how do you diagnose ADHD in adults? What does that process look like?
Elizabeth Hersey: Yeah. We start with a comprehensive mental health intake, which includes asking about attention, memory, emotional regulation, sleep, work, school functioning, and how these symptoms show up in daily life. I also do an extensive medical and psychiatric history review, including symptoms of mood and anxiety disorders as well as substance use. I often use screeners like the ASRS to help clarify some of these patterns. When needed, I'll gather collateral information from family members or consider further psychological neuropsych testing. One important factor to point out and to really figure out and discover, is whether these symptoms have been present since childhood, even if they were overlooked or misattributed at the time, because this is a requirement for the diagnosis of ADHD.
Rachel Kuras: So initially there's a lot of collecting information, kind of putting together that background to get a picture of what's going on, and then once you have more information, using that information to inform treatment. So what does treatment typically look like once someone is diagnosed with ADHD?
Elizabeth Hersey: Yeah. Treatment is always very individualized. For many people stimulant medication, which is the first line treatment for ADHD like Adderall, Vyvance, Concerta can be very effective. But not everyone is a good fit for medication and some people don't feel comfortable starting off with medication and that's okay. We also explore behavioral strategies, sleep hygiene, exercise therapy, and even some specific ADHD coaching or executive functioning tools. I think building a personalized toolkit to support the way your brain works.
Rachel Kuras: All right, so the process is collaborative and pretty comprehensive, looking at different systems and structures in your patients' lives and seeing where attention may be helpful. There's been a lot of recent conversation about overdiagnosis of ADHD, and you've already spoken to how complicated that process of diagnosis can be. How do you distinguish true ADHD from other causes of attention problems?
Elizabeth Hersey: Yes, I'm glad you asked that because that's a really important question. Attention issues can show up in many mental health conditions like anxiety, depression, trauma, sleep disorders or even untreated medical conditions like thyroid dysfunction or anemia. With ADHD, we're looking for a long-standing consistent pattern that started in childhood, not just something that emerged during a particularly stressful time. If the attention problems are new or clearly tied to a specific life event, we will dig deeper to understand what else might be going on. It's not just checking off a list of symptoms, it's about understanding the full context.
There's also been a huge rise in ADHD content on social media platforms like TikTok, which can be kind of a double-edged sword. On one hand, it's helpful to reduce the stigma and it's made a lot of people feel more seen in ways that they hadn't before. That sense of solidarity is really powerful. At the same time, there's a lot of misinformation out there and it's easy to self-diagnose based on very generalized content. So I always encourage people to be mindful about their sources and if they are relating to a lot of what's being said or what they're seeing, to bring those questions to a qualified mental health provider who can help sort that out with them.
Rachel Kuras: That's a very important insight that generalized content is not able to consider context and some of those details, like the onset of symptoms, that working directly with a collaborative provider can give more attention to. Okay. I have a lot more questions that I noticed come up as you're talking through, so I'm sure we could talk about this for hours, and it seems like you have a lot of wonderful insight about these processes. What advice would you give someone who suspects they might have ADHD but isn't sure what to do next?
Elizabeth Hersey: Yeah, yeah. I could talk about this all day. I'm really passionate about this and think treatment and care can be really life-changing for people, so I love helping support people along that journey. But to answer that question, I would say start paying attention to patterns. Notice where you struggle with focus, organization and follow-through and how those patterns might be affecting your daily life. If it's creating distress or holding you back, that's absolutely worth exploring. If this is true for you, the next step would be talking to a mental health professional, ideally, a psychiatrist or therapist familiar with diagnosing ADHD in adults. You don't have to figure this out alone. Getting clarity can be really life-changing and don't be afraid to ask questions and advocate for yourself. Whether or not your symptoms turn out to be due to ADHD, getting clarity can just be incredibly validating and empowering.
Rachel Kuras: Definitely. I admire your perspectives on the process of getting familiar with our patterns, on reaching out for help, on emphasizing that if something feels like it's not working or not supportive, that in itself is enough reason to give more attention to it and potentially seek support from a mental health care provider. Thank you so much for your time, Dr. Hersey. Your insight is very valuable. I think these are things that are on a lot of people's minds that can be difficult to put words to and talk about, so your work and your perspectives are so, so valuable. Thank you for your time and for sharing your thoughts and insights with our listeners today.
Elizabeth Hersey: Of course. You're welcome. Thank you for asking such great questions. I appreciate it.
Rachel Kuras: Of course. No problem. All right. Thank you for joining us. We'll see you listeners for the next Seattle Anxiety Psychiatrist Interview Series. Bye.