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Step Up / Down

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Step up or down based on where you are in your journey
Step Up

⬆️ When We Step Up Care

Extra support for when things feel harder than usual.

There are times when your needs increase — due to changes in mental health, life stress, or medication response. In these moments, we aim to increase support through more frequent appointments, close monitoring, and problem-solving.

Step up in follow up frequency
Comorbidity

🧠 Worsening Mental State

Depression, anxiety, or overwhelm? We’ll meet you where you're at.

Many people with ADHD also experience depression, anxiety, or emotional dysregulation. If these symptoms start to escalate, we may recommend more frequent psychiatric reviews or coaching check-ins to help stabilise things.

Ineffectiveness

💊 Medication Not Working

If focus fades or symptoms return, we rework the plan together.

If your medication seems less effective, or if you begin to notice symptom resurgence, we may step up to review your treatment plan. This might involve adjusting the dose, switching medications, or trialling a drug holiday under supervision.

ADHD Medication not working
Life Guidance

💬 Increased Coaching Needs

When life throws a curveball, coaching can help you recalibrate.

Some clients benefit from stepping up ADHD Life Guide coaching when experiencing difficulty with emotional regulation, procrastination, or significant life changes. These sessions can act as a stabilising bridge while medication is being reviewed.

Benefits vs Side Effects

⚠️ Emerging Side Effects

We keep a close eye on how your body and brain respond.

Sometimes new side effects arise — sleep disturbance, emotional swings, appetite changes, or cardiovascular symptoms. Closer monitoring may be needed to assess whether these are temporary or require medication dose adjustment or switching to alternatives.

Titration

🔄 Medication Optimisation

Fine-tuning dosage to balance benefits and side effects.

Even when side effects are minimal, we may step up care if you're not getting the full benefit of your treatment. This phase involves more frequent titration and tracking to find the sweet spot where symptom control and side effects are in balance.

Crisis Support

🚨 If You’re in Crisis

We’re not a crisis service — if it’s urgent, please seek emergency care.

We do not offer emergency psychiatric care. If you are in immediate distress:

  • Visit your local emergency department
  • Contact your General Practitioner
  • Use the Safe Life Guide app to complete a safety plan
  • Urgent care requests like medication about to run out, i.e. those that can be meaningfully addressed through telehealth are accommodated

Our clinic operates part-time, and while we do our best to increase support when needed, we are not a crisis response service.

Decreasing Appointments in Step Down Phase
Step Down in ADHD Care
If your symptoms are worsening, your medication isn’t working as well, or you're experiencing emotional distress or new side effects, it may be time to step up. This usually means more frequent appointments to adjust treatment, provide additional coaching, or explore new strategies together.
Absolutely. Even when things are going well, we recommend at least annual reviews to track progress and make sure nothing is being missed. Many clients in the maintenance phase also choose occasional booster coaching sessions to stay aligned and motivated.
We’ll discuss it together. If your ADHD symptoms are stable, medication is working well with no significant side effects, and your overall wellbeing is strong, we may agree to space out your reviews. You’ll never be discharged — just supported at a lighter rhythm.
Yes. Life changes, and we’re ready to respond. Most people move fluidly between levels of support over time. If things get tough again, we can step you back up. If things stay settled, we can maintain or even reduce your touchpoints.
Our clinic is not an emergency service. If you are in crisis, we advise that you: • Contact your GP • Present to your local emergency department • Call a crisis line such as Lifeline (13 11 14) You can also use the Safe Life Guide app to complete a safety plan and identify early warning signs.
Not at all. Stepping down just means you're in a stable place right now. Think of it as a calm phase — not the end of care. You can always re-engage more intensively if life circumstances shift.

Mon - Fri: 8AM - 6PM
Sat - Sun: Variable

Brisbane North Medical Specialists,
15 Dallas Parade, Keperra, QLD 4054

(07) 5221 3489
reception@bnms.com.au