When cognition is part of the question
A neuropsychological evaluation is the right level when thinking itself is part of what needs explaining: attention and focus problems, memory concerns, executive functioning struggles, questions about intellectual strengths and weaknesses, or underperformance at work or school that effort alone has not fixed.
It is also the level we recommend when mood or anxiety problems come with a lifelong undercurrent, because undiagnosed neurodevelopmental conditions such as ADHD are among the most commonly missed drivers of emotional difficulties, and specific cognitive weaknesses can quietly limit performance in ways that feel like character flaws but are measurable and addressable.