Sherri couldn’t figure out why the other moms in her son’s play group appeared to have it all together while she struggled to get her son to school on time and make it to the office without losing her cool.
During the week, she would watch in helpless frustration as her house descended into chaos every morning as she struggled to get lunches packed, bills paid, and laundry folded.
As an account manager for a popular food brand, she loved the novelty and dynamic energy of working with new people every day and offering value for her clients.
But she struggled to file her reports on time and sit through weekly planning meetings.
It was all too much and her partner was concerned she might be depressed.
When her son began struggling in school and showing signs of distress with having to sit for more than a few moments, she took him to their family doctor who asked a series of questions then recommended an ADHD assessment.
As Sherri listened to the description of how ADHD shows up, she felt a chill run down her spine.
“That’s me,” she thought. “I checked every single box.”
She started researching adult ADHD online and discovered a wealth of stories from other parents that also discovered their neurodivergence in adulthood.
Reading their accounts helped her feel less isolated and she made the decision to talk to her doctor.
After diagnosis, relief and trepidation
After a full adult ADHD assessment, Sherri was diagnosed with Predominantly Combined ADHD.
“It explained so much! All these years I thought there was something wrong with me,” she says.
“Turns out I’m just wired differently.”
But she was concerned. She had overheard colleagues making fun of the rise of ADHD related content on social media and she worried that her friends might mock her for being different.
“The TikTok videos are great, but I can see why my friends might find them silly and annoying,” she admits.
She decided to keep her diagnosis private while she worked with her doctor to find a prescription medication that would help her focus.
ADHD runs in families
ADHD is highly hereditary. When one or more members of the family have it, the odds of another family member being neurodiverse increase, up to 91%.
It’s important to remember that it is not a disease and not a curse. It's a neurodevelopmental disorder that impacts brain function. There are many effective ways of managing ADHD for both adults and children and there is no one size fits all approach.
Some benefit from stimulant medication, while others learn to thrive with the right support, exercise, good sleep hygiene, and plenty of self compassion.
It’s also not anyone’s fault and despite some myths that blame sugar or video games, it’s not caused by environmental factors.
Back on track
Sherri’s doctor recommended she work with a coach and after a few sessions, she started to develop some strategies to help her cope with the mountain of laundry and dishes at home.
She was even able to help her son feel better about his diagnosis by creating more play time and exercise. He has supportive teachers and they’ve been able to find a tutor that specializes in kids with ADHD.
“As a family, we’re stronger and more connected after ADHD discovery,” Sherri says. “My son and I are closer and my partner doesn’t have to worry about me so much.”
Sherri has been talking to her manager about a hybrid work option so she can spend more time with her son and her partner has offered to take on tasks that she finds overwhelming, such as the grocery shopping and washing the dishes.
“None of it is perfect, and my life still feels messy and chaotic sometimes, but just knowing there is an explanation gives me immense peace of mind.”
Learn more about ADHD assessments.
This is the first in a series of blogs about how women with ADHD navigate their unique challenges. She/her pronouns are used, but these concerns can impact those in gender transition and/or anyone with a uterus.
Andrea used to think she was losing it. For several days every month, she’d be unable to focus, sad, and more disorganized than usual.
“It was like I fell off a cliff. All the systems I had in place to keep me on track were pointless and I would cry if someone looked at me the wrong way on the street,” she says.
For years she wondered why she couldn’t muster the energy or focus to execute basic tasks at home and work around the same time each month.
Diagnosed with ADHD in her late 20’s, Andrea takes stimulant medication and has stabilized on a dose that overall works very well for her. When she noticed it wasn’t as effective as usual, she started to wonder why her male friends with ADHD didn’t have the same experience.
Concerned and curious, she spoke with her doctor.
The estrogen connection
Turns out estrogen plays a crucial role in the production of neurotransmitters in the brain, including dopamine, norepinephrine, and serotonin. They all play a role in cognitive function, so when they’re running low, it can have dramatic and unwanted impact.
When someone with a uterus experiences an average 28-day cycle, estrogen levels remain steady, but around the 14-day mark, called the luteal phase, progesterone production begins to minimize the beneficial effects of estrogen.
For women with ADHD this time of the month, emotional storm clouds gather and it may feel like stimulant medications aren’t working.
“Even with my medication, I would struggle to get to work on time and it felt like I had to make excuses for late deadlines,” says Andrea. “It was like walking through a soupy fog for two or three days.”
In addition to lowered focus, decreased estrogen can lead to anxiety, irritability, trouble sleeping, low libido, and even depression.
It’s no wonder Janice struggled!
Neurotransmitters and medication
Widely considered the standard treatment for ADHD, stimulant medications are either methylphenidate based or amphetamine based and they work by blocking re-uptake of dopamine and norepinephrine, leading to higher available levels in the space between nerve cells, known as the synapse. Note: not everyone benefits from this treatment, it’s important to speak with a professional familiar with stimulant therapy.
Some studies point to estrogen aiding in the effectiveness of stimulants, but more research is definitely needed.
The good news is there are ways to manage your well-being. Some women find relief through doctor-monitored hormone treatment, others find reducing caffeine and making dietary and exercise adjustments are helpful.
For Andrea, adjusting her birth control prescription and stimulant medication made a big difference. She feels more even-keeled throughout the month.
“I know folks often talk about medication feeling like putting on glasses for the first time, but that’s exactly what happened when I adjusted my birth control pill and stimulants. I feel amazing!”
She says even though this has helped her, she still has sad days from time to time. She also says it’s always wise to work with a medical professional.
Some other suggestions to help gain control of your focus and well-being:
1: Keep a diary of your menstrual cycle and highlight problem days
2: Focus on getting enough sleep
3: Reduce caffeine
4: Speak with your doctor about your ADHD medication, it may be time for an adjustment
5: Eat a well-balanced diet with plenty of fruit, vegetables and healthy proteins
Wherever you are on your ADHD discovery journey, it’s important to educate yourself and practice self-compassion.
ADHD + Women: Part Two
This is the second article in a series about the unique challenges that neurodivergent women and gender diverse folks experience.
For adult women with ADHD, the different stages of life can be an unwelcome roller coaster of emotional upheaval and physical discomfort.
Estrogen plays a key role in the production of dopamine, which supports working memory, pleasure, and focus. When dopamine levels are high, alertness, focus, and happiness come easily.
For ADHD’ers that already struggle with low dopamine levels, changes in estrogen production throughout life can be deeply frustrating. In addition, once women reach their 40’s and 50’s, some of the symptoms of perimenopause and menopause mimic and overlap with ADHD, leading to even more confusion. Given that a large amount of the existing research focuses on the male experience of ADHD, it can be mystifying to understand what’s happening.
The good news is understanding how hormones interact and influence the brain throughout life can go a long way in helping you feel empowered to make healthy choices, wherever you are in your discovery journey.
Once in adulthood, women experience three distinct stages that have a dramatic impact on hormones, especially estrogen:
As previously posted on the Adult ADHD Centre blog women of reproductive age experience fluctuating hormones that can impact their ADHD symptoms.
For women during their reproductive years, the time of the month when estrogen levels drop just prior to the menstrual cycle, can be especially challenging. Low mood, anxiety, sleep disturbances, changes in appetite, difficulty focusing, can all take a toll on well-being. For those that have children, the post-partum time can feel even more depleting and disorienting.
Having children, work, and other responsibilities during this time can feel overwhelming. Neurodivergent people need support and self-compassion during these hectic years.
The literal translation of perimenopause is “around menopause”. It’s a natural transition that happens to most people with a uterus, but can feel alarming and scary, which is why it’s so important to have all the facts.
How does this impact ADHD symptoms for women? The dramatic changes in estrogen levels can wreak havoc on concentration and mood and depending on whether you take medication, can also make the usual dose less effective.
For most people, perimenopause starts in their 40’s, but some report symptoms as early as 35. Here’s what happens: the rate of estrogen production by the ovaries begins to decrease. Some women refer to this as estrogen’s storm season, with good reason. It’s unpredictable, sudden and can cause emotional upheaval. Some days, estrogen levels can be high, the next, very low. This can lead to insomnia, anxiety, and depression.
It’s important to consult a doctor or nurse practitioner during this time. Some women find relief with hormone replacement therapy, but it doesn’t work for everyone.
Women that have not had a menstrual period for 12 months are considered to be in menopause. During this time, the ovaries are no longer producing estrogen and menstruation stops. For those that have had a hysterectomy, this can happen much earlier in life.
For some, this can be a relief from the monthly stressors of menstruation, but for others, diminished libido, hot flashes, low mood and insomnia can cause tremendous distress. For ADHD women that already struggle with healthy sleep, it can feel completely overwhelming.
Finding what works for your life situation is absolutely crucial. Not everyone wants or needs hormone therapy. For gender diverse people, this time can be even more challenging, but there is help available.
Information is key
Given that women are often diagnosed later than boys and men, when hormones may have started fluctuating, this can be a difficult time. The grief that comes with an adult ADHD diagnosis can also contribute to feelings of inadequacy. If it’s available to you, work with a counsellor or coach to help sort through the complex emotions that arise with an ADHD discovery.
Informing yourself, asking questions, and talking with others on the ADHD discovery path can be empowering and minimize the confusion and stress of these natural phases of life.
Most importantly, be gentle with yourself as your body changes!