It is still so crazy that women experience hormonal cycles and changes that impact everything, but that this not considered in managing their mental health. Many of the women I work with hesitate to 'blame' their hormones for fear of falling into the 'hysterical woman' trope, but the impact is huge and needs to be recognised. Rant over! Thank you for writing this incredibly informative and well referenced piece, it has given me much to think about.
I am super passionate about the power that comes from understanding your cycle. Often times we think and feel so deeply during certain time of our cycle and we wonder what’s wrong with us and fret over what we need to change…when in fact, all we need to do is ride it out, journal it to see if it has merit for later. I could go on and on about this. If every woman only gave herself permission to slow down and hibernate and plan around when she has energy, work and home life would transform. ✨
Thank you so much for the mention! Everything you wrote here resonated with me. It blows my mind that we are only beginning to understand that many, many medical issues (from mental health to heart attacks!) present differently in women vs men. I’m only starting to explore the topic myself (and am, in typical ADHD fashion, very riled up about it.)
Absolutely! I find it incredible that they've only just discovered we have oestrogen receptors in our brains - seems like such a "duh" moment, considering all the massive changes a woman's body (and brain) has to go through for pregnancy, breastfeeding, etc.
I've been reading a fascinating book called Invisible Women by Carolina Criado-Perez, which is all about how data - for all sorts of things - uses men (and usually white, straight, cis men) as the default with women treated as some kind of variation from the male "norm"! It's a real eye-opener and I highly recommend it.
“For many adult women with ADHD who have children, compensatory behaviors that may have managed ADHD symptoms prior to having children are no longer adequate under the stress of parenting and the high cultural expectations of motherhood.”
I feel like I could write a book about this.
I certainly felt this way, and conflated bring a good mum with being a good housekeeper = messy house = bad mum.
Thankfully, I recently challenged this assumption with this:
You nailed it! At one point I was running the day-to-day lives of two-autistic teenagers with mental health challenges, my elderly mother who lived with me and tried to become helpless, while also managing my depression and burnout. Medical appointments, medications, individual education plans, care and feeding for everyone.
I always felt like a scattered mess. My therapist and doctors kind of brushed off my thoughts of my own ADHD. Saying things like, you’re doing a great job under the circumstances.
I didn’t get my own diagnosis until menopause exacerbated my ADHD. And also my kids are adults now, I have more time to think clear thoughts. I’m finally paying close attention to improving my quality of
life.
Your article definitely tells my story. Thanks for the mention.
I am so glad that this post reflected your lived experience, and so sorry that it took so long for clinicians to give you an accurate diagnosis! I find that it helps sometimes to see our experiences in these bigger patterns -- it can help us feel less alone and more self-compassionate, I think.
I relate really hard to this! I too have 2 undiagnosed but probably autistic and/or ADHD kids with huge anxiety issues, now teenagers but still very dependent on us. I only discovered the idea of autistic burnout several years after my autism dx and not long before my ADHD dx, but then realised I'd been burning out repeatedly since well before my 1st child was born and, by pushing through over and over again, fell deeper each time over years.
I felt like an empty shell for years, the antidepressants I was prescribed doing little to help. It's only since being on stimulant medication that I've felt at all alive again and able to start the long journey to recovery (though perimenopause isn't helping!!)
Thanks for writing this, Taylor. Very interesting. And it makes a lot of sense that girls will make more effort to blend it and possibly will be less disruptive in school making their symptoms less noticeable.
Thank you Taylor! I appreciate this very much and learned a lot! This quote particularly resonated with me: "In an effort to embody female gender roles, girls may exert a great deal of energy into efforts to minimize, hide, or compensate for their symptoms." So much yes here.
That point really spoke to me too! There is so much pressure on girls to white-knuckle through their symptoms. It really concerns me how this can affect girls' sense of self-worth.
Thank you for the mention! I learned from Sandra Kooj about hormones and adhd at a conference maybe 5 years ago. Google her for tracking the science she's constantly researching it. ( also Littman Wasserstein and maybe Solanto) We know adhd women have higher rates of pmdd, post partum depression AND that womens symptoms skyrocket during perimenopause and menopause because of drops in estrogen ( which seems to modulate the symptoms). For the most current theory on this here is the paper: https://www.sciencedirect.com/science/article/abs/pii/S0018506X23001642 Part of paper proposes that there is a spoke in impulsivity just prior to ovulation making girls vulnerable to impulsive behaviors and just before their periods making them vulnerable to depression and mood disregulation ( this tracks). SO Important.
Ooh, this review is SO good and just came out! I will have to do a deep dive into it in an upcoming post soon. Thank you so much for sharing -- agreed, this is incredibly important.
👌 I was going to mention Sandra Kooij too. It was her work that first introduced me to the relationship between female hormones and ADHD, too.
Also, while I don't remember details, I seem to recall a presentation by her in which she showed research data suggesting elevated rates of a wide range of physical health issues/illnesses in ADHDers compared with non-ADHDers. I think it included PMDD and PPD but also other things not specifically related to female hormones.
Thanks for the mention. I'm yet to listen to the whole episode but it's been recommended by a fellow ADHDer.; the Harvard Business Review podcast have cover this topic recently. https://hbr.org/podcast/2023/10/adhd-is-different-for-women
And I 💯 agree that hormonal cycles play a part in symptoms. Also there's evidence of so many comorbidities that if looked at from a more holistic pov, the diagnosis rate might be better. Things like Endometriosis, hyper mobility, PMDD. But regular GPs (I'm in UK) don't have training around this, so someone might have all these things and get missed because they are 'coping' but really they are all connected.
Thanks again, you can probably tell it's a favourite topic of mine!
Thank you for the podcast rec! And you make such an excellent point -- so few GPs/PCPs have the training to help them take a holistic perspective on all of these health conditions, particularly when it comes to the relationship between "mental" and "physical" symptoms.
"regular GPs (I'm in UK) don't have training around this, so someone might have all these things and get missed because they are 'coping' but really they are all connected."
Yes, I relate very much to this! In fact, these things get missed even when someone isn't coping - they are instead attributed to depression/anxiety, hormonal issues (e.g. perimenopause) or hyperchondria!!
(also in the UK and still don't know what is actually "wrong" with me)
Another aspect of hyperactivity, rarely mentioned, in ADHD women can be mental hyperactivity. Personally, I never related to ADHD when younger because I had never seen myself as hyperactive at any point in my life - because I was never very energetic, was poor at most physical activity (among other possible issues, I only discovered I was asthmatic aged 21, so pretty much thought I was just really unfit before that) and being a fidget wasn't the same as being hyperactive, was it??
After realising I was autistic (aged 45) I even found a reason for the fidgeting - stimming. So hyperactivity there was none.
Then I learnt that mental hyperactivity could also be an aspect of ADHD and it finally clicked - all the lying awake into the wee small hours because my brain just wouldn't turn off and worried and worried and worried over ... well ... everything - suddenly it fitted. So - ADHD (combined type) dx aged 50.
It is still so crazy that women experience hormonal cycles and changes that impact everything, but that this not considered in managing their mental health. Many of the women I work with hesitate to 'blame' their hormones for fear of falling into the 'hysterical woman' trope, but the impact is huge and needs to be recognised. Rant over! Thank you for writing this incredibly informative and well referenced piece, it has given me much to think about.
Oh that is such a good point about the "hysterical woman" trope -- there is a real social stigma to talking about hormones and mental health!
I am super passionate about the power that comes from understanding your cycle. Often times we think and feel so deeply during certain time of our cycle and we wonder what’s wrong with us and fret over what we need to change…when in fact, all we need to do is ride it out, journal it to see if it has merit for later. I could go on and on about this. If every woman only gave herself permission to slow down and hibernate and plan around when she has energy, work and home life would transform. ✨
Absolutely!
Thank you so much for the mention! Everything you wrote here resonated with me. It blows my mind that we are only beginning to understand that many, many medical issues (from mental health to heart attacks!) present differently in women vs men. I’m only starting to explore the topic myself (and am, in typical ADHD fashion, very riled up about it.)
Right??!!?! It is absurd to me how this is "cutting-edge" research -- it seems like this should have been investigated decades ago!
I've just subscribed to you... I call myself a recovering perfectionist so HARD RELATE 😅🤩
Me too! “Recovering perfectionist” here, on my way to becoming retired! 😆
It’s a process for sure 😅
Absolutely! I find it incredible that they've only just discovered we have oestrogen receptors in our brains - seems like such a "duh" moment, considering all the massive changes a woman's body (and brain) has to go through for pregnancy, breastfeeding, etc.
I've been reading a fascinating book called Invisible Women by Carolina Criado-Perez, which is all about how data - for all sorts of things - uses men (and usually white, straight, cis men) as the default with women treated as some kind of variation from the male "norm"! It's a real eye-opener and I highly recommend it.
Ooooh that sounds interesting…this recent Culture Study interview covered the same topic and I found it fascinating: https://open.substack.com/pub/annehelen/p/whose-bodies-get-studied?r=taj9i&utm_medium=ios
Another interesting read - thank you for sharing!
Some thoughts on ADHD diagnoses in women.
https://open.substack.com/pub/johannasartori/p/adhd-and-other-animals?r=323u84&utm_campaign=post&utm_medium=web
Thanks for sharing this!
“For many adult women with ADHD who have children, compensatory behaviors that may have managed ADHD symptoms prior to having children are no longer adequate under the stress of parenting and the high cultural expectations of motherhood.”
I feel like I could write a book about this.
I certainly felt this way, and conflated bring a good mum with being a good housekeeper = messy house = bad mum.
Thankfully, I recently challenged this assumption with this:
Love your kids = good mum
I needed to hear this today. Thank you! 💖
I’m so glad 🥰🥰
Taylor, you’re a great mum! 💕
You nailed it! At one point I was running the day-to-day lives of two-autistic teenagers with mental health challenges, my elderly mother who lived with me and tried to become helpless, while also managing my depression and burnout. Medical appointments, medications, individual education plans, care and feeding for everyone.
I always felt like a scattered mess. My therapist and doctors kind of brushed off my thoughts of my own ADHD. Saying things like, you’re doing a great job under the circumstances.
I didn’t get my own diagnosis until menopause exacerbated my ADHD. And also my kids are adults now, I have more time to think clear thoughts. I’m finally paying close attention to improving my quality of
life.
Your article definitely tells my story. Thanks for the mention.
I am so glad that this post reflected your lived experience, and so sorry that it took so long for clinicians to give you an accurate diagnosis! I find that it helps sometimes to see our experiences in these bigger patterns -- it can help us feel less alone and more self-compassionate, I think.
I relate really hard to this! I too have 2 undiagnosed but probably autistic and/or ADHD kids with huge anxiety issues, now teenagers but still very dependent on us. I only discovered the idea of autistic burnout several years after my autism dx and not long before my ADHD dx, but then realised I'd been burning out repeatedly since well before my 1st child was born and, by pushing through over and over again, fell deeper each time over years.
I felt like an empty shell for years, the antidepressants I was prescribed doing little to help. It's only since being on stimulant medication that I've felt at all alive again and able to start the long journey to recovery (though perimenopause isn't helping!!)
Thanks for writing this, Taylor. Very interesting. And it makes a lot of sense that girls will make more effort to blend it and possibly will be less disruptive in school making their symptoms less noticeable.
Yeah, I have absolutely seen this in girls that I know. I'm glad you found this interesting!
Thank you Taylor! I appreciate this very much and learned a lot! This quote particularly resonated with me: "In an effort to embody female gender roles, girls may exert a great deal of energy into efforts to minimize, hide, or compensate for their symptoms." So much yes here.
That point really spoke to me too! There is so much pressure on girls to white-knuckle through their symptoms. It really concerns me how this can affect girls' sense of self-worth.
Thank you for the mention! I learned from Sandra Kooj about hormones and adhd at a conference maybe 5 years ago. Google her for tracking the science she's constantly researching it. ( also Littman Wasserstein and maybe Solanto) We know adhd women have higher rates of pmdd, post partum depression AND that womens symptoms skyrocket during perimenopause and menopause because of drops in estrogen ( which seems to modulate the symptoms). For the most current theory on this here is the paper: https://www.sciencedirect.com/science/article/abs/pii/S0018506X23001642 Part of paper proposes that there is a spoke in impulsivity just prior to ovulation making girls vulnerable to impulsive behaviors and just before their periods making them vulnerable to depression and mood disregulation ( this tracks). SO Important.
Ooh, this review is SO good and just came out! I will have to do a deep dive into it in an upcoming post soon. Thank you so much for sharing -- agreed, this is incredibly important.
👌 I was going to mention Sandra Kooij too. It was her work that first introduced me to the relationship between female hormones and ADHD, too.
Also, while I don't remember details, I seem to recall a presentation by her in which she showed research data suggesting elevated rates of a wide range of physical health issues/illnesses in ADHDers compared with non-ADHDers. I think it included PMDD and PPD but also other things not specifically related to female hormones.
That sounds so familiar. She is really a passionate advocate isn't she!?
Thanks for the mention. I'm yet to listen to the whole episode but it's been recommended by a fellow ADHDer.; the Harvard Business Review podcast have cover this topic recently. https://hbr.org/podcast/2023/10/adhd-is-different-for-women
And I 💯 agree that hormonal cycles play a part in symptoms. Also there's evidence of so many comorbidities that if looked at from a more holistic pov, the diagnosis rate might be better. Things like Endometriosis, hyper mobility, PMDD. But regular GPs (I'm in UK) don't have training around this, so someone might have all these things and get missed because they are 'coping' but really they are all connected.
Thanks again, you can probably tell it's a favourite topic of mine!
Thank you for the podcast rec! And you make such an excellent point -- so few GPs/PCPs have the training to help them take a holistic perspective on all of these health conditions, particularly when it comes to the relationship between "mental" and "physical" symptoms.
"regular GPs (I'm in UK) don't have training around this, so someone might have all these things and get missed because they are 'coping' but really they are all connected."
Yes, I relate very much to this! In fact, these things get missed even when someone isn't coping - they are instead attributed to depression/anxiety, hormonal issues (e.g. perimenopause) or hyperchondria!!
(also in the UK and still don't know what is actually "wrong" with me)
Ah, frustrating. Its a full time job advocating for yourself isn't it? sending strength.
OMG! This is significantly delayed, but thank you so much for the mention!
I am finally coming to terms with the fact that my menstrual cycle might be affecting my ADHD symptoms, so thank you for validating that experience.
Another aspect of hyperactivity, rarely mentioned, in ADHD women can be mental hyperactivity. Personally, I never related to ADHD when younger because I had never seen myself as hyperactive at any point in my life - because I was never very energetic, was poor at most physical activity (among other possible issues, I only discovered I was asthmatic aged 21, so pretty much thought I was just really unfit before that) and being a fidget wasn't the same as being hyperactive, was it??
After realising I was autistic (aged 45) I even found a reason for the fidgeting - stimming. So hyperactivity there was none.
Then I learnt that mental hyperactivity could also be an aspect of ADHD and it finally clicked - all the lying awake into the wee small hours because my brain just wouldn't turn off and worried and worried and worried over ... well ... everything - suddenly it fitted. So - ADHD (combined type) dx aged 50.
Thank you for this great, informative read, and the very kind shout-out, Taylor!
My pleasure! 💜