ADHD & Women: Hormones, Misdiagnoses & More

In this episode of the Hypercast ADHD Podcast, we delve into the challenges and unique experiences faced by adult women with ADHD. We discuss how ADHD manifests differently in women, the effects of hormonal changes, and the frequent struggles with misdiagnoses such as anxiety and bipolar disorder. Listen to learn about effective coping strategies, societal pressures, and empowering insights for living with ADHD as an adult woman. Join hosts Brianna and Melissa for a thoughtful conversation aimed at supporting and informing women on their ADHD journey.

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🔗 Links to Things Mentioned in This Episode

ADHD & Men Episode: https://youtu.be/mrYQv9yzJfo 

ADHD & Women with Dustin Horvath: https://youtu.be/cTcdE15oqS4 

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Transcript

ADHD & Women_Hypercast ADHD Podcast

[00:00:00] Brianna: Welcome to 

[00:00:01] Melissa: Welcome to Hypercast.

[00:00:03] Melissa: Today's topic is ADHD and women. 

[00:00:05] Melissa: 

[00:00:05] Melissa: so we already covered this a little bit with Dustin,

[00:00:09] Melissa: we just wanted to expand on the topic a little bit more, talk more in depth about hormones. 

[00:00:13] Melissa: And, maybe a little more detail about what it's like to live with ADHD as a 

[00:00:16] Melissa: woman. 

[00:00:17] Brianna: So why is this topic important? 

[00:00:19] Brianna: Women aren't studied nearly as much as men have been when it comes to the medical side of ADHD. most of the research has been on young white boys Which causes issues in and of itself. But yeah, that's not just for ADHD. That's for everything.

[00:00:33] Brianna: But we're going to talk about it. ADHD. it affects me personally. I am a woman with ADHD,

[00:00:38] Brianna: very lucky to be diagnosed fairly early. that's not the case for most women with ADHD. I have personally witnessed the struggles and the harm that a late diagnosis can cause, 

[00:00:50] Brianna: There are social aspects that affect us women with ADHD, and especially those that are being diagnosed later, because supposed to act in a certain way. And I think it could be easy to deny that diagnosis because most women present as inattentive.

[00:01:05] Brianna: That means they may be quieter. They're not as boisterous. They're not as loud. And of course, social picture that you get of ADHD are people who are loud and out of control and can't sit still. 

[00:01:17] Brianna: that's not always the way it presents in women. 

[00:01:19] Brianna: in my opinion, we're starting to move away from the inattentive and hyperactive types and more towards a more cohesive, like everyone can have the different symptoms and traits at different times. They just may present differently depending on gender role expectations, societal expectations, how you were raised, just like who you are.

[00:01:39] Brianna: Biologically, but also personality wise the way you express certain traits might differ. women have sought out coping strategies and built up these mechanisms and it's more expected of them because of that whole boys will be boys mentality where they're allowed to be a little bit more rough and tumble, and that's how they get out their hyperactivity piece.

[00:01:57] Brianna: Whereas women have to do it a little bit differently. So yeah, my point is that it's not necessarily hiding Per se, but it's being misinterpreted,

[00:02:06] Brianna: oh, she's just crazy. Oh, it's hysteria.

[00:02:08] Brianna: Oh, it's PMS, We are presenting as having ADHD and it's being misinterpreted because people don't want to accept that 

[00:02:15] Melissa: a lot of women, not only are they not getting diagnosed, younger with ADHD, but they're often getting misdiagnosed with 

[00:02:22] Melissa: other things such as bipolar disorder. if you have periods of being hyper, you may have a doctor that thinks that's a presentation of mania 

[00:02:29] Brianna: Yep. Anxiety, bipolar disorder, borderline personality disorder is incredibly common as a misdiagnosis. depression.

[00:02:36] Brianna: the fluctuations, it's like that's a core trait of ADHD, the fluctuations between the emotion regulation, the hyperactivity, it's not a constant state. That's why we have, distractibility and hyper focus, it's fluctuating, 

[00:02:50] Melissa: you sent me, an image that was representative of the spectrum of ADHD and it wasn't a line. the spectrum was not linear. it was a spider web graph. that makes so much sense because it had all these different points. you could jump from here to here to here in one day I may move all over the spectrum.

[00:03:08] Melissa: I can feel different in the morning or the evening, or, maybe I didn't eat enough and I'm just like flagging, all of these things can affect me and how I'm presenting today.

[00:03:15] Brianna: the bias, the lingering stereotypes, all that kind of thing is Oh, you either have a lot of it or none of it. And that's the spectrum. But that's not the case, It's not linear like that .

[00:03:26] Brianna: And then also once you're in the condition, it's not just you have this trait and not this trait. And it's not just if you have this trait, it's a lifetime of that trait. Okay. Because it fluctuates, not just over a lifetime, not just over a week or a month, but throughout the course of hours 

[00:03:44] Melissa: Life changes, but from childhood to adulthood, regardless of your gender, we change, we grow. our brains change. 

[00:03:51] Melissa: But regardless of your neuro type brains change consistently over time you're saying your presentation may change 

[00:03:58] Brianna: But not just your, presentation, your coping strategies.

[00:04:02] Brianna: if you're six years old, you don't have access to some of the communication skills, some of the self regulation tools. maybe your mom put you in itchy clothes that day, and you don't have the words to convey what's going on. That the clothes are causing you sensory overstimulation.

[00:04:15] Brianna: You're just like, they're itchy. And you're trying to take them off and she's trying to put them back on you. you have the ability as you age to be better in control of your body that includes when you have ADHD, What you present as a child is not necessarily what you present as an adult, which led to the stereotype of, Oh, it's only for children, and obviously only male children, because girls were presenting it differently. Everyone that I've talked to is like, it gets worse. When you're an adult, it gets worse.

[00:04:42] Brianna: And it does, because

[00:04:43] Brianna: there's now more demand on your executive functions than when you were a child. And that's the piece that ADHD causes problems with. It

[00:04:52] Melissa: Yeah. And it.

[00:04:53] Melissa: it. doesn't go away. And it takes a lot of time on our part to create systems, to make plans, to put things in place to make our lives better. 

[00:05:03] Melissa: Do you want to talk about puberty? 

[00:05:04] Melissa: let's talk about puberty. it's been so long. I don't want to remember it. 

[00:05:07] Brianna: When you're going through puberty, all your hormones are changing. You know what hormones do?

[00:05:11] Brianna: They impact your brain. and since this episode is specifically on women, let's talk about the menstrual cycle. When you are just about to ovulate your estrogen levels are really high.

[00:05:21] Brianna: Estrogen is involved in the creation of dopamine. So when you're ovulating, your dopamine is at its highest, your executive functions are doing great, you're logical, you're able to do tasks in a productive, efficient way. Everything is going great. 

[00:05:36] Brianna: And then the worst part of when you're on your period, your estrogen is at its lowest, which means you have less dopamine. So not only are you dealing with terrible cramps You're also dealing with lower dopamine, which means less executive function control.

[00:05:51] Brianna: It also means all of that emotion dysregulation like when you're on your period, you're a little bit emotional. Someone's telling you, Oh, it's just PMS. You're just crazy. 

[00:05:59] Melissa: All of those symptoms and traits that are happening that have been attributed to, Oh, you're just a woman. Oh, I bet it's your time of the month. Oh, someone's a little testy, a little moody today. All of those microaggressions. If you have ADHD, it's probably a combination of PMS, mood swings, and not having enough dopamine because your estrogen levels are really low.

[00:06:21] Brianna: Doesn't it make sense?

[00:06:22] Melissa: it does make sense. Can we talk about the fact that medications are not nearly as effective during our periods? I get so frustrated because I'll have something really important on my plate to do and then my period hits and I am just stupid and I'm stupid, not because I'm an idiot, but because all of a sudden my body is confronted with massive change.

[00:06:45] Melissa: My medication is not working and it's like I'm sitting on a tilt whorl in my head and I don't know where I'm going to land. 

[00:06:54] Brianna: This just happened to me. I had important stuff to do and previously I was blasting through the important stuff, meetings, doing all the stuff. And then no matter how hard I tried. I couldn't focus on it. I couldn't concentrate. I would get started, which is an enormous monumental task in and of itself.

[00:07:11] Brianna: then I'd get distracted immediately. things that I could have done so easily. Like couple days before were all of a sudden impossible. before I knew that my ADHD was impacted by my period, I thought it was a me problem. I didn't understand thatlike, it was harder, like actually physically, I did not have the hormones needed to do tasks.

[00:07:34] Brianna: I thought that I was lazy or something was wrong with me because I was capable. And then I wasn't. I, just needed to try harder or something like that. And it is so emotionally devastating when you're already on your period and things are a little bit more sensitive I felt so awful for not being able to get things done.

[00:07:52] Melissa: I feel like, I feel like every woman out thereunderstands that day that all of a sudden, like your hormone shift and you feel like there's nothing in the world you can do to make life work the way you need it to. 

[00:08:03] Brianna: Exactly.

[00:08:04] Brianna: And then the external perceptions of if you have a partner or a boss or someone who's relying on you, like you have a school assignment due, there's no Delaying it for your period because, men's society don't understand that, there are certain days where it's just not possible.

[00:08:18] Brianna: I'm in a lot of pain, first of all, which is disabling in and of itself. But not only the pain, my brain is battling against me. And I am losing today. In two days, I'll be able to get this done. But right now, I am really, struggling. And there's no empathy, no support, no understanding.

[00:08:35] Brianna: I do have a fabulous partner who if I say my meds aren't working or if he now knows that if I say I have my period, 

[00:08:44] Melissa: I've mentioned it and he's observed it multiple times. So he's educated enough to go. Oh, I know what to expect now. but you have to have someone who's willing to receive that message and to accept it and not just take it as an excuse.

[00:08:57] Brianna: It must be so interesting to see that from the outside, to have a partner who is completely capable, like you have the utmost faith in them. And then just like couple days a month, they're like not functional.

[00:09:08] Brianna: to have to adjust to that balance as a man who's never experienced what it's like, and just to see it from the outside. my partner is amazingly supportive and there are certain things that I couldn't drop and he sat with me while I body doubles system to get them done on, by the time limit. not everyone is that lucky, not everyone understands themselves enough to ask for that. Employers aren't going to understand, unless we make them understand. 

[00:09:31] Melissa: unless we make them understand. Well, let's talk about how do we manage being women in these bodies and being confronted with what that brings when we have ADHD? Because like we're saying, two, three days out of the month, I feel like I'm brain dead and useless. how do we deal with that?

[00:09:48] Brianna: My strategy right now is just to be extra kind to myself. I didn't know, that my period was connected to my ADHD and I couldn't understand why some of the time I wasn't capable. that really affected me internally.

[00:10:01] Brianna: I always viewed myself as being capable of doing whatever it was, not in spite of, but in addition to ADHD, society was telling me, Oh, you have ADHD, you can't. I was like, actually, I can. And then there were certain days where I couldn't.

[00:10:13] Brianna: And I was like, Oh, no, are they right? Is society right? Am I actually broken? Am I actually not okay?

[00:10:19] Melissa: So what you're saying is negative self talk was coming in 

[00:10:22] Melissa: because you felt that 

[00:10:24] Melissa: should be able to do it and you should be able to overcome.

[00:10:27] Brianna: I couldn't demonstrate to myself, let alone to other people that I could overcome it. And I didn't know why. 

[00:10:32] Brianna: I had No understanding of what was going on until I did the research myself, now I am able to be much more kind to myself. 

[00:10:39] Brianna: and lower my expectations of what I'm going to accomplish or get done that day. So like my to do list, cut it in half, cut that half and half 

[00:10:48] Brianna: Just prioritize the very, Top importance tasks that cannot be dropped or pushed a couple days.

[00:10:54] Brianna: be honest with yourself because that goes hand in hand with being kind honesty to yourself means that 

[00:10:59] Melissa: you're not second guessing and pushing yourself to overcome 

[00:11:02] Melissa: something 

[00:11:03] Brianna: Mm hmm. 

[00:11:03] Melissa: Your body just may not want to do today.

[00:11:05] Brianna: There's nothing worse than pushing yourself because your body just will not let you achieve it. So if you're like, oh, I need to get all this stuff done today, and then you don't. It feels way worse than if you just reduced your to do list and achieved one thing.

[00:11:19] Brianna: really praising yourself for just achieving the bare minimum, like you survived today. that is impressive.

[00:11:24] Melissa: can't remember where I heard it recently, I am today's version of me. I'm not yesterday's version or the day before's versionI'm today's version of myself. So what can I do as today's version of myself to care for myself and do what I need to do.

[00:11:38] Melissa: And like you're saying, maybe that's cutting your list in half, maybe asking for an extension asking for help or 

[00:11:43] Melissa: maybe I can move that coffee date,

[00:11:45] Melissa: just do what you need to do to take care of you and the version of you today. 

[00:11:48] Brianna: The things that you planned for yourself when you were at your best don't need to be accomplished when you're at your worst. 

[00:11:55] Melissa: to quote, the book of Mormon tomorrow is a latter 

 Marker

[00:11:57] Melissa: day. 

[00:11:58] Brianna: Oh no! That was funny. I completely lost my train of thought. 

[00:12:02] Melissa: here's the thought. It came back to me. if you find a doctor who understands, ADHD and. Menstrual cycles, if you're a uterus carrier, 

[00:12:12] Brianna: if you currently own a uterus

[00:12:15] Brianna: and have ADHD, if you can find a doctor who understands both of those things and have an honest conversation with them. About. Your medication, for example, if you can find someone to talk to about potentially changing your dose, when you're on your period to increase it, when you're at your lowest, and to actually be able to support, the lower dopamine that you have during that time. And. Like the hormonal birth control pills have that whole week of sugar pills, why can't ADHD medication dosage match your hormonal cycle, might be helpful.

[00:12:48] Melissa: the thing that I hate about psychiatrists is that you have the psychiatrist that you walk in and they just write you a script and you walk out. But if you can find a doctor who's willing to have a conversation with you about your needs, that is a really good doctor. 

[00:13:00] Brianna: Yeah, absolutely. Someone who's willing to, sit down and talk to you for five minutes and ask, like, what is it about ADHD that you're struggling with?

[00:13:08] Brianna: my psychiatrist has a question that she asked the first time she ever asked it to me, it like blew my mind. she asked me, do you feel like you're drowning? Doctors don't 

[00:13:15] Melissa: always effectively ask how well your medication is working and that's her measurement.

[00:13:20] Melissa: do you feel like you're drowning? 

[00:13:21] Brianna: are you saying that someone took the time to ask you how you were coping? And it actually helped? 

[00:13:27] Melissa: Yes,

[00:13:28] Melissa: and I will not let go of the psychiatrist for as long as I can. 

[00:13:32] Brianna: That is beautiful and

[00:13:33] Brianna: amazing. Let's briefly cover some other things. 

[00:13:36] Melissa: to talk about what happens when you don't have this cycle anymore, menopause, perimenopause going through that, or You didn't have it to begin with.

[00:13:45] Brianna: Um, estrogen. estrogen is involved in the creation of dopamine, before we started recording, we started talking about how when menopause hits, a lot of women tend to be diagnosed for the first

[00:13:56] Brianna: time. When you go into perimenopause, your hormones get all messed up, and when you're in menopause, I'm going to say the actual numbers here because it shocked

[00:14:03] Brianna: me. 

[00:14:04] Brianna: normally in your body, you have 30 to 400 picograms per milliliter of estrogen. When you are in menopause, you have 0 to 30 picograms per milliliter of estrogen. Estrogen in your body that 30 to 400 because again, your cycle fluctuates when you are in menopause, the maximum you can have is the minimum when you are on your period and you're feeling absolute s because you have no estrogen in your body, 

[00:14:34] Brianna: isn't that awful?

[00:14:36] Melissa: Yes 

[00:14:36] Brianna: No wonder women in menopause are struggling with ADHD getting diagnosed for the first time. All of their coping systems that they had built up. Over their lifetime, all of a sudden, crumble because executive function disappears as dopamine disappears.

[00:14:53] Melissa: Being a woman in my mid forties, looking down the path of menopause myself, that terrifies me. 

[00:14:59] Melissa: not only is menopause terrifying in and of itself it's already just like a physical nightmare. For women with ADHD, there's an added layer of complexity.

[00:15:08] Melissa: my brain is like, what do I need to put in place to prepare myself for this moment in my life? 

[00:15:12] Brianna: No, but that's such a good conversation to have what can you prepare?

[00:15:16] Brianna: What can you have in advance? what needs to happen for when this happens? 

[00:15:20] Brianna: as a woman, we have to actually prepare for these things, now that I know that it happens, first of all, that's the first step, knowing that it's going to 

[00:15:26] Melissa: Knowledge. Yeah. 

[00:15:28] Brianna: and now how do you prepare? What do? 

[00:15:29] Melissa: Yeah. 

[00:15:30] Melissa: Oh, that's a loaded question. 

[00:15:32] Melissa: how do I prepare for times when I may be at my worst? 

[00:15:36] Melissa: Being mentally aware of how I feel and how well I focus and what I need to support myself when my estrogen is at its lowest and that may give me some data to actually start to gather, what I need and to figure out what I need in the future.

[00:15:55] Brianna: And to put supports in place, to

[00:15:57] Brianna: have that conversation with the people in your life, to realize that your to do list is going to be slashed. In half for, the rest of the future. 

[00:16:06] Brianna: the other piece I wanted to talk about with womanhood and Aging if you're not diagnosed in childhood 

[00:16:12] Brianna: the diagnosis piece in childhood is hard enough.

[00:16:14] Brianna: As an adult, especially an adult woman, if you don't have that history, like if your parents have passed and they can't explain what your symptoms were in childhood, it's really hard to get a diagnosis because part of the diagnosis depends on childhood symptoms. 

[00:16:29] Brianna: Most of the cases of women getting diagnosed with ADHD in their 40s and 50s are because their children are getting diagnosed and they're like, 

[00:16:37] Brianna: that's not abnormal. I have those too. And you're like, oh no, you're both ADHD.

[00:16:42] Melissa: It's genetic people. It's genetic. 

[00:16:44] Brianna: then you have to go through that grieving process of the life you could have had if you'd known earlier.

[00:16:48] Melissa: you know, people who go through that in their 20s, 30s, 40s, but imagine doing that at 50 or 60, you're in the last phase of your life, the last, quarter of your life, that's got to be overwhelmingly upsetting, the 

[00:17:01] Melissa: grief. I can only imagine the grief.

[00:17:03] Brianna: my grandma got diagnosed when I did.

[00:17:06] Brianna: She was in her like eighties 

[00:17:08] Brianna: and at that point in her life, she's I'm not going to do medication. I've lived my whole life without this and I don't want to deal with that right now. But it explains so much. luckily for her, her attitude and mentality was like, Oh, isn't that interesting? Oh, it explains a lot. 

[00:17:23] Brianna: the genetics

[00:17:24] Brianna: 

[00:17:24] Melissa: that shift in perspective can be so healing.

[00:17:26] Brianna: This is my career, my profession. And so when she was like, I think maybe me too. And I was like, probably grandma, let's talk about it 

[00:17:35] Brianna: And I had been told previously Oh, like that's something your grandma did. Like I got grandma's freckles and I got 

[00:17:40] Brianna: this one trait or like your grandma does that too I was like very proud of that because I love my grandma, but I was like, Oh, I know that's an ADHD thing. Grandma, you for sure have it, 

[00:17:48] Brianna: to wrap up we talked about Women and ADHD

[00:17:52] Brianna: this is a companion episode to the one we recorded with Dustin where we talked More about gender expectations and gender roles and the pressure that places and the like impacts on self esteem that has, which we didn't cover in this episode, but it's important to mention that being treated differently or given different diagnoses has a huge social emotional impact on young women and women as they age.

[00:18:15] Brianna: in this episode, we talked about the hormonal impact and just having that knowledge. that your hormones menstrual cycle and certain events throughout your life impact your ADHD can allow you to give yourself the space and grace that you need

[00:18:33] Brianna: in those moments where your estrogen is low, your dopamine is low, and you're not functioning at your best. 

[00:18:39] Melissa: be kind to yourself.

[00:18:40] Melissa: Give yourself, like Brianna was saying, Space and grace and reach out for help. there are some lovely places online. I know, like Reddit, there's the ADHD women's group. there's 

[00:18:51] Brianna: Oh, yeah, 

[00:18:52] Melissa: Facebook groups, things like 

[00:18:53] Brianna: there's so much solidarity I've gotten from my female ADHD friends just talking about this stuff and validating it

[00:18:59] Melissa: We've hit you with two weeks in a row of ADHD and women next week. Stay tuned because we will be showcasing an episode on ADHD and men 

[00:19:09] Melissa: We're very excited about that. So stay tuned. Anything else that I'm missing Brianna? 

[00:19:14] Brianna: knowledge is power. Be

[00:19:15] Brianna: kind to yourself.

[00:19:16] Melissa: That is right. 

[00:19:17] Brianna: You can find me I'm an ADHD coach and intern therapist at understandingadhd. ca and Melissa. 

[00:19:24] Melissa: You can find me at 

[00:19:25] Melissa: likemindcoaching 

[00:19:28] Melissa: Thanks for listening until next week. 

[00:19:29] Melissa: Bye 

[00:19:30] Brianna: bye. bye.