Session transcript

Why Perimenopause Can Make ADHD and AuDHD Feel So Much Harder

with Mercedes Aspland · Day 3 · The Difficult One

Hi there, and welcome to Why Perimenopause Can Make ADHD and AuDHD Feel So Much Harder, and why your attempt at trying harder might not actually be the answer. Let me just get my presentation going. There we go.

A quick introduction to me. I'm Mercedes, and I'm your presenter today. I'm a yoga teacher and coach, and I've got a background in meditation, breathwork, somatic work, and nervous system regulation, so there's lots of those things going on. I'm late-diagnosed AuDHD. I'm currently in perimenopause, and I'm just starting out on HRT to see if that helps at all, which, fingers crossed, it will.

I used to run a knitwear and knitting supplies business, designing my own patterns and getting yarn from all over the place, and I still love crafting and making my own clothes. It's kind of fun. I'm a single mum to a six-year-old boy who also has autism, and I have two cats. I love coffee. I drink far too much coffee, whether it's caffeinated or decaffeinated, and I've had quite a few coffees this morning, so I may speak really quickly. And I'm a lifelong Arsenal fan, for the pain that that brings.

So why is it that everything suddenly feels harder when we hit perimenopause? It was something that I noticed, and for me personally it was compounded by the fact that I had a child around the start of perimenopause. You get to this stage and you think, I used to be able to cope with this, so why can't I cope anymore? I really felt that a lot. Why is everything so overwhelming? And more than that, why does everything seem to be getting harder every year that goes by?

You may find that you're having more reactions: strong emotional reactions, and even physical reactions. I've noticed as I've got older, my ability to wear certain clothes has changed. I just put up with discomfort a lot less, so I'm much more likely to say, no, that's too uncomfortable to wear. It's little things like that which you become more and more conscious of. You may find that noise bothers you more, and spending time around people, and the demands that life puts on you, starts to become too much.

There's a double thing with that, because we find it harder to cope with the demands that are placed on us, but often by the time we've reached perimenopause, the demands have ramped up quite a lot. So we've actually got more demands anyway, and it's all compounding on top of itself.

And we're tired, right? This is one of the things I notice. I'm tired. I hardly ever sleep properly anymore. I might have a good night, and then I'll compensate for that good night by having a really bad night. Everything feels so demanding, so overwhelming, so exhausting, so I'm tired constantly. And even when I get a good night's sleep, I don't necessarily feel like I'm going to recover from the tiredness.

So for some of us, when we hit perimenopause, this is when ADHD or autistic traits just become harder to manage. Or this is when we first start to realise that we're neurodivergent, because we actually start to become aware of these symptoms. You might have been coping really well for years without realising the extra effort you were putting in. We don't always realise that neurotypical people aren't putting in that extra effort. So we think, why am I so tired? We've been doing this all our lives. We may have created a narrative, a story in our head, that we are really capable, but we just find things more tiring than other people. Then as we start to get into perimenopause, we stop being able to mask and control and manage these things, and it really becomes apparent that there's something else happening.

When we were younger, we used to push through being tired, be a perfectionist, be a people-pleaser, and do all of these things to survive. Nervous-system-wise, these are fawn-type responses. We would fawn constantly and do things for people to compensate for our struggles.

Then we would over-prepare. Growing up, I would be so prepared. I would always be ultra early for things. I was never late, because I was always ultra early, and everything had to be perfectly done. Because I have autism and ADHD, the autistic traits of organising things neatly and perfectly, in alphabetical order and all this kind of stuff, would take over. I would push myself into having to be overly prepared for everything, and then not realise the points where I wasn't coping.

Going back to when I was at school, I would get to my exams and be totally overwhelmed. My GCSEs were coming up, and I thought, I don't know what to do. I've got ten subjects I have to learn for, and I don't know how to cope. What am I supposed to do? And I remember my mum sitting me down and saying, you just need to create a timetable of revision periods for each subject, like lessons. And I was like, oh yeah. She had to teach me not to think of the whole thing as one. Obviously, I didn't realise that was an ADHD trait. And when I was a kid, doctors didn't realise that was an ADHD trait either, let's be honest. Girls when I was at school didn't get ADHD. It was a boy thing. So we are just discovering that some of these things we've been living with our whole lives are actually hard work, and they do exist, and it is a neurodivergent thing.

And we would use urgency and stress to get things done. That was a big thing for me. I would always put myself under pressure and stress. If I was doing exams, I thought, you've got to aim to get 100% on everything. If you don't get 100%, you've failed. I wouldn't get 100% in everything, but I would use that immense amount of pressure, and that stress would push me through. And we would just keep busy, and as we got older, keep taking on more and more responsibility.

Those strategies work really well, but they take a lot of energy. And as we hit perimenopause, we stop being able to do them, because we have less energy available. It just happens.

There's lots of other things going on in terms of our dopamine responses. Because we lose estrogen, we lose some of the ability to create dopamine, so we are coping with less dopamine in our brains as well. So we've got less that we can actually do. Getting started is much harder, because we haven't got the reserves that we maybe had when we were younger. Our sleep is more disrupted. And the brain fog that neurotypical women get in perimenopause is amplified because of the neurodivergence. Because we've got less dopamine, we've got more anxiety, we're more emotionally reactive, we have a lower mood, and it takes us longer to recover. We just don't get our energy back.

Life is still asking a lot of us, though, because often women who are neurodivergent will go through perimenopause up to ten years earlier than neurotypical women. So often we begin perimenopause when we've still got the pressures and demands of young families and work and aging parents. All of these things are happening at the same time, and we just lose the ability to compensate for it.

So it's not that your ADHD or autism is worse, although there is some element of that with ADHD, because of the estrogen and dopamine link. Our ADHD actually can become worse because we have less estrogen, so we have less dopamine. All of those things that we found really hard, that we were able to compensate for, we now don't have enough dopamine to compensate for. And that's why you might be saying, I should be able to manage this, but now I can't. It becomes really apparent that there is something happening. And it isn't laziness or weakness or being incapable. It's a hormone and neurodivergent cocktail that is really starting to kick off.

So we had the old coping strategies, and they cost a lot. Now they cost more. You would push through and keep going until you crashed, but now you crash a lot sooner. When we're perfectionists, that whole "good enough" concept starts to feel really unsafe, so we start to spend longer being really picky about things, or going down rabbit holes. And we start to do more people-pleasing. We start to fawn, because we notice we're not perfect, and then we overcompensate by people-pleasing even more, being more controlling, keeping our environment controlled, putting ourselves under more pressure, and spending more time hiding that these are the things we're doing.

We can help ourselves by changing the question. We can ask, what do my brain and body need right now? Often we're asking, how do I make myself cope the way I used to? But that's not helpful, because we're not going to be able to do it. Things have changed. We've changed. Life has changed. We need to adapt. So we can reduce our demands, change our expectations, protect our energy, build in recovery time, and build in support from people we know.

The first step is to notice what's costing us energy, and this is really important. There's your sensory and social effort. How much energy is that costing you? Are you finding peopling harder, and are you getting more sensory input problems? How do you cope with switching tasks? That can be a big one. We don't realise that we're burning through energy, because every time we change tasks, we have to go through the task initiation process again. For me, sometimes I have to take 30 minutes doing something random in order to get started with a new task. Are we taking on other people's emotions? We're very good at that. We carry it. We think, oh yeah, this is our responsibility. It's not. So can we start to put some of these things down? And how often do we push past our limits? That's really important to know. We're not judging. We're just learning.

Step two is to reduce our demands before we try to increase our capacity. Once we reduce our demands, then we can work on capacity. Do we need to manage everything? Look at your list of all the things you're managing. Are there some things you can actually drop? If the next-door neighbour gets annoyed that you don't do X, Y, and Z, but there's no obligation on you to do X, Y, and Z, do you need to do it? Let that person sort their own problems out. Some of those things on your list, you might find you can drop. Perimenopause can actually be quite handy for spotting those things and realising all the stuff we're taking on for other people that we don't need to, because it seems to get amplified in our brains.

So when you're looking at your list: What can you remove or simplify? What things do you not need to do, and what things can be simpler? If you did some things less perfectly, would it still be okay? Just start to bring awareness to that. What can you ask other people to do? We've been doing stuff for our families all the time. What can we say to them? Actually, you can do this. You can take care of yourself. And what can you say no to? What do you say yes to that you don't want to do? Can we start saying no? And what do you do because you think you should, or because you've always done it? We don't necessarily need to do things just because we've always done them.

Step three is to notice our automatic stress pattern, because we're going to have one. Do you move into action? I'm very much like this. Actually, I do both, depending on the situation. If things are going quite well, I'll be quite active. I go into action. I will do, do, do, do, do. And then there are other times when you might find that you withdraw. You don't want to be around people. You freeze. You can't think. Both of these things may be happening at the same time, or at different times, or you may have one that is much more dominant than the other. So just start to be aware of what happens for you. Which one do you do?

Your body will react before your thinking catches up. You'll have a trigger. That might be a demand, an interruption, an overload, lots of things going on. You might notice your body responding with jaw or shoulder tension, or pressure in your chest, or your mind might start racing. This is when we need to bring in a pause. Make a little space for yourself before you respond. Just pause, take that space, and you can make a choice. You might not need to say yes or solve everything right now. You might just want to say, I need to think about that, and that might be all you need to do.

Other signals that might come up for you: you might feel heavy, or numb, or frozen. You might feel like, oh, I don't know how to respond to this. If your brain goes into a freeze, which it can do because we can have decision overload, then again, create space for yourself. And sometimes you can ask someone else to help you make a decision.

The other day, I was going out with my mum. We'd planned to go somewhere, but we didn't have enough time, so we decided to go somewhere else. I was really hungry, and I literally lost the ability to choose what to eat, because the decision was too overwhelming for my brain. I had to say to my mum, you're going to have to decide, because I just can't think about it. Sometimes just doing that, and knowing that it's something that can help us, is enough.

So we create that pause. Whatever will create that pause for you. It might be breathing. It might be a grounding exercise. It might just be becoming aware of how you're feeling. Or it might be saying to people, oh, just give me a moment, let me think, and creating a buffer of space for you.

Small changes. The problem is that often, particularly when we're neurodivergent, we want to make huge changes. Don't. What happens is we overload our brains again, the changes don't stick, and then we decide, we can't do this stuff. So let's start with small changes.

If you notice that you're the kind of person who pushes and pushes and pushes until you crash, maybe one thing you can do when you feel that push coming on is think, I'm going to take a five-minute break. I'm going to put my feet up, rest, and allow myself a little breather before I come back. Or do a nervous system regulation practice that takes under five minutes, so it gives you a little bit back.

If you say yes immediately, or you say yes to lots of things you don't want to do and then find yourself stuck in overload, the next time someone asks you something, just say, let me get back to you. Give yourself space to think. If you're an urgency person and you have to fix everything now, again, give yourself space. Do something regulating that's going to give you a bit of space. If you shut down, tune into your body sensations and notice one thing you can feel. And if you're critical of yourself, you don't necessarily have to change that. Just notice that you're doing it. Because honestly, just being aware will change a lot. Choose one small thing rather than changing everything at once, and that will make a huge difference.

We might need different support in midlife. You might realise that you need more recovery time, and it's about learning to build that into what you're doing. You may need more rest, and you may need to ask for help. We may need to learn, for the first time in our lives, to ask for help. This is something I've been learning over the last two or three years: to actually say, I don't need to take this all on myself. I can ask someone else to do this bit for me. And maybe we need to work on stronger boundaries and having fewer demands on us.

One of the things that can help is predictable routines. With ADHD, even though I've got autism as well, I'm really good at predictable routines, but then I'll forget about them for a little while. So this is about how much we can build in achievable, predictable routines, and maybe reducing sensory input wherever we can. Wear clothes that are comfortable, that give you a dopamine hit. I do that quite a lot. I might wear the same thing regularly because it feels right to me and it feels comforting. It's doing little things like that that will really help. And just being a bit more flexible with yourself, and building structure into your day, so that you don't have lots of things competing for your attention, because that's going to cause overwhelm and that burnout feeling.

And it doesn't mean, when you need these things, that you're going backwards or there's something wrong with you. It just means that your needs have changed, and you're starting to adapt your life to fit your needs.

So you might not need to get better at coping. That's an important thing to say. Just change how you're working and protect your energy. If you can, ask for support. Allow recovery, and make things easier for yourself. And stop measuring yourself against an older version of you, but also stop measuring yourself against other people. Because we do this: why can other people cope? Well, firstly, they may not be neurodivergent. When you're neurodivergent, you're coping with way more than they are. If they had to walk a day in your shoes, maybe they wouldn't cope either. And often, because we're neurodivergent, we're really hard on ourselves, because we've received so much criticism through our lives, and we don't realise just how much we are actually coping with. We're doing a fantastic job. And our goal now is to understand what supports us and to work with that.

With this presentation, my freebie for you is The Stress Pattern Pause. In it, you can identify your automatic stress pattern, recognise how it shows up in your body, understand why it happens, and practise some simple nervous system tools to help you create an alternative response. That's all in the freebie, and it will be with this presentation, wherever you're watching it.

So if everything feels harder, it doesn't mean you need to try harder. Really, it doesn't. Take the time to think about what is costing you energy, what you can make easier, and what your brain and body need. These are really, really important things to think about.

And I just want to finish by saying: be kind to yourself, and accept the fact that life is changing. But that's okay as well.