The Darkest Side Of Female ADHD (And How To Recover FAST) | Dr Helen Wall

Added: 2026-05-12

[00:00:00]Women with ADHD are definitely not coming in begging for an ADHD diagnosis.

[00:00:04]She wants answers. She wants validation of how she's feeling and why she's feeling that way. That's very, very different to wanting a diagnosis of ADHD.

[00:00:12]>> Dr. Helen Wall has over 25 years experience in improving the lives of women with ADHD.

[00:00:17]>> As an ADHD specialist, >> she's dedicated to helping women with ADHD >> who are coping with menopause.

[00:00:23]>> With women with ADHD, there's a high degree of emotional regulation differences. We don't talk enough about the effect of hormones on our brains, on our chemical messengers. We talk about our periods, about fertility, reproduction. We need to get into the nitty-gritty of what this actually does to our brains.

[00:00:41]>> Just how bad can it get for ADHD women as they approach menopause.

[00:00:45]>> I can't even get the words out to tell you how bad this can get because >> huge announcement just before we start.

[00:00:51]Tickets to the ADHD Chatter podcast live theater show are selling fast. I'll be joined on stage by three leading psychiatrists, and we'll be unpacking all things ADHD, how to process a late diagnosis, or ADHD, and of course, the dreaded rejection, sensitivity, dysphoria. I really hope you can join me for a night full of validation, laughs, and insights, and one that will remind you that you're not broken, just different, and that you have always been enough. It's on the 19th of May in London. You can find a link to the tickets in the description. I can't wait to meet you in person.

[00:01:27]Helen, welcome.

[00:01:29]>> Hello. Thank you for having me.

[00:01:31]>> You've been a doctor for 20 years and you've recently authored this amazing book, Menopause and ADHD. During your fascinating career, what have you learned about the trials and tribulations of ADHD, specifically in women?

[00:01:48]>> I think ADHD has so many positive traits to it. People with ADHD are some of the most emotionally intuitive, creative, driven people I'm, you know, I've had the pleasure of meeting. I think the difficulty, particularly for women, is how we define it in society and clinically and medically as well. It really saddens me that I still have colleagues who truly believe, and this is medical professionals, that ADHD is all about being hyperactive. you know that that image of a boy chucking a chair around the classroom, not able to sit down and learn um you know as they get older, having addictions, being in trouble with the police, all of these sort of stereotypes and they're being transferred to women and girls and therefore women and girls are being missed. So I think the biggest travesty for me in this is not that, you know, women have ADHD because actually that's not that shouldn't be a barrier to to anything. We make it a barrier because we we're diagnosing women late. We're missing them. We're mislabeling them, which is even worse. We're we're diagnosing them with anxiety, stress, depression, um medically sort of unexplained symptoms. Um and we're not getting to the nub of the problem. And that's what we need to start doing really. And I think if we can do that, we can open up a whole world of opportunities for girls and women with ADHD.

[00:03:14]>> Wow. Yeah. I couldn't agree more. And I mean it is heartbreaking, right? And what what do you think the the toll is or the knock-on effects to a woman's mental health when they are labeled incorrectly for so much of their life?

[00:03:27]>> It's huge. It's absolutely huge. And this is what happens when I see women in permenopause or menopause. We're not just identifying that they've got ADHD at that point in time. We're opening up a whole can of worms about what's gone before. all the missed opportunities, all the um misinterpretations, the mislabeling. Um many of women are carrying that with them when they come into my room with permenopause and and it becomes evident that there's something else going on here. And I think what we are not very good at in medicine is thinking, well, okay, this lady, this lady may have anxiety, burnout, depression. I'm not saying the two can't coexist, but I think perhaps what we're not good at in women particularly is looking at what's the thread running through this, what's driving this? And if you spend your life chronically having to mask, which a lot of these women have done, um overcompensate, overprepare, try and, you know, copy copy facial expressions, you know, practice, rehearse, and and p these are all things that patients have told me they've done and women have told me they've done. um for you know I had a I had a lady a patient who told me that she was had a really great high-flying career on the surface of it she was just absolutely smashing life and she was smashing life that they can't take that away from her but she said that every night like she said every night when I go home I have to look what meetings I've got tomorrow what I'm supposed to be doing and I can spend three to four hours of my evening preparing for the day after and she did that every single night. Now, that might seem like, well, that's not a cost. You know, that that's what you have to do. But actually, the cost of that to her was huge because it meant she didn't she hadn't had a relationship for 10 years, you know, she she didn't have children and she wanted children. She rarely went out with her friends and engage with them because she just had to put so much effort into the thing that she was doing to focus and to get by and to and to be um exactly what you know what everybody expected of her in this role. Um and I think that's what we miss with women. We miss the hidden costs. So when for example you know my colleagues say, "Oh well that lady can't have uh ADHD because she's been to university. She's got a good job. she's never been in trouble with the police and I've heard all of these things said.

[00:05:47]The frustrating bit is the next question should be is but what was the cost of that to that woman? You know what was the hidden cost? And there are always hidden costs when women have been mislabeled, mismissed and misdiagnosed with neurody divergence until late on in life. And that's what we see unravel then when the hormones go into flux in permenopause and you know we they just can't keep up anymore and keep that mask up. Wow. It's powerful. I'm thinking of so many women that I've spoken to since starting this podcast who have described exactly what you've just said. And it's it's it's the internal frustration of how people perceive them and the words that they use is high functioning when behind the scenes they're crumbling. And they almost wish that it was more transparent. the difference between how the world perceived them sometimes perhaps at work when they were handing in that assignment on time and it was being rewarded and yet at home it was catastrophic sometimes roused with the partner getting home and just bursting >> complete meltdown and this happens all the time I see parents who will say to me you know I think my child my daughter has ADHD you know often they've got a parent or a sibling and they recognize it they know they know something's not right >> and unfortunately now and I think this is the same for the whole country but certainly where I work we can't refer a child for an ADHD assessment we have to signpost the parents to go back to the school and ask the school to get um educational psychology etc involved and um what the school will I can almost guarantee 99% of the time with a girl whose parents think she has ADHD the school will come back and say oh but they're no trouble at school they you know they're perfect child they are a pleasure to have in class. Um, and you the parents say, "Well, yes." And then they get home and there's complete meltdown, complete overwhelm, and it's like having two different children. That child is likely masking at school because that's what girls are conditioned to do from an early age, to fit in with societal norms and to fit in with what um we expect of girls. You know, I've got boys. I've got three children. I've got boys and and two boys and a girl. And I'm guilty of this. You know, I know all this and I'm still guilty of it. I expected my daughter when I went to an appointment at the doctors or whatever to sit and color quietly and not disturb anything.

[00:08:15]Equally, when I had my son and he was climbing around the waiting room and, you know, coloring on things he shouldn't be and all the rest of it, obviously, obviously that wasn't great, but I thought, well, he's a boy. That's what boys do. And so we unc we we sort of we condition girls and we do it unconsciously you know we all do it unconsciously I think um and that's how girls grow up and then they become adolescents who then sort of start to question themselves and why am I struggling what's different um and that has a real sort of burden on self-esteem and you know that's the time when you're meeting your peers and trying to find your place in in in society and who you are and what you are Um, and you've got all the hormones then changing as well in puberty. So, yeah, it's really it's really tricky, I think, for girls and women to be seen in this in this area.

[00:09:10]The thing that's driving the girl in the classroom to put on this character that doesn't cause any trouble, doesn't upset anyone, and the woman that that girl becomes, and therefore they want to put on this perfect version. They'll do they'll stay up all night. they'll put four more hours into that piece of work.

[00:09:31]Is that the same strive for perfection that's running through both stages of their life?

[00:09:39]>> Yeah, I think it is. And I'm not sure whether it's a drive for perfection.

[00:09:42]Like I don't think it's a conscious thing. I don't This is my own opinion.

[00:09:47]Uh I don't I don't necessarily think it's a conscious thing. I think it's just sort of almost like that peopleleasing fear of wanting to fit in whether that's conscious or unconscious.

[00:09:56]And I often see that as a as a theme with women with ADHD. They're very self-critical. Lots of um self-lame.

[00:10:05]And you know, there's at no point have I met one of these women and they've said, "Well, this is, you know, because this happened or that happened or because I I've got a brain that's wired differently. It's very much like this is my fault. It's their own moral failings." And that's really that really strikes me with the women that I meet uh who get to permenopause with late diagnosis. Um and I just think we as society just enable this and we are perpetuating enabling it by not standing up and saying actually you know girls and women do have ADHD and the difficulty is because they mask so well they often are hidden if you don't look for it. you have to look for it and um we you know the diagnostic criteria are exactly the same for boys and girls to be diagnosed but we have clinical bias I think and and clinically we are looking for hyperactivity in ADHD um we're not looking and it's the it's the external hyperactivity you know the the restlessness the chucking things the not being able to climb on everything not be able to sit still as a child with girls and women it's often very much internal little hyperactivity. Uh it's about, you know, that rest internal restlessness, the noise that the voice that's continually running the script, can't rest, you can't switch off um and that inability to focus and really sort of task um progress, etc. So, yeah, I think um we just need to get better at recognizing first accepting that it happens in girls and women and and secondly recognizing that you know what it looks like. And when a woman comes to see you, Helen, perhaps she tells her story of being mislabeled or misdiagnosed in the past, you must see that a lot. And how does that make you feel?

[00:11:54]>> Oh, I get really angry.

[00:11:57]Really angry.

[00:11:59]Um, and I've not quite figured out why.

[00:12:01]I don't know why it makes me so angry. I think women are generally very underserved in in medicine anyway. You know, I can't believe some of the things that are here in 2026.

[00:12:11]Um, and one of the things that really riles me up is the fact that in 2026, we barely talk about the fact that female hormones impact our brains. You know, we we I was at medical school 25 years ago.

[00:12:26]We we weren't taught that estrogen and progesterone impacts a woman's brain. In any woman, whether she's neurody divergent or neurotypical, that is a fact. Um, because the studies have been so late being done, and it's only really been the last few years that studies have started to look at this. Um and you know I went to a conference I do some speaking just education speaking and there was about a hundred clinicians in that room. There were pharmacists, there were doctors, there were nurses from from primary care. And I started by asking them, have any of you in this in this room when you did your training at medical school or nursing school, when you did your specialist training or or ever since postgrad or whatever, have you ever been taught about the effects of women's hormones on on women's brains?

[00:13:12]And it was like tumble weed. Not one person put their hand up. Everybody looked at each other. They looked at me.

[00:13:20]They looked at my screen, which wasn't doing anything. They looked at the ceiling and they were like, "Where is she going with this?" And I just thought, "Oh my god, we're actually screwed." Like, we this needs to change.

[00:13:31]Like, we can't. And and that made me so angry. Not that not at them because that's not their fault, but it the system is not designed for women. And it's and the what we do have is designed for 1950s housewives effectively who are staying at home and just have to sort of worry about what they're putting on fat for tea and what the kids are doing. We are functioning effectively as men now.

[00:13:53]We're in the same jobs, the same roles, leadership positions, running businesses, um doing everything else at home, looking after the kids. You know, we need our brains to be functioning. Um and and you know, 100%. And there's so many reasons why that doesn't happen.

[00:14:09]And as medics, we just don't talk about it. That's bonkers.

[00:14:13]>> Do you think ADHD women deserve an apology from the medical community?

[00:14:18]>> Yeah, I do. And I do say to um women that I see, you know, I'm sorry. I'm sorry you've had to to get to this point. I'll hold my hands up. I'm not by no means perfect. I've been a GP in the same practice for 17 years. And I've seen some women most of that 17 years through all different stages of their life. I've seen their children. I've seen their their husbands, their families. And that's what I love about general practice. But one of the one of the downsides of that is when you screw up, you know you've screwed up because you're still there. You know, you're not somebody who's seen someone in a clinic and never see them again. I get to see my mistakes. And I've seen I've seen mistakes that I've made. You know, I've um I've seen women who I've treated for anxiety, depression. They've kept coming back. They're in crisis. They're struggling at work. Their relationships are failing. And I'm, as I'm talking, I'm thinking of these women. I can see their faces right now. And um they've I I've not known why. You know, I've been totally totally oblivious to why why is this person not getting better? Why can they not just, you know, get on with with this or that? Um, and at least three of the women that I'm thinking of, I've seen recently in per menopause because they've come for menopause support.

[00:15:38]And I've suddenly realized, you know, at that point when things have got so much worse and and their executive function has unraveled because the hormones are all in flux. I've realized, oh my god, like you've you've you're probably ADHD.

[00:15:52]This is this was the thread that was running right through this all along and I didn't see it. And once you've seen it, you can't unsee it. Um, and and I've said to, you know, I said to them, I'm so sorry. Like, I feel like I've failed you. But we just haven't been in that space. Like, I haven't been in that space in my mind. My journey started when my daughter uh when it became evident that my daughter had ADHD and she was assessed and diagnosed. And then it switches you it switches you on to what those what those features are and what you you know you see it you you see it in people whereas before I didn't see it. And I think you know that's the problem that we're just not seeing it. It's there in plain sight but we're not seeing the thread that's running through these life stories.

[00:16:39]>> What reactions have you witnessed when you have revealed to your patient that perhaps it is ADHD after all?

[00:16:46]>> I'll be honest, most of it's relief.

[00:16:49]a huge amount of relief initially.

[00:16:53]Um sometimes there's a bit of you know questioning like denial really you know because obviously women have been um it's not just clinicians that have been told for years that ADHD only affects boys and and men. It's women as well. So you know there's a lot in the press there has been a lot in the press recently about you know GPS are overdiagnosing ADHD. Well for a start GPS don't diagnose ADHD. have to refer them on for, you know, a very, very thorough assessment, which takes years in some places to get. Um, but I would honestly say a lot of the women I see, they just don't know what's going on.

[00:17:30]Their brains are so, you know, their executive functions gone, their emotional regulations all over the place, and they don't all come in going, I think I've got ADHD. I want a diagnosis of ADHD, which is what you would believe if you read some of the the media articles or listen to some of the media outlets. Um, some of it is just absolute burnout and complete exhaustion. And I don't want anyone to think that I am looking for people with ADHD and I am, you know, encouraging people to have ADHD. I think, as I said, it's just when you've seen it, it's hard to unsee it. And um one of the criticisms, one of the biggest criticisms that I get from colleagues is, you know, everybody with permenopause, women with permenopause and menopause, they're bound to have some features of ADHD. You know, they're bound to have brain fog. They're bound to have trouble with focus, trouble with switching off, anxiety, etc. because that's what happens in permenopause or menopause. Yes, they do. Absolutely. And I I'm not saying that's the that's not the case, but these women have had things right through their life going back to childhood. They're not going to get a diagnosis of ADHD just because they woke up one day in per menopause and suddenly they couldn't function.

[00:18:45]This goes back and back, but nobody has seen it because of the masking. The woman herself often hasn't seen it because she's masked. She's kind of I think most of women I've spoken to about this kind of have known there's something not quite right. They've known that things have been a challenge.

[00:19:00]Perhaps things have been a bit more difficult for them than than their peers, but they've never been able to put their finger on it. Um, and then, you know, they get to permenopause and the the sheer volume of hormonal change of is the thing that tips the balance into this realization that something's going on here. Um, but I think, you know, women are not women are definitely not coming in begging for an ADHD diagnosis. I I would really refute that.

[00:19:30]And I would honestly say that I've never met a woman who wants an ADHD diagnosis.

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[00:20:54]You can do it before you've forgotten or been distracted. Give it a go and use the link in the episode description for 30% off. Just a note though, this code is only applicable on the web browser and not the smartphone. Back to the episode. Do you think the hormone changes and fluctuations that women go through, do you think generally that creates a lived experience that means ADHD is harder for women than it is for men?

[00:21:18]>> Yeah, I think there's a few things that make it I mean it's not a competition, is it? You know, it's it's hard ADHD can be very um it can be great, but it can also be quite disabling for men and women, you know, with with certain challenges. I think the difficulty for women is is the one the hormonal changes that we undergo. So puberty, pregnancy, postnatally, permenopause, menopause, you know, huge shifts in our hormones can really impact how ADHD shows up.

[00:21:48]But then I think everything else for why it's difficult for women with ADHD is we can change, you know, we can't we can't change the fact that our hormones flux all over. Yes, we can support them with with medications and and so on. Um but we can change how society manages this and how we see it and how med how medical um how the medical community sees it and manages it. That's what we can change. Um and and that I think that's one of the biggest factors that makes it hard for women. you know, women with ADHD, if they were supported I in a you know, if they were in an environment where their positive strengths were celebrated and embraced and and um not challenged and shut down and they weren't effectively swimming against the tide, which everyone with ADHD kind of is whether you're male or female. Um but probably a little bit more so because of the lack of recognition for it in girls and women. Um that's I think what makes it really hard. Masking we've touched upon and and we know that masking is is a is very common in men and women with ADHD, but do you think hormone changes can it make masking trickier for women depending where they are in their cycle?

[00:23:01]>> Yeah, I mean it can even change from you know month to month exactly that with a with a menstrual cycle. Um we see the biggest changes I think in at times of significant hormonal flux. So, as I've said, permenopause, puberty, pregnancy, but even throughout a month, we know that I think the key to this is the chemical messengers in the brain. Um, and we know that with ADHD, the brains are wired differently. The the parts some parts of the brain are different in volume etc. And the the chemical messengers signal differently. Um, so estrogen really supports dopamine signaling. We really need estrogen to be sta enough estrogen and for it to be stable to have perfect dopamine signaling and dopamine is responsible for our motivation, our reward, our focus. Um so even throughout one month where estrogen is rising and falling as it does in a normal cycle for a woman.

[00:23:58]Um when the estrogen is higher that can mean that she might feel more focused more um able to get on with things because um of this effect on the dopamine signaling and to some extent the serotonin signaling as well. So uh which helps with emotional regulation.

[00:24:13]That's something we've not touched upon, but actually, you know, with women, there's a high I think there's a high degree of emotional regulation difficiological studies in terms of again the chemical messaging within the brain and the effect of hormones on that. And I don't think we give that enough credit and and that happens, you know, throughout a month. That might happen to every woman.

[00:24:39]you know, she might feel better at the start and the the middle of a cycle and then worse towards sort of the end, but if you've got um ADHD, that's likely to be in some women much more significant uh change. So, I think yeah, we don't um we this all goes back to my former point that we don't talk enough about the effect of hormones on our brains, on our chemical messengers. We talk about them, you know, about our periods, about fertility, reproduction.

[00:25:07]um we need to get into the nitty-gritty of what this actually does to our brains.

[00:25:11]>> How big of an event is the menopause and what do I mean by that? Is it possible that a woman could almost self-calibrate how she manages her ADHD with consideration of her own knowledge of how her mood and everything changes throughout the month and then the menopause comes. there's such a drastic change in the hormones, all of her scaffolding falls away and then she enters a crisis and goes for an assessment. Is that quite a common >> absolutely routine?

[00:25:40]>> Yeah. And I think what we have to remember is when a woman's about to hit per menopause or menopause which is generally in her 40s um give or take often they've got so many other things going on at that point in life as well.

[00:25:51]They've often got teenage children who are also going through hormonal changes who are likely going through um assessments for neurode divergence.

[00:25:59]That's one of the key points we see women uh have a light bulb moment. Um you know there's all sorts of things going on often career might be at the peak of her career or having career changes you know questioning what she's doing with her life relationship changes etc. So there's a huge amount of things going on for a woman when she hits that period of her life. Um, and then you know throw into that ADHD and the chemical messenger changes that happening driven by the hormones. Um, I guess in in terms of you know can a woman manage that herself if she's aware of it? Absolutely. Um, but that goes back to the first point. She has to be aware of it. And because we're not talking about this, we're not talking about the effects of hormones on our brains, neither in the medical community or really in in general, you know, female girl environments.

[00:26:50]Um, then we're just not spreading that awareness. And that's what we need to do. I'm very, you know, I'm very give or take medication for ADHD. Um, I think it's a very individual decision, individual choice. It's not for everyone. Um, but in my book I talk a lot about things that you can do if you don't want to go down the medication route. Um, and a lot of it is about, you know, first of all, it's that validation of what's going on, understanding, a bit of self-compassion, and then sort of looking at your um, you know, if once you understand it, it becomes much easier to manage things, doesn't it?

[00:27:26]And, uh, yeah, that's what that's what I think is helpful to women if we can give them that understanding. But in order to do that, our medical colleagues need to understand it first, which is which is tricky because GPS do a bit of everything. You know, I'm rubbish at things like neurology. You know, if you come to see me with a neurological condition, you ain't going to get much from me. Um, so every GP's got a little bit of knowledge about everything and often they've got a bit of a special interest where they're very keen and this is my special interest where I'm very keen. So, you know, it's easy for me to sit here and say GPS should >> not dismiss women. I know that, you know, I know the factors behind why and how that happens.

[00:28:05]>> Just how bad can it get for ADHD women as they approach menopause? And I suppose, do you have any anecdotes or stories, anyone you know, that might illustrate that point?

[00:28:16]>> And it it can get it. Yeah. I mean, I can't even I can't even get the words out to tell you how bad this can get because I've Yeah. I've seen quite a few women now who are just in bits really. Um we already know that per menopause menopause has a seven times increased suicide rate. So the the peak point of time for women to commit suicide or attempt suicide is between the ages of 45 and 55 which again we don't nearly highlight enough. Um and then if you throw into that ADHD and unmasking and all the issues that we've talked about that come to the for the surface at this point in life um I've you know women I've seen women really really at the lowest point. Uh I can think of a lady uh off the top of my head who um was came in you know she she she'd basically given up her job so she'd gone off sick um completely unable to sort of focus brain brain was just felt she described her brain as being like mush everything she'd ever done to try and to to get on just no longer worked for her. Um and she'd give she was on the sick. She then got sacked because she was on the sick for so long they let her go. That started to affect her relationship.

[00:29:36]Um she started to drink alcohol because she was at home all day and she was feeling really low and she needed that sort of something to lean on and and and she went to alcohol. Um and you know she turned up just saying you know my menopause is so bad like why am I going through menopause so bad so bad. And when you actually started to talk to her, this wasn't just a menopause issue.

[00:30:00]You know, she'd had points in her life where things had unraveled for her several times before after the birth of her first child um and subsequently second child, although she was more prepared for that.

[00:30:13]So, she sort of put things support around her to to expect things to unravel a bit. Um she'd gone from job to job. She'd never sort of really been able to to focus. Um, she'd been described at school as pleasant but inconsistent. You know, the daydreamer.

[00:30:29]And this is what I often hear. Women have been called daydreaming, dity, can't get on, lazy, etc. Um, and then, you know, she'd hit menopause and this had all unraveled and and everything was in tatters for her. Absolute tatters.

[00:30:44]And when we spoke about this, I saw her a couple of times because I didn't just go, oh, you know, do you think you've got ADHD? And I sort of started to gather a bit of information. And I started to think, you know, this is there's a pattern once you've once you've seen it, you have you develop a pattern recognition tool as a GP. And I and I said to her, you know, do you think this could be something else? Do you think like there could be some ADHD?

[00:31:04]Um, and she was like, you're not the first person that said that to me, but I thought that was just for boys.

[00:31:14]So the women themselves don't often know what's going on. you know, they they arrive in absolute tatters and they don't they think they're going mad. They think it's their fault. They're blaming themselves. They're blaming themselves that everything is gone. You know, they've not got a job. Their relationship is in tatters. I mean, I I've seen her a few times since. And she's not actually she's on she's still on the waiting list for a diagnosis.

[00:31:37]Um, which is quite common in the NHS.

[00:31:40]But what I would say is I often say to women, you know, if we think this is ADHD, you can still access resources. You can still access support. There's plenty of support groups that will help you. You don't have to go in there with a formal diagnosis. You can still look at things like resources online. Um tools, there's plenty of books for tips and tools of how to sort of externalize your brain, how to how to manage how to see things and understand yourself a bit better.

[00:32:07]And she started slowly but surely. She she got a bit help with the alcohol and then she started trying to to to do that and she did sort of she said to me just you saying do you think this could be ADHD? So I didn't believe it at the time but when I went away and read it and spoke to my family and it all made sense just that was enough to start me on the road to feeling like I could get around this. That was it. Like she didn't need she said I don't need I'll stay on the waiting list but I don't need medication. I don't need somebody else to tell me this. Like that. It's therapy in itself that I've got some answers and I can start to work around this. And I thought that's quite that's key, isn't it? It's it's just listening and being able to validate somebody's story.

[00:32:52]>> So, she came to you, this this woman in a point of real crisis and the final piece of the acceptance puzzle was locked behind a gate of her belief that only boys could have ADHD.

[00:33:03]>> Yeah. How did that make you feel hearing that?

[00:33:06]>> Well, again, it goes back, doesn't it, to this whole sort of societal, you know, it's 2026 for goodness sake. It's 2026. Like, I'm constantly like just nothing. I always say nothing will surprise me anymore.

[00:33:20]But then I I get really surprised when things like that happen cuz how can this be? Um, but it's not her fault. This is what we tell this is what we tell people. This is what we tell um women and girls. this is what is trotted out time and time again if I've got colleagues I've got GP colleagues who've said that very thing to me how can we expect women to know what's going on here um and it needs to change and that's part of my sort of motivation because I don't want my daughter who is ADHD I don't want her to get to her per menopause menopause which is a long way off hopefully and end up in that position you know I don't want her to to have to fight to be believed. Fight to be heard.

[00:34:05]>> What's the silver lining, Helen, for the many ADHD women who listen and watch this podcast who relate to what you're saying? Perhaps they have gone through menopause or they're approaching it.

[00:34:15]What's the silver lining? How can you make them help them see it?

[00:34:19]>> The silver lining is that having ADHD is not a failing or, you know, you're not broken. There's so many positive things to being having ADHD, you know, and obviously we we can generalize, but the the women that I meet with ADHD are often some of the most emotionally intelligent, intuitive, uh, creative women. You know, if you've in a crisis with a deadline, you want that woman with ADHD in your corner. You know, nothing's going to get done as quick as that woman with ADHD fighting for you. um you know if I ever have a crisis I should be fine now because I've got lots of women with ADHD that would come in my corner so you know I'm happy um but you know there's so many positives to it but I think the difficulty is as a society we often talk about it as a deficit rather than a difference and we need to celebrate it as a difference um and and stop seeing as a negative thing and that comes from you know right from the very fact that we're being criticized for overdiagnosing it there was a study done uh Not so long ago, I think it was 9,000 GP records were analyzed and the number of ADHD diagnoses in men and women was only I think it was about 322%. So we are massively underdiagnosing it probably because everybody's sat on waiting list waiting to be seen but we're certainly you know we've got evidence we're not overdiagnosing it.

[00:35:46]We're just not seeing what's there in plain sight. The last time I checked, there's roughly about 800,000 ADHD diagnosed people, men and women, in the UK, >> and if we put the prevalence of ADHD at about 4 and a half%. That's what the World Health Organization puts it at, there is 2 and a half million people in the UK with ADHD, and yet we've only diagnosed 800,000 of them.

[00:36:10]>> Yes, exactly. We're we're massively underdiagnosing it. And I stand by that.

[00:36:15]That is a hill I will die on. We are underdiagnosing ADHD million%.

[00:36:22]>> Women have been missed and let down for far too long. But what do you think women do need to hear for them to start their journey of self-compassion now?

[00:36:32]>> They need to be validated. They need to be seen and heard, listened to. And I think if women are not getting that from their clinician, I want personally want women to know that they can go back again. you know, don't if you really think that something's not right, advocate for yourself. And that can be really hard to do. Uh if you're a woman whose brain is sort of really mushed and and you're struggling and you're anxious. Um but please find that strength to do that because it will it can be life-changing and I've seen it be life-changing.

[00:37:10]>> Amazing. Thank you so much, Helen. We're going to just close with some questions from the audience and I've got three in the washing machine of woes which is >> I thought I'd got away from washing machines today.

[00:37:22]>> I know it's it's it serves two purposes.

[00:37:24]It houses the questions and also it's a public service announcement to remind the listeners to empty their washing machine because that's my my biggest ADHD wear is my memory. I always forget to put a cycle on a gang in that long.

[00:37:35]It needs to relate to it. Oh, good. It always makes me feel less alone when the guest relates to it. So, we'll wait a few minutes for the audience to come back from washing emptying their machine.

[00:37:44]>> Okay.

[00:37:45]>> The first question, Helen, from the audience this week is, "My ADHD is unpredictable as it is. What does menopause have in store for me?"

[00:37:55]>> Well, hopefully it won't be bad. You know, I think I think it's important that I say that that not all women uh are going to have a horrific time in permenopause and menopause regardless of whether you're neurody divergent or neurotypical.

[00:38:09]But I suppose if if you have got ADHD and it already is causing you problems, then you know you might want to be prepared for the fact that your hormones are going to fluctuate. And when your hormones fluctuate, that can have an impact on your chemical messengers in your brain. Um, and you may start to feel like you're not quite as in control as you were. So the scaffolding that we've already mentioned might start to wobble a bit. Um, and I think if you are aware of that and you can know what's happening and be prepared for it, um, that can be so much easier to deal with.

[00:38:42]Um, most of the women I see who have really gone into, you know, catastrophic decline at this point, the hardest thing for them was not understanding what was going on and thinking that they were going mad, being told that there was nothing, you know, there would nothing to worry about, just get on with it.

[00:38:59]You're just going through menopause.

[00:39:01]You're just stressed. Um, so I think if you go into it with your eyes wide open, that can be really therapeutic.

[00:39:08]>> Before your book, podcast, general awareness has obviously gone up massively.

[00:39:13]>> Yeah.

[00:39:14]>> Previous generations of women who who were going through this very natural process of menopause, what have they truly believed? Was did was it quite easy to just assume that you were going crazy?

[00:39:26]>> I think it probably was. I mean, one of the um I go into some workplaces doing some uh training of staff um and one of the key things that I often hear is from older women who've been through menopause saying my day we just got on with it and there's none of this this is rubbish. So some of the most diminishing statements can be from other women. You know this is not all about men in in menopause and per menopause. Um but I think when you actually drill that down and speak to some of those women, what does we just got on with it actually mean? Um you know they they didn't really just get on with it. Many of them some will have like they some some will do now. Um you know they were very emotionally dregulated. They were um having relationship problems. They were um you know crying and emotional. Um, so I think the difference is they just didn't feel they they didn't have the language or the knowledge or the ability to speak up and ask for support. And we do now, you know, things change fortunately and and women are getting that um that awareness. So I think that's a good thing. And I we can't just, you know, just because things have changed and they're not like they were in the past doesn't make it wrong.

[00:40:40]Do you think the the women who were saying that they just got on with it? Do you think do you think to be stoic is just to be high masking?

[00:40:51]Quite possibly. Yeah. I mean I think um as women often they do just get on because they've often got the people to look after. Um I think you know I see that time and time again with women in my surgery when that's for any anything that they come in with. You know, they'll often say, "Well, I can't, you know, I've had women say, "I can't go to hospital with my crushing chest pain cuz I've got to pick my child up from school or my grandchild up from school." You know, uh I mean, that's not just isolated to women. We see it in men as well, but very much there's always a thought for somebody else. It's never just about themselves. There's always, oh, I've got to do this. I've got to do that. Actually, I've got to do that. I think women are quite bad um at putting themselves first, most women. Um and yeah, I think Yeah, absolutely. For some women who were neurody divergent in permenopause that is extremely high masking isn't it to say we just get on with it.

[00:41:41]>> The next question from the audience Helen is my daughter is approaching puberty and she has ADHD. What can she expect?

[00:41:50]>> Yeah, puberty can be a bit of a hang on to your hat moment for any parent, can't it? And um the thing as I've said with girls is emotional regulation can really go a bit haywire in puberty in any girl but I think with with an ADHD brain that is more likely to happen. So I think you know it's those shifts in in emotions that can be quite hard to to manage and and often adolescence is the time when things like RSD so you know rejection sensitivities for it can kick in. um just his sensitivity can be seen more fluoridly things like that. So I um yeah I think puberty is tricky and I think what helped what helped me with my daughter who went very much like this in puberty and that's sort of what led to us getting an assessment and diagnosis was just understanding that it wasn't directed at me. You know it wasn't it wasn't us. It wasn't me and her dad that were the actual attack points. It was just the brain that was just sort of firing and and couldn't couldn't be controlled. And I think once we got our heads around that, we stopped taking it personally and just let just were there to support and just sort of to hold the space really in that moment.

[00:43:04]>> Really helpful. Thank you, Helen. And the final question from the audience is um are there any superfoods that can help with hormonal stability?

[00:43:14]Oh, I get asked this a hell of a lot.

[00:43:16]You know, I think if there if there was one superfood that I could um I could tell people about, I'd be, you know, I'd be very very famous. Um generally speaking, we we don't sort of say, "Oh, there's this food or that food." You know, it's about having a varied diet.

[00:43:30]It's all the boring stuff that you don't want your GP to say to you. Haven't got a magic uh food, you know, that we can tell you. Um I think just make I think for for menopausal women really key is having enough protein. Um it stabilizes the blood sugar and therefore stabilizes help stabilize the cortisol and the hormone levels and you know good for your your bone and muscle health as well.

[00:43:54]>> Fascinating. Thank you very very much Helen. And just finally I want to deliver to you a letter >> okay >> that was written by the previous guest.

[00:44:01]Oh >> okay >> there we go.

[00:44:02]>> Thank you to my younger self. You weren't too much. You were enough. You don't need to shave your edges off. Be yourself.

[00:44:14]I think that's perfect, isn't it?

[00:44:15]>> Very nice tone to finish. Helen, on behalf of everyone listening struggling to grapple to understand how hormones and menopause affect their brains, thank you so much.

[00:44:26]>> Thank you.