What Is ADHD Like During Menopause?
🔊 Audio Recording
I chat with Lisa Alecci, life coach and founder of ADHD Freedom, about hormone fluctuations and their impact on ADHD. Lisa, who has ADHD herself, didn’t realize she had it until menopause hit. She explains why this happens and her thoughts on the broader conversations (or lack thereof) in our community.
Lisa explained estrogen decreases by about 65% during menopause. Estrogen is a key factor in the production and use of serotonin, dopamine, norepinephrine. Lisa points out people with ADHD don't have enough of these in the first place which explains why executive function capabilities drop along with them.
Mentioned in this episode:
Rude awakening
A rude awakening
Is it Alzheimer’s?
Managing hormones
Summary
When Lisa Alici started experiencing early menopause, she didn't just face the usual symptoms; she was blindsided by a surge in ADHD-related challenges. In our latest episode, Lisa shares her personal story and professional insights, shedding light on the critical but often-neglected connection between menopause and ADHD.
As we unpack this complex issue, we turn our focus to the broader challenges women face when tackling ADHD amidst hormonal shifts. Join us as we explore the necessity of consulting ADHD specialists and integrating lifestyle changes like sleep, exercise, and mindfulness practices to manage symptoms effectively.
Highlights
(00:00) Menopause and ADHD
(11:09) ADHD, Hormones, and Self-Advocacy
(19:38) Finding ADHD Specialist and Managing Menopause
Transcript
00:00 - Sarah (Host)
For many years now I know that if I pop Brain FM into my ears I'm going to get something done. That's because their music, optimized for focus, is just amazing. Now they have music for sleep and meditation and even relaxation, so that you can get into whatever mental state you need to get through your day and get things done. To give this a shot, go to adultingwithadhdcom slash brainfm for a three-day free trial. This is the Adulting with ADHD podcast self-empowerment for women with ADHD.
00:39
Today I am excited to welcome Lisa Alici, an ADHD coach. How's it going, lisa? Doing well? Thanks, sarah. Thanks for having me. Well, I'm so happy to have you here and to set up our interview a little bit. We had discussed in a group that we're in about how ADHD and the relationship to hormones is so huge in a woman's life. I have a feeling you have experience with this because as soon as I said that, you were like, oh my gosh, like you knew exactly what I was talking about. And yeah, and I specifically remember you saying, because we were talking about my podcast and I specifically remember you saying when you're doing this work, please include the menopause piece. It was so important to you when we were talking, so I had to have you on the show to talk about it. What better person than you, since you've probably talked to a lot of people who've probably experienced some issues, and maybe yourself. So welcome to the show.
01:40 - Lisa (Guest)
I'm so happy to have you here, thank you.
01:43 - Sarah (Host)
For those of us not in the know because I come across a lot of people who are even surprised there's this hormonal link to ADHD. Can you explain a little bit what the link is between menopause and ADHD symptoms? Sure, yeah it's huge.
02:00 - Lisa (Guest)
So, with menopause, your estrogen decreases, and it actually decreases by about 65%, which is huge. That's a lot. It's a lot the production and use of serotonin, dopamine, norepinephrine, all those neurotransmitters that those of us who have ADHD don't have enough of anyway. So as your estrogen drops, so do your other neurotransmitters, serotonin and dopamine especially, which means that our executive function capabilities drop along with them. So it's that's, that's the basic link.
02:59 - Sarah (Host)
Yeah, and that sounds like a complete nightmare. Oh it is.
03:02 - Lisa (Guest)
Oh, it is yeah.
03:03 - Sarah (Host)
That sounds like a complete nightmare.
03:04 - Lisa (Guest)
Oh, it is.
03:04 - Sarah (Host)
Oh, it is. Yeah. Do you get this from clients? Do they come to you with this? Are they aware of it, or how did you become familiar with this?
03:19 - Lisa (Guest)
I became familiar with it because I experienced it unknowingly. It was a rude awakening. I had had symptoms of ADHD all my life, but back then there wasn't such a thing as adult ADHD in the first place. In fact, what professionals looked for was mostly little boys who were acting out in school. And that's about it. Little boys who were acting out in school, and that's about it. And other people thought, you know, it was just an excuse for the little boys to act out. They didn't even look at little girls back then. So all my girls I have three daughters adults. One was diagnosed with an executive functioning deficit at age 12. One was diagnosed with ADHD at age 11. She has an identical twin who also has ADHD. So when they were diagnosed they were telling us about all the symptoms and I kept thinking, well, I have that. Well, I do that. Well, yeah, I thought everybody did that Right.
04:30 - Sarah (Host)
Yeah, totally Wow. So did you get tested? Or how did that conversation happen? Or you know?
04:38 - Lisa (Guest)
no, I didn't, I just in fact, I remember feeling envious that they actually had a medication and for these things, and then I just thought, oh well, you know, keep going with however you're doing it and how old were you when you found out?
04:59 - Sarah (Host)
if they were 11, 12, you were.
05:03 - Lisa (Guest)
So at that time I my girls have an eight-year gap in between. So what happened that? So I don't even remember how old I was then, but what happened is I went through menopause very early, and so perimenopause struck at about age 42. So that's when my estrogen really started tanking and I started. I couldn't remember anything. I lost everything, including both financially valuable jewelry and also just treasured jewelry Sentimental, Sentimental, oh yeah. And I was confused a lot. I couldn't assimilate what was being said to me or what was being asked of me.
06:00
My career was in corporate health care back then. So I was in corporate health care for about 35 years and it had always been sort of an up and down performance. I went from all levels, from the face-to-face, on-the-ground kind of sales to the executive suite. So I was at all levels and always people I did well, but then I didn't do well and no one could figure it out, nor could I, and I just kept working hard and pretty soon, you know, especially once perimenopause hit, I couldn't hide it anymore. Yeah, so it just kept. Menopause actually happened for me at age 47. Okay.
06:58 - Sarah (Host)
So it's early, early, yeah, wow. So when this is all going, going on, what did you think it was before you figured it out? Oh, what did you think was happening?
07:10 - Lisa (Guest)
I went in for an Alzheimer's test, right, I hear this a lot. I literally did because I was panicking.
07:18 - Sarah (Host)
Yeah like early on exactly yeah.
07:22 - Lisa (Guest)
So they told me I didn't have Alzheimer's. So I went back to work and did my thing and finally, at about age 57, I was asked to step down from an executive level position because they said they didn't know which me they would get the high performing Lisa or the one who had just missed her latest deadline. So I was unreliable and I was crushed and embarrassed and shamed by me. And so I was very lucky. I had an executive coach who used to be a doctor, an MD, and she said Lisa, have you ever considered that you might have ADHD? And I don't know how this happened, Sarah, I must've been in la-la land for all those years. But I said no, I haven't. And she said I think you do. You need to have it, you need to be tested.
08:29
So I took a leave of absence and found a guy named Dr William Dodson who is one of the foremost specialists actually in the world on ADHD. He was here. He lives here in Denver where I live. Wow, I was so lucky, so so lucky. So he diagnosed me. I'll never forget I was in his office after I had done I mean, hours of different sorts of testing. So I was in his office and I was in tears and he said what are the tears about? And I said I'm afraid you're going to tell me I don't have ADHD. Oh boy, yeah, I know that feeling.
09:15 - Sarah (Host)
And he said no, you have profound ADHD Wow.
09:34 - Lisa (Guest)
So it was. It was really remarkable. The journey began there. I had to try five different meds before we found the one that was right for me. Then I found an ADHD coach who I stuck with for a year. She was great. Coach who I stuck with for a year. She was great. She suggested I become an ADHD coach, which I ultimately did, was able to leave the corporate world. And here I am.
10:04 - Sarah (Host)
Wow, I was just about to ask how you came into ADHD coaching. That is, that is some story. There's a lot of elements of that that I definitely related to while you were talking. Yeah, yeah, wow.
10:19 - Lisa (Guest)
And it's not uncommon. I mean you say you related to it job.
10:36 - Sarah (Host)
The same kind of thing. They never. I mean my. If you read my annual reviews, it's like Jekyll and Hyde and it's like I mean one time, the the person reviewing me used the word outstanding like five or six times. A few months later, I'm in a boardroom getting the talk about if you make another mistake, we're going to have to cut you all within months of each other. And nothing had changed. I'm like, okay, this is so scary, you know. So, yeah, I'm definitely just listening to you. It's like yup, yup, and and it was such a relief because I I actually did.
11:09
Also, even though I was in my thirties, I wondered if I had something like early onset Alzheimer's or maybe some sort of neurological condition. I was like, do I have brain damage? Like what is going on here? I mean, just, I was in this boardroom with like a pile of papers and I it was like I was about to give like a case or something, like I was going to prove my case. Like no, no, no, no, no. I you know this is what happened. And I had all these emails and they're just looking at me like well, you, this has got to stop, and and and. To me I just felt like I was losing my mind. Yeah, that's it. Yeah, that's it, yeah. So that, that's incredible. And so um did when you went to Dr Dodson was were hormones a part of the conversation? Was that, and did that come later?
12:07 - Lisa (Guest)
You know. Interestingly, I'm not sure we have ever discussed hormones Same, yes, and very, very few doctors bring hormones into the equation. When talking about ADHD, or especially when talking about medications, it doesn't even come up Right, and a big part of that reason is because in med school they don't even talk about ADHD. I have had so many doctors say to me that things to the effect of you could put in a thimble or in two or three sentences the amount that I heard about ADHD in med school.
12:55 - Sarah (Host)
Well, I believe it. I believe it. Yeah, I don't get a lot of engagement when I bring it up to any other doctors besides my psychiatrist. So, yeah, I get that feeling and even my psychiatrist. I'm so grateful she diagnosed me and figured it out. She's the one who put it all together.
13:16
But hormones never came up, even through my pregnancy and beyond. It never came up once. I know it never came up, yeah, and the stereotypical stuff like being emotional and being stressed and being a new mom, but it was never brought up. In the context of there's also this link to ADHD and cognitive function and you know, I I remember talking about mom brain when I went home to see my folks, you know, and they just roll their eyes about mom brain, like what are you talking about? Like that's so silly, and it's like, no, no, no, this is science, this is a thing, and my grandma thought it was a wife's tale, so can you imagine in her day how awful it must have felt, you know, cause it's like you do feel, like like you're going out of your mind and it's like, oh, there's something wrong with you.
14:18 - Lisa (Guest)
Oh, absolutely, and my grandmother so clearly had ADHD. She, she was like my soulmate I. She's the woman who I was closer to than, I think, anyone else in my life, and everything was always a mess in her house. I have such warm and wonderful memories of that mess. She forgot everything, she lost everything and she was so ahead of her time. She was so ahead of her time, she was so brilliant and read the new york times every day, even though she had a fourth grade education. Wow and so and so here is this woman who's losing everything, forgetting everything. Her clutter is everywhere. What appropriate medication could have done for her it? It just makes me sad.
15:16 - Sarah (Host)
I've always wondered if weighted blankets could help me with anxiety During the pandemic. It was the perfect opportunity to find out. Ever since the first night I have slept with my weighted blanket, I have had very relaxing sleep. Don't deal with insomnia nearly as often, and at a point where I don't want to sleep without it, it is.
15:35
it is that awesome to find out which blanket I use. It's just so comfortable and so beautiful. Go to adultingwithadhdcom slash mosaic and you'll see my favorite one, and there's many, many others to choose from. Yeah, and from what I hear, it's highly, highly inheritable from the mother to the children. From my understanding, I took yeah, I took an intro to coaching, intro to ADHD coaching class earlier this year when the pandemic first hit, and I forget the number, but it was like, it's like 85%.
16:10
Yeah, it was super high, yeah, yeah, really high, and that to me really stuck out. And then the other thing I did I did a control F Back to your thimble comment. I did a control F on the word estrogen in my, my really thick textbook and it had all this stuff about ADHD and the word estrogen came up once and that to me, mirrors what the doctors are saying, like it. You know how little, first of all, how little ADHD came up and even within our own ranks, estrogen not even coming up, but once in an entire. And it had the deepest scientific and don't get me wrong, it was an excellent text. Like I feel like I know a lot about ADHD now, but I was so surprised it was like a few studies they talked about it could have fit on one page, like wow, there's so much more than one page, right, like we need more of this.
17:05 - Lisa (Guest)
Oh my gosh. I just in front of me right now, full disclosure. I have a page's worth of bullet points, just bullets. I have a page's worth of bullet points, just bullets, just bullets On things, too, that I could talk about with regard to this, and I'm not an expert, exactly.
17:23 - Sarah (Host)
Well, me especially. I'm a lay person. Oh, yeah, me too, yeah, and I was talking to a guest a couple of weeks ago and she's like, yeah, I'm learning about this stuff on TikTok, I'm learning about it on Twitter, me.
17:40 - Lisa (Guest)
And I've heard people are on Reddit. Oh yeah, adhd Reddit channel. There are so many ADHD Facebook groups you can't count them anymore there are so many ADHD Facebook groups you can't count them anymore.
18:01 - Sarah (Host)
Yes, which are great in their own right for community building Absolutely, but the fact that that's where we're left to getting information about this, it just blows my mind. Yeah, I agree. So when you put it together, are there things you've done differently, now that you know the relationship between low estrogen and ADHD, have you done anything differently, or is it just the awareness that helped?
18:24 - Lisa (Guest)
What happened for me was I was diagnosed pretty much after my estrogen had dropped. You know that her had taken that steep plummet and I believe they had leveled off already. So, finding the right dose. We we tweak the dose over time, but my dose of my medication has stayed steady. That makes sense, yeah, yeah. But the biggest thing that I can say is that when you're going through perimenopause and menopause, you really need to self-advocate. You really need to self-advocate because the absorption of your medication is different in your body and you've got to, as we've discussed, doctors don't even bring it into the conversation, so you have to, as a patient, bring it into that conversation.
19:38
If you're not seeing an ADHD specialist who is your prescriber, you need to find one. And in order to find one, you can go to chadcom or addcom and they can help you find resources in your area. But you do need a specialist. So many people go to their family doctor. That's great. To get an initial prescription. That's not okay. To really titrate your meds, that's. You need a specialist, yeah. And so your dose does need to be modified or changed to a different medication or to taking it at different times during the day. Taking it at different times during the day. Those are the three variables what the med is, how much and what time of day you take. It Also something. The two most important things especially during perimenopause and menopause, but anytime that are not medications are sleep and exercise. So those are two things you can do for yourself.
20:49 - Sarah (Host)
I believe it, and I I started getting interested in this a few months ago because I was having. I thought I was, I thought I had hit perimenopause and I may have, who knows but I became so aware of the exercise and the sleep after that. It got my attention because I realized how few resources I had except for taking care of my body, like that's all I had. I had, no, I had a doctor who didn't, who wasn't listening to me. I had, you know, I had Google and that's it. And I developed so many healthy habits out of that experience, cause I'm like this is the only body I got. I, oh my gosh, so well, that's it.
21:32
Yeah, like I better take care of this, cause, you know, I I started realizing how much it does affect your cognition and you always it's one of those things like you always hear these things that are good to do and you're just like, okay, I know, you know, whatever. But then, when, like, something happens to you and you're like, okay, you got my attention now, okay, okay, I'll do so now. It's like I track my sleep, I track my exercise. It's so funny Cause, um, I got this thing. I don't know if you see it, but it's a fitness tracker, oh my gosh.
22:05
Yeah, I, I I'm garbage at charging trackers and so I got this one and it has a like a watch battery. So only every six months you have to charge it. Such a lifesaver, yeah. But the reason I bring it up is in the app. It actually has, you know, it's got your water and your movement and all that. But it has this panel where it tells you kind of like your likelihood that you're going to be stressed, based on how often you've been sleeping and exercising and your menstrual cycle, and it just gives you this like percentage. And so I'm setting up this app.
22:46
Yesterday, as soon as I typed in first day, I got the thing on the first day of my cycle. As soon as I typed in, today was my first day immediately it shoots the 90%, like you're going to have, you know, problems right now with stress. But then I started typing in my movement, my water they have something for meditation and the numbers fluctuate and so you can. It's empowering to know that there are some things you can do to bring that number down. You're not completely, you know, a prisoner, but it just like just the visual representation of just how doing those things can bring down your stress level absolutely, and I think you bring up one other really important factor, and that is meditation.
23:34 - Lisa (Guest)
Yeah, um, I recommend that to my clients, um, probably three or four or five times a week. Um, because what we need is for our brains to calm down. More than anything, we need to be centered, and it's that's the case for everyone, but for us it's absolutely critical. And so, and the flip side of that coin is that most of us who have ADHD hate the idea of meditation. It's like no, no, no, that's not for me, oh no, so I there. There are two apps that I love. One is Calm and one is Headspace, and I love I do too. I do too. That's mine, and the thing that I love about those and about being able to remember the recommend those, is that you can do it. They go all the way down to three minutes, so you can just meditate for three minutes and it it actually affects the level rate at which your brain fires. It brings you down, so it's amazing.
25:01 - Sarah (Host)
I believe it. I believe it Because I I remember when I first returned to work after my my daughter, after having her, I would do this in the car, like three minutes on headspace, like it's like, okay, I have like five minutes before I have to walk in there, okay, I'm going to pop, pop in my earbuds and I would meditate in my car in the parking lot before I go into work. Game changer, just complete game changer. And I that was another one where it was like, yeah, I know I'm supposed to. You know, this is supposed to be helpful, whatever. Like it never made sense to me until I was so desperate I was like I'm going to try this, cause I am just frazzled as hell. I'm going to try it. And then it works. And you're like, oh, that's why everyone keeps saying to meditate, got it Okay?
25:44 - Lisa (Guest)
And then you kind of think, why didn't I do this before? Why did I?
25:49 - Sarah (Host)
wait, yeah. Or if you're like me, my father, he was really into yoga and meditation growing up and so I heard it so many times that, being the defiant teenager, I'm like, stop pushing it on me, I'll do it if I want you know. And so then it's just like I went the other way. But I think I think you're right that a lot of us, like for me, I always said, well, I can't calm down long enough to do yoga, like it's like this catch 22 thing, um. But when you say, well, only three minutes, we'll, we shoot, I can do you know one pose, I can do that. And if you could just do that little bit a lot of times, you know you can build from that, at least in my experience. Oh yeah, oh yeah, yeah.
26:37
And then the only problem for me is, like, when people say to unwind and to pause, my fear is, if I pause, am I ever going to get that momentum back? Like I'm afraid of losing that momentum. It's like, oh my gosh. I mean today is a perfect example. You don't know this, I'm going to tell you right now in the interview. But like, after my daughter was picked up today she's with her grandma. I completely forgot about our interview. I was so focused on my daughter and then she got picked up and I was like whew. So immediately the pajamas went on and I was like, all right, I'm getting my Netflix picked out and I happened to look at my phone. I just happened to look at my phone and I was ready to just like game over, like this is it. I'm going to. Just you know, and I'm always afraid of that. Whenever people say take a day off, I'm always afraid to do that because it's like will I ever come back if I, you know, let myself do that.
27:43 - Lisa (Guest)
Yes, yes, and it's interesting with my clients. What I always suggest is, if they're, especially with regard to hyper-focus, which is either bad or good but when we're hyper-focusing in a very productive way, don't interrupt yourself. Take advantage of it, keep it up, but check in with yourself every half hour, 45 minutes, just to make sure that what you're hyper-focusing on is what you want to be doing at that time. So set a timer for 45 minutes and just do that 30 second check-in. If it is, stick with it, and if it's not, then step back and pause and make a mindful choice. Is this what I want to be doing or is it transition time? Do I need to take that time for either, as you said, the meditation, or for walking outside or something to transition me into what maybe I really need to be doing at this moment?
29:02 - Sarah (Host)
I love that and I'm definitely going to use that the next time I start Googling the Royal family. Every time I watch the crown, I have to pause it and I have to get on my phone and be like, did this really happen? And then I Google and it's like game over. It's like just like down as a rabbit hole. I love that idea. I think you could get so much out of your day if you approached it like that. Well, did you have anything else on your bullets that we missed, or do you think we covered?
29:36 - Lisa (Guest)
menopause. Yeah, a couple quick things is because one of the big things is always keeping your ADHD symptoms under control. That is important, not to let them control you. Instead, you manage them to the greatest extent you can, with full knowledge that they're going to win every now and then. But when you sense that they're starting to get out of control, don't wait. Contact your specialist, because something may be going on and it very well could be hormonal that needs to be attended to in that moment, so or in that time period. So don't just say this is going to pass, this is going to pass, and pretty soon. A month, two months have passed and you've been unproductive and you're mad at yourself. Pay attention and do get in touch. Attention and do get in touch. And hormone therapy is something that people often say oh, no, no, no, but there is very safe hormone therapy out there. So, around the topic of perimenopause and menopause, consider it. It actually really can make a difference. I did do that and that it was a huge help to me.
31:10 - Sarah (Host)
I'm glad you mentioned that.
31:12
I forgot to ask back when you were talking about the stimulant medication, that that that's one of the other things you could do is look at that, and I was looking at Patricia Quinn Dr Patricia Quinn's work. And the third thing she also said is depending on what kind of SSRIs you're on, if you are, they might be able to do stuff with that as well. So there's like three different things it's stimulants, hormone therapy and SSRIs. They might be able to help you there. So there's there's always something hopefully that they can do for you. I know sometimes I'll go through something and think what's the point of contacting them? What are they going to do about it? But you might be surprised. There's new information coming out every day. Maybe they'll have something up their sleeve for you if something weird's going on. So really great advice. Yeah, so where can people find you if they want to learn more about what you're up to? And you have a website for your practice? I do.
32:09 - Lisa (Guest)
I do. It's ADHD freedom, that's all one wordcom, adhd freedomcom, and people can reach me. They can email me at Lisa at ADHD freedomcom.
32:24 - Sarah (Host)
Excellent, Lisa. Well, thank you so much for being on the show. This is going to be such a wonderful episode for our listeners and I really appreciate it.
32:31 - Lisa (Guest)
Oh, thank you so much for having me, Sarah.
32:40 - Sarah (Host)
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