Doctor (25 years experience): ADHD Women Need To Stop Doing THIS | Dr Helen Wall

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0:39That's very, very different to wanting a diagnosis of ADHD. Dr. Helen Wall has over 25 years experience in improving the lives of women with ADHD. As an ADHD specialist, she's dedicated to helping women with ADHD who are coping with menopause. 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. Just how bad can it get for ADHD women as they approach menopause?

1:14I can't even get the words out to tell you how bad this can get because... Huge announcement just before we start. Tickets to the ADHD Chatter podcast live theatre 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.

1:49You can find a link to the tickets in the description. I can't wait to meet you in person. Helen, welcome. Hello, thank you for having me. 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? I think ADHD has so many positive traits to it. People with ADHD are some of the most emotionally intuitive, creative, driven people 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.

2:40it 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 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're diagnosing women late we're missing them we're mislabeling them which is even worse we're diagnosing them with anxiety stress depression medically sort of unexplained symptoms 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.

3:43Wow yeah I couldn't agree more and I mean it's heartbreaking right and 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? It's huge it's absolutely huge and this is what happens when I see women in perimenopause 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 misinterpretations the mislabeling many women are carrying that with them when they come into my room with perimenopause 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 overcompensate over prepare try and you know copy copy facial expressions you know practice rehearse and 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 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 we're 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 engaged 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 exactly what you know what everybody expected of her in this role 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 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 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 were always hidden costs when women have been mislabeled misdismissed and misdiagnosed with neurodivergence until late on in life and that's what we see unravel then when the hormones go into flux in perimenopause and you know they just can't keep up anymore and keep that mask up.

6:42Wow, 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. 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 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 rouse with the partner getting home and just bursting into tears.

7:21Complete 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 educational psychology etc involved and 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 and 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 we expect of girls you know I've got boys I've got three children I've got boys 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 doctor's or whatever to sit and colour quietly and not disturb anything equally when I had my son and he was climbing around the waiting room and you know colouring 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 sort of, we condition girls and we do it unconsciously.

9:06You know, we all do it unconsciously, I think 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 and that has a real sort of burden on self-esteem and that's the time when you're meeting your peers and trying to find your place in society and who you are and what you are and you've got all the hormones then changing as well in puberty. So yeah, it's really tricky, I think, for girls and women to be seen in this area. 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, and they'll stay up all night, they'll put four more hours into that piece of work.

10:00Is that the same strive for perfection that's running through both stages of their life? Yeah, I think it is, and I'm not sure whether it's a drive for perfection. Like, I don't think it's a conscious thing. This is my own opinion. I don't necessarily think it's a conscious thing. I think it's just sort of almost like that people-pleasing fear of wanting to fit in, whether that's conscious or unconscious. and I often see that as a theme with women with ADHD. They're very self-critical, lots of self-blame. There's no point have I met one of these women and they've said, well, this is because this happened or that happened or because I've got a brain that's wired differently.

10:43It's very much like this is my fault. It's their own moral failings. And that really strikes me with the women that I meet who get to perimenopause 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 hyperactivity uh it's about you know that rest internal restlessness the noise that the voice that's continually running the script, you can't rest, you can't switch off and that inability to focus and really sort of task progress etc.

12:01So yeah I think we just need to get better at recognising, first accepting that it happens in girls and women and secondly recognising that you know what it looks like. And when a woman comes to see you Helen and 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? Oh, I get really angry. Really angry. And I've not quite figured out why. I don't know why it makes me so angry. I think women are generally very underserved in medicine anyway. You know, I can't believe some of the things that are here in 2026. 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 I was at medical school 25 years ago we we weren't taught that estrogen and progesterone impacts a woman's brain in any woman whether she's neurodivergent or neurotypical that is a fact 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.

13:11And, you know, I went to a conference, I do some speaking, just education speaking, and there was about 100 clinicians in that room. There were pharmacists, there were doctors, there were nurses from primary care. And I started by asking them, have any of you in this room, when you did your training at medical school or nursing school, when you did your specialist training or ever since postgrad or whatever, have you ever been taught about the effects of women's hormones on on women's brains and it was like tumbleweed not one person put their hand up everybody looks at each other they looked at me 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 like we can't 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 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 for tea and what the kids are doing we are functioning effectively as men now we're in the same jobs the same roles leadership positions running businesses and doing everything else at home looking after the kids you know we need our brains to be functioning um and you know 100 % and there's so many reasons why that doesn't happen and as medics we just don't talk about it that's bonkers do you think ADHD women deserve an apology from the medical community 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 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 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 the 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 the 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'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 and at least three of the women that I'm thinking of I've seen recently in perimenopause because they've come for menopause support and I've suddenly realized you know at that point when things have got so much worse 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 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 I've 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 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 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.

17:08What reactions have you witnessed when you have revealed to your patient that perhaps it is ADHD after all? I'll be honest most of it's relief a huge amount of relief initially sometimes there's a bit of you know questioning like denial really because obviously women have been it's not just clinicians that have been told for years that ADHD only affects boys 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 over-diagnosing ADHD. Well, for a start, GPs don't diagnose ADHD. We have to refer them on for a, you know, a very, very thorough assessment, which takes years in some places to get.

17:53But I would honestly say a lot of the women I see, they just don't know what's going on. 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 media articles or listen to some of the media outlets. 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.

18:34And one of the criticisms, one of the biggest criticisms that I get from colleagues is, you know, everybody with perimenopause, women with perimenopause 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 perimenopause or menopause. Yes, they do. Absolutely. And 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 perimenopause and suddenly they couldn't function 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 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 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 perimenopause and the the sheer volume of hormonal change is the thing that tips the balance into this realization that something's going on here but I think you know women are not women are definitely not coming in begging for an ADHD diagnosis I really refute that and I would honestly say that I've never met a woman who wants an ADHD diagnosis 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 So sorry to interrupt your hyperfocus, but I finally found an app that actually works.

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21:35Back 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? Yeah, I think there's a few things that make it. I mean, it's not a competition, is it? You know, it's hard. ADHD can be very, it can be great, but it can also be quite disabling for men and women, you know, with certain challenges. I think the difficulty for women is one, the hormonal changes that we undergo. So puberty, pregnancy, postnatally, perimenopause, menopause, huge shifts in our hormones can really impact how ADHD shows up.

22:17But then I think everything else for why it's difficult for women with ADHD is we can change. We can't change the fact that our hormones flux all over. Yes, we can support them with medications and so on. but we can change how society manages this and how we see it and how medical how the medical community sees it and manages it that's what we can change 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 in a you know if they were in an environment where their positive strengths were celebrated and embraced and 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 but probably a little bit more so because of the lack of recognition for it in girls and women that's I think what makes it really hard.

23:15Masking we've touched upon and we know that masking is very common in men and women with ADHD. But do you think the hormone changes, can it make masking trickier for women depending on where they are in their cycle? Yeah, I mean, it can even change from month to month, exactly that, with a menstrual cycle. We see the biggest changes, I think, at times of significant hormonal flux. So as I've said, perimenopause, puberty, pregnancy. But even throughout a month, We know that, I think the key to this is the chemical messengers in the brain. And we know that with ADHD, the brains are wired differently.

23:56Some parts of the brain are different in volume, etc. And the chemical messengers signal differently. So oestrogen really supports dopamine signaling. We really need oestrogen to be enough for oestrogen and for it to be stable to have perfect dopamine signaling. and dopamine is responsible for our motivation, our reward, our focus. So even throughout one month where estrogen is rising and falling as it does in a normal cycle for a woman, when the estrogen is higher, that can mean that she might feel more focused, more able to get on with things because of this effect on the dopamine signaling and to some extent the serotonin signaling as well, which helps with emotional regulation.

24:43That's something we've not touched upon, but actually with women, there's a high, I think there's a high degree of emotional regulation differences with women with ADHD. And that's been shown in some of the neurobiological 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 that happens, you know, throughout a month, that might happen to every woman, you know, she might feel better at the start and the middle of a cycle and then worse towards sort of the end but if you've got ADHD that's likely to be in some women much more significant change so I think yeah we don't 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 we need to get into the nitty-gritty of what this actually does to our brains.

25:40How 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 yeah and i think what we have to remember is when a woman's about to hit perimenopause or menopause which is generally in her 40s give or take often they've got so many other things going on at that point in life as well they've often got teenage children who are also going through hormonal changes who are likely going through assessments for neurodivergence That's one of the key points we see women have a light bulb moment.

26:33You know, there's all sorts of things going on. Often a career might be at the peak of a 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. And then, you know, throw into that ADHD and the chemical messenger changes that are happening, driven by the hormones. I guess in terms of you know can a woman manage that herself if she's aware of it absolutely 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 and women environments then we're just not spreading that awareness and that's what we need to do.

27:24I'm very give or take medication for ADHD. I think it's a very individual decision, individual choice. It's not for everyone. 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. 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 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 neurological condition you ain't going to get much from me and 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 GP should not dismiss women I know that you know I know the factors behind why and how that happens.

28:34Just 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 and 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 and we already know that perimenopause menopause has a seven times increased suicide rate so 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. And then if you throw into that ADHD and unmasking and all the issues that we've talked about that come to the fore and the surface at this point in life, I've seen women really, really at the lowest point.

29:33I can think of a lady off the top of my head who um was came in you know 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 her 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 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 she went to alcohol 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 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 and subsequently second child although she was more prepared for that so she sort of put things support around her to expect things to unravel a bit she'd gone from job to job she'd never sort of really been able to to focus she'd been described at school as pleasant but inconsistent consistent, you know, daydreamer.

30:59And this is what I often hear women have been called daydreaming, ditzy, can't get on, lazy, et cetera. And then, you know, she'd hit menopause and this had all unravelled and everything was in tatters for her, absolute tatters. And when we spoke about this, I saw her a couple of times, 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. 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 said to her you know do you think this could be something else do you think like there could be some ADHD and she was like you're not the first person that said that to me but I thought that was just for boys so the women themselves don't often know what's going on you know 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've seen her a few times since and she's not actually she's still on the waiting list for diagnosis which is quite common in the NHS 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 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 and she started slowly but surely she got a bit of help with the alcohol and then she started trying to to to do that and she did sort of it 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 should I don't need shall 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 just listening and being able to validate somebody's story.

33:22So 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. Yeah. How did that make you feel hearing that? 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 but then I get really surprised when things like that happen because like how can this be um but it's not her fault this is what we tell this is what we tell people it's 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.

34:09How can we expect women to know what's going on here? 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 perimenopause menopause, which is a long way off, hopefully, and end up in that position. You know, I don't want her to have to fight to be believed, fight to be heard. 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. What's the silver lining? How can you make them help them see it?

34:49The silver lining is that having ADHD is not a failing or, you know, you're not broken. There's so many positive things to be in having ADHD, you know, and obviously we can generalize, but the women that I meet with ADHD are often some of the most emotionally intelligent, intuitive, creative women. You know, if you're 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. 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.

35:32So, you know, I'm happy. 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. We need to celebrate it as a difference and stop seeing it as a negative thing. And that comes from, you know, right from the very fact that we're being criticised for over-diagnosing it. There was a study done not so long ago, I think it was 9 ,000 GP records were analysed, and the number of ADHD diagnoses in men and women was only, I think it was about 0.32%. So we are massively under-diagnosing it, probably because everybody's sat on waiting lists waiting to be seen.

36:12But we're certainly, you know, we've got evidence we're not over-diagnosing it. We're just not seeing what's there in plain sight. The last time I checked, there was roughly about 800 ,000 ADHD diagnosed people, men and women, in the UK. And if we put the prevalence of ADHD at about 4.5%, that's what the World Health Organization puts it at, there is 2.5 million people in the UK with ADHD, and yet we've only diagnosed 800 ,000 of them. Yes, exactly. We're massively under-diagnosing it. And I stand by that. That is a hill I will die on. We are under-diagnosing ADHD. million percent 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 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 you're struggling and you're anxious um but please find that strength to do that because it can be life-changing and i've seen it be life-changing 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...

37:49I thought I'd got away from washing machines today. I know, it serves two purposes. 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 biggest ADHD woe is my memory. I always forget to empty the machine. Yeah, and then you have to put the cyclone again to put in that long. It needs to be washed. Oh, good. It always makes me feel less alone when the guest relates to it. We'll wait a few minutes for the audience to come back from emptying their machine. Yeah, okay. The first question, Helen, from the audience this week is, my ADHD is unpredictable as it is.

38:21What does menopause have in store for me? Well, hopefully it won't be bad. You know, I think it's important that I say that, that not all women are going to have a horrific time in perimenopause and menopause, regardless of whether you're neurodivergent or neurotypical. But I suppose if you have got ADHD and it already is causing you problems, then 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 messages in your brain. And you may start to feel like you're not quite as in control as you were.

38:58So the scaffolding that we've already mentioned might start to wobble a bit. And I think if you are aware of that and you can know what's happening and be prepared for it, that can be so much easier to deal with 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 they were nothing to worry about just get on with it you're just going through menopause you're just stressed so I think if you go into it with your eyes wide open that can be really therapeutic Before your book, podcast, general awareness has obviously gone up massively, previous generations of women who were going through this very natural process of menopause, what did they truly believe?

39:51Was it quite easy to just assume that you were going crazy? I think it probably was. I mean, I go into some workplaces doing some training of staff 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 it was 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 permanent menopause 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 you know they they didn't really just get on with it many of them some will have like some some will do now um you know they were very emotionally dysregulated 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 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 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 quite possibly yeah i I mean, I think as women, often they do just get on because they've often got the people to look after.

41:30I think, you know, I see that time and time again with women in my surgery when that's for 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 because I've got to pick my child up from school or my grandchild up from school. You know, 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 like 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 at putting themselves first most women and yeah I think yeah absolutely for some women who were neurodivergent in perimenopause that is extremely high masking isn't it to say we just get on with it.

42:11The next question from the audience Helen is my daughter is approaching puberty and she has ADHD what can she expect? 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 awire 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 sensitivity is for it can kick in um justice sensitivity can be seen more floridly 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 really helpful thank you helen and the final question from the audience is um are there any superfoods that can help with hormonal stability?