ADHD, Motherhood, and Invisible Overload

0:28So good, so good, so good. That's why Oli's science back support is made with a blend of melatonin and L-theanine for both kiddos and grownups. So when your mind won't switch off, you've got something that can help. Erasing thoughts and restless nights won't stand a chance. Find Oli's sleep solutions for the whole family at Oli.com. That's O-L-L-Y dot com. We're going to have some real talk, y 'all. I don't think people understand how brutal ADHD can feel when it collides with perimenopause. menopause, PMDD, chronic pain, motherhood, a workload that demands one million tiny decisions a day. Because I think like people hear ADHD and they just think like, distraction.

1:12And what they don't see is like 12-hour workdays, the million tiny decisions that are bogging us down that we're making regardless or the hormone shifts, co-occurring PMDD, co-occurring endometriosis, school lunches that still have to be made, and the private internal shame spiral of when your brain stops cooperating. And this is me currently. And this is why Dr. Brayden is still in her gym clothes, because I worked out for y 'all so that my brain would actually work, and because I learned a tough lesson this week. And I also am wearing my blue light blocking glasses. Don't tell the biohackers.

1:44I know it's daytime, but I cannot deal with the big light. I hate you big light, but I need the big light. Okay, so in this episode, we're going to talk about my ADHD. We're going to talk about the hellish last couple of weeks I have had, what mistakes I've made, what supplements, and lifestyle routines are absolutely non-negotiable. And I just had to be like bitch slapped by the universe to be reminded of that again. Yes, I like to fall on my face a couple of times a year just to be reminded of like what I need to actually function and to stop denying myself that. And we're going to talk about some PMDD and ADHD overlap information.

2:20So if you love this information. Can you subscribe, like, share this, comment, give me some love with it? This is the Dr. Brighton Show. I am your host, Dr. Jolene Brighton. I am an ADHD girly. Let's not hold this up any longer. And let's talk about what the hell just happened these last two weeks. Okay, so firstly, let's just talk about like what I struggle with. Time blindness. My nemesis is a clock come five to seven days post ovulation. Like I never knew how bad my time blindness was until after my endometriosis excision surgery. And then they like traumatized my ovaries rightly so because they had to remove bilateral endometriomas, type of endometriosis that is sometimes called a cyst, but it's not.

3:03It is endometriosis growing in your ovaries. Anyhow, when they, this is so embarrassing, but I'm going to share with you because like, let's just like normalize this stuff. Okay. So I have my excision surgery. I have my post-op. Okay. But my ovaries are just like, they're not working. And I don't know why I didn't prep for this. I think it's just because I was like in IVF and I was doing all the IVF drugs and then I wasn't doing IVF drugs. It's just like a lot to manage. I have excision surgery. They set up my post-op appointment and whatever reason in my mind, I get it set in my mind that the post-op appointment is at 1.30.

3:37Therefore I have to leave at 1.30. Okay, but despite doing that in my mind, at 1.40, I get a phone call and I'm at the florist because I am buying my excision surgeons flowers because yay, I'm feeling better. That went so well. I'm so proud of them. I want to say thank you. And the office is like, where are you at? And I'm like, what do you mean? I'm on my way. And they're like, your appointment's at 1.30. I'm like, yes, of course. I know. I'm going to leave at 1.30. And they're like, okay, it's 1.40. It's 140. And I'm like, I don't understand. And then I say it to my husband and he's like, wait, your appointment's at 130.

4:10You needed to leave like at one, probably 1245. And like, what are you thinking? And what are you doing? And I can't know what time I need to leave at and then work it backwards and actually understand how to, how to leave on time and how much time everything is going to get me or take me, get me. What the hell does that mean? Anyhow. So like I, this week, It was my son's first day of school. I'm supposed to get him to his first day of school. And it's like, we have to be there at 845. And I start out at 7 o 'clock in the morning. I'm just like, you guys, I'm going straight into like getting ready.

4:46Like I'm going to be ready on time. Okay, like, but somehow I forgot to eat breakfast in all of this, which I'm like a big breakfast person. And you guys know on the podcast, I'm always talking about eat your breakfast. I was the best. And I was not ready to go on time. and my husband comes at 8.30 and he's like, okay, we got to go. And I'm like, what do you mean we got to go? And like, no, yeah, literally 90 minutes had passed. And I'm like, how do I not even, how am I not ready? I hurry up and get dressed. I go to school. I'm talking to him later in the day and I take a photo of us and I'm like, what the hell is wrong with my eyes?

5:19You guys, I did not put mascara on. I put primer on. So my son's first day of school, I show up with white eyelashes. I don't know. Maybe that was a thing. I think that was a thing in like the 90s. But it is not a thing to be in your 40s making a first impression with white eyelashes at school because I put primer on. I didn't put my mascara on. And I didn't even realize it until the afternoon came and we were about to go do pickups. So what the hell has been going on with me these last two weeks? Okay, I'm working on a book. It's a freaking epic book. It is a monster of a book. It's got like 600 citations and it is called ADHD and women because this became my special interest because my child was diagnosed with ADHD.

6:04And then I got diagnosed with ADHD. And then I got diagnosed with endometriosis. And then I got diagnosed with autism. And I was like, hold the front door. These things must be related. And actually, I have seen this connection. I have seen this connection in patients. What I first saw was this connection of PCOS and ADHD. then I started seeing ADHD, autism and PMDD and then now and then it was me getting diagnosed with endometriosis where I'm like get me into the research get me into the research now and in my book ADHD and women I do talk specifically about how hormones are altering our experience with ADHD why it looks different than it looks like with men why perimenopause is so freaking hard exactly what to do about it I gave you an entire chapter with the dosing of hormones of like how to do HRT, but make it ADHD and autism friendly.

6:56Okay, so why am I bringing all this up? This book had me in such a chokehold, you guys, because they were like, oh, copy edits are coming back during my kids spring break was the course, of course. If you don't know what copy edits are, it is like an ADHD freaking nightmare, okay? But it's also like such the most important part of the book. But it is, I'm not even kidding when I say one million micro decisions. I want to do like Dr. Evil, like Pinky, one million micro decisions where every single line has like, oh, we think we should put a comma here. Oh, they are like, we don't think you explained this well enough.

7:36So like, can you explain this more? And like, then what do you think? Should you make a table about this? So like, what am I telling you is literally line by line of a 639 page document that I had to go through. And that is mentally exhausting and taxing. And I said in a previous episode that like we had already like planned things that my husband was like going to take over meals and like any decision I didn't need to make, like I was not going to make it. Enter the rat. Enter the rat. Oh my God. Okay. So here's the deal. I go on vacation with my kids because it's their spring break. And I'm like, no, I'm not missing out on life with them just because I have this book to write.

8:14I'm going to do spring break with them. We're going to take this vacation. We're going to come home. It's going to be epic. I have never regretted a vacation more in my life. A rat moved in while we were on vacation because nobody was at our house. So we've got this rat. We're trying to get this rat out of the house. My husband is like frantic about it. We're setting traps. The morning my book is due because of course the universe is ran by Loki and he is always laughing at me, that little prankster, okay? So I get up at 5 freaking a.m. I have already been working two weeks, 12 to 15 hour days.

8:49And I'm like, I'm gonna get this book done. I'm gonna like wrap this up because the publishers are on the East Coast and they want it at the start of their day. I'm in my office trying to do my work. And the next thing I hear is my son screaming. He's screaming through the house up the stairs like boom, boom, boom, boom, boom. Okay, now I'm dysregulated because that's a phenomenon in your luteal phase. You have more emotional dysregulation. Here's the thing. Okay. So you drop progesterone, allopregnenolone rises, allopregnenolone, that stimulates the GABA receptors, say work better with that GABA system.

9:22So we're chill. So we're calm. Like in sometimes with PMDD, it doesn't work that way. But here's the thing about us with ADHD. Is that in that luteal phase, what we got that chill and calm going on, the HPA system, the HPA axis. And one theory is because like we might be pregnant, so we should freak out. The HPA axis is like, but maybe like super sensitive. And so like when you get stressed, like we're going to be really stressed. Oh, and you're neurodivergent. That means that executive function of emotional regulation, that's not going to be in place. Here's my son. He's like, I sat on the couch in the library.

9:55I think the rat is in there. Something was moving behind my back in the blanket. Oh, that's nasty. Okay. My husband, bless him. He is scared of rats. Okay. I mean, nobody likes rats, right? But he's like, I would tell him like, go get your dad. I go in. I'm like, moving the couch. I can see the rat behind there. I got a broom. I'm like, oh, this is like Tom and Jerry. Like literally, I'm like Tom and Jerry character. If you know, you know. And like my husband comes down, but he's putting the couch between him and the rat and making me being near the rat. We get the couch moved. I whack the rat.

10:29It jumps into my books. Well, jumped into the kids' books, RIP them, because they didn't get destroyed, but they had to get all wiped down. My husband's like, I'm not digging out these books. I'm like, okay, I'm down there digging out the books. There's the rat. Oh my God. I pin it with the broom. I'm like, okay, let's figure out how we're going to get out. Nope. This is a slippery guy. Runs through my house. So I spend an hour and a half literally chasing a rat through my house, okay? And then finally he jumps in a bag. And I'm like, this is what's best for both of us. And I get that bag. I take it outside.

11:00He jumps out and he tries to run back at my house. So I like have to whack him through the room, run into the bushes. Okay. Like I'm dysregulated now. And I've got to sit down. I've got to do my book coming off a tail end of like two weeks of working nonstop. Now in the two weeks of working nonstop, this is stupid. Okay. I was like sacrificing exercise. I was sometimes forgetting to eat. I do that. And when I hyper focus and that's really problematic, usually my follicular phase, but it can happen in my luteal phase. And I'm just overall super stressed out. And so what comes next? Adenomyosis, endometriosis flare.

11:38So of course, like I've dysregulated nervous system. I'm not exercising, which is potent anti-inflammatory work. Plus it would have helped me focus better. So what the hell was I thinking? That was really dumb. And then I'm just sitting too much. And lunches still have to be made for school. And like I could try to designate that to my husband, but my kids are like, he just doesn't do a good job. I'm dealing with my younger one who's like, you know, I call him a picky eater. He's just like it's sensory sensitivities. But like I got to do special things in his lunch to make him feel like it's a special experience.

12:15And that helps him eat a more nutritious lunch. and that's just not my husband's forte. He is not the nutrition scientist in the house. So what was this endometriosis adenomyosis flare? That's my body paying the bills. I was writing checks. I was writing 12 to 15 hours a day checks and I'm just out there writing them, writing them, writing them, overloading my nervous system and then the adeno, the endometriosis flare, check, bills came due and it had to be paid. It had to be paid in pain. And fortunately, I'm very good at this, of getting out of pain. And so within 24 hours, things were better.

12:53But the first thing I had to do is I was like, I got to load up on omega fatty acids. I've got to get my magnesium on board. And then I got to get my ass in the gym. Like that's the, that's really it. I have a home gym. There's no excuses. I just want to be like really clear about that. I exercise is non-negotiable. and I know this and I still fall into the trap of feeling like I just didn't have the time. This is a unique experience of women with ADHD. ADHD in women doesn't always look like, we're just like bouncing off the walls and like, you know, we can't sit still. Although you can tell in this podcast that you can't sit still.

13:31But I'm also a Latina and I always talk with my hands. It's like very cultural, okay? So there's that. But ADHD also looks like being so freaking high masking and making sure that you look okay, but that everyone else is taken care of at the expense of yourself. That is ADHD in women as well. And we don't talk enough about that. And I fall into that trap just as much as anyone else. And I have been very good, like very good in my 40s of setting boundaries and I'm doing all these things. This book, the timing of that, the school, they're all at a podcast guest during it. Like there's just so much stuff that was outside of my control.

14:15And like allowing the emotional and nervous system dysregulation to take root didn't give me the space to realize that when everything feels like it's out of your control. You must focus on things that are in your control. But I have a bad habit when I'm writing books of hyper-focusing, going all in, being such a perfectionist about it, stressing about it. Mistakes happen. My copy editor was really good. But then I had a salmon recipe and he took out all of the salmon in the recipe. And I was like, why did you remove salmon from the salmon recipe? And why did you remove lemon from the lemon chicken recipe?

14:53And then I her freaking out. I start spiraling because this is a legacy moment when you write a book, like you will be remembered for this. And then people are brutal on the internet where they're just like, like this book's about ADHD and women and I have ADHD and someone's going to be like, she didn't do this perfect enough. And I'm going to be like, that's been my whole freaking life with ADHD, which is why I am such a perfectionist, which is why I developed like these other conditions because being a perfectionist in your nervous system is super bad, super bad for long term health outcomes.

15:23And yet is what so many women with ADHD are struggling with. Now I've alluded to this piece of the luteal phase. No one talks about it. I actually made a chart in my book I went through. I made it like crystal clear for you to understand what is happening with your hormones. One thing I hear from women all the time is that they're struggling with symptoms like hot flashes, sleep disruptions, and brain fog, but aren't sure where to turn to for help. Menopause is inevitable, but suffering through it isn't. That's why I want to tell you about Alloy. Alloy is a digital health platform that connects you with a menopause specialized doctor who can create a personalized treatment plan tailored to your needs, all from the comfort of your home.

16:06Join the 95 % of women who tried Alloy and saw relief in the first two weeks. Head to myalloy.com and use the code Dr. Brighton. That's myalloy.com, M-Y-A-L-L-O-Y.com and the code Dr. Brighton, D-R-B-R-I-G-H-T-E-N. Share your symptoms and you'll get a fully customized treatment plan and unlimited messaging with your doctor. Plus, you'll get$20 off your first order today. That's M-Y-A-L-L-O-Y.com, code Dr. Brighton. adhd symptoms luteal phase that's the worst of it it's a it's a little peek into what's coming in perimenopause that is the absolute worst of it and and that's not just coming from me that is coming from women in surveys who have said like over 90 percent like every freaking time you survey women with adhd they're like you're like how's perimenopause and they're like it's the worst time of my life and that is so real because of how our hormones are changing And by the way, everyone out there talking about just estrogen, I love that estrogen is getting your air time.

17:19But friends, I'm taking you through hormones because estrogen doesn't operate in isolation. And estrogen is not the whole story of why ADHD gets so much worse in perimenopause. But what I want you to understand is that luteal phase, perimenopause, puberty, coming on or off the pill, or having a baby and being postpartum, irritability, overwhelm, emotional reactivity, can't keep a list in your head, time blindness. That is all par for the course of what we're dealing with because as hormones change, neurotransmitters follow, brain energy follows, inflammation follows, like it's a whole cascade of things.

18:00But it doesn't have to be that way. It is that way right now because medicine in society is just like throwing us out like into the water and being like, you don't know how to swim? Figure it out. I think you could figure it out. You're a woman. You're so capable. Whoa, smile. Make sure you hold it all together. And that's not doing us any favors. There are ways to actually address your brain and support yourself that can make perimenopause so much easier, can make all these hormone transitions easier. But the first thing we have to recognize is that just being someone with a neurodevelopmental condition, you likely have heightened hormone sensitivity.

18:34So as hormones change, your sensitivity changes. And as I said to you, in the luteal phase, things can get worse for some people because of progesterone. Things can get better in some ways because of progesterone. But also we've got HPA access reactivity happening. And as you get into perimenopause, the HPA access is so much more sensitive. If you start losing testosterone, your HPA access is going to be primed to see just about anything as a threat. Why? Losing muscle mass, losing strength, you weak. Uh-oh, we got to just start thinking everything's a threat so that we can survive this. So we have to be thinking about all of the hormones and the full experience of the ADHD woman.

19:18I also think it's important that we stop saying that ADHD is just a focus problem or that we're just distracted because it is so much more than that. ADHD is what makes decision fatigue hit us so much harder where you're like, I can't make another decision. Like I'm going to collapse. I can't talk to people. Executive dysfunctions across the board. Nervous system overload. Emotional dysregulation. Task switching burnout. Like I got to write a book, chase a rat. Then I got to make my kids lunches. That sounds disgusting. Rat to lunches. And then I got to go back and I got to write this book. Oh, and then I got to go to like school pick out like a pickup.

19:55Like that is so much for the brain to do. And then you talk about a brain that's running on an energy deficit, which is what a perimenopausal brain is doing. I hate to break it to you. ADHD was already struggling with his energy production. Then you add perimenopause and it's just like, what, what am I supposed to do? The brain's like, what do you want from me? This is where you can't skip exercise because the ADHD brain struggles with glucose metabolism and energy production and lactic acid, which builds up when you work out, can actually be a backup fuel supply. Then you got to get good sleep because you got to move that out because that lactic acid then becomes a problem if you're not getting deep sleep.

20:33It's like flushing it out. But the exercise will help you get better sleep. It's just not usually enough in perimenopause. I will say that because if you're like, I'm doing that, it's not enough. I hear you. You may need more strategies. Now, the last thing I want to say before I get into like some things that help me other than exercise is this invisible load, the labor tax that is on women and moms. We are expected to mask, to camouflage, so to like fit in always, to show up, to make other people comfortable, to always be high achieving, to never ask for help, to like be a super mom. So whoever branded super mom, I'm gonna come for you.

21:08I'm gonna find you. We're not gonna be friends. It's not gonna be fun. I'm gonna have some real talks with you because that harmed us. And we have to stop carrying loads that are not ours to carry. Now, as I'm telling all these crazy stories, which was more because I was just like, look, I can't even bother to get dressed today because the executive function required to actually go take that shower to do my hair. Oh my God, I can't even think about doing my hair. to put on makeup, to get camera ready, to smile and be pretty on the internet for people. Like, I just couldn't do it. I just don't have it in me.

21:43And I very much woke up and recognized with the energy levels that I had. And I took inventory. Oh, yeah, it was parent and teacher conference night too for my oldest son last night. So you want to talk about high masking, really stressful environment and then having to co-regulate someone. But I want to talk about, I just want going to talk about some things that can help though. So I'm going to talk about that. I'm going to talk about PMDD as well, because that's PMDD, endometriosis, ADHD. I actually should do a whole episode on it. So let's talk about what I actually do. Okay. Creatine. Creatine, which by the way, I have my water here because it has creatine in it right now.

22:20And the only way I'm going to drink it is if I have a straw and I just keep going all day. Creatine can help with brain energy production. So what I do, I take creatine three to five grams, usually in my follicular phase. If I start to struggle in my luteal phase, I'm going to kick that up. I'm going to go closer to like eight to 10 grams. Now, what do I mean when I struggle? If my kid is sick and I'm not sleeping, the studies on creatine and sleep deprivation are really good. So creatine, have it locked down. Oh, but wait, can't creatine make endometriosis worse? We have no evidence in humans that creatine makes endometriosis worse.

22:54What we have is animal studies. a hypothesis and a study where their supplementation with creatine was injecting it into a rodent's peritoneum, so into their abdomen. Not a problem for endometriosis as far as we can tell, and the way it makes my brain work. I can't really see myself giving it up, but what I would say is that if you're concerned, the three to five grams, that's a mild dose. In the sleep studies that they've done, they've used like 20 grams or more. I think that's a little bit, you know, that's like we're playing we might be playing with fire because we just don't know right now when there's no reason to be doing mega doses like that like let's not do that the other thing i use is omega three fatty acids so omega three fatty acids i have actually upped it to four grams a day for myself um as i came across the new research on endometriosis cardiovascular disease risk um understanding that like you know adhd individuals autistic individuals we may also have these increased risk of cardiovascular disease and it being related to inflammation, stress, all of that.

23:56I'm not saying that you, because you have ADHD, you're going to have a heart attack or anything like that. I'm not saying that. But because of the research and then looking at what the American Heart Association has said and being like four grams is more of like the sweet spot to be at, I've increased it to that. I got bad about my supplements. I ended up in an endo flare. I I did four grams twice a day. And then the next day, four grams twice a day. And then I was out of that flare. I also was making sure that I was drinking lots of broths that I was graining fresh turmeric into. I was taking magnesium.

24:31So I was actually taking 600 milligrams. And I'm someone that I'm a rapid metabolizer. So I don't do well on pain medications. So I tend towards these more natural things. I just bring that up because you don't hear in my protocols, knee taking, ibuprofen. And then when it comes to like something like tramadol, which is sometimes given for endometriosis, that just gives me headaches. It doesn't actually work. So I just share that because people will be like, oh, do you not believe in pain meds? It just doesn't work for me. So I've got to find other ways around it. I also did sauna. I did, I have a near infrared sauna, sunlight and sauna.

25:09As you guys know they sponsor the podcast. And then I was doing abdominal massages as well. Lots of stretches, like really trying to take care of myself. I don't think I should be waiting for a flare to take care of myself. And that was a good reminder of how I just fell off everything because the book was such a priority. And listen, I'm proud of this book. And I don't regret any of the energy I've put into this book. What I want you to understand about PMDD is we actually don't know the cause of it. It's not about how many hormones you have that much we're starting to understand. It's more about how your brain adapts to those hormones.

25:43So for some people, progesterone makes it worse. For some people, estrogen makes it worse. For some people, you take away their hormones altogether and it's still bad. And for other people, it's the combination of the hormones. There might be subtypes to PMDD, but we see a high crossover between ADHD and PMDD, autism and PMDD, endometriosis and PMDD. We're not bothering to study PMDD. I mean, we study very little about endometriosis and even less for PMDD, but we are seeing lots of women report it. We don't even have studies on PMDD and histamine, and yet women take antihistamines and their PMDD gets better.