How do we know it’s ADHD when so many of the ‘symptoms’ overlap with some of the symptoms of perimenopause? 

Super good question. 

There is a fair degree of overlap between some of the challenges of ADHD and some of the symptoms of perimenopause. Hmmm. Frustrating right? Namely the struggles that ADHDers and perimenopausal women can experience in relation to their cognitive functioning and their emotion regulation. Perimenopausal women often talk about their experience of brain fog. When you ask more questions, brain fog is a word they tend to use that captures difficulties with their memory (recalling words, names), forgetting intentions (reason for going into a specific room), maintaining a train of thought given their distractibility and task-switching. Perimenopausal women also often report that their mood can ‘change in an instant’, going from feeling relatively ‘even-keeled’ to irritable within a very short space of time.

As a quick lesson (or reminder) the primary hallmarks (and diagnostic criteria) of ADHD include challenges with attention / concentration and hyperactivity / impulsivity. Individuals can be a combined presentation (both inattentive and hyperactive), predominantly inattentive presentation or predominantly hyperactive/impulsive presentation. If you want to know more, you can read Part 1 of this series*. 

So I’ll drill down a little further with a few ‘real life’ examples.

When we consider the cognitive and psychological challenges described by perimenopausal women, there are a few that are going to be super familiar with ADHDers. Maintaining a train of thought (focus) due to being constantly distracted, task-switching and mood changes are part and parcel of an ADHDer’s daily life. Having said that though, there are nuanced (albeit for most but not ALL ADHDers) differences that are important to note.

For example, for ADHDers, the abrupt mood changes are often a response to feelings of frustration when our ADHD challenges arise (i.e. frustrated that you’ve just spent a solid half an hour reading a document only to realise you stopped paying attention 2 words in). Or a response to feeling rejected or disapproved of by others (referred to as ‘rejection sensitivity dysphoria’). This is different from biting your partner’s head off because they are chewing too loudly (a very real comment made to me by a perimenopausal woman). 

And yes, ADHDers also have challenges with our memory but that’s far more likely to be related to forgetting the paragraph we’ve just read, because our mind has wandered off task while reading. The perimenopausal woman might also have similar troubles but they also find it difficult recalling words and names etc.. And that’s not necessarily a common feature of ADHD. So you can see that generally, there are nuances in perimenopausal women’s cognitive and emotional challenges and those experienced by ADHDers. And it’s this nuance that forms a part (of many parts) of an ADHD assessment process. 

In addition to this, there are other critical (can’t ignore, must be present) criteria for an ADHD diagnosis. If you’re keen to understand this more deeply, then please have a read of Part 3 in the series. 

Raising awareness and deepening the understanding of perimenopause and ADHD is crucial—not just important—for timely and effective support. If you suspect you might be one of the many perimenopausal women with ADHD, check out the other articles in this ADHD and Perimenopause Series www.allabouthercentre.com.au and/or seek out a healthcare provider who knows this space well. Feel free to reach out to me via www.allabouhercentre.com.au if you need guidance as to how to go about being assessed or ongoing support.