As mentioned in Part 3 and 4, there is some overlap in the cognitive and psychological challenges of perimenopause and ADHD. I also gave some examples of the subtle differences in how they ‘show up’ for perimenopausal versus ADHD women (albeit for most, but not ALL ADHDers). Now, if you’re reading this it’s because you want to know more about this. And so here are some more things for you to mull over if you’re wondering if you’re an ADHDer or if it's ‘all just perimenopause’.

The first one I want to highlight is that one of the critical factors a diagnosis hinges on is whether the challenges of ADHD have been present throughout your life. In short, you must be able to provide ‘evidence’ of ADHD related struggles throughout your life; not just since you hit perimenopause. If you’ve gone so far as to google for ADHD screeners / questionnaires, the items/questions don’t specifically ask whether you did ‘X’ as a child. That’s why they’re called screeners and are NOT used for diagnostic purposes in any way. 

Should you head off to get assessed you may still be asked to complete these screeners as well as some other questionnaires. They’ll ask you to get ‘someone who knows you well’ to also complete some (i.e. a partner, a parent, a sibling). In the assessment session(s) you will also be asked lots of questions from childhood, adolescence, early adulthood and now AND as they apply across your home, school and work life. The questions are to understand if (or if not) you have experienced difficulties with your attention / concentration and hyperactivity / impulsivity and over what period(s) of your life and in what setting(s). You will be asked to provide examples. 

You will likely be asked to provide school reports which when I was asked, I laughed and laughed. Like, I was 46 years old, as if I had copies of my school reports! But hey, I have colleagues who did and therefore provided them to the assessing practitioner. Surely they can’t possibly have ADHD if they're in possession of the school reports from 30+ years ago (just joking, that is NOT a diagnostic criteria). 

Some of you will have NO trouble at all identifying countless examples that will likely lead to a diagnosis. To you I want to say, I’m so sorry. Because that means you have struggled in so many ways for so much of your life. You’ve likely developed a whole bunch of negative beliefs about yourself, simply because the way your amazing brain is wired wasn’t recognised nor appropriately nurtured. For you, a diagnosis will likely be validating and bring both enormous relief as well as sadness and anger. It can take time to process this and find a way to move forward. Be kind. Surround yourself with compassionate people. Seek support if you need to.

For others, you might be freaking out because you can’t recall your childhood let alone examples of these specific kinds of difficulties. But you’ll likely find that the assessing practitioner is able to help you do so (and I don't mean they’ll help you ‘create’ something that didn’t happen). The other reason you may find it difficult to think of examples is because your ADHD challenges may not have shown up so ‘obviously’. Why? Well, if you’re a Gen Xer, there are many reasons. 

1. We know that females are more likely to experience the inattentive type of ADHD and/or that hyperactivity and impulsivity are often more subtle (i.e. hair twirling and/or internal thinking, thinking, thinking and being extremely chatty, interrupting people, finishing their sentences). Neither draw the attention of adults too often or are attributed to you being ‘precocious’ (funny how that’s only ever used to describe girls). 

2. If you’re ‘bright’ (and you may not recognise yourself as such, but you likely are) you were able to muddle through school ‘well enough’. 

3. Females are also quite good at developing compensatory strategies that help us ‘muddle through’.

4. Females are good at squishing themselves into the shapes they are expected to take. That means, we are good at pretending so that we ‘fit in’. Another word for it is ‘masking’.

5. Females presenting with some of these symptoms have often been told they are anxious. You can be anxious AND have ADHD but the ADHD bit, for Generation X (and even females up until the last decade), was often not even considered. 

5. Life was different back then. And by that I mean, we weren’t as busy, the Internet didn’t exist or wasn’t readily available, we weren’t consuming social media, school wasn’t as demanding nor rigid (seriously, it wasn’t) and perhaps our home lives were a little more structured, organised and predictable. So in short, we had fewer demands on us so that we could channel our resources into developing compensatory strategies and masking.

 All these factors CAN make it hard to look back, even with more accurate information at hand, and find the evidence. But a practitioner who is well versed in ADHD and ADHD in females and even better, in ADHD in ‘older’ women, will know this stuff and in fact, be keeping an eye out for them. 

So if you have been wondering if you are an ADHDer and these articles have only made you wonder more, you can consider a formal assessment. You don’t have to. Really you don’t. But if it’s something you want to do, don’t let any naysayer stop you. I mention that because I know it’s a common response even from people who love you to say, ‘Really? Aren’t we all just a little bit ADHD? I mean, I also [insert the challenges you’ve mentioned that make you wonder if you have ADHD here] sometimes’. Perimenopause is a time to pursue what’s important to you. And the blessing of it is, that it often gives us the courage (sometimes for the first time) to say ‘I don’t care what you think, this is what I think and I’m going to do it’. Embrace it. It’s your superpower now.

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.