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perimenopause ADHD neurodivergentie
Chaos in Your Head: Is It Menopause or Actually ADHD?
Karolien Koolhof •
Sounds familiar? You are in your forties or fifties and no longer recognize your own mind. Everything is louder, brighter, and busier. You walk to the kitchen and, halfway down the hall, forget what you wanted to get. Planning your workweek, which always came easily to you, suddenly feels like an impossible puzzle. Often, someone will exclaim: "You must be burned out!" But there is something else that is very often the culprit: the years leading up to menopause (perimenopause). And its impact on your brain is enormous.
There is a lot of confusion about the symptoms in this phase of life. It looks like stress, but sometimes it also looks exactly like ADHD. Sometimes women are incorrectly told they have ADHD. But in other cases, ADHD is actually surfacing for the very first time. How exactly does that work?
The Brain
To understand this, we need to take a look inside the brain. It all revolves around the female hormone estrogen. That is not only important for your menstrual cycle, but it is also indispensable for your brain. Estrogen helps your brain produce dopamine, the chemical that provides mental calm. It helps you concentrate and manage your emotions. It essentially acts as a built-in pair of 'noise-canceling' headphones that filter out unimportant stimuli for you.
In the years preceding menopause, your estrogen levels fluctuate and ultimately decline. The logical consequence? Your brain receives much less dopamine. The 'headphones' come off. This creates the well-known 'brain fog' and causes you to become overstimulated much more quickly. Everything suddenly hits you at full volume.
Because your brain is temporarily deprived of its regular fuel, you see two things happen in practice. The symptoms of an estrogen deficiency (forgetting things, losing perspective, and being easily overstimulated) closely resemble ADHD. Some women are suddenly given an ADHD label, while their brains are actually just confused by the changing hormones.
Masking
There are also women who have had an ADHD brain their entire lives. Often, these are highly intelligent, creative women. They were always able to hide their lack of organization well ('masking'). They compensated for everything through sheer willpower. Estrogen gave them just that little bit of extra energy to keep this up. Now that the estrogen drops, that house of cards collapses. They no longer have the energy to pretend. For them, menopause is the final straw that finally makes their hidden ADHD visible.
This is especially tough for women who naturally think deeply and feel strongly (for instance, if you are introverted or gifted). Your brain naturally processes stimuli much more deeply. That is a beautiful trait, but it means your bucket fills up faster. When the protection of your hormones also disappears, that bucket constantly overflows. You have a much greater need for silence and time for yourself.
Lower the Bar
Whether it is menopause, hidden ADHD, or a mix of both: the chaos in your head is one hundred percent real. Your biology is changing, but you can accommodate it. That starts simply by lowering the bar and stopping the masking. You have been running at a very high pace for years, and right now, that just isn't possible.
Communicate honestly at work and at home that your mind fills up faster, so you can save your scarce energy for what is truly important. To actively help your brain decompress, incorporating daily 'brain breaks' is essential. No screens or podcasts, just staring outside or taking a walk. Fast thinkers, in particular, desperately need this emptiness to process all the information.
Additionally, it can help enormously to keep a log for a month, noting when the brain fog is thickest and whether it correlates with your cycle. This is valuable information for a professional. In any case, do not struggle with this alone and do not settle for the remark that 'it is just part of the deal.' Seek guidance from a doctor or coach who truly understands how both menopause and a neurodivergent brain work, so you can give your brain the time and space it needs.
About the author
- Karolien Koolhof is a coach voor introverts and gifted individuals
- Author of the book Introvert Leadership
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