Ep 6- is it perimenopause? ADHD? or am i going crazy?

Foreign. Hello and welcome to episode six of Unmasked Minds, the podcast. I am Sarah, the psych from Instagram and I am just so happy to be here. I woke up this morning, we are still in school holidays, but I just had the package perfect, perfect start to the day. Bit of me time, bit of connection with the family, bit of connection with the hubby. And then I just noticed I was feeling so inspired. So I've popped on over here to film an episode or two of the podcast. Now, one of the topics I get asked about a lot because I talk a lot about it on Instagram is perimenopause for middle aged women like myself. The impacts of that on mental and physical health, but also the interaction or the connection that we are learning about with ADHD and perimenopause. And this is something that I am currently learning about for myself and professionally. So I thought it would be a great opportunity to jump on and share an episode on it because I know there are so many women out there asking that question, like, are these changes that I'm noticing in my body and in my mind and in my mood, are they perimenopause? What even is perimenopause? When does it start? Aren't I too young and. Or is it adhd? Because we're learning so much more about ADHD and you may have heard that in my episode two, I think around why so many middle aged women are now being diagnosed with adhd. But the thing is it can be both and there's this beautiful, it doesn't feel beautiful interaction between the two that I really want to address today. The interaction between perimenopause and ADHD and why so many women are talking about it now. Because for so many years women haven't understood this and we have just felt like we are going crazy, right? That is just what I constantly, constantly here. So to get started, I recently, just last year, had an appointment with Dr. Shauna Watts, who is known as this like menopause perimenopause specialist Dr. GP on the central Coast. I highly encourage you to follow her on Instagram and maybe check out some of her seminars. I was engaging with her content for a good two years before I had an appointment with her because I was going through all of these, like I'd see a reel or I'd see a talk and I'd be like, wow, those symptoms are me. I must be perimenopausal. But then because I wasn't ticking all the boxes, I'd write it off. And just say, no, Sarah, you're just, you know, you're burnt out, you're overworked, you're just, you know, losing it a little bit. Let me start by explaining what perimenopause is, because I only Learned this about 18 months ago when I attended a seminar of Dr. Shauna Watts. Perimenopause is the period up until menopause. Now, menopause is actually just one day of your life. Now, this blew my mind because I always heard people say, I'm in menopause. Basically, what it means is when you have had no menstrual cycle or period for 12 months, that day is your day of menopause. And everything after that day is post menopause. Everything before that day, when we're starting to see shifts and changes in your hormonal cycle, is perimenopause. Now, perimenopause can last for a period of up to 10 years before menopause. And that is something I don't think people understand enough about. I certainly didn't. And that's why when women are starting to present with a lot of the symptoms in their 30s and 40s, particularly to me as a psychologist, it's one of the things I'm getting them to look at at the moment, or I'm certainly asking questions about their hormones and their cycles and that kind of thing. So the next thing I want to talk about are some of the symptoms that I experience. And there are so many more symptoms, and I might touch on ones that I don't experience. But I also want to talk about I don't tick some of the more obvious symptoms, and therefore was like, nah, that can't. That can't be right. And I guess the. The main reason why I kept saying to myself, I can't be in perimenopause is because my period or my menstrual cycle is regular, right? Every 28 days I get my period. And because of that, I just kept saying, nah, it can't be, it can'. What I've learned since is that having irregular cycles is just one of the symptoms of perimenopause. And instead, when I actually saw my doctor, what she asked about was not necessarily the regularity of the cycle, but have there been any changes in the cycle? So in the flow, is it heavier, is it lighter, is it different, or has it been changing? And my answer to that was yes. So the main symptoms that I am currently experiencing from a physical perspective, and the doctor actually goes, let's start at the top of your head and go through your entire body. The first one is at the top of my head. I have noticed over the last few years this like dermatitis, psoriasis thing happening in my head. And I'm so self conscious about it because for those of you who have followed me for a long period of time, we had multiple bouts of head lice in our family. I've got four children and they would just pass it on to each other. And so I've got a bit of like trauma from any time I feel my head itch or see myself notice myself scratching my head, I'm like, oh my God, it's headlights. But what I've noticed is when I change shampoos or even with fluctuations in temperature, I'm starting to notice changes in my scalp, particularly at the back here where it gets really hot and sweaty. And I actually have started to develop like head sores and things that then as an ADHD woman, part of my stimming is skin picking. And so that's been getting worse as I've started to notice these changes in my body. The next symptom that's been really difficult for me or really noticeable for me is again, further changes in my skin. My skin seems to have lost any form of elasticity that it once had. And you know, I often put that down to, you know, I spend a lot of time in the sun and I'm not very well hydrated and my skin is aging. And I'm okay with aging skin. I don't get any botox or any fillers or anything like that anymore. There was a phase of my life where I really, really, I was going to say enjoyed getting Botox. I enjoyed it, but I was really uncomfortable with the aging process. So I used botox as a way of avoiding that discomfort. And I've done a lot of work in that space now to be like, I'm a 40 year old woman and I'm aging and part of that is, is getting wrinkles. But what I noticed was, you know, just the dryness in my skin. And what was interesting was when I went for the consultation, they actually took me into this room to begin with and took these photos of my skin, like on really deep level. And to be honest, I kind of was like, what the hell? Why do you need photos of my skin? Are they just gonna try and sell me products? But part of the consultation was looking at those photos. And when the doctor saw these photos of my skin, she was like, wow, you are definitely perimenopausal. And I don't know the detail. Details of that because we didn't really focus on that. But I just remember her going, wow, you can see from the dermal layer beneath, I don't know the technical terms, that your skin is going through perimenopause. And I thought that was really interesting. So the other thing I noticed with my skin is just it's been much more reactive. And for those who follow me on Instagram, you've probably seen it, like, if I get a mozzie bite, or when we were traveling Australia in our caravan last year, I would get a midgie bite, but it would turn into this whole rash across my body, this big inflamed red rash. And I had no idea that that was related to perimenopause, but apparently it can be. So that was another thing. Now they're all quite physical. So whilst they are all the physical symptoms in my body, the more worrying symptoms for me were mentally. And they were the ones that were actually making me start to go, is there something wrong with. Like, I literally was starting to worry that I was getting dementia or Alzheimer's or something like that, because the shifts in my brain over the last couple of years have been significant. One of the main mental symptoms that I noticed was brain fog. Like, serious fucking brain fog. And serious forgetfulness. Like, in the line of work that I do as a psychologist, I am meeting people all day, every day. But I was getting to a point where I was heavily relying on my notes, not my memory, when I was seeing clients. And there's nothing wrong with that because I made sure I took adequate notes. But it was starting to worry me. I would have conversations with people and completely forget what I was saying halfway through, and then completely forget the conversation. And I was really studying to question my cognitive decline and just be like, is there something wrong with me now? I kept dismissing it. So I think I've been experiencing these symptoms for about three years, probably since I turned 40. And I kept dismissing it as, you're busy, you're burnt out, you've got adhd, you know, you're inattentive, you just can't focus. But the more it's been happening, the more worrying it was getting. And so that was one of the main ones. Why was I getting forgetful and just noticing my processing just wasn't keeping up? The other thing that was getting significantly worse was my sleep. Now, I have never been a good sleeper, and I know now part of that is just the way my brain works. It is a busy, busy brain. And there have been many times in my life where I have become reliant on or needed the help of medication to help me sleep. So I think when I first started to notice notice my sleep getting worse, I was like, oh, you know, I've never been a good sleeper and I've got four children and two of them still wake up every night and come into our bed. So for years I've just been going, well nah, that's just life. And I just am destined to be tired my every single day. But the biggest shift was when I started waking up at like 4 or 5am and at first I'd be like, is it like it's the shift with daylight savings? But to be honest Rick, recently my kids have kind of started staying in their own rooms and I'm still waking up at 4:30 in the morning, ready to go for the day, but still exhausted. Does that make sense? Like waking up like, yeah, I've got to be awake, I can't go back to sleep, but I'm absolutely exhausted. And that tiredness adding to that brain fog and the cognitive decline was just getting so worrying for me. A couple of other symptoms that are a little bit more well known, the vasomotor symptoms which essentially are hot flushes. I think I'm experiencing one right now. To be honest. We, we all I ever knew was when you're in menopause you have hot flushes. But what we now know, menopause being just one day during perimenopause, as our hormones start to fluctuate, we start to notice that we generate and hold heat a lot more. For me it was during the night I would wake up in these huge sweats of a night where I'd literally have change my pajamas because I was so hot. And more recently we've gotten to a point where Rob has slept in the other room a couple of times because I'm like, I need the fan on, I need the aircon on. It is so hot. And he's like, babe, it's freezing. Like it is not a hot night. And so there's definitely been huge changes in my temperature. I'd also be like working online, seeing a client and all of a sudden I'm having these hot flushes and just like, like oh, I'll try to stay focused while my internal temperature is just roaring. And probably the last symptom that was also huge for me, which is more of a mental symptom, was the mood disruption. I have always been a person, I talk quite openly about it I've done a lot of therapy in my time and worked through, I guess, in what some people might call anger issues or dysregulation. And now that I know I'm adhd, that makes a lot more sense to me. Why? Over the years, I have struggled to regulate my emotions. And since being diagnosed with ADHD about three or four years ago, that helped really, really help me to understand why my mood was. I would struggle to regulate my mood. However, over the last year or so, even with all the tools and all the strategies and all the support, I've noticed that at certain. More like, times of the month, my MO Is just so out of its normal window. So I can just be sad and crying or really irritable and, like, really picking on Rob or the kids are just really getting to me. And I know people talk about that, you know, PMS and that kind of thing, but the. The level of this was just so extreme that I. I started to question, am I just a. Like, am I becoming one of those cranky old women in my time? Am I becoming less tolerant of people? And then I'd be like, well, is that a good thing? You know, is that boundaries, or are you just moody as. Anyway, turns out it was a symptom of perimenopause for me. So last year I went to the doctor and she did this kind of assessment with me, and it was actually fantastic because she, you know, I had to do blood tests. Although what also is really interesting is you cannot work out or diagnose someone perimenopausal from a blood test. And I think the reason for that is because we're actually looking at swings and changes in hormones in your estrogen, in your progesterone, and your testosterone decreasing. I've learned so much about it, even the fact that, do you know, as women, we actually have testosterone and a lot of it. And I'm reading this book at the moment, the menopause moment or something that the doctor gave me, and it really talks about how important the role of testosterone is for females and what we start to notice as it drops. So essentially, during this period of perimenopause, we're having reducing amounts of estrogen, progesterone, and testosterone, but they're also, like, coming up and down as they're, you know, not quite sure if we are fading out of our reproductive zone or not. So it's really the ups and downs, the unpredictability that throws most people. So it was really enlightening. I guess the word is to Be diagnosed, if that's the word. I don't know whether it needs to be diagnosed or for the doctor to say to me, yes, you are perimenopausal. There are so many things that are going on that we can see that are happening for you. She did also make me go and do all of the health checks. My. I had a mammogram. I had a Pap. Pap smear. I just all a skin check, just all of the things to make sure I'm in good health. I even had a DEXA scan where it checks your bone density and body fat and lean muscle mass and that kind of thing. And I'm just. I'm really proud of myself for prioritizing that and doing all of that, because it's, you know, once you reach this age, things will start to decline. And for me, it's. I really value and. And prior want to prioritize making sure I'm looking after my health so that I can live a life thriving as best I can, but also so that I can be here for the people that I love for as long as I choose to. And, you know, I'm healthy and thriving and have a good quality of life. So I want to quickly talk about the link between ADHD and perimenopause. Now, I'm no expert on this. I've been doing a lot of research, and there is a lot of research coming out at the moment, and there are some wonderful people to follow on Instagram that talk a lot about this. What we know in simple form, what we know is that people who are adhd, we struggle with regulating and absorbing our dopamine. Okay? So dopamine is the NeuroTransmitter, predominantly with ADHD. And we're essentially always fighting for dopamine. And we're like, you've seen the memes. Most people understand this by now. It's like we're constantly, constantly seeking dopamine, which is why we're constantly distracted looking for dopamine. We're inattentive, we're impulsive, we're hyperactive. This is me. I have combined type fidgeting all of the time because we struggle to get our dopamine at the level where we can be a bit more regulated. Now, what we're learning, or what I'm learning, is that estrogen plays a huge role in regulating dopamine and other neurotransmitters. And the way Dr. Shawna explained it, she was like, estrogen is like the conductor of all of the neurotransmitters and the problem is for ADHD women who are already struggling with their dopamine when they hit perimenopause and their estrogen starts dropping. We're already struggling with dopamine, and now estrogen isn't able to help regulate the dopamine. So it becomes a lot harder for us to get the dopamine in the way that we need it to feel better or good within ourselves. There is now evidence that women with ADHD experience more severe symptoms of perimenopause, and also that perimenopause exacerbates ADHD symptoms. So this is why there's absolutely no surprise that women in their late 30s, early 40s, who may be perimenopausal are also starting to notice all these ADHD symptoms as well. And we've got this huge influx of women showing up saying, am I ADHD or am I perimenopausal? And my belief, for a lot of people what I'm seeing is sometimes it's both. You know, sometimes it's just because we've got both things happening that it is becoming more obvious. And. And the strategies and tools that we have used for decades to mask and regulate ourselves are just no longer enough to be able to manage all of these changes that are going on for us. One of the next questions that I get asked all the time is around hormone replacement therapy. What are the natural alternatives? And what are the medications that you can be prescribed for perimenopause? Now, I am not going to talk too much about this because I'm not a doctor, I'm not an expert, and I would hate to mislead anybody in this space, but I can share with you my experience. I spoke to my doctor about a pill, so hormones, like. Like the contraceptive pill. But some of the things we discussed in that was my previous experience with the pill, which, to be honest, I was not favorable. I. I learned a lot, early late teens and early 20s about being on contraceptives that just didn't really align with me and my body, where I'm at now. So I really wanted to avoid that as much as possible. Also, I don't need contraception because my husband has had a vasectomy. So we did discuss that, and apparently that is a really great solution for many, many women. But I. It wasn't what I chose to do. So instead, I am on hormone replacement therapy. And I asked a lot of question about it because I have had these stigmas and, and potentially misconceptions, but also beliefs around medications and hormones and, and that kind of thing. And my discussion with my doctor really cleared some of that up for me. I think a lot of my beliefs around the role of hormones were based on synthetic hormones, which is what we used to take sort of 20 years ago. And there's been a lot more advancement in the types of hormones that are available now. Am currently on a gel, an estrogen gel to help deliver estrogen to my body more regularly. And during a certain phase of my cycle I am on a progesterone tablet to increase my progesterone. Now we are very early on in that, maybe a couple of months in and as we monitor that we may be introducing testosterone as well. But we are just seeing how we go with this at the moment and I am having some really, really positive results. Since being on this hormone replacement for a couple of months, I have found something that I think works for me. My sleep improved instantly. Just, I just cannot believe it that I'm getting much better sleep now. I have definitely noticed a change in my mood and then I sort of go oh yeah, but you've been on holidays so maybe that's why. But I, I've definitely noticed more capacity to regulate my mood and to be more present than I was and I've definitely noticed some changes in my skin. So whilst at the moment I've still got something going on in my scalp because I changed shampoos, I haven't had any flare ups in my body on my chest. That's why I normally get them on my chest. So overall it's feeling really positive for me on this journey of hormone replacements. I do know there are a lot of natural alternatives that really appeal to some people and I believe there's, you know, a lot more evidence around them being effective. And for me as well, it also, this whole process just reinforced to me the importance of looking after myself. One of the things my doctor said was you are not drinking enough water. And she like pinched my skin and it like stuck together. And I kind of laugh because I've been telling my followers for years that I suck at hydrating myself. But it really made me start to think Sarah, like your body needs, needs water, your body needs nutrition. You know I, I skip meals all the time. So whilst I've gone on the hrt, I've also really prioritized all these other things that I know are important but often just go to the, the bottom of the priority list. So yeah, that, that is my journey of perimenopause discovery. My increased understanding between perimenopause and ADHD and my my journey with medication. I am sure there's going to be lots of questions on this one, so feel free to put questions on wherever you listen to the podcast or on the Instagram page where I post sort of the summaries of each episode because I definitely read there and that's where I actually get all of my ideas for upcoming episodes. So if you are interested or have anything that you would like to know more about, go in there, interact with me over there and often it might turn into a new podcast episode episode. So thank you for being here. I am still so humbled that there are so many of you listening to this. Loving it. I am getting so many messages, so much feedback. My favorite story so far is someone I know drove past me the other day and they pulled up to say hi and they were listening to me in their car and I was like, oh my gosh. She said, have you ever heard yourself through someone's car radio? And I was like, no. But now I have. So I am just so grateful that you're all here. And yeah, talk soon.