How to Advocate For Your Hormonal Health and Improve ADHD Support

Speaker A: 00:00:02

So, hi everyone.

Speaker A: 00:00:03

Welcome back to another episode of the Summer Toolkit series.

Speaker A: 00:00:07

And as mentioned, I'm having a little bit of a break over August, which I really did need after launching my book, which so many of you have been messaging about, telling me, reading the reviews, I'm reading your emails.

Speaker A: 00:00:19

I'm just so, so glad that it is helping so many of you.

Speaker A: 00:00:23

And what's making me smile even more is that you are buying the book for other people as well.

Speaker A: 00:00:28

You're sharing this information, this knowledge and you're also giving to family members.

Speaker A: 00:00:33

So honestly, I love hearing from you.

Speaker A: 00:00:35

Please, I do read everything.

Speaker A: 00:00:37

Sometimes I don't have time to reply.

Speaker A: 00:00:39

I try to, but I just want you to know that I wrote this book so deeply wanting to help many, many people with ADHD and understand themselves and see it through this, this lens and understand that we can feel empowered after a diagnosis.

Speaker A: 00:00:54

So thank you so much.

Speaker A: 00:00:56

So what is happening with these Toolkits episodes throughout August and early September is that we are featuring past workshops, wonderful resources which have been packed with insightful and practical guidance.

Speaker A: 00:01:07

You know, we've handpicked them, we've curated them, we've tried to sort of work in line with the book chapters and I still wanted to be able to offer you while I'm on this break, some valuable support and this self empowering knowledge.

Speaker A: 00:01:20

So you're going to get these toolkit episodes every Thursday throughout August and into early September and hopefully by then I'll come back all energized, all refreshed, lots of exciting news and there's going to be details of my membership coming up which is probably going to launch properly late September, early October.

Speaker A: 00:01:39

So if you're not on the wait list and you're interested in a really accessible, aligned membership that feels good to you.

Speaker A: 00:01:48

All the information I'll put on the show notes and there's a membership page on my website as well.

Speaker A: 00:01:53

Now you're going to hear a snippet of a episode which was part of this toolkit subscription model.

Speaker A: 00:02:00

And this is with Elizabeth Swan or Lizzie Swan.

Speaker A: 00:02:03

She's a teacher, she's a coach and she's also an education consultant who, who focuses on neurodiversity.

Speaker A: 00:02:09

Now Lizzie supports children and families specializing in support with anyone who is understanding their adhd, their autism, all the different executive functioning differences, challenges and their emotional well being needs.

Speaker A: 00:02:23

And we discuss this sort of through the lens of understanding how ADHD relates to hormones, our cycles, especially people who have experienced PMDD or continue to experience PMDD and MIGRAINES and how we balance all of this alongside ADHD medication or hrt, but also self advocacy through trial and error.

Speaker A: 00:02:45

And obviously there's going to be practical tips on cycle tracking, perhaps adjusting our diet to support our hormones and finding those people that can support us.

Speaker A: 00:02:57

So I'm really happy to bring this piece of information to you.

Speaker A: 00:03:00

I know it's very, very helpful.

Speaker A: 00:03:01

Have a listen to my conversation with Lizzy Swan.

Speaker B: 00:03:05

So in terms of my own journey, I was diagnosed with ADHD at 4:42.

Speaker B: 00:03:10

I got a private diagnosis and I then had an NHS diagnosis a few months later of adhd.

Speaker B: 00:03:17

And I'm also, I say, awaiting confirmation.

Speaker B: 00:03:20

It's like waiting for the gold mark of confirmation of my diagnosis of autism as well.

Speaker B: 00:03:25

But when I look back through the amount of times I'd already been to the doctors and the diagnoses I've collected along the way to getting accurate understanding of needs, I also have a diagnosis of gad, which is Generalized Anxiety Disorder, which actually I don't think is applicable really to me.

Speaker B: 00:03:44

I feel anxious at times, but I don't think I have an anxiety disorder.

Speaker B: 00:03:50

I also have a diagnosis of PTSD and I have collected lots of other descriptions over the years, but it has taken decades to get to a place of understanding and effective treatment.

Speaker C: 00:04:04

Regards to your teenage years, puberty, hormones, what was going on there and what were you experiencing?

Speaker B: 00:04:11

I mean I don't really remember, you know, attributing much to my hormones apart from the fact that I started having migraine with Aura when I was 10 and migraine blighted my.

Speaker B: 00:04:22

It continues to because I'm hyper vigilant to it, but really blighted much of my teen years and on into university because whenever I would get excited and tense about something, whether that's something really good like a party or an exam, the second that, that that tension was over be hit by a migraine and we now know that there's an association between migraine and adhd.

Speaker B: 00:04:45

It's just a real common co occurrence in terms of my teen years though, and I say this as the mother of a 10 year old girl who's sort of going into that phase now.

Speaker B: 00:04:55

What I really do look back on with a sense almost of bereavement is the risky behaviors and I was a really good pupil, I was academically minded but like so many others, totally missed my potential and always felt that sense of missing my potential if only were the two words that came up quite a lot, but particularly in terms of that sort of sense of hormonal imbalance.

Speaker B: 00:05:20

What I started to notice as I was getting older and had that self awareness was the most horrific mood swings and almost that sense of loss of control.

Speaker B: 00:05:30

And then I'd have these periods of clarity and at that age you don't really have that self awareness to be able to attribute it.

Speaker B: 00:05:37

But I was going back to the GP myself as soon as I was what's called Gillick competent or Fraser competent.

Speaker B: 00:05:44

And I recall going to the doctors when I was 14 and making my own GP appointment to say and I remember articulating it to them saying I feel like I vibrate at a higher than normal frequency, like I can feel my body vibrating at all times.

Speaker B: 00:05:58

And you know, again I was having difficulties with sleep and that those sleep disturbances were looking back cyclical but often I was rebuffed.

Speaker B: 00:06:08

I was given sleep medication when I was 14 and then, you know, as I got into my university years other medication was offered but I really did feel a sense that my, just before my period I had the issues of the migraine as well.

Speaker B: 00:06:23

But also just the absolute loss of almost like a loss of self control.

Speaker C: 00:06:28

Yeah, I understand.

Speaker C: 00:06:29

I've got a 15 year old daughter and I see very similar patterns and she's been diagnosed with adhd and I remember it myself as well, I really do.

Speaker C: 00:06:40

And there are so many girls out there who are thinking they just have really bad pms.

Speaker C: 00:06:45

Oh and they have this and they have that and you know, the connection between pmdd, endometriosis, key coughs, anything like that.

Speaker C: 00:06:55

Now like we're able to understand, we're able to see anecdotally this is prevalent in the ADHD or the, and the autistic community.

Speaker C: 00:07:03

But if we're able to maybe start there, like what did you notice?

Speaker C: 00:07:07

Would you say that you probably had or have PMDD and how, I guess how your cycles affected you?

Speaker B: 00:07:16

Well, in terms of the pmdd, I had a better understanding of PMDD when I was growing up than I did women with ADHD because of my age and awareness.

Speaker B: 00:07:27

And it was this absolute intense feeling of being completely out of control.

Speaker B: 00:07:33

I would literally hear the things that were coming out of my mouth and I would feel totally disconnected.

Speaker B: 00:07:39

So there's this element sort of like disassociation and.

Speaker B: 00:07:43

But I would almost, I mean the biggest challenge around this for me at the time and looking back and this one went on well into my 20s and I'll be honest, I still experience this now is, but less so was this absolute loss of control around my behavior.

Speaker B: 00:08:00

And as I say I was, I grew up in a, with a lot of privilege but this idea of, of losing that sense of control.

Speaker B: 00:08:09

And I self medicated through alcohol particularly, which I think, you know, really support a lot of my social anxieties around that time as well.

Speaker B: 00:08:19

But just in terms of pmdd, I have gone into GP surgeries and suggested PMDD and been brushed off many times.

Speaker B: 00:08:29

I mean, that's going to be a recurrent theme.

Speaker B: 00:08:32

I mean, I didn't really even understand that your cycle starts in the first day of your period.

Speaker B: 00:08:37

That basic biology that I hope children are now getting in their pshe lessons, I didn't really understand that.

Speaker B: 00:08:43

But we now know from research that particularly in the week before our period starts, that's when our estrogen levels are the lowest and when progesterone is highest, estrogen drops, progesterone goes up and dopamine drops as well.

Speaker B: 00:09:00

And it's a, you know, I look now and I can almost pre plan what's going to happen so I can adjust my medication and do want to talk about that because I'm really passionate about that.

Speaker B: 00:09:11

I wish I had some scaffolding to enable me to have that insight into how, how those major hormones work in relation to your period so that I could be more empowered as a young woman.

Speaker B: 00:09:25

Because I think, I mean, it's great to look back with hindsight, but if I did have that understanding, first of all, I wouldn't inherently blame myself for how I was and see myself.

Speaker B: 00:09:37

And you know, you get into that shame cycle which then fueled more of the negative behavior.

Speaker B: 00:09:42

But also I'd be able to, you know, get the treatment that I needed and personalize it in the way that women and girls should have.

Speaker C: 00:09:49

Oh my goodness.

Speaker C: 00:09:50

Absolutely.

Speaker C: 00:09:51

Absolutely.

Speaker C: 00:09:51

It's that shame, it's not knowing, it's thinking there's something wrong with us when actually genetically and biologically, neurologically, there's so much going on that we have no idea about.

Speaker C: 00:10:03

We're going on to what you do from a professional perspective.

Speaker C: 00:10:06

But what you've learned now about we can medication, how did that come about?

Speaker C: 00:10:11

Was that through an amazing, insightful doctor, Was that yourself or were you blending lots of information together?

Speaker B: 00:10:19

I think, well, a combination.

Speaker B: 00:10:21

I've been really fortunate to have two incredible gps, one who saved my life, she'd always book me a double appointment.

Speaker B: 00:10:30

And I think this is a top tip is you can request a double appointment for mental health.

Speaker B: 00:10:35

And she'd always make space for me because it takes me, you know, I'll say in 500 words what most people can say in 10, because I talk a lot, but she'd always make time.

Speaker B: 00:10:45

And time with GPS is something, you know, those two words don't usually come together positively at the moment, but I have that time and that space to explore.

Speaker B: 00:10:54

And then I moved house and I almost didn't want to move house because I'd lose my gp.

Speaker B: 00:10:59

But, you know, we'd got on this pathway to really positive treatment and then I met another gp.

Speaker B: 00:11:05

I was really fortunate and I have to say, in order to get that gp, I had to see six others in the same practice first.

Speaker B: 00:11:12

And so if you hear no, or you have treatment that doesn't work for you from one gp, try another, go back and see another.

Speaker B: 00:11:20

You know, as people with ADHD and women with adhd, we are determined.

Speaker B: 00:11:25

Most of us have been through incredible adversity to get to this place.

Speaker B: 00:11:29

Don't take no for an answer.

Speaker B: 00:11:30

Go back in and, like I say, ask for that double appointment.

Speaker B: 00:11:33

But it gave me the opportunity to try different things.

Speaker B: 00:11:36

I mean, if I could tell you all the different medications that I've been offered and tried, it would go on for a while.

Speaker B: 00:11:41

I mean, just some ones that your listeners will have heard of, probably citalopram, sertraline, venlafaxine, pregabalin.

Speaker B: 00:11:48

These are.

Speaker B: 00:11:49

These are medications that I have tried and just weren't successful for me, because I knew that the sense of.

Speaker B: 00:11:56

I call it, I'm vibrating at higher frequency.

Speaker B: 00:11:58

But at all times, I had the difficulty with the mood swings that were really severe and those periods, not so much of depression, but of almost flatline.

Speaker B: 00:12:09

And I now know that that's the period when I need to rest.

Speaker B: 00:12:12

But going on to the medication, what I've been able to do with my current GP is go to her with recommendations from Additude magazine, from Chad, from people like yourself online, and be able to say, I know this isn't the silver bullet, but can we try?

Speaker B: 00:12:30

And I've been able to try these medications and find one that works for me.

Speaker B: 00:12:36

Similarly with the ADHD team who.

Speaker B: 00:12:39

That's how they're supported the nhs.

Speaker B: 00:12:41

We have an ADHD team, but in terms of treatments, the first medication I was prescribed was a stimulant medication called Concerta.

Speaker B: 00:12:49

And it's really important that everyone knows that what works for one person may not work for another.

Speaker B: 00:12:54

And likewise.

Speaker B: 00:12:56

But what happened with the concert, when I took it, particularly when you titrate, which means you get your medication levels right, I actually was flung straight back into feelings of absolute panic.

Speaker B: 00:13:10

All of the time and it heightened my feelings of anxiety to an almost unmanageable level.

Speaker B: 00:13:16

And I did some research and it seems that Concerta, there are links to exacerbating pre existing conditions of anxiety.

Speaker B: 00:13:24

And I was able, I did have to chase quite a bit.

Speaker B: 00:13:27

It wasn't easy, it wasn't a matter of me just phoning up.

Speaker B: 00:13:29

I had to chase over a few weeks, sort of come off the concert and to find another way.

Speaker B: 00:13:34

And I was terrified at that point because I thought, first of all, I thought, okay, maybe I've not got ADHD and I've imagined everything because if I had ADHD and I took medication, then the medication would stop my ADHD symptoms and I'd feel better.

Speaker B: 00:13:47

But now I've taken it, I don't feel better, I feel worse.

Speaker B: 00:13:50

So maybe I'm.

Speaker B: 00:13:51

Maybe I've just been making all of this up and it's all in my head.

Speaker B: 00:13:54

And then I had to manually override that and I was able to try another stimulant.

Speaker B: 00:14:02

I'm really open about.

Speaker B: 00:14:03

I take lvans and actually the ADHD team said to me, some people find this a smoother ride than Concerta and for me it works.

Speaker B: 00:14:13

But alongside that I have other things going on like lots of people.

Speaker B: 00:14:16

And I was able to work with my GP to manage those symptoms and address what was happening there.

Speaker B: 00:14:23

It's been trial and error, but it also means you have to stick with it and, you know, it is exhausting and you're going through a process where you have this sense of bereavement for yourself and those years that this young person that you look back on didn't get that support and you're sort of managing all of those emotions, trying to understand yourself better and then you're going on this crazy ride of meds.

Speaker B: 00:14:49

But I do want to say also what's been revolutionary for me is I take hrt and, you know, one of the things that I would love GPS and healthcare professionals to understand is that having the understanding of supporting estrogen levels for women with ADHD alongside other elements of treatment really needs to be part of a cohesive plan.

Speaker B: 00:15:12

I tried to share freely as much information as I can, but I.

Speaker B: 00:15:15

That's years of research that got me to that place of what to request and it's.

Speaker B: 00:15:20

I don't feel it should have been my responsibility as the patient to come up with those suggestions and some of those ideas.

Speaker B: 00:15:27

So it's a real constant conflict of emotion.

Speaker B: 00:15:32

But trial and error and not expecting anything to be the silver Bullet, maybe.

Speaker C: 00:16:52

We can talk a little bit about postnatal depression.

Speaker C: 00:16:55

I don't know if that was something that you experienced, if that was maybe your mood was exacerbated post birth and how, maybe how did you find it being pregnant with adhd?

Speaker B: 00:17:07

I have a couple of areas that I'm really deeply passionate about and I'm doing lots of research and at the moment to try and raise understanding.

Speaker B: 00:17:13

One is around girls and they're going through puberty and how they can have that empowerment and support within the school environment because of my background in education.

Speaker B: 00:17:22

arch article that came out in: 2023

Speaker B: 00:17:46

And first thing for us to be really clear about is that in that immediate postpartum period, just after that baby is born, your estrogen levels will drop, absolute steep decline and by 100 to a thousand fold.

Speaker B: 00:18:02

And hormonal fluctuations are likely the same for women with ADHD without.

Speaker B: 00:18:08

But we have to come from the place that ADHD is a neurological condition and estrogen impacts on the brain.

Speaker B: 00:18:16

And we just have to think about how those things correlate.

Speaker B: 00:18:20

And the research, the recent research suggests that there are many reasons why perinatal depression is more likely in women with adhd.

Speaker B: 00:18:31

And one of as well as the estrogen fluctuations, our social anxiety is a major risk factor for women who, particularly in the third trimester and immediately after the baby is born.

Speaker B: 00:18:44

Because what can happen as a consequence of that social anxiety is that we, this is a huge generalization, but we may be more unlikely to have those social structures in place to provide that support.

Speaker B: 00:18:58

And looking back on my own experience, I did not want to ask for help.

Speaker B: 00:19:04

I wanted to be capable.

Speaker B: 00:19:07

You know, I'd come from a really successful career that wasn't, hadn't really failed.

Speaker B: 00:19:11

I was doing great.

Speaker B: 00:19:12

And then all of a sudden I was in a situation where things were out of my control and I, you know, I make myself feel safe by trying to get control of everything.

Speaker B: 00:19:22

But if there's one thing that's going to make you feel out of control, it's having children, whether that's biologically or that's through the adoptive process or fostering.

Speaker B: 00:19:29

But research from: 2009

Speaker B: 00:19:49

And having read that research, I look back and I think I constantly thought that I was failing and I didn't really understand.

Speaker B: 00:19:58

I'd read books and I'd seen things and I'm so grateful that I parented in those early years without Instagram because I think I'd find that comparative culture too much.

Speaker B: 00:20:08

But even with when I would go to playgroups on the rare occasion that I did and I saw other women, I always assumed that they had it all together and they knew what they were doing and by comparison I didn't.

Speaker B: 00:20:20

And so one of you know, the research is trying to challenge that there's better screening during those perinatal period for ADHD and better understanding and definitely around improving training knowledge and understanding of how ADHD affects girls and women.

Speaker B: 00:20:41

Midwives and health visitors would be one of those areas that I would desperately want better training to be in place.

Speaker C: 00:20:47

But what would you say to someone now who is understanding their neurodiversity for the first time?

Speaker C: 00:20:53

And this is like quite new to them and it feels very overwhelming and they've seen, it's almost like they've had like a little bit of flashback throughout the years of definitely how their hormones have played up.

Speaker C: 00:21:05

What can they do now to sort of start helping themselves?

Speaker C: 00:21:08

What sort of like very non overwhelming ways can someone move from this conversation and be like, okay, I'm on the right path now.

Speaker B: 00:21:18

I think the starting point and I find this really hard because of my executive functioning as best you can try and keep a diary because you will always be asked by healthcare professionals what evidence you've got or what log you've got or go away and come back in a month.

Speaker B: 00:21:33

But if you can always go into those conversations almost armed with evidence, it's really helpful.

Speaker B: 00:21:39

I know that there are apps available for tracking your cycle.

Speaker B: 00:21:41

I know that in some countries that that's dis, you know, people are being dissuaded from using them because of data collection.

Speaker B: 00:21:47

But even just in a paper diary or on your Google Calendar, just rating it out of 10, just simply rating your mood out of 10 and then putting an asterisk.

Speaker B: 00:21:59

I remember doing this when I was really young, I think I did it twice.

Speaker B: 00:22:02

But putting an asterisk next to when your period start charts and then you can start to almost do a mood tracker.

Speaker B: 00:22:07

There are some great ADHD trackers out there on Etsy and things like that, but they're quite over complicated and you have to be really Invested to do some of them, but just find a notebook or a diary and just start to track your mood and rate it.

Speaker B: 00:22:20

That'd be the first thing I do.

Speaker B: 00:22:22

I think one of the simple.

Speaker B: 00:22:24

I say it's not a solution, but one of the simple things that you can do in terms of supporting yourself hormonally is around diet.

Speaker B: 00:22:32

And I would never advocate for anybody to restrict any aspect of their diet.

Speaker B: 00:22:37

I always like to say add things in.

Speaker B: 00:22:39

Adding protein to your diet is really essential for anyone with adhd, but it will also help.

Speaker B: 00:22:46

I find if I have a protein rich diet, I crave carbohydrates less, which means I'm eating less sugar and it means that my mood feels more stable.

Speaker B: 00:22:56

So just really thinking about those things, like vitamin supplements as well.

Speaker B: 00:23:00

But again, if you have adhd, it can be hard to remember to take them.

Speaker B: 00:23:04

And then once you've got an understanding perhaps of your cycle and how it affects you, then go and speak to your gp.

Speaker B: 00:23:11

Ask to speak to a gp.

Speaker B: 00:23:13

If you don't want to see your normal gp, ask to speak to a GP who is a specialist in reproductive health or women's health.

Speaker B: 00:23:21

And most GP practices tend to have one person who tends to do a lot of the family planning aspect or tends to do lots of discussions around hrt.

Speaker B: 00:23:32

But ask specifically which would be the best doctor for you to see and go in with a bullet point list of how you're feeling and the aspect of.

Speaker B: 00:23:42

I notice these mood swings here and here.

Speaker B: 00:23:45

There is research that suggests that teenage girls can benefit from the contraceptive pill to even out their moods.

Speaker B: 00:23:52

But I would really strongly say at this point that I'm not healthcare professional and whilst the research does suggest that that may help in terms of that, you know, you talked about the cognitive functioning and I really do feel that I get brain fog and I had that when I was younger as well.

Speaker B: 00:24:06

But it can really support.

Speaker B: 00:24:08

But it's not suitable for all girls and it's about speaking to your GP to get that expert advice there.

Speaker B: 00:24:16

So I track your cycle as best you can.

Speaker B: 00:24:19

I'd consider diet and then the last thing I do is reach out to networks.

Speaker B: 00:24:25

Even if you want to just observe other women with ADHD on social media, because having an understanding that you're not on your own, that this is a neurodevelopmental condition and these are not active choices that you're making to dysregulate is so empowering and so important and gives you that determination to keep going.

Speaker A: 00:24:48

If this episode has been helpful for you and you're looking for more tools and more guidance.

Speaker A: 00:24:52

My brand new book, the ADHD Women's Wellbeing Toolkit is out now.

Speaker A: 00:24:56

You can find it wherever you buy your books from.

Speaker A: 00:24:59

You can also check out the audiobook if you do prefer to listen to me.

Speaker A: 00:25:03

I have narrated it all myself.

Speaker A: 00:25:05

Thank you so much for being here and I will see you for the next episode.