E22 Perimenopause and ADHD

Listen to the episode here: E22 Perimenopause and ADHD - https://apple.co/4dLOqBH

Hey there, friend, it is episode 22 with Dr. Tiffany. This is Integrative Mental Health Therapy with Dr. Tiffany and I'm talking about my brain, body, and mind approach and always that three-leg stool of trying to get you balanced and stable. I wanted to say thank you to all of you for sharing the podcast and telling people about it. There are definitely more downloads.

Definitely more people listening and that's exciting. I think this is a really important message to just share. So I do wanna take a beat to just explain briefly, just kind of how we're here, because I know I have people who aren't gonna go back to the very first episode or don't have access to the private podcast, which is where I started to kind of tell my story and talk about just the mission, because I do feel like this is a mission.

I was interviewed recently for someone's Instagram live, this really amazing naturopath that's in Canada that is pregnant with her third child and just an exercise, just I don't know, authority. I was going to say fiend, but that's not a nice word and that's not what I mean. She's just this authority on just women's health and really active. Pregnancies and just doing all these amazing things with her body during these pregnancies and just was totally inspired and quite tickled that she interviewed me so there is a link to that interview now that I'm on a tangent talking about this and there's a link to that interview in the show notes please check it out. She's just really great and it's just amazing to be part of the community that she and I are in and she was asking me about how I got here, why am I talking about integrative mental health, holistic interventions, brain-body mind? And then she was also wanting to interview me because her husband's been diagnosed with ADHD for a while, and I have this personal, unique perspective on being surrounded by neurodivergence, neurodivergency, or neurodivergent brains; however, we want to talk about this and are just loving it and saying, "Whoa, this is fun". And just, this is a special sparkly brain with its deficits for sure. But it is a blast to work with people who are on the ADHD spectrum and in AUDHD spectrum, which has been just an amazing experience to.

I don't know; be aware of this here in 2024. And then, from the ASD perspective, I explained to her that I have a number of high functioning autistic individuals in my practice. And high functioning always means that they can operate independently outside of the household and make a lot of life decisions and aren't dependent on family and parents and so forth to just get through school, get through jobs, that sort of thing. And that it was a, just a kind of a heart centered decision to start to shift my practice to focus on integrative holistic treatments for a neurodivergent brain because my husband, was diagnosed and then this was something that we needed to figure out, and then I started to work with Melissa Orlov, learning about the ADHD effect on marriage. And that whole approach of Dr. Amon's interventions and all the things helped me to unlock my husband's, just his brain and our relationship, but also his brain and like life in general. And I started to realize that there were a lot of limitations to how I had been trained as a psychotherapist and that if I had any hope of deeply, radically supporting my clients and my patients and my practice, I was going to have to go elsewhere. And so I learned from Dr. Aiman and she was super excited because she had recently read Dr. Aiman's book, trying to understand her husband and trying to love him the best way and support him the best way and also get her needs met in the relationship, right? Because the brain is divergent, right? So it's different. And so then the expectations one is going to have have to shift the person who has the diagnosis and the person who is loving the person who has the diagnosis, taking care of all these different things. And that this really was a labor of love personally for me. I had to study with Dr. Melillo, that went on for a year and a half.

I have done trainings from some of the greats in ADHD, Dr. Barkley, Dr. Ned Halliwell, just all the different kind of hodgepodging I did to be able to put together the Doc Brown Bush method of brain, body, mind. And so I just wanna put all this out there so people, because I'm getting more and more interviews here recently about just why I do what I do and why I have this perspective.

I'm on a couple of summits coming up and it is very much born of an in the trenches kind of desperation. And then it became like, hey, I want to be like a better practitioner. I want to be a supportive clinician. I want to help my clients deeply look at what is going on in their body that impacts their psychological presentation. What is going on in their body that impacts how their brain is functioning, what is going on in their brain that impacts these other areas. And I think to be really, not just adequate, but just like a premium offering, you know what I mean? Just like somebody you can go to and they're like, they deeply get your diagnosis, it requires this holistic perspective. And as I worked and worked in the ADHD space, I doubled back and started to realize that there's a lot of other areas. So you start with men and then you go to kids with ADHD. And then as you start to, and this is the focus of today's podcast, perimenopause and ADHD, as you start to work with women, you realize that the research is quite terrible. And it's a whole different ballgame when you start talking to young women and perimenopausal women with ADHD. So in my work, I started having to address like brain fog, overwhelm, anxiety. Like it just started to look very different. And so I've had so many requests from people to talk about perimenopausal ADHD. I'm going to really kind of focus in on that because I think it is an area where there's just not enough conversation. And there are unique challenges. So what is perimenopause? It's that decade of time where women are preparing to go into menopause when estrogen production decreases, when hormones shift and women are no longer cycling. And as we all, you know, I'm in that perimenopausal window. Now I don't have a diagnosis of attention deficit, but I can relate to the perimenopausal part.

You know, your everything starts to shift. Okay, so let me say this. This is a beautiful time for women, beautiful time. It is compared to when young women first go into puberty. So I will oftentimes have young girls in my practice who are hitting puberty who also have an ADHD diagnosis because it is a very tumultuous time for them because their hormones in their brain are changing. The brain has receptors for hormones, it's a whole thing. Okay, I've done numerous podcasts kind of talking about that timeframe for young women. And so for us in this time in our lives, our brains are changing, they're remodeling. The biology of this is that the job is done. It really is, it's done. Like, you know, as women, our bodies were created to be able to create and the time is winding down. And as it winds down, the brain is remodeling as all of these hormone inputs are decreasing and women start to, it's just beautiful. Those of you who are my clients who are in this time of life, you know that I've kind of talked to you about how amazing this time can be. There's this self-actualization that occurs. Careers have been established, children have been birthed and cared for.

Maybe you're lucky and they're on their way out, maybe they're still very young, doesn't matter. But that work is done. A lot of the angst and pursuit in life is now behind a female. And now she starts to think about how satisfying is her relationship, who is she, what does she want to do with her next phase of life, how satisfying is the career she chose at 22.

There's just this shift and it is partly happening because the estrogen, the progesterone, and the testosterone are dropping. And depending on where you are in this phase, right, it can be very different. So some women will hit menopause quite early. I do take issue with women having to go into menopause in their late 30s, early 40s. I think it can be quite hard to have that drop off so early.

I really love it if I can see females organically and naturally go into menopause in the late 40s, early 50s. It just is a little bit easier because it's hard anyway, but it's a little bit easier. But if you add this shift to ADHD, to that backdrop of ADHD, almost liken it to a fire that now we've turned gasoline on.

These hormone disruptions are going to change the way the brain performs. And so in this podcast today, I'm not going to talk about all the changes. I want to talk about one of the main areas that is going to be affected briefly here and then just give some suggestions and hope for this, just like how do you deal with this? What women will notice as the hormones are dropping off is just progesterone specifically isn't as high as we're going to need it to be. It's really okay that the estrogen is going down. It needs to be corrected when it's time. It can't go off a cliff, but we can we can deal with that. Believe it or not, we need testosterone, and if that's too low, we actually are supplemented for that or provided some support around that because it gives us a lot of our get up and go, our motivation, our drive. But progesterone is a big problem.

Okay, if you are grumpy or you're not sleeping all the way throughout the night or you are experiencing like tenderness in the body, specifically like the breast during ovulation and perimenopausal, excuse me, I keep wanting to say perimenopausal, PMS. So pre-menstrual syndromes, if you're during that time, if you're having just these big drop-offs, I really want you to think about progesterone.

Okay, now this isn't a hormone talk, but then what does that do? If it is off, we're gonna have things like an increase in anxiety, which is how I end up talking about anxiety a lot with women who have ADHD, who are perimenopausal and brain fog, which is why I end up having to talk about these things so much. So if you are perimenopausal with an ADHD diagnosis and you already deal with things like foggy brain, and anxiety because these can be side effects and consequences of an ADHD diagnosis. Welcome to more fogginess. Welcome to an increase in anxiety. And so you can see your provider, whether it's a naturopathic functional medicine provider or it's your Western medicine medical doctor.

Some of you know I have a couple of people that I work with now for hormone support. I don't really like doing that myself. I have a lot of things I enjoy doing. Hormones is not one of them. But there are options and there are really brilliant people able to take care of pure menopausal and menopausal females. Okay, so that saying that. We need to deal with the fact that as your hormones are dropping, your cortisol is going up.

So that again is gonna add to anxiety. And sometimes this lack of sleep and the fogginess. What are you supposed to do? This is a time of life outside of the hormones where I start to work with women around more brain typing. What type of ADHD do you have? Do you already have a predisposition to an over anxious part of the brain, the basal ganglia?

Do you already have a predisposition to an overactivation of the anterior cingulate gyrus, which is the gear shifting part? Is it that you are dealing more with what I talked about in the previous podcast, rejection, sensitivity, dysphoria, which has a lot to do with the limbic brain being very active in the prefrontal cortex, not gating? Do we now need to start to really look at the brain type supplementing for that?

Adding ashwagandha and different supports in, maybe some GABA, do we need to look at that? And then ladies specifically, or moms, if you're listening to this and you have your daughter in mind, the diet really starts to matter during this time. We need a diet that is not inundated with carbohydrates and sugar, that has a bit more high protein, high fat earlier in the day. And as the day progresses, an increase in carbohydrates to help support, focus and heightened attention earlier in the day. But as the day progresses, we're adding in supports for sleep and comfort and all of those things. The diet and blood sugar are super important. I will talk about this as I talk about the different brain lobes.

But especially when it comes to ADHD and perimenopause and us looking at heightened anxiety, we've got to get that diet right with a prefrontal cortex that's impaired, right? So we need to have half the body weight in grams of protein, half the body weight in grams of protein, minimum, minimum. So if you weigh 150 pounds you're taking in a minimum of 75 grams of protein, minimum a day to make sure your brain is staying online and your blood sugar is stable. I'll talk a little bit more about like ideas around carbohydrates and, you know, when to eat them, timing, all those things, but big picture clean eating is super important. And so if you feel like you're like going crazy and you've become more symptomatic, during this phase of life, it's true. And menopause becomes even more challenging on the other side of not cycling at all because the drop off is so dramatic of hormones. And there are receptor sites in the brain for the hormones. And so it really does affect the brain. And that's research that's come out of just all my Alzheimer's training; that women do need support for hormones to prevent dementia and to keep the brain healthy. So there's a lot here when it comes to brain health and women and women and period menopause. And here's the beautiful thing I'm gonna offer to before I close out here, is a lot of women will find that this is just almost like a rebirth of all the things they were interested in and who they were before. Their brain starts to shift so much, they just feel like they're someone else. You know, like it's not a midlife crisis, it is a shift because identity is now different. And it's a biological shift. It's not like it's just a psychological decision that women are waking up and making. As those hormones shift, it's almost like there's something internally communicating, like, okay, like whispering, you know? Just like the clock was ticking on wanting to have a baby, now the clock is now shifted and ticking to like, who are you and what is that magical thing you want to create or do? Or, you know, who do you want to be in the world?

One of the most amazing stories is I think Vera Wayne didn't hit her stride until perimenopause to menopause. And I think that's just a testament. If you don't know who Vera Wang is, she is a designer who became incredibly successful and popular like in her 40s to 50s. Her career started at that time. And I couldn't help but think when I heard that story about brain changes and hormones. So I hope this perspective on brain, body, mind was helpful today. And I know you know a woman in perimenopause, share this. And if you know a woman who is perimenopausal and ADHD, share this, right? It's a kind thing to share because women can feel so alone, especially this particular window of perimenopausal ADHD. So I'll talk more about it. I'm also dropping a bonus recording. So there'll be another podcast kind of right after this dropping to talk about a different topic, so check that out. Because not everyone is ADHD or perimenopausal and there are other things that we're talking about, so I just want to be there for you as well. Okay, until next time, be well.