New diagnosis and menopause coincidence?

[Betterlatethanlater]

Hi!

I’ve been noticing a lot of people are getting diagnosed later in life around the time of change- is this a thing? For me, it was going back to grad school and saying “ hey, I can’t do this all-nighter sh*t anymore, it’s way too exhausting and my brain is way slower than it used to be!” It’s taking me so much longer to get through readings and assignments and it’s causing a lot more anxiety with deadlines ( I have always lost marks for late assignments my while life…so many extensions and pleas to my profs. ) I have started an anti- anxiety med for the first time in my life because of school anxiety. It’s a whole different show.

I said I would never make myself go back to school again and here I am. University turns out to be a great place and a one stop shop for student skills development, counselling, ADHD diagnosis and referrals and accommodations through disability. I wish I had accessed these resources for my undergrad- I always had to work so much harder and for so much longer than everyone else to get through my course work. Instead of getting easier, every year it got harder as the fear of late assignments was near crippling.

Presently, I thought it was important to rule out thyroid or other adrenal imbalances ( adrenal fatigue, I’m a nurse). Now I am finally getting a medical diagnosis for a lifetime of struggle which I was always able to compensate to a degree because I had good grades, was in the gifted program and was great with apologies, but it comes to me as no surprise that the majority of my friends are also neurodivergent ( also late diagnosis ADHD in 35+ range) and late . We can all talk at the same time and no one gets upset 🤣

My job was a real challenge without proper diagnosis and treatment. I wasn’t slow, but took a long time to organize myself and complete my tasks at the end of my shifts. I always stayed after everyone else left to do my charting, would often go home with ward keys ( big no no!) and end up coming back to add something to my charting or return keys. I wonder now how I ever kept my job for 20 years! Maybe because I was working with kids who often dictate the care schedule so I got around it and also took a lot of night shifts where there weren’t as many distractions. I see it all now how I made it work for me- I’m just too exhausted to keep compensating and I couldn’t care less now if people know.

Has anyone found their ADHD symptoms to exacerbate and become unbearable during peri-menopause? I also take many of the suggested ADHD supplements like omega 3, vit D and B complex. I feel at this point in my life everything needs to be considered in supporting the freaky changes in hormonal neurochemistry. How has it affected you?

[BlessedLady]

For most women undiagnosed with ADHD or ADD. The coping skills that worked when they were younger. no longer work. The change in hormone levels play a large role.

Are you taking medication specifically for your ADHD ? It is common for those diagnosed with ADHD or ADD to also have anxiety and/or depression. It is also common for patients to be misdiagnosed with anxiety and/or depression alone. Unfortunately, most doctors do not take the time to look beyond the anxiety and/or depression because they have a diagnosis.

[Betterlatethanlater in reply to BlessedLady]

I was prescribed Effexor for school-related anxiety mid-semester last fall while I was trying to prevent myself from another crash and burn situation for over committing work and school and adjusting to relearning ‘how to learn’ after 15 years away from academia.

It was difficult to assess at the time whether the exacerbated ADHD symptoms and accompanying ptsd-like symptoms from school traumas ( likely resulting from undiagnosed & untreated ADHD) were causing the anxiety or the anxiety was causing the learning difficulties. This resulted in a plummet of my self confidence as I had previously completed 8 difficult years of university 15 years prior, and was really hard on myself for having difficulty with seemingly simple tasks surrounding getting organized to be back in school.

Once I was treated for the anxiety, I was certainly feeling less overwhelmed, but completely lost all my initiative to make deadlines ( no worries, right?). For many years I had relied on the adrenaline/ fear of being late response to get my tasks narrowly completed. That anxiety goes into overdrive in school settings where the burden of work never seems to show any relief until that last paper is handed in.

I was referred to the university psychiatrist who had me complete forms and ‘references of my symptoms’ as well as a comprehensive interview to confirm the AD(HD) diagnosis, which my dr and counsellor had already leaned toward.

So about a month after starting Effexor I got my official ADHD diagnosis, and after a failed start with Vyvanse ( crazy tachycardia, fatigue, dry cough, wobbly legs with zero focus improvement) I’ve now started a low dose of Concerta 18mg and seem to be feeling it is more helpful even from the first dose. My body is tolerating it much better and hoping I can go up on the dose quickly ( weekly as needed?) as my schoolwork is again beginning to pile up. I just have to complete the year. Fingers crossed we get the meds right before then.

Bonus is the Effexor seems to have cut my hot flashes down by about half, which is another indication for its use. Not sure if I will stay on the Effexor once school is completed if the adhd symptoms are in check.

I’ve noticed a lot of people here have anxiety with their adhd and take concurrent meds. Definitely, I feel that anxiety and adhd synergistically contribute to eachother. Something that should never be overlooked-I’m still of the belief that if I could just function better ( with the help of the meds and some learning strategies, CBT, etc), then I wouldn’t have this situation-specific anxiety.

( p.s. my family is riddled with ADHD- my brother, sister and niece have it. I was inattentive not hyperactive so I was under the radar plus I got really good at hiding it because I didn’t want to be like ‘them,’).

Thanks for your reply!

[Gettingittogether]

A guy here, but I've seen a number of women in the past two weeks post about menopause combining with ADHD to devasting effect. Just keep scrolling down ....

BTW: I actually got a kick out of reading about your compensatory strategies that you deployed. Have you talked with your provider about your increased difficulty in concentrating? Your provider might adjust your ADHD med and recommend some other changes.

[lostphone]

Hi there! Also a nurse here. The ADHD, peri-menopausal, return to academia trifecta is my story as well. Your experience of compensating via anxiety and adrenaline is all too familiar. I would guess that trading sleep for productivity has also been a compensatory mechanism for you as well. Returning to school 15 years after my MSN and 28 years after my undergrad also brings lots of fun surprises. Presbyopia and alternating between computer screens and the real world is a great joy. Which pair of glasses should I wear now and where did I set them? Being twice the age as the second oldest person in my class is also a mixed blessing.

I've been on Adderall for about 5 weeks now (I also take a low dose of Wellbutrin). I have an appointment today with my teleNP. The dose seems to help for a while but then stops helping. I am getting headaches and am thinking that may be r/t the Adderall. The irritability is a big problem, and I don't know if it is a symptom that is situationally exacerbated or a side effect. I have wondered if Concerta would be better or perhaps adding guanfacine. The problem with guanfacine is that my blood pressure is already on the low side so I don't have much wiggle room there. (I am not good at taking off my nurse hat and putting on my patient hat).

I'm digressing (I do that) ... I am interested to see how things will evolve with Concerta for you. I wish you success in finishing up the year and completing your program!

[jilllewis84]

It's totally a thing! Estrogen regulates the availability of dopamine in the brain. When estrogen levels crash, either around menopause or during PMS, menstruating people feel their ADHD symptoms intensify beyond what typical coping strategies are able to compensate for. This also means people that were maybe subclinical before menopause suddenly meet criteria and the need for treatment.

More anecdotally, I've noticed friends entering menopause expressing more fears about early-onset dementia when they first see a decline in their working memory. I wonder if concern around dementia or senility simply brings more people to the doctor for diagnosis.

ADHD is so impairing and yet it's wild how much we normalize the struggle of being undiagnosed before something gets our attention! Of course, it would be so much easier for us to find info and know what's going on if women's health was given adequate consideration by medical establishments 🙃

[KGknits]

Honestly I hadn't connected the two, but that may be why I've started having more noticeable ADHD related problems, especially forgetting things and focus. I've always thought of menopause as reverse puberty since they are both times of hormonal fluctuations. 😜 Now I'll have to do some research on possible connections.

[Slmndrs]

This has been very real for me. Due to taking estrogen blockers for cancer prevention, I've had a long and sort of odd perimenopausal period. It definitely impacted my functioning.

I currently take wellbutrin and concerta. When I think it's stopped working for me, usually it's actually because it's started impacting my sleep quantity/quality (which menopause also impacts, FUN), and the benefit from the meds is being undermined by the harm from lack of sleep. It feels like a constant balancing act of going up and down on one or the other to try to keep all my shit together.

That said, 18mg is technically the lowest dose available, but it's not necessarily a low does in that it's a perfectly adequate dose for a lot of people. That is my dose most of the time.

I'm really looking forward to Vyvanse being generic as I want to try it - it's been working really well for my brother. At some point I'd also like to try the non stimulant drugs, but there just rarely feels like a good time in life for potentially messing with something that is actually mostly working! But if I can get a setup that helps with my symptoms AND is good for my sleep, I feel like my quality of life has so much room to grow!