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ADHD & Midlife, Part II

This is a follow-up to my June 5, 2023, post about the relationship between ADHD and menopause. If you haven't already, you can read it here.

This journey started when I asked myself, "Do I have ADHD, or is it perimenopause?"

The answer is that it's a bit of both. In mid-June, I got an appointment with a highly recommended psychiatrist who takes insurance (I know -- a miracle!) and received an official diagnosis of ADHD. As I mentioned in my previous post, I was pretty confident I'd dealt with this since childhood. Still, it wasn't until I hit perimenopause that the symptoms were exacerbated, and I was forced to pay closer attention. With ADHD being underdiagnosed in young girls, this is the story of many adult women. Suddenly, so many strange behaviors over the years made sense, like my ability to have singular hyperfocus on a task yet procrastinate uncontrollably on others, speaking a million miles an hour, unable to let others get a word in, yet I can employ active listening in my coaching. My ability to have a rockstar-level executive function as an administrative assistant, but I experience time-blindness in my personal life. ADHD is contradictory. This much I have learned.

It's such a relief to know there is a reason for the madness, but it's still a struggle. So, what steps have I taken to make it more manageable?

Medication isn't for everyone, but I wanted to try it. This was particularly important to me because it's (believe it or not) the surest way to confirm the diagnosis. When you start an ADHD medication, it will either help with focus immediately or make you feel um...unhinged. In other words, if the meds work, you have ADHD; if you feel like you're going to have a panic attack, you don't have ADHD. Pretty simple. I started a low-dose prescription of Vyvanse, and fortunately, it was not the latter. It was a keeper. What do I like about it? Unlike Adderall, it's the timing of the time-release -- Vyvanse provides 10 to 12 hours of symptom control and takes up to one hour before it first takes effect. In comparison, Adderall can last for 10 hours, but the immediate-release formulation only lasts six hours, causing most patients to take an additional mid-afternoon dose. With that, on Vyvanse, you're less likely to crash, and (most importantly) it's less likely to f*ck with your sleep schedule because you're not double-dosing.

I'm not thrilled with the idea of taking medication, but the good news is that I don't have to take it every day.

For example, I didn't take it on vacation last month, and I don't take it on most weekends. This ability to skip doses also makes it more productive long-term - a genuine concern because as time passes, you can plateau with the dosage, forcing you to take more to get the same results. I want to avoid this.

"How about lifestyle, Julia," you might be thinking to yourself.

Yes, I changed my lifestyle in addition to taking meds. Firstly, I added additional morning workouts because I feel more focused and energized when I exercise in the morning; if you want to know more about the science of that, you can listen to CTD season three, episode 56, with Dr. Wendy Suzuki here.

I started using the Task List feature in the Evernote app and incorporated deadlines with alarms to help me organize my scattered noggin. When having a particularly disordered brain day, I can go to my list and tell myself, "You have X things due by X day. Choose one of these three things on the list and START." I find that's the hardest thing. I often feel so overwhelmed by my to-do list that I don't know where to begin. Parsing my list out into sections by the due date helps with that feeling of being overwhelmed because I can see exactly where I need to start.

Another thing I began using is the super, basic iPhone alarm. If I have a busy day, I program my entire schedule into my alarm app. I set each notice to go off at least 15 minutes before the actual task, meeting, or whatever! For example, I set an alarm for 30 minutes before leaving for Physical Therapy and 15 minutes before a podcast interview. This has done WONDERS for my time blindness.

Lastly, and most importantly, I've given myself grace. I know it's corny, but I've spent countless minutes, hours, and even days beating myself up for missing an appointment or not remembering an evident and essential detail about something like my dad's birthday. I've been cruel and unforgiving of myself when I would never treat a person I cared about that way.I'm happy that I now better understand what's going on in my head. As I've said before, naming the thing is everything. If you are the slightest bit sus about having ADHD, it's crucial to get a diagnosis. We have SO much coming at us as mid-life women, and it can be empowering to know what the heck is what. Only then can you take the steps to manage it.

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