Brain Fog, Rage, Overwhelm: The ADHD and Menopause Overlap with Dr. Sasha Hamdani

**Mary Claire Haver** (0:00)
Because there was so much to cover with Dr. Sasha Hamdani, we have broken this episode into two parts. This is part one, and we will publish part two later this week.

**Sasha Hamdani** (0:11)
To me, I feel like getting an ADHD diagnosis is so incredibly validating. Yes, and it helps you understand your brain.
I don't think that there's an age limit for that.
So I think if you have access to that, you should seek out and find someone who can evaluate you for ADHD. By the way, an ADHD evaluation is so much more than just looking at ADHD in a vacuum. They look at ADHD over the course of your life, but just as importantly as ruling in ADHD, they rule out other things. So focus can be fragmented from a lot of different things. So they're going to rule out like, is this partially due to hormones? Is this a thyroid dysfunction? Is this another medical disorder? Is this something psychiatric? Is this anxiety? Is this depression? Is this bipolar? So there's so many things that a skilled provider will piece together. I think everybody deserves to have that.

**Mary Claire Haver** (1:16)
The views and opinions expressed on unPAUSED are those of the talent and guests alone, and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment.
Something started showing up in my clinic that I could not explain.
Women who had been managing careers, families, and complicated lives for decades, were suddenly struggling to manage any of it. They could not finish tasks, could not hold a thought, could not figure out why. When nothing in their lives had changed, everything felt impossible. I was doing what most doctors would do. I was attributing it to perimenopause mood changes. I was writing prescriptions for anxiety, and I was missing something. Then my inbox exploded. Thousands of messages from women asking the same question, is this perimenopause? Is this ADHD?
Or am I just losing my mind? The data is alarming. Women are leaving their jobs during the menopause transition at rates we have never seen before, stepping back at the moment they should be at the peak of their careers. I realized that we weren't seeing something new. We were just uncovering something else. Here's the reframe. Perimenopause does not cause ADHD. It unmasks it. The hormonal shift of perimenopause was not creating a problem. It was revealing one that had always been quietly managed. Until the estrogen scaffolding fell away, and suddenly the systems women had spent a lifetime building to compensate, just stopped working. That is not weakness. That is biology. And it means that there's a generation of women who were never diagnosed, never supported, and never given the tools they needed because nobody was looking for ADHD in the girls who got straight A's and just seemed a little scattered. When I first heard the way today's guest, Dr. Sasha Hamdani, explains the overlap between ADHD and the perimenopause brain, it sent me down a research rabbit hole.
Dr. Hamdani is a board certified psychiatrist, ADHD clinical expert, Harvard recognized public health leader, and author of Self Care For People With ADHD. She worked with the White House and Surgeon General on Mental Health Awareness in 2022 Her new book, Too Sensitive, comes out this August, and she also has ADHD. This is one of the most requested topics I have ever brought to the show. If your brain stopped working the way it used to, and you've been told it's just stress, just anxiety, or just getting older, it's not.
This episode is going to tell you why. I'm Dr. Mary Claire Haver, a board certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to unPAUSED, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.
Dr. Sasha Hamdani, welcome to unPAUSED.

**Sasha Hamdani** (4:37)
Hi, I'm so happy to be here.

**Mary Claire Haver** (4:39)
I said this in the intro, but literally, our DMs, our emails are filled, filled, filled with so many questions about your area of expertise.

**Sasha Hamdani** (4:47)
Oh my god, amazing.

**Mary Claire Haver** (4:48)
So, what is ADHD?

**Sasha Hamdani** (4:51)
Okay, so ADHD is a neurodevelopmental condition, and it stands for Attention Deficit Hyperactivity Disorder, which frankly is, I hate that name. I hate that name because I think ADHD is so much broader than just an attention issue, and I think it's not a deficit problem. I think it's a regulation error. It deals with not only attention, but it also deals with memory, energy, motivation, emotions, sleep, appetite, all of it. All of it's dysregulated. So I think that's what ADHD is.