What is this? ADHD, Depression, Menopause, SAD?

[whatsupwithmyhead]

I’m feeling mentally sub-par at the moment and I don’t know what’s at the root of it.

Am 49, probably perimenopausal (erratic periods for last few years), diagnosed with ADHD. Have taken anti-depressants a couple of times in the past which have worked for me, but I felt there were external triggers for the depression on those occasions, though both times it was this time of year it really hit me.

I feel like my head is noisy all the time - not with particular thoughts, just a sense of “noise”. I am easily irritated. I find it difficult to motivate myself to anything. I don’t want to talk to people, I find having to engage with my family often feels like an annoyance. I often feel like I want to slam my head into a wall and have intrusive thoughts about it (I don’t actually want to act on these thoughts).

I’m wondering whether I need to get on the ADs again and treat it as depression. Or whether this is menopause related and HRT is the answer. Or it might be ADHD related. Or this is the third time I’ve felt like this going into winter so maybe it’s seasonal?

Probably a trip to the GP needed but throwing this open to Dr Mumsnet first for advice - what’s going on here do you think?

I would ask for blood tests first. Do you take vitamin D. Then try HRT and then ADHD meds.

Menopause can exacerbate ADHD but your description makes it sound more likely to be linked to the time of the year so SAD would be treated as depression.

Ha, so basically it could be any of them, this is what I am struggling with. Maybe it’s a bit of ADHD mixed with Peri mixed with SAD! I’m just not sure where to start. I could go to the GP for ADs or HRT but would have to go privately for ADHD meds.

Both the disruptive ADHD symptoms and these bouts of (seasonal?) depression have only really hit me in the last few years so the root could be peri, maybe?

The hormonal changes that come from peri/meno can make ADHD a million times harder to manage. My ADHD is through the bloody roof and that’s despite taking meds for my ADHD and being on HRT. God knows what I’d be like without them, it doesn’t bear thinking about. I do also have (diagnosed)SAD but to be quite frank, that’s the least of my worries (get a Lumie lamp, it WILL help).

To me what you describe sounds exactly like a woman with ADHD going through peri. I’d suggest you try HRT first as ADHD meds will take a lot longer to get sorted (and are very expensive privately). I feel a difference in mood within 24-36 hours if I don’t apply my HRT(Oestrogel) correctly. I’m literally in tears (or a complete bitch) at the slightest thing. Then I realise and up my dose a little and within 24 hours, I’m back to ‘normal’ mood again. Quite amazing really. That’s hormones for you.

Edit: just to add that I’m sure you’re already aware that ADHD is often mistaken for depression.

My ADHD has ramped up thanks to perimenopause. I was struggling with it and had my ADHD meds increased to a higher dose and I’m starting to feel better now. I’m due to start HRT when I can finally make up my mind what route to go down, torn between getting the mirena and patches or just trying the sequential patches but my ADHD is making me very indecisive. My GP explained how perimenopause makes ADHD worse and said lots of women who’ve masked it for years finally get diagnosed, it’s more common than you think and there’s plenty of research about it.

Oh gosh you are dealing with all three! All strength to you!

Thank you for such a helpful post.

I do think it’s possibly the overlaying of ADHD + peri + an element of winter blues/SAD + the extra mental load at this time of year overloading my ADHD brain.

I think you might be right that HRT could be the one, worth a try at least.

Yes I was only diagnosed a few years ago - I had assumed it was reaching a tipping point with juggling more life responsibilities that made it all more obvious (they joys of ADHD being hereditary and trying to manage your DC’s ADHD on top of your own!). But peri may be a factor too.

Try hrt for 3 months and see how you feel. It completely lifted my mood and helped my spiralling brain.

I feel your pain. Very similar here. Ask your GP to run an in depth thyroid panel too. Be quite firm as it often co-occurs with menopause and will make your cognitive processes feel wonky.

Also - find a good friend and spend time with them.

All the very best to you.

It’s incredibly common for women with ADHD to really struggle when they hit menopause. Oestrogen significantly impacts on dopamine so when it drops in menopause, it has a huge impact on ADHD symptoms. I would definitely suggest seeing your GP to check bloods like Ilovecheeseyah mentioned to rule out other causes but I suspect HRT will help you!

Thanks, it sounds like it is worth a try!

I’ve had bloods taken for other reasons over the last couple of years, would it have shown up then?

Sounds very much like peri and that will definitely be a huge factor.

I had no idea that I might even have ADHD but was diagnosed a few years ago when I was in peri (but also didn’t realise that either!) so one of those late diagnosis middle-aged women cliche types. I have long Covid and I was assessed by psychologist for coaching to help me at work with the cognitive issues and fatigue from the long Covid and he asked me if I’d ever considered I might have ADHD. Er no, I haven’t. 😳He was right. I score very highly and now have a formal diagnosis and take methylphenidate. Now I actually know something about ADHD in women, it’s actually very clear that I have it and is bleeding obvious to anyone with half a brain cell.

In parallel with this, I was also seeing a specialist about all the injuries I was getting in the gym (I’m a qualified gym instructor so I knew my level of injuries wasn’t normal) and she suggested it was peri as she’d been through early menopause herself and recognised the symptoms. She was right. So I’ve been taking HRT (Oestrogel & Utrogestan) for a couple of years and felt an improvement in mood within a week of starting it.

I have adhd, am peri and have sad, plus another chronic condition. Can't have hrt. I find the peri gets bad for a few months then settles down. Taking time to do nothing helps. Sad is manageable with vitamin D and sad lamp, I just take vitamin D and K2 spray from August to March. I'm medicated for adhd so that helps. I'm also now on low dose anti depressant escitalopram which is meant to help with focus and motivation specifically (my psych recommended it). I try and eat a mediterranean diet as that's also gotnsome evidence that it helps adhd symptoms. Avoiding sugar.

Could you not just be tired and burnt out and overwhelmed?

I think we are quick to look for the something that must be ‘wrong with me’, but maybe you’re just exhausted, bored with life, don’t enjoy seeing extended family at Christmas, have too much on your plate and it’s stressing you out.

I’d look to change my life externally before I went on ADs, especially if you have been on them before and you’re still struggling. I have been on ADs and they were a godsend when I needed them to get out of the slump, but what really made lasting change in my life was cutting out toxic family, changing my lifestyle (more exercise, more fresh air, no alcohol), changing my job, changing my routine, I rested more. You can’t do it all at once, of course. But I don’t wake up anxious anymore, I don’t dread seeing people anymore, I don’t feel miserable about life because I’m not exhausted and overwhelmed like I used to be.

Blood tests aren’t used for peri menopause now unless you are very young - below 43. Basically every woman loses their oestrogen so there’s no escaping it.

yea blood tests rule out things but given your age and symptoms just try it and see if you feel better or not

That’s exactly my experience. It’s taken 2 years to get my HRT right (Mirena coil has made a difference to me) and didn’t know I had ADHD until I turned 50!

Dr Summerhill diagnoses a case of middle aged woman in need of a holiday from her life syndrome. Currently at epidemic levels, especially brought on by winter/Christmas, treatment starts by telling everyone to start dealing with their own shit 😁

Sorry. You're not alone at least.

I was really burnt out and made some significant life changes as a result a couple of years ago and have been doing much better since then but in last few months it’s creeping back again. And there’s no obvious reason why (I am not under a lot of stress or anything).

You’re 49. Peri-menopause seems a very obvious reason to be frank.

Yes sorry I meant any external factors. Like i’ve made the lifestyle changes I can make already, it’s not something I think I can readily fix by taking up exercise or changing my work-life balance or that kind of thing, because I’ve already done it. So yes I’m thinking peri.

Sounds like perimenopause to me. Same as what I had, classic symptoms.

They are supposed to offer HRT before anti depressants. I wish I'd had HRT at your age, I tried to cope and it was hell.

Have a look at a symptom checker on line, as youay have other things that you may not associate with perimenopause.