ADHD - unmedicated and menopuase. Which should I treat?

[lowmo]

This is a bit long and rambling. If too long, skip to the end sentence to see my question

I'm late 40s and have been diagnosed with ADHD for about 5 years. I took medication for 2 years but stopped for several reasons. I got referred for CBT but that was pointless. I intended to follow up and request I try a non-stimulant but then Covid hit and everyone's life changed and many people were living life with a taste of my world. So I compartmentalised my ADHD, and had more focus on taking each week by each week, and hyperfocussed on helping my teenagers through covid lockdowns and schooling.

Now I feel paralysed with inaction and I am completely unmotivated and apathetic about everything. I want and need to make changes to my life, but I can't make any decisions or see the point in putting effort in to doing something. I'm not depressed. I go out with my DH and friends on a weekend, and I am able to enjoy life, but I feel stuck and unstimulated by my life and I don't now have the benefits of what ADHD used to give me, which was a zest for life and wanting to experience new things, and that (false) optimism that better things are round the corner. I feel very much 'this is it' and this is how things will always be.

I can't work out what is causing this and how to fix it. I made the decision I was happy to live without ADHD medication as I have a job I can cope with and a DH who is super-organised and manages a lot of home stuff. I suspect my low-stress job is not stimulating enough. I also have had peri-menopuase symptoms for many years and as I get closer to menopause, those symptoms are getting worse.

I've thought about contacting the ADHD clinic to ask about different medication but I am also keen to take HRT at some point. To cut a very long story short has anyone (unmedicated) noticed a positive effect on their ADHD symptoms when they started HRT?

What were the problems with the medication?

Concerta XL. I took 18mg - minimum dose.

The positives I got from it were the quieting of my mind. Lack of rumination helped me be less anxious overall. It also helped with working memory and I could articulate my words when in work meetings or speaking with colleagues or writing.

BUT - it did not help me initiate tasks. And whilst it helps with focus, I could also end up spending time on the wrong thing and then it would help me focus on the wrong thing. If I was in a stressful or anxious situation, my heart would race faster than without the medication. I did not like that feeling. Also, I did not like the feeling when it wore off and I would sometimes be angry and ragey. I also resented having to take a medication that is a controlled substance, I did not like feeling like a criminal when I picked up my prescription. So, for me, the benefits did not outweigh the negatives.

Ok, thank you. I must confess my response was somewhat selfish as I have diagnosed but as yet unmediated ADHD and am also perimenopausal.

I would suggest chatting to your consultant

I do think our hormones are responsible for quite a lot of our emotional stage and energy levels so I think the HRT is worth a try

I've just lost a long post due to battery running out!
I'm undiagnosed but have children with Dx and guess who they take after?
Im in my fifties and am recently menopausal.
I also felt flat and unmotivated after almost manically taking care of everybody during lockdown.
I am finding life off the hormone rollercoaster easier on an emotional level as i seem to be sensitive to progesterone and suffered badly from PMT and birth control sude effects, in fact i put a lot of my ADHD problems down to hormones for years. This puts me off HRT.
I was thinking of trying meds for ADHD but my blood pressure is borderline high so i decided to try and bring it down through lifestyle changes first and to my great surprise i have found them very helpful with my sleep, anxiety, motivation and mood.
The two main changes were getting a pleasant but unchallenging part time job outside the home and joining a gym and making myself go 5 or 6 times a week (through gritted teeth at first).
I have found that the gym (+ music and podcasts) suits me and the exercise has improved my poor sleep and anxiety (main peri symptoms). The routine has helped me be more organised, often tagging other chores like shopping onto the gym or work journey and i often feel energised enough to do a bit of housework when I get in instead of slumping on my phone (procrastination has always been a major issue).
I always cynically doubted that exercise would work and generally found it boring but it has helped perk me up and calm me down at the same time.
I've also cut back on alcohol for sleep and anxiety reasons.
Ive seen the major difference meds made to my boys but also the problems so I think i will carry on managing without for the time being as I'm not doing exams or major work projects. However i will review if anything changes.

Thank you for your responses.

I was playing tennis before covid and haven't been able to get back in to it as the coaching days changed. I only learnt to play tennis a few years ago and thought it did wonders for my brain. You have to be in the moment so it's good for focus but also interesting because you get the chance to win a point every few minutes. I've always liked sports but never kept anything up. My eldest has recently left for univeristy and I miss taking watching them play sports each weekend. I miss being outdoors but just haven't the will or brain capacity to think of what to do. It's not the doing it, it's even the wanting yo do it enough. It's hard to explain. I guess I just want someone else to tell me what to do. Perhaps I am spent having run everyone else's lives for a few years.

I know what you mean, i have three ND young adult children and a husband with a creative career, I'm always problem solving for others but nobody does it for me (tbh I am not good at following other people's directions anyway!).
The old maxim "the best is the enemy of the good" is worth bearing in mind. Doing anything, however small, is better than nothing. I'd maybe try something like trying to do a certain amount of steps on fitbit type thing while listening to a stimulating podcast, outside if its not too grotty.
Recently when I've been stuck I've revisited old interests and ideas and worked forward from them, i reread some old books that were favourites of teen me and that got me over my inability to read books. I'm doing the same with music. I think I'm partly trying to remind myself of who I was before motherhood took me over! Of course the present version does not have the luxury of unlimited time to try things.
If you think HRT will give you a boost to get going again then give it a go, I will be having a chat with my GP when face to face for non urgent is back as my one annoying symptom is a low libido, not good for keeping a middle aged marriage fresh!
It's difficult to give advice without knowing you.

I have set the ball rolling and contacted my gp asking to try hrt. I figure it will be obvious if it makes a difference and if it does, that could be a more consistent difference than concerta which wore off by the afternoon. If it does not do enough, I will then make contact with the ADHD team and enquire about non-stimulants.

I’m the opposite. I’m facing up to possibly having ADHD which has all come to a head because my organisation and concentration skills have tumbled since menopause. I take HRT but no ADHD meds. I don’t really know what’s making me so distracted / unable to think - I suspect both - ie I’ve always had undiagnosed ADHD and now the impact of the menopause is compounding matters to the point where it’s significantly affecting my life.

I learned from my mother that the basic (oestrogen/progesterone) HRT is a must. It restores the body to balance. Protects your joints and bones and all the other good things. Only once that’s stable is it worth considering other options.

My diet is good. I work out including resistance training. So next I’m thinking about testosterone. Or maybe increasing my oestrogen although this is bad for me because fluctuations cause migraine and a higher dose mean more fluctuations and more/worse migraine. Once I’ve done as much as I can with hormones replacement, then I’ll start to look at the ADHD independently. TBH if I can get back to how I was pre-menopause I think I’ll be happy without ADHD stimulants.