Wednesday, February 18, 2015



Me: What do menopause and ADHD have in common? 
You: What do they have in common? 
Me: What do what have in common? 

If you are a woman (of any age), you know that hormones can affect your body and your mind in various ways.  If you are a woman of "a certain age", you likely know that your changing hormone levels also affect you in many ways, most of which are not much fun. 

However, what you may not know is that many perimenopausal and menopausal women experience ADD-like symptoms,  because hormonal fluctuations affect brain chemistry.  Due to lowered levels of estrogen, women with ADD often experience a worsening of their existing symptoms and new symptoms can manifest.  In addition, the dropping levels of estrogen, which can be as much as 65%, can also affect both serotonin and dopamine, two of the key neurotransmitters found in the brain.  

What does this mean in practical terms? Lowered levels of estrogen can cause the following: increased difficulty concentrating, memory dysfunction, word retrieval and other cognitive problems, and less mental clarity, or 'brain fog'.

It's difficult enough being a woman with ADD but if you are in perimenopause or menopause, your symptoms are often exacerbated, and according to Dr. Patricia Quinn, M.D., a developmental pediatrician and director of the National Center for Girls and Women with AD/HD, "for some women, the decline is sudden and dramatic." 

This cartoon probably looks familiar to most women, (and men) with ADD.   I'm sure this kind of thing happens to everyone once in a while, but for those of us with "ADDed" gifts, it can be a way of life.  For women who are not used to experiencing these occurrences, I imagine it can be extremely frustrating, if not downright scary to feel that your memory is not working as well as it used to.  If you are a woman with ADHD, it's probably not at all frightening and likely even commonplace, to walk intently into a room and then promptly forget why you are there.  And, this can occur a few (or more) times per day and not just occasionally. It's also not particularly scary, though it is frustrating, to be in the middle of a sentence and completely forget the word we were about to use, or even what we were talking about!  Sometimes, we find things in really weird places and demand to know who put them there, although it's a bit more difficult to shift the blame if you happen to be the only one at home.  (Um, yeah, I found the masking tape in the fridge last week.) Yes, really. 

Even if you've become accustomed to some of these occurrences, they can still be exasperating, especially if they now increase in number and frequency. Some women find that were once speed bumps are now roadblocks.  

In addition to notable cognitive differences, many women experience an onset or increase in feelings of fatigue, low energy, brain fogginess and apathy or even depression. If you are a woman with ADD, these symptoms may not be new, but again, they could worsen and if you're on medication for your ADD, you may find that the meds don't appear to be working as well to control your symptoms.


What is paramount, as with new or worsening symptoms of any kind, is to see a doctor to determine the cause and get treatment options.  If you suspect that you could be entering menopause or perimenopause, see your gynecologist to confirm this diagnosis.  If you already have ADHD and your symptoms appear to be getting worse, you will likely need to see your gynecologist and your ADD specialist, especially if you are currently on medication for the ADD.  If you are not currently treating with a professional for your ADD, The National Resource Center of ADHD advises to visit a specialist who is familiar with ADD in adult women. 

If you are a woman in your 40s or 50s, have had some brain fog and other ADD-like symptoms for all or most of your life, but now they just feel out of control and unmanageable, it's possible that you have undiagnosed ADD, and the lowered levels of estrogen now make it much harder to cope.   Physicians often diagnose ADD/ADHD in women who are in perimenopause or menopause.  If you are are menopausal and also have ADD (whether just diagnosed or not), it's important for your gynecologist and your ADD specialist to communicate with each other about diagnosis and treatment. 

Although it's normal to experience symptoms from your altered brain function, whether due to menopause, normal aging and/or ADD, there are ways to improve your brain's performance: 
  • Brain training exercises;
  • Getting the right kinds of exercise;
  • Eating brain healthy foods;
  • Some form of meditative practice;
  • Actively socializing;
  • Learning new tasks;
  • Increased self-care, and my own favorite and self-prescribed treatment, 
  • Laugh, laugh, laugh, cry and laugh!  Often.

Friday, February 13, 2015


Every Friday (well, most Fridays, when I remember) I post a "FRIDAY FUNNY' on my Syndala Facebook page.  This morning, this is what I posted:

It is amusing, and I LOVE Dory.  However, for many people with ADD/ADHD, our memories often don't work the way we want and need them to.  In the case of ADD, the issue is not typically problems with short term memory, as many seem to label it, but with working memory. 


Working memory is NOT 'memory that works', as I have heard Dr. Ari Tuckman say on a few occasions.  Working memory is one of the key executive functions affected by ADD/ADHD.  It is our ability to hold and process some information in our minds while simultaneously attending to something else. Working memory is also responsible for retrieval of words or information from our longer-term memory.  

Here are some examples of the way this can manifest for people with ADD/ADHD (and for others whose working memory is not functioning optimally). 
  • Completely losing what you were about to say next, while in the middle of a sentence or thought;
  • Forgetting a word that you do know, but which completely escapes your mind when you are about to use it;
  • Test-taking, reading comprehension, written and verbal expression;
  • Forgetting a person's name immediately after an introduction;
  • Forgetting what you JUST said or did, i.e., where you put your keys 10 seconds earlier
Although everyone likely has experienced these situations occasionally, for folks with ADD, this is a frequent occurrence and a barrier to optimal functioning.  And though it can often be humorous, when it is a true impediment, it's not always so amusing.  

For children and students, this can be a serious problem in school, because working memory is crucial to learning activities.   Some ways you might see it manifested in children and teens: 
  • Appearing as though they have not paid attention, such as forgetting all or part of instructions or messages;
  • Losing their place in complicated or multi-pronged tasks;
  • Difficulty taking notes in class, perhaps because they forget what was said when they are concentrating on writing or spelling it;
  • Trouble with test taking;
  • Easily distracted
These struggles don't only apply to children, but they absolutely can be barriers to scholastic success and learning.  

Fortunately, are brains are a bit malleable or neuroplastic, and therefore, they have the capacity to be "trained".  There are also many structures and strategies that we can use to support ourselves and others so that these deficits don't ultimately become barriers to our personal and professional success and self-worth.  

It is critical to understand what is happening, why, and that it's not a reflection of intelligence or innate ability to learn.   As a coach, mother of a daughter with ADD and  as a woman who also is wired this way, THIS is what is paramount to me.  Although the struggles from the underlying ADD/ADHD can be troublesome, derivative blows to self esteem and self worth are usually more in the way than anything else and can sometimes be tragic.  THIS is why I am passionate about working with people who have ADD; because once we understand it and how it manifests for us personally, there are countless ways to address the obstacles so we can achieve our goals, our dreams and live successful, fulfilling lives. 

Thursday, December 11, 2014

ADD and the Holidays

Yikes!  Another article about the holidays?! Isn't it more than enough that Christmas music starts on radio stations the day after Halloween, or that every magazine has beautiful edibles on the cover and gorgeous photos of decorated homes featuring Normal Rockwell scenes? Everywhere we look, we are inundated with photos, advertisements, music, articles, TV shows, and let's not even mention the stores.   We know that therapists' offices are busier at this time of year.  (Well, maybe you didn't know that, but it's true.)  And why is that?  It's due to stress, of course,  and overwhelm and inner critics and old stories.  What is this all about?  Likely, we know the many and varied answers to this question, but I will list them here anyway, in case you may have missed or forgotten one.  The main causes of stress and angst during the holidays include: 
  • Extra tasks (shopping, writing cards, mailing, wrapping, cooking, cleaning, planning);
  • Financial hemorrhage;
  • Forced interaction with people we may not even like (even if they are family);
  • Losing our routines and structure;
  • Repeating old patterns from childhood;
  • Guilt;
  • Travel;
  • Gaining weight;
  • Expectations, of others and of ourselves;
So how does this have anything to do with ADD? 

The last item on the list, expectations, is the focus of the rest of this article.  I sense that this may be the biggest stressor for all people, with and without ADD.  However, adults with ADD/ADHD have even more stress during the holiday season, because accomplishing what is 'expected' can be so much more challenging than for the average person.  "I often say that living with ADHD is like being in the height off the holiday season all year round", says Sari Solden, MS, LMFT, author of Women with Attention Deficit Disorder.  She continues on to say, "People feel embarrassed when they can't cope well.  We tend to have high expectations during the holidays and if we can't meet them, we feel like failures."  This may be true for all adults, but what is different for those of us with ADD is that our challenges are much more in the spotlight at this time of year.  Many of us feel that we really can't hide.  Hiding is a way of life for many people with ADD, and particularly women. We may not invite people to our homes, because they aren't tidy (a huge understatement for some) or because we feel they are not well-decorated, or because the thought of planning and preparing a meal for our own families, let alone company, is simply overwhelming. 

Shopping???  OMG!  It's bad enough that some folks with ADD fear and/or loathe shopping at anytime, but at this time of the year?  So not only do we have to do all of the things that may normally be challenging, but now there are both added and public expectations.  If we actually do manage to purchase the gifts (at all or on time), we now have to wrap them.  Did we remember to get the wrapping paper? Or did we choose not to purchase it because we knew we already had some, but now can't find it?  Do we even have time to wrap them before we get to Grandma's or just to get them under the tree in our own homes?  Or worse, what if we actually have to MAIL THEM???  OH NO!!!! Mailing is the worst!  We have to figure out how to package them, determine if we have the appropriate packing materials, tape, markers and do this enough IN ADVANCE to transport them to the post office (yet another issue) in enough time to ensure delivery BEFORE the holidays are over.  Often we can't even get a birthday card purchased or mailed on time during the rest of the year... how are we supposed to manage this monumental feat, in addition to everything else that is expected?  And, uh-oh... what if Hanukkah is early this year?  Fortunately, this year, it's not nearly as early as lit was ast year, when we celebrated Thanksgivikkah. ;-)  

So if societal and familial expectations appear to be unattainable for the majority of folks, not to mention those of us with ADD, what is the solution? I contend that if you consciously adjust your expectations and DEFINE YOUR OWN TERMS of what constitutes a fulfilling and successful holiday season, you will be able to shed a great deal of angst, stress and heavy energy.  What does this mean in practical terms?  Here are some suggestions: 
  • Think about what is important to you;
  • Determine the most difficult or challenging tasks and either drop them or delegate;
  • Be creative (not in the Martha Stewart kind of way, unless you love that AND it does not cause you stress); 
  • Don't overbuy;
  • Solicit the help of family or friends to come with you when you shop, mostly so you actually DO IT, but also to help you stay on task while you are out.  (Or, if you have enough time, shop on line!) 
In addition to these practical tips, I encourage you to think a bit more spiritually.  Regardless of whether you celebrate Christmas, Hanukkah, or another holiday, take some time to think about what is important to you at this time.  Just sit quietly and let go of merchandizing,  family and societal expectations, and ego.  Just breathe...  How do you YOU WANT this holiday season to be?  Realistically, what can you let go?  Try to take yourself forward in time, to when you are drifting off to sleep on 12/25, or waking up the next morning.  Perhaps even further, to next year, looking back on the previous year.  What do you want to remember?  What do you want your family to remember? Is it the stuff, the food, the decor, or is it a feeling?  If it is about a feeling, what do you want it to be?  Try to really put yourself in that space... really inhabit it...  Once you know how you want to BE, now decide how you want your holidays to look from this perspective.  

Perhaps you can create a new tradition, one in which everyone chips in somehow or you decide that everyone will make a present for one person, like a grab, but that you have to create the gift yourself.  Maybe you'll decide that you won't buy presents, but instead, create a collage of gifts you'd buy for your loved ones if you were rich, or even if you had simply had a bit more discretionary income.  What if you drop some of the expected food items and make one particular treat?  Maybe you and family can start a tradition of taking a walk together... you get the idea.  

Once you know how you want to feel and the energy you want to create, own it and BE in that space.  Even if you say what you consider to be the "right" things to family and friends, if you are just giving lip service, people know.  They can feel it.  Drop all expectations, unless they serve you and give yourself (and your family) permission to just be.  Wherever you are and however you are, simply enjoy and what is and don't dwell on what isn't.  Keep in mind that if you are a parent, you are modeling how to conduct yourself during the holiday season and you are creating memories for your children.  Do you want them to remember stress and lack?  Do you want them to remember gluttony and excess?  You can only be who you are; no more, but quite possibly, less.  Do the best you can with what you have, capitalize on your strengths, remember your sense of humor and enjoy this and every other time of the year without the pressure of living up to others' expectations.  And don't forget to breathe... 

Thursday, November 13, 2014

It's all about dopamine!

What is dopamine? 

Dopamine is a type of neurotransmitter, or brain chemical. It helps level out the nervous system, thereby reducing anxiety and stress, and it is responsible for feelings of mode, attention, motivation, thinking, sleeping, seeking and reward. 

The dopamine loop

In the past, scientists have held dopamine responsible for our experience of pleasure. However, recent research indicatesthat dopamine is actually the chemical that causes us to want, desire, seek out and search.  Dopamine induces a loop - it starts us seeking and anticipating, and then we get rewarded for the seeking which makes us seek more. So, dopamine is responsible for the wanting, which triggers us to seek. When we find what we seek, we get satisfaction, or pleasure.  It's actually the opioid system which allows us to feel pleasure which allows us to feel pleasure. Feeling pleasure is , well... pleasurable, so we start the cycle again.  And again. Want, seek, anticipate, achieve, feel satisfied.  So, what's the problem?  The dopamine system is stronger than the opioid system so we tend to seek more than we are satisfied.

What does dopamine feel like in our bodies? 

If all of these words and the image don't make much sense to you, try thinking about it in terms of what it feels like in your body.  Although everyone experiences it differently, it basically feels like a little (or big) energy blip, or burst.  It's that feeling of: YES!...Let's get going!... Aaaaahhhh..... WOO-HOO! and so on.... It is the anticipation feelings we get from our successes, completions and victories, both small and not-so-small. 

ADHD and Dopamine

Although research is ongoing and often conflicts, it does appear that both scientifically and anecdotally, there is a relationship between ADHD and dopamine.  Specifically, for those of us with ADHD, the problem is that we absorb dopamine too rapidly ("re-uptake") before it has a chance to do its job.  We are, therefore, chronically under-stimulated.  This can explain why many folks with ADD, particularly when it's unmanaged, constantly seek out stimulation, and often by things things that mimic or trick the brain.  Unfortunately, not only do many of these activities NOT help us achieve our goals, (or even set any goals), they can actually prevent us from doing so, or worse, they can can harm us.  Some examples of activities that can trick the brain are: computer games, texting, Facebook, Twitter, solitaire (for me it's Freecell), crossword puzzles, sudoku, crossing off the quick or minor items on our to-do list first, shopping, socializing, making art, watching TV, reading or gambling.  Although low dopamine is certainly not the only reason that people engage in this activities and most are not harmful in an of themselves, they can create the feelings of reward and motivation that many of us with ADHD so crave, and which we do not get from low-interest, low-stimulation tasks such as homework, tax returns, household chores or any kind of maintenance tasks. 

When we struggle to apply our under-stimulated minds to these types of activities, we often find ourselves day dreaming, bored, distracted, avoiding and procrastinating.  Sometimes, and for some people, this behavior is initially unconscious or reflexive, but can also occur knowingly and guiltily.  Another issue caused by problems regulating dopamine (which many with ADD are intimately familiar), is the phenomena of getting really excited and motivated to START a project, task, business, but either not finishing, or even starting.  It might be really exciting to go out and buy all of the stuff for an art project or house project, but then not actually begin it.  You might start it, but if it takes longer than you expected, gets hard or boring, or the novelty simply wears off, it might just get left and 'stuck' somewhere, to be forgotten and/or replaced by a new idea.  (I personally, have NO idea what this might feel like.)  ;-) 

I've attached a link to a short, informative but easy-to-follow, animated video, which explains how dopamine is the cause of our dependence or addiction to texting and other social media.

If you have identified with some, or much of what has been described here, you may be wondering what to do about it.  In my coaching practice, I work with teens, college students and adults who struggle with the challenges ADHD can present, including our ever increasing reliance, even even addiction, to our cell phones, social media and other ways we avoid what is painfully boring or monotonous. There are many strategies we can employ to overcome these, and other ways, ADHD can get in our way of achieving goals and enjoying our lives.  In addition, in the near future, look out for 'Part II' of this blog, in which I will include specific strategies to address issues and problems caused by a lack of dopamine. 

NOTE:  In this, and other articles, I use the terms ADD and ADHD interchangeably.