Wednesday, February 18, 2015

MENOPAUSE and/or ADHD?

A RIDDLE:

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.


SO WHAT CAN WE DO ABOUT IT?

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

IS YOUR MEMORY WORKING?

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. 

WHAT IS 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.