For much of my life, I coped by pushing through. I kept going, even when I was exhausted. I threw myself into work, family, caring responsibilities and whatever challenge was in front of me. From the outside, I could look capable and high functioning. Inside, I was often running on adrenaline, anxiety and sheer determination.
Then perimenopause arrived, and the strategies that had helped me survive for decades began to fail. It felt as if everything I had relied on suddenly stopped working. I could no longer depend on the same energy, urgency and last-minute pressure that had always got me through. My brain fog worsened, my hormones felt like a rollercoaster, and the tiredness became much harder to ignore.
At the time, I did not know this could be connected to ADHD. I did not yet understand how hormonal changes can intensify ADHD traits, particularly for women who have spent years masking, overcompensating and holding everything together.
Looking capable does not mean coping
For years, I had been able to perform, achieve and keep moving. I built a career in health and care, worked as a social worker, moved into project work and became a senior leader in the NHS. I cared deeply about my work and gave it huge amounts of energy.
But being able to function does not mean functioning is easy. Many women with undiagnosed ADHD become experts at coping. We learn to mask, to work harder, to people-please, to stay late, to overprepare, to say yes, to carry on and to hide just how much effort everything is taking.
That kind of coping can look impressive from the outside, but it can be deeply costly. It can lead to anxiety, exhaustion, emotional overwhelm and a sense that you are always one step away from dropping everything.
Perimenopause was not the whole explanation. It was part of the story, but not all of it. The ADHD had always been there.
When life became too much to hold
My son’s difficulties at secondary school brought a level of pressure I had not experienced before. As he became unable to attend school, I had to navigate meetings, assessments, anxiety, low mood, the SEND system and the fight for specialist support. At the same time, I was working full-time and trying to keep performing, even when I was already stretched far beyond what felt sustainable.
I was not just tired. I was carrying the emotional load of being a parent carer, the pressure of work, the desire to please people, and the habit of never stopping. The cracks started to show, but even then, I kept going. I accepted antidepressants because I needed some relief, but I still did not know how to stop or ask what needed to change.
Looking back, I can see that pushing through had become part of my identity. I was the person who got things done, fought for people, solved problems and carried on. But when perimenopause arrived, my body and brain seemed to say: no more.
The missing ADHD piece
I saw a menopause specialist and, after increasing my oestrogen several times without resolving the brain fog, she suggested I may have ADHD. At first, I did not believe it. Like many people, I had a narrow stereotype of ADHD in my mind: boys at school who could not sit still or climbed the walls. I did not recognise myself in that image.
But then I started reading. I read about ADHD in women, hormones, masking, emotional sensitivity, overwhelm, impulsivity, inattentiveness, anxiety and burnout. I found a leaflet about ADHD and hormones, and the woman in the case study felt like me. It was one of those moments where something clicked into place, and I could not unsee it.
Suddenly, perimenopause was not the whole explanation. It was part of the story, but not all of it. The ADHD had always been there. Perimenopause had simply stripped away some of the coping mechanisms that had kept it hidden.
Burnout was not a personal failure
The more I learned, the more I began to understand that burnout was not proof that I was weak or failing. It was the result of years of overcompensating, caring deeply, masking, pushing through and expecting myself to keep going without enough support, rest or understanding.
That understanding mattered. It helped me stop blaming myself and start asking different questions. What was my brain needing? What drained me? What helped regulate me? What had I been doing because I thought I should, rather than because it supported me? What would happen if I stopped trying to force myself to function like everyone else?
Rebuilding meant slowing down, understanding my ADHD brain, and making small changes rather than trying to overhaul everything at once. HRT and medication helped bring some calm. Therapy and coaching helped me process what diagnosis meant. Exercise, breathwork and meditation helped me reconnect with my body and nervous system, rather than living only in push-through mode.
Why this matters for other women
So many women reach midlife believing they are simply anxious, overwhelmed, disorganised, too emotional or not resilient enough. They may have achieved a lot, cared for others, built careers and managed families, while quietly wondering why life has always felt so hard. They may also recognise a familiar boom-and-bust pattern: pushing through, doing everything, giving too much, and then crashing afterwards.
In ADHD, this boom-and-bust cycle can happen when we rely on urgency, adrenaline or pressure to get through, rather than having enough steady energy, support and recovery. Over time, that way of living can become exhausting and can contribute to burnout.
Perimenopause can be the point when old coping strategies stop working. For some women, that becomes the moment ADHD is finally recognised. That recognition can bring relief, grief and a lot of rethinking, but it can also open the door to self-understanding and more compassionate support.
If you are in midlife, exhausted, overwhelmed and wondering why you can no longer keep going in the way you once did, you are not alone. It may not be that you are failing. It may be that your brain and body are asking to be understood differently. For me, perimenopause was not just a hormonal shift. It was the moment my old coping strategies stopped working, and the beginning of finally understanding my ADHD with more compassion.
Resources that helped me
These are some of the website resources that helped me begin to understand ADHD, hormones, perimenopause, burnout and neurodiversity. They are not a substitute for professional advice, assessment or diagnosis, but they helped me feel less alone, gave me language for some of my experiences, and supported me as I began to make sense of my own ADHD journey.
- Dr Louise Newson - ADHD and hormones in women: A helpful article explaining links between ADHD, hormones and perimenopause, and why ADHD traits can become more noticeable or harder to manage during hormonal change. Read the article
- Dr Louise Newson Podcast - Women, ADHD and hormones: A useful podcast episode exploring how ADHD can show up in women and how hormonal changes may affect attention, mood, energy and emotional regulation. Listen to the episode
- The ADHD Women’s Wellbeing Podcast with Kate Moryoussef: A warm and accessible podcast focused on women’s experiences of ADHD, including diagnosis, masking, burnout, self-understanding and wellbeing. Explore the podcast
