Unmasking ADHD in the Workplace

Are you tired of hearing "You don't look ADHD" or being told your struggles are "just a fad"? You're not alone. In this revealing conversation with Dr. Alex Cappai we unpack the unique challenges women with ADHD face in professional environments and why being believed is often the first significant hurdle.

Dr. Alex Cappai dispels common myths about ADHD, emphasizing that while many associate it with hyperactivity, the central issue is actually attention management. For women especially, ADHD often manifests less visibly - through mental overwhelm, racing thoughts, and periodic burnout rather than external hyperactivity. This difference in presentation frequently leads to misdiagnosis or dismissal of symptoms.

We explore the fascinating connection between hormones and ADHD symptoms in women. Dr. Alex Cappai explains how estrogen levels affect dopamine production, creating fluctuating ADHD symptoms throughout the menstrual cycle and intensifying during perimenopause. This biological reality adds another layer of complexity for professional women managing their careers alongside ADHD.

The conversation shifts to practical workplace considerations, with Dr. Alex Cappai suggesting that finding the right environment may be more productive than trying to mask in unsuitable settings. Someone with predominantly hyperactive ADHD might struggle in desk-bound roles but thrive in dynamic positions. Understanding your specific needs allows you to seek workplaces where your neurodivergent thinking becomes an asset rather than a limitation.

Whether you suspect you might have ADHD or have been diagnosed and are navigating professional challenges, this episode offers valuable insights about professional assessment, workplace accommodation, and embracing your neurodivergent strengths. Subscribe now and join our community of professionals learning to thrive with neurodiversity in the workplace.

Chapters

• 0:00 The Struggle of Being Believed
• 4:56 Myths About ADHD and Attention
• 8:37 Overwhelm and Mental Paralysis
• 12:56 Distinguishing ADHD from Anxiety
• 19:30 Self-Diagnosis and Social Media
• 27:17 Women, Hormones, and ADHD Symptoms
• 39:31 Professional Help and Closing Thoughts

Transcript

Speaker 1: 0:00

Because I feel right now we're living in a society that some people come back into my community and they write to me and they say the biggest problem they have is that they're not believed. People don't believe they have ADHD. Oh, it's just a fad. You don't look ADHD, you don't look like you have an issue, you look normal. That is that means and um, it's a. It's a big thing about being believed and having an invisible disability. So it would be good to know, from your perspective, what are the biggest myths or misunderstandings people have with ADHD treatment, which people knew.

Speaker 2: 0:46

Yeah, that's actually a very good point. It's important that you really think about the company and the kind of job that you like, because if you are, if you have a very hyperactive type of ADHD, you probably and many of my patients they have, they know, they know because they are aware of themselves, so they would never choose a job that is an indoor office job.

Speaker 1: 1:15

They that would be just the end of them, and they are aware. Hello and welcome to Divining Egmar, a podcast that talks about how to navigate through the complexities of the workplace as a modern day professional, whilst simultaneously having a side hustle. We appreciate all of our audience members for taking some time out of their day to tune into another episode and look forward to providing you all with some value through our show today. My name is Sarah and I will be the host for this podcast. This podcast will be available on all platforms where you can find podcasts, including Spotify, amazon, apple Podcasts, and we're also on YouTube. Now, before we dive in, I have a small favor to ask. Creating this podcast takes a lot of time and energy, and every bit of support helps me keep it going and growing. If you're enjoying the show, five star rate comment on Apple Podcasts or Spotify can make a significant difference in helping new listeners discover us. Your support is invaluable in our growth journey. And if you're also watching on YouTube, hit the subscribe button and tap the bell so you never miss an episode. Want to show your appreciation more? You can even buy me a coffee through buy me a coffee page. It's a simple way to support the show directly and helps cover production costs. Together, we can build an incredible community for ambitious professionals like you. Thank you for your support. It means more than you know. Now let's get started.

Speaker 1: 3:11

What I wanted to do is I wanted to kind of continue from our last conversation, which is really good.

Speaker 1: 3:15

I've had so much feedback from the community that heard your episodes on YouTube and it will also be on every podcast platform I can think of, so I wanted to go back into more detail. In our previous episode, you emphasised the importance of educating ADHD patients, and so what I wanted to understand is what are the biggest myths or misunderstandings about ADHD treatments that you wish people knew? Because I feel right now we're living in a, in a society that what some, some people come back into my community and they write to me and they say the biggest problem they have is that they're not believed. They don't. People don't believe they have ADHD. Oh, it's just a fad. You don't look ADHD, you don't look like you have an issue, you look normal, whatever that is that means and um, it's a. It's a big thing about being believed and having an invisible disability. So it would be good to know, from your perspective, what are the biggest myths or misunderstandings people have with ADHD treatment that you wish people knew?

Speaker 2: 4:34

Yeah, that's actually a very good point, and one myth is that ADHD doesn't exist and that the adhd is created, and, again, that it is basically not something. It's something that we have created with the social media or that we have created with the sort of life that is more modern computers, social media, podcasts and so on. Probably we could open another discussion about the fact that maybe social media and surely there is a role of the mind, mindless, um scrolling or, uh, the destruction of social media in procrastination and making adhd symptoms worse. But what is needs to be really considered is that adhd has always been there, uh, since, uh, it's described in the probably the first time in medicine was described in the 1800s or 1700s or even before I I there has been this script that there have been description of hyperactive children or problems with concentration.

Speaker 2: 5:58

Of course, the other misconception is that ADHD is a disorder that is related with hyperactivity. In reality, the common and main issue with ADHD is a problem with attention, or selective attention or a specific focus on a specific task, and that and the hyperactivity is in fact a consequence of inattention is a way that the brain has to maintain attentiveness. The real central symptom is related to attention symptoms, and so not seeing a person running up and down as an adult or not being extremely chatty and so on not necessarily does not necessarily means that they don't have a diagnosis of ADHD or they wouldn't fulfill that criteria for it criteria for it.

Speaker 1: 7:09

I think adhd is is it? It's an invisible disability because how it presents in people and different people, like, for example, like we talked about the example of how it presents, maybe in men in comparison to women. That's just one example. But there are some men that you wouldn't think they have adhd because they're a lot, you know, demure and they don't. They don't present the hyper, hyper active, you know presence of what an ADHD person may have. So I feel, like me, as a fellow ADHDer, my ADHD is a lot of the time in my mind and that my mind can skip from one point to the next and I get very frustrated with my brain, that I get like this whole world of being overwhelmed. I can even give you an example, like last week. I had so many things that I had to do and I thought I could manage it and then I got to the point where even the simplest of tasks, like phoning someone or sending a text, just got too overwhelming for me because my brain had gone into overwhelm, because my thoughts were just going, running crazy and running wild and I just had to sit down for one second and go. You know what I need to ground myself. There's too many things going on. There's too much and I'm overwhelmed and I had to literally just go. It's okay, sarah, you don't have to have it all together. You can do one thing at a time. But sometimes, when you don't know how to do that and you're so used to working in a hyper focus mode and you think you could do everything because, like, your brain has allowed you to do it, because you know how to almost thrive in a survival mode, I don't know um, you end up. You end up doing more than you should and it can literally send you into crashing. That burnout and you crash. And that's what happened to me last week. I literally burnt out and crashed. Like the simplest of things that I want to do I couldn't do because I was just overwhelmed.

Speaker 1: 9:12

Yeah, um, and then on top of that, there's other things being a female, you have like pre-menstrual issues, so that my hormones are all over the place, and I was just like I can't do anything today, right, I'm like it's just really difficult, um, and I've got to this point where I'm just accepting that's just how I'm like I'm going to be sometimes, um, and not being so hard on myself, but I get, I get um a lot of people that have ADHD. They go through that that motion of they. They're really high achievers and they can get so many things done but then because you're such a high achiever you don't realize actually I can't achieve everything and actually I need to give my brain a little bit of a rest yeah, absolutely yeah also that um one of the main, if I probably, if I, if it was for me, one of the I I would probably describe adhd and the problems related to adhd.

Speaker 2: 10:09

I think one of the most important one is that sense of being overwhelmed and the paralysis that being overwhelmed can give you, which is very typical of uh and very well described by by patients with adhd. Um, there could be other things that may be. You know, the symptoms themselves may not create that much of a problem per se, but the feeling overwhelmed and the weight of the to-do list and the burden of I have to do things is a very typical ADHD thing. Many people people that haven't got necessarily a severe ADHD or that haven't got ADHD at all may simply have the same number of tasks and still know that they have to do things, but they may not feel crushed by this sense of having to ensure that they keep everything in their mind, that they don't miss things, and they, they finalize everything and they keep tracking on a list because otherwise they're gonna forget it.

Speaker 2: 11:17

It's such a continuous um issue and that continues, uh, continuous like work of your mind, uh that never stops keeping track and functioning and it's always like a hundred percent of of the energy, isn't it like partially. So that's why I wouldn't be surprised I don't get surprised that at some point, eventually, you just reach the end of that and you are so tired that you cannot even do the most basic things, things like phone calls. Actually, phone calls require quite a lot of energy because you have to interact with another person, you have to be in the because you interact with another person. You have to be in the mood to interact with another person, and it's actually something that people that suffer from adhd that is symptomatic, um do sometimes keep that social interaction, isn't it because it's so draining? It can be so draining it is, it's um.

Speaker 1: 12:22

There's another thing that I've also noticed with ADHD, um, and actually telling the difference between someone who has ADHD and anxiety.

Speaker 1: 12:32

So a lot of the time when and I'm referring back to women, I'm not sure if it's the same with men, but with women when, when my community contacts me, a lot of women have been diagnosed with anxiety but really they don't have anxiety, they actually have adhd. How can you tell the difference between someone who has anxiety and then secondary anxiety that's caused by adhd? Because a lot of the time what happens is, um, maybe a woman will go to her gp and that she's having Russian thoughts, she's always feeling panicked about stuff, just the language is quite similar and the doctor will say, okay, I'll give you some antidepressants that will help you with your anxiety, but the reality is they don't have anxiety, they have ADHD and they get wrongly diagnosed as they're not getting the proper treatment and help. So how is it that individuals and clinicians can just tell the difference between the two orders and making sure that people are properly diagnosed between having ADHD or even or secondary anxiety that is caused with ADHD?

Speaker 2: 13:38

yes, it's such an interesting point, um, so my personal view is that all mental health problems shouldn't be assessed by the gp, but should be assessed and treated by a professional psychiatrist, which is a doctor specialized, specialized in mental health. I, I personally think that, um, it is true that anxiety and depression can be very frequent, but I also think that antidepressants are medications. As such, they have side effects and they shouldn't be just prescribed after a very short consultation. Now, I understand that a gp, a standard consultation, is about seven minutes. I, yes, that's the standard as a to to discuss a one issue, many surgery, as a of a in in in the uk, of a a cut off of seven minutes per issue, and you can only probably discuss one issue per appointment. So it means that you have two issues you have to discuss two different times. So anyway, just to cut the story short, I think that depression and anxiety are very frequent and they should be treated appropriately. And before treating, it's important to diagnose appropriately. And so just to also ensure that we, we label depression if we are talking about depression and anxiety, if we are talking about anxiety now, anxiety is a general term where, um, we, we in, in medicine, psychiatry, we, we, we describe anxiety is anxiety as an umbrella which has several other disorders under. One of them, for example, is OCD obsessive compulsive is an anxiety disorder, but it could be also GAD, which is generalized anxiety disorder. There are also other other problems, for example, phobias are still in the anxiety domain, but what we probably were considering and describing, which is more similar to and could be confused more with, adhd, is the generalized, generalized anxiety disorder, so a general sense of anxiety that happens for a life. Everything could be anything really. Now, um, we need to consider that generalized anxiety disorder can coexist with adhd, so a person may have both of them and may need treatment for both of them and may need treatment for both of them, may have ADHD and generalized anxiety disorder.

Speaker 2: 16:30

The way in which I would diagnose a person as suffering from an anxiety secondary to ADHD is very much about asking the right questions and trying to understand where the anxiety is coming from. So, for example, if the anxiety is all and completely related to this burden that we were talking about, the to-do list, the fear of not being able to keep up with everything that you have to keep up with in life, they, um, for example, uh, the, the list of the things that you have to do, these, uh, this heavy weight of, uh, all the, the, the issues that you need to keep in your mind and uh, they, they may, just the people with ADHD is this feeling that they could just disappear and escape if you don't do it, them or you don't say them straight away. So all of this will make me think, most likely, that if we do treat the ADHD also, this anxiety, the associated anxiety that comes with it, will also improve and possibly disappear. A person that has got, let's say, adhd but also is anxious because, for example, it could be that, um, I have to buy Christmas presents and uh, but I'm not sure if the my friend is gonna like it, and I'm anxious because I'm I'm not sure how I am gonna uh introduce the give that, give her a present, or uh, it she may not know, she may dislike that.

Speaker 2: 18:22

Or, um, if I um have to go to university and uh, I I am unsure that people are gonna accept me and like me, or they're gonna like my shoes, or I may be anxious because, um, I've heard that there is quite a lot of covid going around and I have to take the tube and I feel very anxious about that. All of this, you can see there is a different quality and different. This is just examples, obviously, but they are more random and aspects that are more varied in life. Rather than having to do with your to-do list and being able to function as in your, in your work life or, you know, it could be work life but could also be like maintaining the house tidy you know all the things that your ADHD is affecting you with.

Speaker 1: 19:23

What about sort of this rise of um people now diagnosing themselves as having adhd? There's this kind of self-diagnostic thing and sometimes I think that kind of like you mentioned about social media and people like watching a tiktok and thinking, oh, I watch this TikToker, I think I have ADHD just from what they say. Or watching the Instagram rule or something on Facebook or whatever you know. I feel like I see this as a double-edged sword it's good and it's bad. So, for example, it's good that we have the awareness and it's online and people can find the resources for themselves and speak to people that are similar and they can build community with people who are going through the same thing. But also it can also cause a lot of pitfalls because some people could be given a lot of misinformation which isn't really true and getting the wrong advice, and then people might like, for example, there's a there's a lot of ableist language where people say I think I'm a little bit ADHD, um, because they can't do their work or they're procrastinating, and that might be just for a few days. They're like that, but that doesn't necessarily mean you have ADHD. It might just be you're just a bit, you know. You're just a bit tired because you know you've had a long week and maybe that's why you can't get your work done.

Speaker 1: 20:54

But when you have ADHD, that is a constant. It's not like I don't want to do my work. I physically sometimes cannot do my work because even to get myself to do it is incredibly hard. Like my brain works much harder to do things, but it's because it's not visible. It's difficult to express that to people because they don't actually understand how can you not do your work? Just do it. You know I get I feel I feel like not doing it sometimes, but I get it done, um, so it's sometimes it can be good to know that we have these online resources and things that we can find, but also we have to be very careful about thing that, things that I miss in misinformation and people you know diagnosing themselves ADHD when the reality is they don't really have it. Um, I don't know what your thoughts are on that, but I think it can work to the greater good but also could be a greater evil as well.

Speaker 2: 21:54

So I completely agree with that. Um, I think it's dangerous. Uh, it can be dangerous. I would agree it is a good thing to be informed about mental health and I wouldn't only make it a an ADHD thing. I would consider that more awareness about ADHD but also other problems which could mimic ADHD um are, uh, it's, it's a good thing. At the same time, I definitely wouldn't advocate for the self-diagnosis and I wouldn't promote doing so, exactly for the reasons that you have mentioned.

Speaker 2: 22:40

First of all, as you are aware, because obviously having a when a person is diagnosed and with ADHD, they will know that ticking some boxes is not going to make a diagnosis. In fact, that's just a little part of of the assessment. Adhd assessments are, in fact, very long and involve also a proper review of the background information since childhood Often, for example, considering also what the family has to say, the memories of the parents when they can do that, and considering school reports and so on. And again, having traits of ADHD. So, for example, having distraction or having some ADHD symptoms or even a big number of ADHD symptoms, may still not give you a disorder, because very much of the definition of a disorder is something that is dysfunctional and it's causing an impairment. So having such and such symptom doesn't really confirm that you have an ADHD diagnosis. So that's a very important difference, I think.

Speaker 1: 24:08

Yeah.

Speaker 2: 24:10

There is another thing also. There is, for example, what do we have? The procrastination or inattention. They are common to so many other disorders. Consider depression, but also anxiety, as we discussed before. In depression it's very or sleep problems. In depression, you may have sleep problems and I actually bet no one, no one that hasn't slept at night, is able to focus absolutely perfectly in the morning, because it's not possible. We're not just made for that. So, in reality, if you spend your uh, your night scrolling on instagram or go to bed very, very late and then you don't sleep your number of hours.

Speaker 1: 25:00

You cannot expect, but you cannot expect to to be focused no, I feel like you're talking to me, because I have a bad habit of doing that.

Speaker 2: 25:09

Many people, many people do. Yeah, reality is that it's something that you can. The severity also of the symptoms can be definitely controlled or improved without even taking medications, for example. Just the structure and habits are, in fact, very important. Not saying for everybody and always, but a good proportion of people will respond very, very well to um, to structure and some habits that are very, are strict or stricter in some cases. But just going back to what we were saying, not necessarily not focusing in the morning is due to adhd.

Speaker 1: 25:53

It could be given by you know you really need a proper assessment yeah, yeah, no, yeah, I think maybe with people like that, they need a mixture of maybe, depending on how severe it is and obviously actually understanding what the issue is, because it might not be ADHD. They might, they may have those traits, but it might not be ADHD. It could be the case that they might just need a bit of coaching or just someone to guide them, just to get themselves a bit structured. But, yeah, yeah, I like that answer, thank you.

Speaker 1: 26:24

There's something else I wanted to go into about ADHD in women and the professional, the professional workplace setting, because this podcast is all around neurodiversity in the workplace and one of the things that a lot of women tend to do is mask. They mask because it's a survival and a yes, it's a survival and technique to get through your day, but we do it because we have to do it. Um, I know for many years I've had to mask because, um, if I told anyone I had ADHD, I was just afraid of that stigma that came and the preconceived notions and stigma that people have about what they view someone with a hidden disability. But what I'm interested to know is what do you think are the long-term effects of masking? And another thing to go with that question is how do you think workplaces can better support employees?

Speaker 1: 27:35

who have hidden disabilities and give them that, I guess, those adaptations they need to do their job effectively. I think sometimes we have in the UK we have the Equality Act and obviously you can't discriminate someone because of their disability and I believe ADHD is classed as a disability. But it doesn't mean that the way that workplaces and I find just from the community feedback they see someone with ADHD as an inconvenience rather than seeing the person as something of value to bring their brain and the way they work, is different. But does it mean this is wrong? And this doesn't mean that, uh, they're not an asset to the company and I think people have to view it in a different way.

Speaker 1: 28:36

Um, and I think this is, this is a struggle with a constant workplace policies changing and you know things like a lot of companies saying you've got to go back to office or we're going hybrid, you can't work from home. All these different things are coming into into play right now in real time. As we see, things are changing in america, which that's another story. We're together, um, yeah, yeah, but um, yeah, like what do you think the long-term effects are going to be on someone who's sometimes in this situation? You have no choice but to mask. You know how's that going to affect them?

Speaker 2: 29:15

because they're just trying to survive and get through work every day yeah, well, I think every an individual, every individual has they have their own reality. So you may have situations which are ideal where, um, an individual can discuss openly about the mental health struggles could be adhd or could be another problem and they are aware or supported to understand which measures they would need to work as the best that they can and with a provider, an employer, that is understanding and open to mental health problems. Reality is that also. I would like to see, ideally, that if that wasn't the case and the employee doesn't find this level of support, it would be nice to know that the employee can actually change that and and switch from one workplace to another and to find happiness and more, a more fulfilling career somewhere else. So that would be lovely to if if life was able to be so simple sometimes.

Speaker 2: 30:48

Sometimes, actually, we will have a situation where that is not an option and you may have an employee that doesn't feel accepted for what they are or who they are and they still need to stick with that employer for one reason or another. Sometimes they cannot leave. Sometimes it's also true that we make our own limitations, so we tell ourselves that we cannot leave and that there is no other option. Sometimes there is an option, most often than not there is another option. So, for example, leaving an employer that doesn't support us could be.

Speaker 2: 31:30

It's often possible, but let's say not often, not always. Work masking continuously where they are unable to access support. You know, even like the department for work and pension support and all the the general support which could be available to them, obviously that it's gonna be probably. Um, I would imagine that this employee would struggle with using triple quadruple the amount of energies of the peer to achieve the same or even lower results, and that leads to very often to burn out. And we also know statistically people with ADHD especially if they are not supported, they are prone to burn out.

Speaker 1: 32:35

I think I'm just thinking about this I honestly think that we have to start from a point where we ourselves and I'm as a community, and I'm just speaking to the community in general we ourselves have to start from a point where we are not looking at workplaces that are not going to accommodate for us, and sometimes that might take a little bit of homework. You know every employer ultimately has to say they are, you know, they're an equal opportunity employer. In the UK, from my understanding, we have to say that we we can't say that we don't want someone because of that their background, their skin color, where they come from, whatever, like you have to be an equal opportunity employer. But the reality is, when it comes to it, not all workplaces are the same, and so I think sometimes us in the neurodivergent community and they know it's hard you have to kind of put the work in and do the research and find the employers that will work for you, and that might mean maybe doing a personality test and looking at the type of job that fits your personality, your skill set and where you can truly flourish. There are companies out there that genuinely are happy to have people that are neurodivergent. They love the fact they have people that come from diverse thought processes and have diverse thoughts and diverse backgrounds, and you can flourish in an environment like that. Yeah, there's no point and I know it's. This is the reality, and I'm just speaking from the reality. There's no point in going for a company, as shiny and glossy as that company might look, going there and knowing when you get there you're going to be incredibly miserable and you're not doing yourself any justice or service by working for an employer that is not going to be accommodating to your needs, in believing that there is possibility for you to have more than you have today, rather than just saying I have to stay here because it's the only place I know and I'm scared to stay and I have to keep masking, and you can mask for a while, but it gets unsustainable after a while and the mask will drop off and you will get overwhelmed, you'll get sick, you know, and I think it's just important that just people in neurodiverse community do not keep hurting yourself trying to be in an environment that is not made for you. So I think it's for you to do that research.

Speaker 1: 35:33

Um, since COVID, what I've noticed? There's a trend of having more of a globalized viewpoint in terms of looking for jobs, and the doors have opened for many of us to go to other parts of the world. The world is large and if you're looking for jobs around the world, you're bound to find at least one employer that is divergent, friendly, um, and will accommodate you based on your needs. Um, because it's I think it's harder on women. You have to be like, honest, especially for a woman that maybe you have children and you've got a husband and a family to take care of, and then you have, on top of this, a neurodiverse condition like ADHD. You really need to set yourself up for the best possible way so that you can flourish and thrive. But that's just me talking and that's probably a soundbite.

Speaker 2: 36:24

But I just think it's important. I think it's very important and also another aspect is the kind of jobs that it's also important that you really think about the company and the kind of job that you like. Because if you are, if you have a very hyperactive, uh type of adhd, you probably and many of my patients, um, they have, they know, they know because they are aware of themselves so they would never choose a job that is an indoor, office job. They. That would be just the end of them and they are aware.

Speaker 2: 37:04

But then you have other people that are less aware, maybe because they were brought up with the idea from parents and family that they are gonna be, I don't know, some lawyers or solicitors or anything, and they actually pursue a career in a certain department.

Speaker 2: 37:21

But they really are never going to be particularly happy with a job that is an office job and not a hands-on job where you actually are creating and doing. And you know there is also this consideration to make that sometimes happiness comes with a little bit of struggle and sacrifice. Initially, because obviously, as you said, the self-awareness and the choice and they do their research all of that also could be. Also not necessarily research on on the internet could be also research within yourself, where you are honest and true to yourself and you really think what is that I can, I, what I can do for the the next 30 years of my life, when it is 30 sometimes it's more, sometimes it's less but a a person in a starting or in a in a starting with a career, they are gonna have to really think what they can digest in terms of a little dose or even career switching.

Speaker 1: 38:25

You know you, you might have a career and you have. You want to switch careers and you've been in this career for a long time. You've been masking, so maybe even that. It's just that time to take yourself, like you know what I need, to really sit down and think about what are the right companies I can work with, what skills do I have? You know, how would my ADHD look like if I end up working in this type of environment and how can I flourish and thrive in that environment so that I can get the most out of myself and give the most to my employer? You know, because it's a two way thing, it's just as much as you want to be a good employer, employer or a good employee, you need. You need to be able to be in an environment that you can truly flourish and thrive rather than struggling.

Speaker 1: 39:10

I wanted to cover more actually around the impact of hormones actually with women, because I'm we're focusing on women and ADHD and I know with with women, we go through different stages in life. So we have our menstrual cycle when we are girls, then at one point in our life we may end up being pregnant and that's going to affect us, and then on the perimenopause and menopause, which start affecting us probably from, I think, the age of 45 around that time, and how those things can kind of affect your ADHD symptoms. Because I feel like with women you're not only dealing with the ADHD, you're dealing with the hormones sometimes that come with that. And managing those things in the professional setting how, how can we kind of manage that as women, especially in demanding work for work environment?

Speaker 2: 40:00

yes, um, it's very uh, it's such a good um question and um, reality is uh, um, women has always had a little bit more complex, so you have an extra layer and um, this is uh, very much due to um, to the, the, the hormones that change in the life of a woman, so through a lifetime, but also during the during every month, really.

Speaker 2: 40:29

So there is these up and ups and downs, yeah, which is uh less seen in the males, isn, isn't it?

Speaker 2: 40:37

In reality, we know that when we have reduced estrogens, which are typical of the menopause, so why, for example, many women were fine or kind of fine most of their life and then ADHD symptoms become much, much more intolerable during perimenopause? That's because there could be a decrease of the estrogens, which is related to a decreased functioning of the ovaries, which is also linked to a drop in dopamine levels, and that is something that, according the models that we are, they we consider dopamine levels are already lower in in women with ADHD and they are responsible of of inattention and symptoms of the typical symptoms of ADHD. And this is also why, when in the first phase of the cycle, every month, normally we tend to have a better ability to focus and concentrate, but at the end of our cycle, so during our nearly around our period, or a little bit earlier than that, it takes a little bit longer, it takes a little bit more organization to um, to get the same things done. So and that's the thing.

Speaker 1: 42:03

So day one of the day one of the woman's cycle is the hardest, isn't it? Day one, yeah, and then it gets better.

Speaker 2: 42:11

It gets better until then it gets again like to a average level and then again goes down. Yeah, definitely it could be also um, the end of uh, also the end of the cycle, like uh 27, 28, 26, those days are also not great.

Speaker 1: 42:32

So just getting towards the, the end of the cycle and the beginning of the new one, ah, the estrogen, the, the, the, basically the progestinics are higher so maybe women need to be more aware of their cycle and how the adhd might impact them during those times in the month I I find that interesting because I find that I'm I don't know and I think maybe this stuff I have to look into. During sort of the end of my cycle and the beginning, I have very bad migraines, like they're just so bad, they're so blinding, that I have to just sit down for like I have to lie down, and then, once it's gone that first part, I'm okay and I'm normal and I've got energy, and it starts all over again. So once a month I've got to take migraine type tablets to manage it. But I think that has been another way.

Speaker 2: 43:21

That's what I'm thinking yeah, I think it's very obviously there are. There are two. I think we need to consider that there are. There are several issues even when women don't have any problem. So, for example, even for women that haven't got polycystic ovary or they don't have endometriosis, even just for a general standard cycle, you will have a little bit of several symptoms like you could have bloatness or the headaches, some pain. It's absolutely normal and you're obviously not gonna feel feel great most of the women don't feel great around the their period time but on top of that you can have also other problems which are typically related to females. It's very frequent to have, for, for example, polycystic ovary, which complicates things even further. So you may have, in that case, abnormal secretion of estrogens, so levels that go up and down, and testosterone which may be a little bit higher, and again all of this can fluctuate. Also the levels of dopamine and again you may have ADHD can vary also over time in a woman. So you can have issues that are absolutely chemically and you can call them endocrinological, so meaning that the hormones are dictating how, uh, the levels of dopamine so that are going to be going up and down, but equally you may have different um phases of of a life of a woman.

Speaker 2: 45:15

So, for example, we can say that a woman, a child, a girl, could be functioning fine at school because there is a very high level of checking and controlling and checking on her. It could be from the family and from the school. There is structure in place and, after all, it is possible for the girl to function at the normal standards expected for the age. But the issues become more pronounced when growing up. You have A-levels and then university and we are talking now of a teenager and a woman that is starting to function on her own, where the external, there is not any more external checking, external structure, it's the internal structure.

Speaker 2: 46:17

Either you have, you have it and you have learned it in a way or an or another, or you may struggle. So, for example, um, a levels is another moment when girls may come to my attention frequently, and another one is university. University is, uh, completely unstructured. Um, you may have women that simply have all this time and they may appreciate they, they lack of structure, because we also know that for adhd women and men as well, it's a structure can be, um, like a horrible thing, in a way, like a very annoying, the horrible thing, but actually it can also be a tool just to help you get your.

Speaker 1: 47:10

Yes, I don't like structure personally, but I know that by having structure it is it keeps the boundaries for me to kind of manage my ADHD as much as I possibly can.

Speaker 2: 47:21

But indeed, but maybe you said that at 19 when you were a unit. If you were, you know, at 19 you just really dislike the structure. You want to explore, you want to and you don't know.

Speaker 2: 47:35

These are things that we tend to learn the hard way yeah when we, when we have experienced that the lack of structure actually is really unproductive and maybe we see the difference between us not progressing much and our friends progressing more and faster, and we realize, but it just it may take years to realize that actually that structure wasn't that bad after all.

Speaker 2: 48:00

Probably that that was a, that was a meaning, but, yes, that's actually just to, yeah, just to finish my. What I was saying is that, yes, uh, there are several phases in the life of a woman, not just the purely chemical substances. It's also have to match, for example, yes, the changes in the university and in terms of menopausal symptoms. You can have perimenopause Children if the woman has had children, which is not always the case, but children that may be grown up and they are teenagers themselves at this point and the struggles and struggles in the family. We don't know about any other issues within the life of a woman at that age which could be typical of that age, and trying, as usual, to to juggle all day the, the, the stressors and the tasks that could be relevant.

Speaker 1: 49:02

Dr Alex Kappa. I wanted to ask one final question and then we will kind of wrap up, I guess, but there was one thing that I think that maybe you have awareness of Do you think there's enough research and medical understanding about ADHD in women, or is it still sort of heavily male focused?

Speaker 2: 49:22

yes, I in fact not enough. I don't think there is enough um enough research yet. Um, I think we are progressing and we are uh improving the number of studies that are um considering women specifically themselves. So we have some awareness in that women present a little bit different clinically. But surely some more work needs to be done, for example in the way some specific treatment for women could be attempted, especially considering the fluctuation of the menstrual cycle, and also if there is a quality, a different quality of the ADHD, and why. What are, for example, the reasons why women much more rarely present as hyperactive and um and um and also uh antisocial in that way, um with antisocial behaviors like that are much more frequent in in males.

Speaker 1: 50:32

So probably some qualitative studies as well would be useful it is interesting because, yeah, women do tend to be sort of inattentive to adhd. They're not hyperactive as much, although some are. That'd be interesting to find the research on that, to be honest with you, because I would be really intrigued to see what comes out of that. Um, just my final question, because this is a podcast all around neurodiversity in the workplace. I just wanted to know just what advice would you give to women professionals who may suspect they have ADHD and they don't know where to start. They're just like I think I have ADHD. I don't know if I have ADHD, I probably have ADHD, but I don't know what to do and how to overcome that. And I've got my job and I've got my kids and I've got my partner.

Speaker 2: 51:25

Yes, yeah, yeah, I, I personally think that, um, I would suggest, strongly recommend, to uh obtain a professional opinion. Um, I wouldn't probably waste much time on the internet because I in fact have. Um, I'm, I, uh, some studies have been done on the information that is uh is on tiktok or other social media, and at least 50 to 70 percent of the information provided is actually inaccurate, so that actually, you know why to spend that much time on something that is not accurate. Number one, number two, as we said before, um, I also think that the poor gps they do an incredible job in the nhs, but they just are not given enough time to deal with mental health problems.

Speaker 2: 52:22

I wouldn't probably advocate or advise anybody to discuss their own mental health problems in seven minutes and to be prescribed a medication within seven minutes or 10 minutes. I don't think it's appropriate. Even if you fill in a questionnaire, it's still not appropriate. I would still want to have a valid assessment by a psychiatrist, which is a medical doctor specialised in mental health problems, in psychiatry, and I would consider be open. You may or may not have ADHD. There is no reason to be attached to a label of ADHD to explain the difficulties that you are having, because the difficulties that you are having, you are absolutely legitimated to have any difficulty and having the right support and the right assessment may actually help you to reach the sort of support that you need quicker. Not doing it and bearing the your head under the sand is actually probably something that is going to simply procrastinate the issue and not giving you the answers that you could have today no, that's good.

Speaker 1: 53:40

And also, um, sometimes, also sometimes, when you have adhd and this is what I've found. Actually, before we wrap up, I can go on for ages for this but there's, um, there's a thing where sometimes you may have a child that has ADHD but not realize that you also have ADHD, and people in the community where the only time they realized they had ADHD is when their child was diagnosed with it and they're like, oh, my son or my daughter has this, but I also have it.

Speaker 2: 54:12

I'm like, oh, many of my patients actually I can tell you many of my patients that are in their 40s or 50s. They have been diagnosed with ADHD, probably by me after, and they only became interested and aware of all the issues from the diagnosis of their child. And this is the same for autistic spectrum disorders as well oh which is very interesting. It is interesting dr alex kappa.

Speaker 1: 54:45

Thank you so, so much for coming on. Divine enigma again. I love to have you on again and again because you, yeah, absolutely, let's do it again. Conversation I can wish for this conversation forever, but we can always do like another part three and exactly, absolutely.

Speaker 2: 55:02

Yeah, I will be around, and thank you so much for inviting me today. It was lovely, lovely, having a chat with you again you.

Speaker 1: 55:10

We'll catch up soon, thank you. Please follow me on all platforms where you listen to podcasts. Thank you for listening to Divining Edmum and, if you got to the end, this is a safe place for project managers, professionals, side hustlers and anybody who's looking to navigate the complexity of being neurodiverse in the workplace and the corporate space. I'll see you next time. Of being neurodiverse in the workplace and the corporate space. I'll see you next time.