ADHD and Hormones: Why Women's Symptoms Are a Moving Target with Bailey Pilant

GUEST BIO

Bailey Pilant is a New York and Florida-licensed therapist, ADHD-CCSP certified, and the founder of The Wave Counseling, a practice specializing in neurodivergent affirming therapy for women navigating ADHD, anxiety, burnout, and life transitions. She brings both clinical expertise and lived experience to her work, helping women understand themselves more deeply and advocate for the support they actually need. Find her:

Website: https://thewavecounseling.com 

Instagram: https://www.instagram.com/thewavecounseling 

TikTok: https://www.tiktok.com/@thewavecounseling

SHOW NOTES

Have you ever felt like your ADHD symptoms get dramatically worse at certain times of the month, and wondered if it was all in your head?

On this episode of Organizing an ADHD Brain, ADHD coach Megs welcomes back therapist Bailey Pilant to break down the connection between ADHD, hormones, and women's health, including cycle tracking, perimenopause, and PMOS. Whether you're looking for ADHD coaching, a supportive ADHD community, or practical ways to get organized, this episode meets you where you are.

By the end, you'll understand why women's ADHD is so often missed, how your hormones are directly affecting your symptoms, and what you can start doing right now to track, plan, and advocate for yourself.

Bailey explains how estrogen affects dopamine and why that means ADHD symptoms can shift dramatically across the menstrual cycle, worsen with age, and intensify during perimenopause. She walks through why women's ADHD is so frequently dismissed as personality traits rather than a neurological difference, the knowledge gaps that exist around diagnostic criteria and co-occurring conditions, and why girls often mask in ways that hide their symptoms entirely. They also dig into emotional overwhelm, what borderline hormone test results can mean, and why "normal" results don't always tell the full story.

Bailey shares her own experience with PMOS (formerly PCOS), the value of at-home hormone tracking, and how using real data can help you plan supports, communicate your needs, reduce reactivity, and extend yourself genuine self-compassion, through what she calls "experiments" rather than expectations.

The good news? Once you understand what your hormones are doing and when, you stop wondering if something is wrong with you and start working with your body instead of against it.

Previously on Organizing an ADHD Brain — Bailey's earlier episodes: 

Cravings & Cognitive Chaos: Decoding the ADHD-Eating Disorder Connection for Women

Cognitive Chaos: Interview with Bailey (Part 2)

This episode is for any woman with ADHD who has ever felt like her symptoms were a moving target — and is ready to understand why.

3:31 — Why women's ADHD is so often missed and dismissed as personality traits 

8:18 — How ADHD presents differently in girls versus boys due to socialization and masking 

14:18 — How estrogen affects dopamine and what that means for ADHD symptoms across your cycle 

17:49 — When to test your hormones and what to look for 

20:39 — When test results look "normal" but something still feels off 

26:26 — Cycle tracking as a self-support tool, using data to plan and regulate 

36:03 — Perfectionism, self-compassion, and reframing progress as experiments 

44:03 — What PMOS means and Bailey's personal experience with her diagnosis 

50:55 — How to work with Bailey and closing thoughts

Would you like to learn more about hiring Megs as your ADHD coach? Start here> The Perfect Place to Start

The Community is OPEN! Join right here: Organizing an ADHD Brain

You can also learn more about the community HERE> OrganizinganADHDBrain.com

Transcript

Audio Only - All Participants 0:00

welcome back to the podcast. I am so excited to reintroduce you to my friend, Bailey Pilant. I had her on the podcast two years ago, and I just found out it was her first podcast interview, It's so neat because I think that we met on TikTok, but then it was Instagram too, and I watched you grow in this space And you started out just knowing you had ADHD and then eventually got diagnosed with autism as well, and you are a wealth of information. You are a therapist home-based in New York, so if you guys are in New York, please check her out but also just the things that you do and advocate for when it comes to ADHD and autism are just fascinating to watch. And in my own experience, when we had that podcast interview, I was also navigating a death of a family member, and I felt really, really disconnected. And also, I felt like I wasn't being myself, like providing all the tools that you needed to be able to share on social media, right? All of those things that I felt like I needed to show up for, and you showed me such grace and kindness and support when it came to navigating that space, and I remember how you made me feel, and it was just with such kindness. And since then, it's just been so fun to check in every once in a while and to see how you're doing. I'm honored to be in this space with you. So welcome to the podcast. Thank you so much, Megan. I just-- This is, like, so fun. I'm really excited for this conversation because it has been two years since we spoke, but as you already mentioned, this was my first podcast recording. And I remember when you sent me that message, and I was like, "Oh my God. Oh my God, it's happening." I'm reaching people, and this person values my content enough to invite me onto her podcast." And I just remember being so honored, and I'm so honored to, like, show up today and, to be able to, share this space with you and to just be able to be a foundation of support for one another. Over these last two years, I just am so glad that we connected early on to be able to, foster such a supportive relationship because, this, these last two years, I've watched you grow, and it's been incredible to see your podcast grow and reach so many people. Your podcast was also the first podcast I posted to my LinkedIn. Like, there's just so many firsts for us here. And so, I'm just so happy to be back and to be able to have this conversation And just like I'm grateful, really grateful. Yeah. Thank you so much for sharing that. That's... I didn't know about some of those things too, There's so many things we could talk about. I will go ahead and drop our first interview in the show notes below 'cause it was so good. We talked about eating disorders in women, and you and I both navigated that when we were in our youth and as young adults, but in different ways, right? So like that was really interesting. And today we're gonna talk more about women's health. And if you're a gentleman, I would encourage you to stay on and listen because this can help you support so many of the women in your own life, just having this knowledge. I recently went to a webinar the other day, and there was an ADHD expert in there, a woman who'd be- who's been in this space since the '70s, which is crazy. And she was sharing about how much we still just don't know when it comes to women's health and ADHD, and this is something that is your specialty. So my first question to you is- what's the first

Why Women's ADHD Is So Often Missed

Audio Only - All Participants 3:31

thing that we should know as women when it comes to understanding ADHD, and how much we don't know at this point? Oh my gosh. There's a lot that we don't know, there's so many layers to it, right? And so one of the first things that I think about is, looking back on my diagnostic journey, but also on the diagnostic journey of so many other women, is that ADHD women we're really resilient, and we're really incredible people for so many reasons. I know so many women in my life who are ADHD and who are late diagnosed or were diagnosed in childhood, but what I see is this incredible power to all of us to be able to know our truth and stand by our truth and to be able to continuously advocate for ourselves despite the fact that many of us have been brushed off over and over and over again. And so when you feel that there is something that is just not clicking in the mental health space for you, lean into that and trust that because that's what has led so many women in my life and so many women who are my clients to be able to finally seek out and build the courage to seek the diagnosis, the correct diagnosis, to truly, really understand themselves and that relief that comes with it. That kind of just touches on the things that we already don't know, which is we're still understanding and developing more accurate diagnostic criteria that is representative of women and our presentation, our unique presentation, because there can be some overlap in similarities of how we present in childhood, but majority of the time, our presentation is brushed off as just personality traits. So what is the difference between a personality trait and ADHD becomes the larger question, right? And looking at persona-personality trait, I'm gonna put that in quotes, is really impacting that individual's life, right? Is she just a spacey girl who's always daydreaming, or is she struggling to regulate her focus and attention, right? And how is that impacting her confidence? How is that impacting her development through her childhood, through education, through work, et cetera? So I think that this always becomes like a larger question. Is it really personality, or is there something else going on for her that's really making it difficult for her, impacting her confidence, impacting her, ability to, like, believe in herself, et cetera? And then there's also the realm of, like, hormones. We know very little about the overlap of hormones and ADHD. We know very little about the overlap of other co-occurring disorders like, hypermobile Ehlers-Danlos syndrome or just Ehlers-Danlos in general, MCAS, And a plethora of other endocrine disorders like endometriosis, PCOS, and the list goes on. there's just so many intersections that, what we're seeing now especially with the inclusion of women, is that we're starting to see that ADHD isn't really just a standalone disorder anymore, that if there's ADHD, there's also other things happening too like autism or OCD, et cetera. I-- what came up for me as you were talking about is not me necessarily thinking about myself. I was thinking about my nine-year-old daughter and thinking about, you know, we had a meeting with her teachers, she has three of them, she, like, switches, and how they were describing things that she was navigating at school. Like, "Hey, sometimes she is daydreaming at school, and it's hard for us to get her to pay attention." And I'm like, "Oh, here's what could be happening." And that felt really cool to advocate for her, and yet there's still so much I don't know about myself, and so learning how to show up for her feels holy smokes, and I'm doing the best that I can. I'm curious, like, when it comes to, you know, kiddos, what's the difference between how ADHD might show up in a little boy versus a little girl? Well, so we're looking at three different types of ADHD, right? 'Cause ADHD is a spectrum. So we have ADHD predominantly inattentive, ADHD predominantly hyperactive, and then ADHD combined type. And so in that, we post-2013, we got rid of the differentiating between, like, ADD and ADHD, and we just said it's all ADHD within these three, subcategories. And I don't always necessarily believe

Girls Vs Boys ADHD Signs

Audio Only - All Participants 8:18

that there is a true difference in the physical representation or presentation of ADHD in boys and girls when we are children. And it goes back to because we tend to identify women and girls as having personality quirks. Oh, she loves to be the center of attention. She's such a drama queen. She has a wild imagination. She is always daydreaming, right? She's so emotional, et cetera. The list goes on and, and like I was told all of those things growing up. But what people were labeling as like my personality, the physical manifestation of that was I was in gymnastics six days a week, and when I wasn't in gymnastics, I was at home building obstacle courses. And I remember my dad getting so mad at me because I would take all the couch cushions off of the couch, and I would stack them up, and see if I could jump over them or do flips on them. I was really physical and super active as a kid but nobody saw that activity as me having ADHD. They just said, "Wow, she just really loves gymnastics." Right? Or she just has a lot of energy. she's so creative, and I had this best friend who I did gymnastics with too, and we would write our own musicals and choreograph our own dances to them. I had a hard time sitting down in class. I remember, like, trying so hard because I also really hated getting in trouble, that I would, like, try so hard to sit still, but I would be the kid to be like, "Can I go to the bathroom? Can I go to the bathroom?" It wasn't that I really actually had to go to the bathroom, it's that I literally could not physically sit still anymore, and I needed some way to get up and move and get out some of my energy. I'm just one example of, it just being mislabeled or labeled differently when we're looking at it in a boy versus a girl. but some of the ways that ADHD can show up differently for boys and girls really has to do more with the socialization, how we socialize boys and girls, right? We hear it all the time, boys are gonna be boys, and we write off boys' hyperactivity as them just, like, being boys. But then when it becomes disruptive in classrooms or, dangerous behavior at home, that's when we start to be like, "Oh, is there ADHD happening for this little boy?" But for girls are more socially motivated, and that has to do with how we're socialized. Because early on, we're taught that people are perceiving us, sit down, be a good girl, be quiet All the things. Mm-hmm. And we internalize that, and we want to try and fit in. And I think that, sometimes our rejection sensitivity also starts to develop, slightly differently early on. But just kinda like high level you're gonna have a girl who's more daydreaming in the classroom, a girl who's doodling in her notebook, to get out excess energy rather than, like, always having to stand up the physical fidgeting is much smaller. The girl who's, like, playing with her hair, she probably loses things all the time, has a hard time or becomes extremely emotional when it comes to doing her homework, or, like, challenges with, with her ability to, like, sit down and focus on her homework. And the physical presentation of that is just through crying and what looks like a, again, in quotation marks, "a tantrum," but it's not a tantrum. It is this internal overwhelm that she's been masking all day. She's been trying so hard at school. She's probably had a few blunders at school, some mishaps with friends, with teachers, et cetera. She's upset about those. Then she's coming home and feeling upset about having to, carry that load and that confusion that also sits in that too of, like, "Why can't I get through this? Why is everything so much harder for me?" You say that so beautifully, and it's easier to hear it and to say, "That all makes sense," than to put action around it to support our kiddos or to, have expected that from our own parents who had no idea what the hell they were doing. So we're finding that the more we know. my daughter Cora, who just turned seven, when she comes home from school, I've been practicing checking in with her because she's had some trouble at school with a couple other kids. And while she's very vocal at home and she has a safe space to do that, she doesn't feel comfortable at school speaking her mind and defending herself. And so when I check in with her, she, like, word vomits on me all of these things that have happened at school. And I find that if I don't check in with her, that's when the implosion or explosion happens because she doesn't have the chance to truly express herself. And that has been really interesting to see as I navigate and learn about myself and then seeing it in them as well. There comes the messy middle again, right? You see, you're like, "Oh, now I know this. Now how do I implement it? What does that look like?" And I appreciate you sharing that. So when it comes to adult women right now, so many of us are navigating, like, our 20s, our 30s, our 40s. I would like to say I'm still in denial about perimenopause, but I know it's gonna happen. I'm accepting of it. I'm looking for the signs while also trying not to think about it too much. But in your experience, in what we know now in this world, how do hormones impact us as women? My Favorite topic. So hormones and ADHD is, this new area of research, and we're starting to understand that hormones also impact our neurological functioning. And so we need to understand that ADHD is a neurological condition, right? It's gonna impact the way that our brain develops. It impacts the way that our brain works. It impacts the way that our brain communicates using certain chemicals, brain chemicals,

Hormones And ADHD Basics

Audio Only - All Participants 14:18

right? But our hormones also impact the way that our brain uses, produces, and is able to absorb the different chemicals being produced across our neurotransmitters in our brain. essentially, women have a menstrual cycle, we are very unique because our hormone, our hormones fluctuate throughout the month, right? So we go through ebbs and flows, peaks, like rising and falling, production of different hormones of specifically estrogen and progesterone. And estrogen is like our neuro primer, meaning that like it enhances our brain's ability to work with our dopamine, so like producing and absorbing and using dopamine in our brain. So when we move through our menstrual cycle, our estrogen will influence our ADHD symptoms and how predominant or how well we can effectively manage certain symptoms throughout our cycle. So when we are thinking about like perimenopause even, estrogen is really important for brain functioning. And we've noticed that women, all women, as we age, our estrogen production slowly declines. So over time, our ADHD gets worse. Yay. Whereas for men, it's largely been thought that like ADHD just goes away and then like men grow out of it. They used to think that ADHD was just a childhood disorder because they were only studying it in men, and as men age, they produce more estrogen, so it becomes easier for them to manage their ADHD symptoms because of the enhanced brain working of estrogen in their brain, right? But now we throw women into the mix, and we're looking at estrogen in the brain, and we're like, "Oh, wait, actually, ADHD doesn't go away. It gets harder for women because we produce less estrogen as we age." and here's the other tricky thing for women, from what we're starting to understand with ADHD is that women with ADHD have increased risk of developing dementia and Alzheimer's, and this directly relates to estrogen. There was new research that came out that wasn't specifically targeted to women with ADHD, but was targeted on women going through perimenopause and into menopause, and they said we, we've done it all wrong. this was released, I think, early last year, and the research noted over a- across studies that like hormone replacement therapy for estrogen for women starting in perimenopause was critical in the prevention of the onset or even the development of dementia or Alzheimer's. So hormones are key Wow. Holy crap. with that being the case, what do we look for in our life to understand when we are ready for hormones? And like, this is me totally not knowing, and so I bet so many of my listeners don't know. I heard someone the other day saying "It's a patch," or "Is there a pill?" "Do you hook me up to an IV?" "How do you fix me, Bailey?" So obviously I'm not a medical doctor, so I don't prescribe hormones or anything like that. But what I do is help my clients navigate whether or not they need hormone replacement therapy. ADHD is so funny because what we know about like the brain development and when we talk about ADHD, it's such

When To Test Hormones

Audio Only - All Participants 17:49

a paradox, okay? Because our brain development is delayed by about three years, and then our hormone production, like melatonin and brain functioning is delayed by about three hours. But then when it comes to our hormones, it's like, okay, here's where the paradox comes in. Women with ADHD are more likely to start perimenopause earlier, so at like age like 35. And so if there's any indication of like your cycle i- it feels off, this is also a lot harder to answer if someone is taking hormonal birth control. typically for hormone testing, you, they won't test your hormones if you're taking hormonal birth control, because the hormonal birth control will mess up the test results. So I'm purely talking about women who are not taking hormonal birth control. But if you notice that there is any change in your cycle and in like the number of days and like your, your period itself, like is it heavier, is it lighter, is it longer, is it shorter? Any changes like that is an indication and tracking it for a pattern too is like, okay, maybe I need to go in. And do a hormone panel, and see like what's going on. If you're finding that like even with your ADHD medication, your, working memory is feeling even more delayed than normal, that's an indication of like, okay, let's go just double check the hormones just in case. So I encourage my clients to one, when I start working with them, if they're not on hormonal birth control, if they have not recently had a hormone panel done, I encourage them to go get that done because it's gonna give us insight into like where are their hormones? How is their hormone functioning and their hormone health? Is there any hormonal dysregulation happening that we need to address first because of how hormones impact ADHD symptoms? And then from there, it's just regularly testing every couple of years anytime you notice a difference. But if you are hitting that perimenopause age get that hormone panel done, and it's gonna be an indication of like, okay, where is my estrogen levels? How is my estrogen functioning? And is now a good time to start estrogen replacement therapy? But keeping up on tracking estrogen production is gonna be key in knowing and understanding when to start that hormone replacement therapy. Interesting. I went to that webinar the other day, and this woman was sharing that when you get the hormone testing done, sometimes it can show up as your hormones being perfectly normal, even if they are still off. Can you speak to that? Yeah. that's when I say find a really good endocrinologist. 'cause I have had hormone testing done where my hormones came back normal, and they go, "Nothing's wrong with you. Wipe our hands, send you off on your merry little way." I don't remember if I had talked about my diagnosis with PMOS, which it was PCOS, now it's PMOS, and that is

What to do when a Test is Normal but you Need More Answers

Audio Only - All Participants 20:39

a recent change to the name. So we recently changed it from polycystic ovarian syndrome to, polyendocrine metabolic ovarian syndrome, so PMOS, which I have. And, it took me 16 years to get diagnosed with PMOS because, my tests always showed up borderline. And I had a really wonderful dermatologist, at 28, 'cause I was like, I have had hormonal acne since I was nine years old, and I couldn't get rid of it. I did Accutane when I was 23, and that got rid of it for, like, a couple of years, but then it came back full force, and I was really upset and frustrated. I remember it being my wedding day and being really nervous about pictures and, like, how my skin was gonna show up And I was like, I, I can't do this anymore. And I found this incredible dermatologist, and PCOS wasn't even something that I considered for myself. I didn't think I had it, because I have an atypical presentation, which is why I'm also really glad that they've changed the name of it, because it's a lot more inclusive symptom-wise for women like me who are atypical, which is, I'm birth control intolerant. So when I take hormonal birth control, and this was part of the issue, because everyone, you know, put me on hormonal birth control, I would go off of it 'cause I didn't feel good, and then I'd be put back on it, and then to try and regulate everything, and then it was just a whole cycle. It was a mess, right? But when I would go on hormonal birth control, I would break out really bad hormonal acne everywhere, all across my face, my chin, my neck, my chest, my back, shoulders. My hair would start falling out. Yeah, it was-- my mood's crazy. I would gain weight, and I wouldn't be able to lose the weight. I had a really hard time. Like, my body just, like, became so inflamed. And I would get, like, really-- I have a pretty naturally round face, but my face would round out even more on hormonal birth control. And so when I had this dermatologist, she was like, "Have you heard of..." She said PCOS, but PMS. And I was like, "Yeah, but I don't think I have that." And she's like I think you should just go see this endocrinologist just in case. Let's just rule this out." And, and, like this woman, she like saved my skin. I'm so grateful for her. Shout out Dr. Doyle, in New York City. She's amazing. And she gave me a couple referrals, a couple names of some endocrinologists, who she had sent clients to, and I booked an appointment with one of them, and I went in and I was going through my medical history. And my medical history is also so complicated. But I've al- I've always been borderline on every single test that... Like, when I got diagnosed with POTS, I was borderline for on the testing for POTS, where I always fall just within normal range, just within. And so I go to this endocrinologist. I explain my history, everything. I explain to her that my dermatologist thinks I have PMOS, but I'm unsure. And she goes, "Let- let's do this hormone test." my hormone panel came back borderline, meaning I was just within normal range. And she said to me, "Given your history, and given everything that you've shared with me currently, let's have you go get an ultrasound just to confirm it, but I feel confident giving you a provisional diagnosis. We'll look at the ultrasound and that will confirm the diagnosis." And I said, "Amazing. Great." I go get the ultrasound, and sure enough the way that my ovaries looked aligns with PMOS, and I called my endocrinologist. She got the test results, and she was like, "Yeah, so even though your hormones are within normal range, I do wanna do regular hormonal testing with you because there is something that could be off and we could be seeing it different- like your hormones showing up differently throughout your cycle. But I'm confident that, that this is an accurate diagnosis for you." And then I u- started using a at-home hormone tester, to track my hormones. And right now, all these hormone testers are really... They're technically, they're meant for women who are trying to get pregnant, but they're also super insightful. I personally use Mira because I can see where my estrogen and my progesterone is throughout my cycle, and how the hormonal fluctuations impact me. And I started noticing that I do have certain indicators or symptoms of like when I'm going through a hormonal change. And what's funny is like Mira does frequently ask me before they used to not let you put in if you had like an endocrine disorder, but now you can actually like put in your profile that you have an endocrine disorder. But my first year u- using Mira it was like- Hey, might I go get tested for PCOS? 'Cause my hormones are like this throughout my cycle." He was like, "Oh my, what are we doing here So at-home hormone testing can help you gather that data that can't be captured in a one-time hormone test with an endocrinologist. but also having a really great endocrinologist who understands that the range of what's normal is really big and isn't always gonna be normal for every single person who falls into the range. And in addition to that, now that you have the diagnosis, you are tracking your hormones, what does that mean for you in terms of living your life in a way that supports you? Mm-hmm. Yeah. I think that going through this whole process, I've just built so much compassion for myself. There's this wonderful psychiatrist, or psychologist, excuse me, Tara Brach, and she wrote a book on radical self-compassion. And I think that being able to have that raw data in front of me was what I needed in order to give myself the permission of like, okay,

Cycle Tracking Self Support

Audio Only - All Participants 26:26

today is gonna be a harder day because I have the evidence that, like, my hormones are not where they're supposed to be, or they are where they're supposed to be, but that I know that when they're in this phase, that things are a lot harder for me. I deal with insomnia at this time. Like, my energy is lower. I have a harder time, feeling connected to friends and loved ones at certain times. And it's also helped me better predict when I'm gonna be having these different types of emotions, when I'm gonna be wanting to engage and be social more, and when I'm gonna feel like it's really hard and, like, everyone hates me, truthfully. because I can predict it, I can build in more protective factors, right? I can communicate in advance where I am in my cycle to cue in those around me who have learned that, especially my husband, I tell him, I'm like, "Whoop, I'm heading into the luteal phase." It's gonna be rough, right? But he knows that, when I am in the luteal phase, there's certain times in my cycle where my energy and my tolerance to be able to do things like clean the litter box is out the freaking window. Can't stand the smell. Just the idea of like having another task feels like too much. It's overwhelming. I'm more easily, like, irritable. Like, that, that thing that like I do it every single day, but during certain times of the month, it's so much harder for me, and it makes me angry to do it, right? But knowing this and understanding this about myself, it's makes it a little bit easier for me to go, like, "Okay, you can be angry about this, but we don't need to be angry at your husband about this, right? we don't need to be mad at him 'cause it's not his fault. But maybe we just need to ask him for help that, like, right now it's too hard for me to do, and I, I need him to do it, right? But how can I ask him kindly so I can get that support?" Rather than just being so reactive all the time, whereas before, like, I'd just be reactive and not understand why, and then feel so guilty and so ashamed and so upset with myself afterwards because the reactivity feels so out of control. because I have insight into like, "Oh, like I know that this is happening for me and that this time of the month I'm am more irritable," I can ask for that help before I become reactive, right? That's not to say that I'm never reactive, but it's a lot easier to come down from the reactivity, and it's a lot easier for, you know, even my husband to be like- I'm noticing something's off. if he meets me with a little bit more compassion during that time too, I'm more likely to like pause the reactivity and just go, "I'm so sorry," right? And just like go straight into tears. but it-- So I think like the compassion, the ability to communicate in advance what my needs are to seek that support, but then also being able to set up other systems of support for me. Like, I know eating's gonna be really hard for me just because nothing's gonna sound good, and everything's gonna feel like too much work. So, that's a good time to order from my favorite restaurant, the family meal things that they do. and so then I don't have to think about it. I don't have to worry about, dragging myself to the grocery store when that just like feels so intolerable. or having like things in the freezer ready to heat up so that I don't have to think about the cooking or anything like that. So it, it's helped me redesign my life to be more supportive and while also like predicting and understanding that like, okay, this is how my hormonal fluctuations specifically impact me, and these are the supports I need to, in order to manage these hormonal fluctuations with minimal distress. One thing I wanna call out because I identified with something I related to in there is oftentimes I notice, so the week before I get my period, I'm so much more unkind to myself. And as I vocalize that, my husband notices, and he goes, "Well, you're about to get your period." And sometimes like I'm so grateful that he has that awareness to like give me that information because It's not to blame someone, right? And it's not to blame me. I'm looking for a cause, and I'm looking for a scapegoat. And sometimes that can be my husband, sometimes that's me, and I've learned to talk to myself that way. But knowing that it's science- Yeah and like there's more to it, it's chemicals working in a way, and that's the way that your body works, helps you to navigate the space to say, "Okay, well, science is to blame. The chemicals are to blame. The way that my body works is to blame. So now how do I know how to support myself? How can I learn how to ask for help in these moments when I can't show up as the person that I want to show up as?" And I love that grace that you've learned to give yourself. Really beautiful. the biggest shift that I've learned is that during that time, I cannot expect myself to show up how I normally would show up in my life, and that's okay. That like during that time I don't need to go to the gym if that feels too hard and too triggering that day. I don't need to, get dressed in something that like feels too tight and sensory, like overwhelming. 'Cause that's the other component that comes in when we're neurodivergent is like this like sensory piece especially those of us who are like ADHD, but ADHders and people who just have ADHD and, and people who have just autism can also experience this like sensory overwhelm. I don't think we talk enough about how overwhelming sensory-wise our period is. And because of the hormonal changes I mentioned I have PMOS, so when I'm about to start my period, like two, three days before I start my period, my entire body becomes super inflamed. And like we talk about the bloat, but like, you know, this bloat is my face, my arms, my belly, my thighs, like everything looks like my body just like retains the water, cannot flush out that excess water. And it is a it's a mind... Excuse my language, it's a mind F. You know? Like you're like sitting there like, "Is this what I look like?" You know, it's hard to not go down that rabbit hole of that negative self-talk and that self-criticism and this like general like feeling of disgust 'cause like internally everything feels off, and then externally you're looking at yourself and you're like, and everything outside looks off too, right? it's such a- sad experience. That's like really the word I can think of because that's how it feels. It feels like really draining and depressing to like feel that way. It's sad to feel that way. and so I think like what I've learned is that like during that time, it's turning the mirrors around. I don't need to look in a mirror. It's moving away from like punishing myself for something that is like gonna happen, that's natural, that's normal, that is out of my control My body's gonna do what my body's gonna do. So instead of trying to punish my body out of it, how can I support my body through it? That's powerful too because, you know, as we talk about... My gosh, I'm gonna come back to organization in this phase because oftentimes the people who are coming to me, they want their places to be organized right away, or their digital spaces to be perfect, or to finally have control over their finances. And this need for external regulation through having things in order is something that we often don't prioritize because our lives are so incredibly busy. But then because we're so busy, we don't even tune into what our bodies are doing at certain points. So not only are we being hard on ourselves, but then we have no idea why we can't function one day versus another and why we show up so differently. So I think it's really incredible how you found a way to show up for yourself and work with your ADHD and the way that your body functions. So something I know in the corporate world, I was in a leadership position and then I wanted to get to this other position, and so I was always looking for the step-by-step process on how to get there. And I even said to my leader once, I remember saying this, I was like, "This feels so real. I need you to tell me exactly what to do, and then I will do it. That's easy for me. I just need rules. Tell me and I will follow this." But when things aren't clear for me, and when they're fuzzy, there's no clear path, the messy middle is really messy because you have to discover and find clarity for yourself. So, like, you navigating this, it's like, "Oh, well, Bailey, what did you do first? And tell us how that worked, and then tell us about step two and step three." Like, that's what I want, except I know that my body works differently than yours. And in this case, how did you navigate Looking for what worked for you, and yeah, tell us about how you navigated your own messy middle and finding-- 'cause caveat to this, you're also in, I'm sure, these other messy middles right now. Like- Oh, yeah. Oh, yeah just because you're here doesn't mean you're not at the end, right? Like, you're in your, your other phase right now, but- Yeah yeah, tell us a little bit about navigating that space to get where you are now. You know, it's so funny. I love life sometimes. I mean, I love life most, basically all the time. I can't stop laughing to myself 'cause

Perfectionism And Experiments

Audio Only - All Participants 36:03

as you're talking about the messy middle, I literally pulled out my, perf- like, Perfectionism workbook by Jennifer Kemp yesterday, and I am forever a recovering perfectionist. And so I was like, "You know what? I think it's time to pull out the perf- the Perfectionist workbook here and like start working on it." And then you ask me about the messy middle, which that book is all about, like, learning how to live in the messy middle and doing things just good enough, not always trying to strive for the next thing. Because trust me, I, I am the same way. I wanna know all the steps, and then when I like feel like I'm doing everything right and everyone's telling me I'm doing everything right, I get really frustrated really quickly about like, "Why am I not there?" Right? "What, what am I doing wrong? There must be something I can do differently or that I need to fix or," you know, et cetera. But anyways, that side tangent over. I just love the parallel of like how life works sometimes. My process of figuring all this out is, was messy. It was trial and error. there's no like beautiful way of saying that except that it was pure trial and error and a lot of support from my own individual therapy and working with my own therapist and trying to understand this. But then there's also this part of me that is just like I love to understand why, and I always wanna understand why. So when I learned that I had PMS, it was deep dive into what the heck is PMS I must learn everything about it, the way that it impacts women. And then as I was learning and reading about PMOS, I realized, I was like, "Wait a minute, PMOS is a neuroendocrine disorder," meaning that, like, it impacts our neurological functioning, and a lot of the neurological symptoms of PMOS are symptoms of ADHD. And so then I, it got me questioning like, okay, but then so these have to be related, because also women with PMOS are more likely to have children with ADHD. But then how are we getting PMOS? PMOS is now, heritable. It is genetic. Men can carry it too. It's not just coming from women. And I was like, there are so many factors here, and I was like, and so I just, it was rabbit hole after rabbit hole after rabbit hole. But I needed to know why PMOS was so hard for me, how does it impact my period? How does it impact me neurologically? not just like the physical symptoms of like weight gain and weight loss and challenges with that and then if PMOS, a hormonal endocrine disorder, can cause ADHD symptoms and similar functioning, brain functioning as ADHD, then- Hormones must impact ADHD. So that was just like my rabbit hole of questions. Like it was question, question, question. Why? I needed to figure out why. And so I did, I read a lot of research studies, and I started talking about it, the research that I was reading with my therapist and really with anyone who would listen and my psychiatrist, and I started just asking to do some, small experiments. so with my psychiatrist it was like, "Can we just raise my dose during the week of my period? Because, like, I'll take my medication and it feels like it's not working." There was this study that came out in, I think it was Denmark, where they, tested increased dosages of, stimulant medication during the menstrual cycle for women with ADHD, and they had a huge success. And I just was like, "I'm just gonna run experiments on myself." I was reading research on, the multiple hormone sensitivity theory and what they were seeing in the hormonal fluctuations and how women with ADHD are more sensitive to those hormonal fluctuations and the symptoms that most of the ADHD women were experiencing during those different changes. And I started to track my own hormones to see, like, w- when I was experiencing symptoms, did it correlate or relate to those types of hormonal fluctuations? And sure enough, it did. And so I was able to start developing and, like, seeing a pattern in myself. and then also just in the work that I do with my clients, I was starting to see patterns with them too. It very quickly I started to realize like, oh, like if we have an understanding that our hormones impact certain executive functioning skills, then it's gonna be a lot easier to develop supports or like accommodations for when those executive functioning skills are gonna have more challenges. And then we can start planning, predicting, preparing for the downfall of certain skills during certain times of the month and create systems that are supportive to help us get through that month. But then that gives us more space during that time of the month mentally, cognitively, to hold more compassionate space for ourselves too, to build that radical self-compassion, to help us move through it too. And, and to move out of, needing more discipline or needing con- consistency, but moving more into the realm of continuity, that messy middle. That like what I, what can I do today to support myself? Not what do I feel like I have to do in order to be successful? Beautiful. I have been incorporating in my own life lately the idea of playing around with things. Mm-hmm. And I love how you use the word experiments, right? Like, oh, I have a hypothesis that this could be something that could support me- Yeah and now I'm gonna play around with it to see what happens. And that has been a huge thing for my own perfectionism because, I mean, we just moved into another house, but part of the messy middle is I really like it when things look good. I have an eye for design. I love color. That's part of my goal now is to incorporate more color into my life. And even these panels behind me, I wanted them to come up in my office in a perfect way, and I needed to design that. And then I was like, "If I sit around here all day and just imagine it, nothing's gonna happen. So what if I just put them on the wall to see what it looked like?" Yeah. And then I did, and I was like, "Well, I actually really like this. This works." And then I did it the other day in my hallway where I had these really big pictures that they had the perfect place back in our old home, and now I need to find the perfect place here. So I was like, "Okay, but what if I just put them up? They're command strips. They can be removed." Yeah. It's like this idea that it needs to be perfect so that I don't have to come back to it, so it's done. But the truth is, is that we're on this journey. It's not only that we're all a work in progress, but we are on a journey to find what works for us. And there's a lot of people who have written self-help books, right? Here's all the methods, here's all the processes, here's all the things you can do. But it is truly about playing and hypothesizing and doing the experiments to find what works for you in your own life. So thanks for that tangent, 'cause that inspired me, and I, I love that 'cause it is so much this perfectionism- Mm-hmm which it holds us back from achieving so much. I love to live in the realm of everything's temporary. And the only constant we can count on is change. Mm-hmm. And- Love that. there's so many really big words that you dropped, and I will put those in the show notes too. I am curious, can you give us your own definition of PMOS so that I can make sure that I have that in there in your own words? What does it stand for? PMOS stands for polyendocrine, so it is multiple endocrines, right? We have a, a, a large endocrine system. What's an endocrine? An endocrine system is our hormones. Cool. Is our hormone system. Yes. Okay. So hormones, endocrine, that's kind of... Yeah. so our endocrine system is our, is the system in our body that manages our hormones hormone

What PMOS Means

Audio Only - All Participants 44:03

production, hormone fluctuations, all of the things, right? So we love the endocrine system, but there's lots of hormones that we have, right? We have melatonin, testosterone, progesterone, estrogen. There's a lot of hormones going on in our body, But so we have polyendocrine, multiple hormones metabolic, because, PMOS what the original name PCOS stood for polycystic ovarian syndrome. So PCOS was really only focusing on our reproductive organs, specifically our ovaries, and was categorizing PCOS as a reproductive disorder, which was leaving this huge gap because PCOS doesn't just impact our reproductive organs. It impacts our entire body, that polyendocrine, right? Our entire hormonal system, because our hormones impact our whole body. So our hormones don't just regulate, you know, when we ovulate, when we're fertile, when we're carrying a baby. It also regulates our hunger cues. It regulates when our brain turns on and off. it regulates our sleep, right? So it's not just reproductive. It's a whole body system. when we're looking at the metabolic, So I mentioned atypical PMOS, and how I, under the old definition, have atypical PCOS. But, a key factor, a key, symptom in PMOS, is insulin resistance. So it impacts our metabolic system. Our metabolic is our body's ability to absorb and use nutrients and calories efficiently and effectively. Oh, I did forget a hormone, cortisol, 'cause cortisol is also a huge hormone in PMOS. I knew I was forgetting something. And so we're also looking at cortisol and cortisol production too, right? But our metabolic system is like our body's ability to absorb nutrients, use nutrients and, and it has to do with how much does our body, u- how well does it effectively like use calories, but also break down calories in food and the different nutrients. And so a lot of women with PCOS also have what's called insulin resistance, which means that that's what makes it really hard to lose weight when we have PCOS, because our, our body can't effectively, break down glucose in food. And so a lot of women with PCOS are also on metformin, which is typically used to, for like pre-diabetes or like type 2 diabetes management. And because again, that goes down our body's ability to break down glucose, our insulin is related to our metabolic system, right? So polyendocrin metabolic ovarian, we're talking about there is dysfunction with the ovaries. Some women have ovarian cysts. Some women will have an enlarged ovary and a smaller ovary. A lot of women with PCOS have what's called polycystic sacs in, which is just like a bunch of little pockets in our ovaries of like eggs that never fully matured because there's the luteinizing hormone which we call LH and then we also have the follicular stimulating hormone, FSH, that are responsible for helping our ovaries mature an egg and then release that egg. And a lot of women with PCOS, the eggs never fully mature, and they, they just kind of stay stuck. So then our body continues to try to, mature an egg, and so then we end up with all these like little polycystic sacs, and the polycystic sacs are also, sacs that b- were cystic at one point or currently have cysts on them. So Our ovaries are really impacted, with PCOS. So, ovarian is kept in there because it does impact our ovaries largely syndrome. So, but it really is like, so the, when we changed the name from PCOS we said this is no longer just a reproductive disorder. This isn't something that only impacts a woman's ability to reproduce and have children, but this impacts multiple systems in the body, the endocrine system, the metabolic system, and our reproductive system Wow. Yeah. That's so crazy. Not only does, I mean, like, hormones are crazy impactful to our ADHD, but then you have a syndrome that is literally impacting all of your hormones, which has got to make things so much more difficult. as you were talking, I was thinking about different friends, different clients, people who are going to benefit so much from your experience and you sharing to get on their own journey to understanding their own bodies a little bit differently. 'Cause I know I've had so many of my friends who have struggled with PCOS who might not even know that it has a new name now. Thank you for being so open and vulnerable. Yeah, it's powerful stuff to be able to share your journey, and other people can learn so much about it. I think kinda going back to what you had mentioned earlier, about, like, what is the step-by-step process for, like, figuring out how to work with your hormones when you have ADHD, and this is something that I do help my clients with. and I do trainings on this too, so I teach clinicians and other medical providers how to work with women with ADHD, specifically with hormone cycle syncing and understanding the hormonal impact on ADHD symptoms. I do trainings, speakings, and I also do this work with my clients, and because I am licensed, not just in New York, but also in Florida. Cool. I forgot about that. Thank you for mentioning that. Yeah, of course. Okay. In the interest of time, I just have to say, I felt like this last time too, I could probably sit down with you for an entire day, and we could just keep talking- Great So, tell us, where can we find you? Yeah, you can find me on TikTok and Instagram at bailey.adhdtherapist, or you can find me at my website, thewavecounseling.com Amazing. Thank you so much for your time and all of your knowledge today.