Why ADHD in Women is Not a Productivity Problem with Tracy Otsuka, Author of ADHD for Smart Ass Women (Part 1)

What if your productivity no longer defines you? That question anchors a candid conversation with Tracy Otsuka—host of the ADHD for Smart Ass Women podcast and author of the best-selling book ADHD for Smart Ass Women: How to Fall in Love with Your Neurodivergent Brain.

We talk about how midlife hormones collide with ADHD traits and force us to reshape identity. As estrogen fluctuates through perimenopause and menopause, dopamine signaling gets shakier, and the classic ADHD pain points—working memory, sequencing, and emotional regulation—can suddenly intensify. Tracy explains why even high-achieving women can feel their confidence slip, how a “brain of interest” thrives only in the right environment, and why she reframes ADHD as an identity issue rather than a productivity flaw. 
 
Tracy also shares the personal story that changed everything: her son’s diagnosis, the schools that missed his brilliance, and the decision to build spaces where curiosity is an asset, not a problem. From bold career pivots to building an approach that maps values, strengths, and passions into a clear purpose “sweet spot,” she shows how alignment restores executive function and self-trust. Along the way, we challenge disorder-first narratives, hold space for the seriousness of suicide risk and depression, and return to hope as a skill—tested through small actions, anchored by purpose, and protected by boundaries.
 
 If you’re navigating midlife, exploring ADHD traits, or simply craving a more truthful way to measure your days, this conversation offers both science and strategy. If it resonates, share it with someone who needs to hear it, and subscribe to support more honest, hopeful stories.

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Transcript

Sponsor And Safety Notice

Janine 0:32

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Host Intro And Guest Bio

Janine 1:14 Janine 1:14

Welcome to Bipolar She. I'm your host, Janine Noel. The content of the show may include suicide or suicidal ideation. If you're ever in need of immediate support, please dial 988-A Suicide and Crisis Lifeline. I'm really excited about today's guest, Tracy Otsuka. Tracy is host of the podcast ADHD for Smart Ass Women with a library of 365 episodes. She is author of the bestselling book, ADHD for Smart Ass Women: How to Fall in Love with Your Neurodivergent Brain. Tracy is also the creator of your ADHD Brain is A-OK Academy and most recently the AOK Mind app to get your brain performing at its best. Now, Tracy isn't a physician or therapist, but she has worked closely with thousands of women to help them see past the ADHD label of disorder and find their true interest and purpose in life. I admire Tracy's gusto to step out and challenge prevailing theories and attitudes towards women who are navigating ADHD. In 1 of this double episode, Tracy and I talk about the interplay of hormones and dopamine for women with ADHD, particularly at midlife. We talk about how she believes that ADHD is an identity problem rather than a productivity problem, how her son Marcus's diagnosis led to her own, and how if she can help women discover their true purpose, those ADHD symptoms will no longer apply. And now, on with the show.

Starting A Podcast And Self-Story Shifts

Janine 3:03

So welcome, Tracy. Thank you so much for coming on the show. It's great to see you.

Tracy 3:08

It is my absolute pleasure. I'm just so delighted to see that you've been doing this podcast, it's over a year now, right?

Janine 3:15

Yes, I have. And I would not have it if it weren't for your advice. Just telling me to go for it, put a date on the calendar, and just get it out there. So I would never have done it without you. So I'm I'm so grateful.

Tracy 3:29

I was right, right? It is the best self-development program you will ever do. And I'm sure it's allowed you to meet all kinds of people that you would have never had the opportunity to have in your life.

Janine 3:41

It's so amazing. And you realize just how much you change after being in conversation with other people and then looking back and like the stories I carried myself, they're outdated.

Tracy 3:54

Yeah. Yeah. And they were never true to begin with. You know, I mean, maybe a small snapshot in time, and even that I would question. But I just personally, I just saw your brilliance. And I saw that you had this story and this message to share. And if you didn't do it, you would explode. That, you know, it would literally transform who you are and and what you do. And I just think podcasting is amazing.

Janine 4:26

It is amazing. I was a little worried after I started my podcast because I was like, oh my God, I'm talking about all these times I was delusional and just like in the thick of it, and I'm like, oh, poor Tracy. She must think she like released some monster onto the scene of bipolar illness.

Tracy 4:44

So

Bipolar, ADHD Labels, And Diagnosis Tensions

Tracy 4:45

absolutely not. And sometimes I question, you know, even the term of delusion. And now, would you remind me, have you been diagnosed with ADHD as well, or no? So not officially. I'm trying to remember what the statistic is. 70% of people that have been diagnosed with bipolar disorder, I think it's 70%, have ADHD. And so are you, do you believe that you have ADHD or ADHD tendencies? Or although honestly, Janine, I think it's all connected. So, you know, it has all these different labels, or we have all these different labels, but I think they're all connected. This whole neurodivergent brain thing.

Janine 5:24

I think so, absolutely. So I had a therapist who gave me the Hallowell book and was like, you are this.

unknown 5:30

Yeah.

Janine 5:31

And then, and you know, of course I go through it, I'm like, oh God, I am this. And I took it to my psychiatrist who treats me for a mood disorder and OCD. And I said, I think I'm ADHD. This is what my therapist is saying. And he kind of looked at me like, really? Do you want to add another diagnosis to your diagnoses? Right. He was like, let's just keep it where it's at and not go into ADHD at this point. But at the same time, I was really pulled into your programs online. And it was exciting to get more information about myself, even if it wasn't exactly that diagnosis. But I thought it was kind of funny that my my psychiatrist was like, eh, let's just hold off. We don't, we don't need to add another. But you know what I thought? I went back and looked at my life because when my early depression started, I wanted to, I always wanted to change my environment. And I always believed that if I just change my environment, things were going to be okay. And I think if you have ADHD, there is a high probability that things will get better when you're in the right environment.

Tracy 6:41

Oh my God, it's it's a hundred percent.

Janine 6:44

Yeah, yeah. But it didn't for me. So I would go to these, you know, acting programs, things I was so interested in, and then just be miserable and depressed. So I couldn't shake it by changing locations. Yeah. So I kind of wanted to have ADHD. I wanted to get rid of the bipolar label to some extent. That would have been exciting, but no, and I looked at my life more fully, like this is this is my label, and I'm gonna have to stay with it. And then you had a pretty late in life diagnosis after your son was diagnosed, right?

Tracy 7:20

Very late in life. I mean, I, you know, I work with women with ADHD, and some of them will come to me and they'll be like 26. I had a late in life diagnosis, and I'm like, honey, this is not late in life, you know. What I typically call late in life is maturity onset. Well, I call it maturity onset ADHD.

Estrogen, Dopamine, And Midlife ADHD

Tracy 7:38

And it's all related to hormones. And I think so many of these mental health challenges are related to hormones as well. What happens is, you know, our brains don't make enough dopamine if you have ADHD. And they don't know is it that it doesn't, we don't make enough dopamine or we process it differently. But what we now know, not because there are many studies on women with ADHD or women with anything, frankly, what we now know is estrogen modulates dopamine. And so all women struggle with their dopamine levels going down when they go start going through perimenopause and menopause. Women with ADHD already have lower levels of dopamine.

Janine 8:16

Oh, wow.

Tracy 8:17

And so when you, you know, you tack that on top of just the natural levels of dopamine going down because your estrogen starts bouncing around and starts declining. You tack ADHD to that, and you can have a lot of women. I work with very successful women with ADHD who it doesn't matter how successful they are, they still feel like they're not doing as much as they could be doing. And it's exactly, you know, this that they get to a certain level and maybe they really felt like, okay, there were signs of ADHD from the time they were children. They talked a lot, they were hyperactive or their brain was moving all the time, they're entrepreneurial, they're fearless. And so all of those traits really served them. But then all of a sudden, when their estrogen starts plummeting even further, they can't cope. And it then becomes an identity problem. They don't even know who they are anymore because they have learned that society likes women that are productive. And the more productive we are, the more visibility we get, the more, you know, pats on the back, and oh, she's a good this, a good mother, a good, you know, whatever she's doing in her career, she's a good wife, and she can't do anything anymore because it's just like all your confidence goes.

Tracy 9:39

And I, all of these things that I could do before, like I could literally do a dinner party for 25 people and not even bat an eye. I couldn't barely make dinner for just our family. I couldn't follow a cookbook, a recipe, like everything that was working. And I mean, I will say when I was cooking, especially for company, I would do this weird thing where I'd get totally overwhelmed and I'd literally, you know, be with a pot in the kitchen spinning, literally physically spinning, trying to figure out what am I going to do next, because I would get so overwhelmed. But it got to the point where like I never even got to that, you know, I couldn't, I couldn't do any part of it. So it was always there. I was never great at all. I was kind of bad with timing, but I had written it all down and I was super organized, and even that wouldn't do it anymore. So this has not been part of the diagnoses as far as in the DSM. But um, most experts in ADHD will now, you know, say that yeah, there definitely is something about. And there there have been a few tiny little studies showing that all dopamine levels go down, and especially in women as they age. And so, of course, it's gonna their executive functions get worse. And so then, you know, obviously, if you are a woman with already with ADHD, your executive functions, they can literally just bottom out.

Janine 11:05

Well, I feel that happening

From Competence To Collapse: Executive Function

Janine 11:07

with me and bipolar, although I do hear sometimes bipolar can get a little better around midlife.

Tracy 11:13

I think mood disorders, and and I have seen this firsthand just around like it's anecdotal, but around people that I know that really struggled with anxiety or depression or bipolar. And as they age, women is who I'm talking about, it actually gets better and better. And I know with the anxiety and depression, it kind of just goes away.

Janine 11:35

Yeah, well, that would be lovely. For now, I am well, I've been sick, and so I notice these things, it happens when I'm just kind of under the weather. But yeah, I've been having the let's walk to the refrigerator. What am I getting? What are we getting out of the out of the closet? So sometimes, I mean, I'm I'm definitely feeling that I think that's just that drop in estrogen. Absolutely. You know, I had a lot of questions for you, but uh, maybe my biggest question for you is I mean, you kind of came in here and you redefined ADHD for women in a way that made sense to you and the community you were building, and just what you were seeing anecdotally. But you had this real like uh fierce determination or lack of worry of what uh it might be to put yourself out there. And I just think it, I was like, wow, like she stepped out to be a voice of ADHD. How do you do that? Like how do you just really step into that and say, hey, what I'm going to say, I may, you know, I'm not a physician, but what I'm going to say, I firmly believe in, and it's my mission to share it with you. How did you do that?

Tracy 12:54

Okay, so I call myself an outsider. I , you know, people are so important to me, and I always want to be the insider. But the truth of the matter, and

Midlife Mood Changes And Brain Fog

Tracy 13:05

this is an ADHD thing, I believe, we are not meant to fit in. We are meant to stand out and lead in an area. The ADHD brain is a brain of interest. If we're not interested, can't get out of bed for it. But if we are interested, we are gonna dig as deep as anyone would ever dig, and we are gonna find out everything about it. So I've always been this outsider. I've never been able to just fit in with a crowd and go along and get along. I've always needed to change things to make them better. And I have a history of actually going into industries I know nothing about. So I, you know, when I graduated as a lawyer, I went to graduate school as well in my, I was a securities lawyer. And it wasn't that I hated law, and I practiced law for about five years, but I knew there was something more that I wanted to do other than law. I didn't know what it was, but I'd always been interested in like I love aesthetics, they are so important to me and how things smell and beauty.

Tracy 14:04

And so I decided, I don't know, one day I was doing a sit-up and I was like, I was a lawyer, and I thought, you know, nobody makes really good blouses for suits. You buy these expensive suits, and then the blouses are like $1,200 to go, who buy, who spends that kind of money? And then they're not appropriate, right? For, you know, professional women. And so I did a sit-up. I had the idea and I said, screw this, I'm gonna do that. So I left law, which is so ADHD, and I started a company. And within eight months, 60% of our business was at Sachs, Neiman Marcus, and Nordstrom. And I knew nothing about design or fashion or anything. I remember I took a pattern making class when I was in undergrad, and I was like, this is really hard. This is like math,

Stepping Out As A Non-Clinician Advocate

Tracy 14:51

and I don't want to do this. And so I dropped the class. But I, you know, I ended up getting a uh, you know, someone who would do all my pattern making for me. And it just like, I don't know.

Tracy 15:01

I think what happens is, again, women with more combined type hyperactive ADHD, we learn that when we're in action, we're out of our brain and we feel better. And so we just start doing things that we may not know how to do them, but just through sheer force of will, we make it happen. And so I believe that is what builds confidence, right? It's not, you're not born with confidence. No, you learn that, okay, you do stuff and sometimes it's stupid stuff, and you're like, oh, I didn't die. Okay, well, I can do the next thing. And so I think that is what really helped to develop my confidence is I was just constantly doing things that I didn't really know how to do. And I'd figure them out, and sometimes I would make them really work. With the ADHD, however, so I was talking about peramenopause and how all of a sudden my confidence started to plummet and I didn't know what it was.

Tracy 15:59

See, I don't believe that ADHD is a productivity problem. I believe it's an identity problem. And I pretty much knew who I was when I was younger, but all of a sudden, all the things I counted on, this Tracy, who was super productive, she couldn't do it anymore. And who was I without all my productivity? And so I really had to figure out who I was. And then the other side to it is I saw my son and I saw how much he struggled and how we would be constantly, well, when we found out he had ADHD, I almost fell off my chair. I was like, there's no way. ADHD means you're not very smart, you're all over the place, and you're not just destined to be successful. And I knew my son, I knew how bright he was. And when he was interested in something, he would learn every little bit about it. He was interested in baseball. He would learn about baseball since the beginning of time. All of the players who founded baseball, like, and he, you know, he was like eight years old. So, World War II, the same thing. Every battle, like he just knew everything. But we would hear comments from teachers, well, the therapist or the psychologist who was an expert in ADHD. She actually met with us three times, once with our entire family, once with just Marcus, and then my husband and myself. And she told us, your job as his parent is to reduce his expectations so he won't be disappointed in life.

Tracy 17:27

And I remember thinking, wait a minute, reduce that kid's expectations? Like, I don't care if he was intellectually disabled. Why would I ever do that to any human being ever? And so we never went back there. And so that's why I started to learn. And so I looked at Marcus and I knew how bright he was. He would be told,

Action Builds Confidence: Tracy’s Career Pivots

Tracy 17:49

you know, by teachers, I don't know how a child who's so bright can be so unmotivated. Or the director of his um high school, his second high school, he went to three high schools in four years. She told us, I'm sorry, there's just nothing more that we can do for him. And it wasn't that she asked him to leave, she wanted him to stay, but they were going to keep teaching the way they've always taught. And when we went into the school, they promised him they would teach to interest. And then they just acted like any other school. You know, it was a it was a brand new private school. And so he was angry and he was like, well, screw this. And whenever, you know, the thing about ADHD is we are the kind of kids who were annoying because we, when we're interested, we want to know more. Why? How? And for a teacher, you can understand they just want to get through the lesson plan, right? If every child is asking 15 minutes of questions, they're never going to be able to get through what they're trying to teach.

Tracy 18:49

And so I saw the struggles he had in school, yet I knew how bright he was. And then all it took was, you know, starting that Facebook group. And then what I really wanted to do was a podcast, starting the podcast, having even one person that got something that my podcast made a difference in their life, and then I was never going to disappoint them. And so then I started to meet woman after woman. And I realized even the woman who I met who was addicted to meth and she was living in her car, she was friggin' brilliant at something. And so I realized this is not, these women are not exceptions.

Tracy 19:30

Every single woman that I have met with ADHD is exactly this way. If she can be in her proper environment and she doesn't have all this trauma that she hasn't worked through, which is huge. The women that struggle, and I don't want to discount the fact that there are women that really struggle with ADHD. I mean, the statistics tell us that 24% of women diagnosed with ADHD will attempt suicide. So it is serious. But those women all have trauma. And so it, and just like paramenopause and menopause, what does trauma do? All the symptoms of trauma are exactly the same as, I won't say exactly the same, but very identical to the symptoms of ADHD, right? So they're dealing with double the amount of executive function and emotional dysregulation and all of those things. So of course they're struggling more.

Tracy 20:25

So I know I went on and on because that's what we do when we have ADHD, but did I answer your question about? I think it was just having all these women behind me and seeing the evidence. And yeah, I know I'm not a clinician, I'm not a doctor, I'm not even a therapist, but I have had so many women come to me who've gone through all of that for decades, and they have not been able to help them. And then they work with me and they're like, oh my gosh, you changed my life. Because ultimately,

ADHD As Identity, Not Productivity

Tracy 20:56

I do believe that ADHD is an identity problem. We have so many ideas. Which of the many ideas that we have is the one we're supposed to follow? And so we do a little bit of this up here and then down there and up above, and we're just all over the place because we don't know what it is that we're meant to do with our life.

Tracy 21:16

So if I can get you in that sweet spot, nobody teaches this, right? If I can teach you what it is that is truly important to you, and most ADHD women do not know, most people don't know. If I can show you what is truly most important to you, if I can show you what are your natural-born strengths, the talents that you build skills around and turned into superpowers, of the many passions that you have, which is the passion, or maybe two passions that you should pursue? And then where, at least if you're young, is the neighborhood of your purpose? If you're over 40, where what's your purpose? If I can show you that sweet spot where all of those things convene and you are working in that sweet spot, guess what? You're gonna have none, if not very, very few of the executive functioning challenges that you have in all the other areas, because we are gonna be in your area of interest. And so that is the kind of work that I do. And the more that I see women that benefit from it, the more that I see that you're absolutely right, Tracy. Every single woman you met, you meet is truly brilliant at something, then how can I not argue against the narrative that ADHD is a disorder? ADHD is a disorder if you're in the wrong environment and if you have a lot of unaddressed trauma.

Janine 22:42

That's so interesting because I'm actually not surprised because it's in your book, but acknowledging that trauma and the nurture nature element of ADHD, and if it is something that maybe wouldn't have come up if there was less trauma in your life. So, because I know with bipolar illness, we still really do look at nurture nature and trauma. And I'm a strong believer in that really impacts who ends up struggling and maybe who gets by and it doesn't manifest. So I was interested to see that you even apply that to ADHD. I think because I feel I guess I feel like ADHD is like the lighter of the diagnoses, right? Like, oh, right, as I said before, oh, I wish it was ADHD. But you're really recognizing this trauma factor and not leaving it out. And the idea of identity, I that's so so interesting to me. I mean, I took some of did some of your coursework. We did those values worksheets, right? And just I I found them so exciting. But to think of it as an identity issue, I won't use the word disorder.

Marcus’s Diagnosis And School Struggles

Janine 23:57

But then sometimes I'm gonna interrupt on myself, because sometimes disorder is good because it highlights this what can really go wrong, right? Like it's it's like it gives it gravitas, like this is still a serious issue. Women can still fall into depression or suicide. So we we have to give it a strong label, even if we don't quite see it like that, because you know, there's a responsibility here too. And I think of you and your position, that responsibility, I don't know if I could carry that.

Janine 24:35

I don't believe it's a disorder. Yeah. Okay. I just don't. And I I will argue that till my death. And I am not the first person who came out and said this. So I think who really gets should get so much of the credit is Ned Hallowell. You know, he's a psychiatrist. He wrote the foreword for my book, which I the most beautiful forward I've ever read. Every time I read it, I cry, and I am not a crier. But Ned Hallowell was the first one that saw for every struggle, for every weakness, there is an opposing strength, right? And in all of his books, there is, and you know why though, because Ned Hallowell has an ADHD, and his partner, John Ratey, has an ADHD. And so that's why it is so important.

Janine 25:24

And I've listened to a number of your podcasts, you know, where you talk about, you know, at first you didn't want to talk about it. You didn't want anybody to know, your family doesn't want you to talk about it. But I think it is so important that we speak about it, and especially that experts speak about it. To me, it's all about hope. If we can't give people hope, then what's the point of going on? Right. And so when we I just think that for everything that is a quote, quote unquote, disorder, there is something that is opposite of it that is part of their brilliance. And I believe that our best purposes give meaning to our past. And if you are constantly going to look at something as I am disordered, I get, I mean, I get that everybody should be able to call it what they want to call it. This is just my opinion.

Janine 26:16

But if you are constantly going to think that the only thing in this thing is disorder, and you can't also see where the brilliance of it is, I just think it makes life so much harder. And so anybody that wants to talk about something that they've struggled with, all of that is trauma, right? All of that creates trauma. These little cuts over time can end up being one big trauma. And how do we process trauma? You know, we either do it through our body or we talk about it. You write about it, we we write. And those things matter. It makes it so much better.

Janine 26:50

So I don't know if I'm answering your question. I am not the first person who felt this way. I just, I was probably the first person, in fact, I know I was the first person who became adamant about it, that is not some sort of clinician in this area. And I don't know how I do it. You know, there are people that write a lot of books, and if you go on Google, nobody says anything bad. If you Google me, there's all kinds of negative things, specifically that I don't believe in medication, which is so annoying because it is as far from the truth as you can get. But somehow that started. And so for me, I just can't pay attention to what anybody says. And I think I probably told you that when you started the podcast, just keep your head down. Don't look at numbers, don't look at what people say, just

Environment, Interest, And Women’s Brilliance

Janine 27:39

keep your head down, unless someone sends you a nice message. Because I don't want you or anyone to think that, oh, this is really easy for me and I'm just a rock and who cares. I do care. But I have learned to kind of put horse blinders on and focus on whose life am I making a difference for and not worrying about what they're saying about me. I think that you did say that to me. And I think I may have taken that a little bit too much to heart, really putting out episodes and content that was really important to me and perhaps wasn't commercial, but but I wanted to have those conversations.

Tracy 28:16

Janine, though, you are so kind and warm and lovely and open that I bet no one ever says anything nasty about you. I don't know. I haven't been looking. Good. Don't look. Don't look, but I bet you that's true. Versus, I got out there and really took a stand and I pissed people off that want to believe ADHD is a disorder.

Janine 28:49

Join us for the second half where we circle back to Tracy's belief that ADHD is not a disorder, her passion to get women to understand their strengths, and to also learn more about Tracy's own routines and practices that have helped her change her own ADHD brain. And please share this episode. I have a new iPhone, and seriously, I'm having trouble finding where to leave stars or write a review. But it's super easy to see the share icon with the little upwards arrow. So please do share any episode with someone who it may help. And as always, thank you for your support.