The Messy Intersection of ADHD + Perimenopause with Dr. Rebecca Richey

• Dr. Rebecca Richey returns to talk about the wild intersection of ADHD and perimenopause, or as she calls it, “When the wheels fall off the bus.”
• Anxiety might actually be your ADHD talking – When you treat the ADHD first, the anxiety often gets way quieter. It's not the main problem; it's the monkey on your shoulder that comes with ADHD.
• Perimenopause + ADHD Your estrogen is ping-ponging all over the place while your executive function was already struggling. No wonder everything feels impossible.
• There's literally no protocol for this – Research on women's hormones and ADHD is basically nonexistent. We're all just figuring it out together through trial and error (and group texts about estrogen patches).
• Late diagnosis is super common – So many women get diagnosed in their 40s because they finally hit the point where all their coping systems can't keep up anymore. Career peak + aging parents + big kid problems + perimenopause = diagnosis time.
• Stimulants aren't scary – Kids with ADHD who are medicated have better outcomes across the board: fewer car accidents, less substance abuse, better relationships, lower suicide rates. The zombie thing was a 90s problem.
• The hypervigilance is real – That constant "am I forgetting something?" anxiety comes from decades of being the "good girl" who couldn't let anyone see how hard things were. BUT: You're not in danger anymore – Your 8-year-old self believed she was in danger when she got in trouble. But you're an adult, and nobody's putting you in timeout.
• Perimenopause has gifts too – Like suddenly realizing you're not always wrong. And giving way fewer fucks about what other people think. Welcome to your "actually, I'm the fucking queen" era.
• Find practitioners who actually listen – You might try 17 medications before finding the right one. You need someone who won't treat you like a burden.
• Hang on—it gets better – Women in post-menopause are the happiest they've ever been (aside from ages 0-10). So buckle up, but know there's light at the end of the tunnel.

Follow Steph on IG @stephsprenger, and on Substack at The Reclamation Era. Looking for a community of creative midlife women? Check out MidCircle

Check out Dr. Richey’s appearances on The Mother Plus Podcast:

• Why ADHD Women Are “Too Sensitive”
• How to Regulate Your Emotions When You’re “Too Sensitive: A Conversation About
• RSD with Dr. Rebecca Richey
• A Psychologist Explains How the ADHD Mom Can Advocate for Herself:
  Part I Part II

Dr. Rebecca Richey is one of Colorado’s first prescribing psychologists, dedicated to empowering women, girls, and gender-diverse individuals through compassionate, evidence-based care. With advanced training in clinical psychopharmacology and a deep understanding of the unique mental health challenges faced by her clients, Dr. Richey offers an integrative approach that includes medication management, psychedelic therapy, and psychological testing. Learn more here.

Transcript

0:07

Midlife, A DHD can be scary. But it doesn't have to be. Here on paranormal, we are demystifying neurodivergence and perimenopause. Plus, with candid conversations and advice from experts, join me for a no holds barred exploration of what it means to be neurodivergent at midlife. Let's redefine normal together. I'm Steph Springer, and this is paranormal. Welcome back to the Paranormal Podcast. I'm Steph Springer, and on today's episode, I am speaking with one of my favorite people ever. Dr. Rebecca Richie was on the Mother Plus Podcast. And I think her episode might have been the most popular one, and actually we had her on several times because we could not get enough of her. She was such a lighthouse. During my early days of my A DHD diagnosis. Dr. Ritchie is one of Colorado's first prescribing psychologists dedicated to empowering women, girls, and gender diverse individuals through compassionate. Evidence-based care With advanced training in clinical psychopharmacology and a deep understanding of the unique mental health challenges faced by her clients, Dr. Richie offers an integrative approach that includes medication management, psychedelic therapy, and psychological testing, passionate about creating a safe and inclusive space. Dr. Richie combines innovative treatment modalities with a commitment to holistic healing. Whether navigating anxiety, depression, trauma, or life transitions, her goal is to foster resilience, self-discovery, and lasting wellbeing. Dr. Richie is triple licensed in the mental health field holding clinical psychologist clinical, so social work and certified addiction counselor license in Colorado. She is the right woman for this job, and we are going to talk about the wild intersection. Of A DHD and perimenopause. We are gonna talk about the overlap between anxiety and A DHD. We're gonna talk about hormones. We're going to talk about why there is no protocol and why late diagnosis is so common. We're going to talk about this. Stigma of stimulants and why so many people have a bad taste in their mouth about them. We're going to talk about what happens when the good girl who is so worried that she's going to get in trouble becomes an adult and we're going to talk about the gifts of this shit show. It is not all bad, so please welcome to the podcast, Dr. Rebecca Richie. So first of all, tell us a little bit about your practice, because I think this is one of the things that makes you very unique. Yeah, thank you. So I'm a co-owner and operator of a private practice called Solstice Psychology, where, um, my business partner and I, we have, three people working with us now, three psychologists who work under us. Um, and, um, we only work with women, girls, and gender diverse people. And it's not because we don't like men, it's just that the world is made for men and we wanted a safe and sacred space for women. So that's what we created. Um, and so I don't do any therapy. I do neurodivergence testing and now I do also medication management. So I'm the sixth Colorado licensed. Um. Prescribing psychologist, which means that, you know, I have these 20 years of clinical experience as a behavioral health clinician, and now I can also do medication management. So, um, it's been lovely. It's been pretty cool. Uh, and it, it really dovetails nicely with my actual, what I've been doing for the longest time, which is just NEURODIVERGENCE testing. And so that means testing for A DHD. That means testing for autism, testing for learning disabilities, just a sort of a plethora of different ways that your brain works beautifully, differently than, um, typical people. I love this and congratulations on that. Huge accomplishment. I can imagine how wonderful that must have felt. Yeah. I actually, when I got it, um, the, the email from Dora that I was licensed, I was in the middle of, um, Alexa for another thing I wanna tell you about. And I just turned it off and started bawling. And my husband was like, are you okay? And I was like, I'm licensed. And he was like, oh, these are happy tears. That's so good. Yeah. That's beautiful. And the fact that you've got this niche that now you can, it's even niched down into girls, women, and, and gender diverse folks. Like this is just this, what a gift. So, um, what an amazing practice. I have a sort of, I think a unique way of thinking about, um, medication for women who have a DHD specifically, because I think that, um, so many of us develop anxiety alongside the A DH. Yes. And I think that a lot of practitioners are, um, just really, you know, have some reservations about giving women who have anxiety and A DHD, um, stimulants, you know, I mean, and Right. Rightfully so. There's, so there, it's, it's concerning, but I only prescribe for women who either have gone through testing, um mm-hmm. And girls. Yeah. Little uh, girls up, down to age 11. But, um, I, who've, who've either been through testing with me or they work with a, you know, a different psychologist or therapist that I know pretty well and has like a good diagnostic acumen. Um, and so if, if what the testing is telling me or if their, what their therapist is telling me is like, this anxiety is secondary to the A DH adhd, then like, let's go ahead and treat the A DH ADHD and see what happens. Right. And I'm finding that overwhelmingly women are coming back to me and saying like, the anxiety is so quiet. Even OCD sometimes gets like so quiet when, um, the A DHD is under control. And so, um, so yeah, I, I just, I work a little bit more close with the, my patients than like a, like A PCP would. And I, you know, they have a, there's a number that they can text and. You know, I'm a little bit more available than like A PCP would be, and I just am sort of like, we're, we're just getting through this together. You know, we're just gonna see how it goes. That is amazing. I, I love that you brought up the anxiety thing because it's like there's that Venn diagram of is it anxiety or is it a DHD? Then there's the comorbidity, like, or is it both? Yes, but I've cut my Lexapro in half after being on a DHD meds and I think that the, the whole time I was on anxiety meds alone, which was like a good five years, they helped with certain things, but that wasn't, I feel, I feel strongly that that wasn't treating the source of the problem. It was treating a symptom of A DHD. Yes, that's exactly right. And I think that, that, that is overwhelming. Another response I get from the women that I work with is just that like, Hey, now that the A DHD is actually being addressed, now my anxiety feels, so much better. Like I can, I can work with it a little bit better. Like everything else feels so much quieter. Um, and not everybody, some people are like, I had a panic attack the first time I took that. And I'm like, okay, well that's not for us. Let's try something different for sure. Right. But, but I think that, um. You know, I think that a lot of people in the world are sort of like, uh, don't wanna give stimulants to women who have anxiety, if any kind, even if it is secondary to a DHD. And I just, I think that that's giving people a disservice. So I'm so glad you brought that up. I knew that there are some women that don't respond well to stimulants, even if they have a DHD, but I remember the first time I took a Ritalin, I was like, am I going to feel like I am amped up and jittery? And it was such a relief to me when the opposite happened, right? Totally. Yes. Like such a relief and it felt like, I don't know, it was validation, right? It was like, oh, if I didn't have a DHD, this would not feel calming to me. Absolutely. But then there was a time we tried Vyvanse and that made me a little agitated, right? So again, I think that it is a chemistry thing, right? Women respond differently to different meds. Absolutely. I mean, I think that's a huge part of it, is that I am like honored to work with a population of people that can give me active feedback. Like, I noticed I was more jittery today. Like I kept a journal. I, you know, I would like mm-hmm. Making notes all day about how I felt and this one did this to me and this one did this other thing to me. And so like, great, like let's take that feedback and find something that works for you. Right. So one of the reasons I think I've hesitated to mess with my anxiety med too much is that I've also been, and this is where the perimenopause part comes in, I have also been going up and down on estrogen patches and progesterone. And then, I have a family history of diabetes, but also I. You know, hit perimenopause in full force, right about the time I got a divorce. That was, it was a god awful divorce. And so the result of all of this was insulin resistance. So now I have, I'm wearing a CGM, I'm taking metformin. We're trying to get my hormones balanced. I'm monitoring my glucose constantly. And so, you know, one of the reasons I'm like, uh, forget going down on Lexapro. Like, I don't wanna make any more modifications to these different factors, but what do we do when we've reached this stage of life where it is, it's like, is it a DHD? Is it my hormones? Like, how do we deal with this treatment of our A DHD while we are also trained to balance our hormones? I mean, the shitty truth is that there's, there's no protocol for this, right? No. I mean, the research that has been done in this area is scant. Um, and there's no money clearly now for research with all the, you know, sort of stuff that's happening in the world. Um, and so, so we just don't know. And I think the best approach is exactly what you're saying, right? To take sort of, um, like a broad approach and like, let's try this and, and then let's see, see how this does, and then like, let's, let's j this a little bit and see how that does. And like, all you can really do is, um, kind of hang on, um, right. And, and change things as they need to be changed. But I think it's so, it's so impossible for us ladies in squarely in the perimenopausal time period because your estrogen is like a ping pong ball. It's like Right. You know, just all over the place. And it's unpredictable. And I mean, it can switch from low to high in, you know, a very short time period. And so if we say, you know, for, for women who are. Premenopausal, little pre-menopausal and their like reproductive stages. It's more predictable, right? And we can say like, in your luteal phase, you're gonna need to have more medication because you know, the estrogen is dropping and you're gonna need more, more medication to kind of support your attention and, and focus and things like that. But like, we're kind of booked, you know, for until we figure this out. Um, and so just, just doing what you're doing, I think is the best approach. And that's like learning your own body, getting to know your own body and just, um, you know, sort of, sort of doing what your body needs. And that could change from month to month. Uh, I mean, that's probably okay, you know, so just having, having providers who are on your side and who are supportive and helpful and, um, willing to work with you and willing to listen to you, I think is the big key. I think you're right. I think you're saying some very important things here, like number one. Trial and error is kind of the way, there isn't really a protocol. And some of that, um, I think is due to really shitty systemic things about women's health not being researched or funded. And we had Jolene Brighton on the podcast a while ago, and she just went on this amazing mic drop rant about how ba like, this is how you go in and speak to your gynecologist, ask for this, use these words, say this script, because there is not, there's not research for, for women's hormones and, and women's neurodivergence. And so it's like, I mean, she was just. It was a beautiful tangent about how, and you were the first person that I remember saying the DSM, like, this is a, this is a white man's book. Like Absolutely. Absolutely. I mean, and you'll not find a word about perimenopause in the entire DSM, you know? Mm-hmm. So like, cool, cool, cool, cool. Uh, we're just like, out here on our own, just kind of like, just trying to figure it out, you know, just. Every woman that I've had conversations with this about, I had Amy Newman on the podcast recently, and we were talking about this DIY aspect where like, on the one hand, the great thing is all of our friends we're all like gathering around the fire again. And everyone's like, how much estrogen are you on? Does this happen? Is this, like, I didn't start taking estrogen until I was hosting a happy hour and realized that all my friends were on it. And I was like, wait, what? Like, I'm supposed to be doing this out and right. And, and so it's like, in a way we're all like talking to each other and yeah. Again, the underground estrogen patch train, right. Like, are you out? I'll leave some on the front step and, and I love that we're talking about this, but Amy's point is like. That's so great. But this DIY thing, like I don't want my best friend to be my medical practitioner. That's exactly right. I mean, and isn't it, isn't it so messed up that there's just, like I said, there's just a dearth of, of knowledge and understanding about this. And so I saw, um, uh, it's probably a reel or something the other day of a ob, GYN, and she was saying that like she's a board certified ob, GYN and in her program she got like a month's worth of information and study on perimenopause. Right. And the rest of it was around pregnancy, which is of course very important to also, but like, we're here too, and this time period of life is, it can last up to like 10 years, right? And as a woman in perimenopause, like maybe you have a period every six weeks, maybe you have two weeks in between, like you don't know and your body doesn't know. And it just makes its own decisions about what it's gonna do. That that's what it feels like. And it's like, again, you get to this stage of life where it's like, oh, I've been managing these things. I've got a system. And now I'm just like, why am I just randomly bleeding all that? Was that ovulation? Does this a period, um, I feel like it feels like your body's been hijacked, and that's really alarming. Like being a teenager again. Like you have to carry a tampon with you literally everywhere you go. Because who knows, who knows When you're shopping for like pickles in the pickle aisle and you're like, oh, I'm bleeding. Let me just jog to the bathroom real fast. Yeah, no, that was me at the art museum. I was like, hi. Um, oh, I'm, looks like I'm throwing my underwear in the trash and I don't have a tampon'cause I haven't needed one in a long time. So I sophie's rifling around in my purse getting quarters to get, you know, like vending machine tampons for me. No, it's right, like, it's like we need a pair emergency kit. Like always have a spare pair of underwear and some tampons and liners with you. A hundred percent. Like they, they need to do, have those old school machines in every bathroom, but like, you don't actually need a quarter, you just like press the button and like you get your table. Oh yeah, we should not have to pay for those anymore. I feel so grateful every time I walk into a bathroom that just has like little. Same. Yeah, I'm wondering as Gen Xers are kind of coming of age and midlife, that's where I'm seeing more outspokenness about this stuff. It's sort of like as the Gen X female doctors are hitting midlife, it's like, oh. Maybe we are gonna do things differently. So I, I've loved every conversation we've had. We've talked about RSD rejection, sensitive dysphoria, which is such a thing. Yes. For girls and women with a DH adhd Totally. And we've talked about, how A DHD shows up differently in girls and women in other episodes that I will link to in the show notes just because I think there's such a great primer course in a DHD in Girls and Women. I was pretty new in my diagnosis the first time I spoke to you, but I'd love for you to talk to us a little bit about the specificity of A DHD in girls and women, and particularly how our hormones impact that. Because I guess, gosh, as you're thinking about it, it's not just perimenopause. We've got, we've got puberty, hormones in adolescents. We have pregnancy and postpartum hormones. Like, just honestly it's one thing to be a dude with neurodivergence when your lifelong hormones are relatively stable, but like, my God, to be a neurodivergent female person with hormones. Yeah. Like what? That's exactly right. I mean, and, and I mean, it's a surprise to none of us that women are so complex. Right. But it's a surprise to the research community for some reason, since, you know, the nineties. That that's, that's true. Um, and so that's another, you know, I was just saying like, the world is built for men. That's another example of it, right? Like men's hormones have a 24 hour cycle, and that's pretty constant from the time they're, you know, whatever, 15 until they're in their whatever, like retirement years. Um, and then women go through all of these different stages and some of them overlap. You know what I mean? Like, I was a geriatric mother and so was probably starting perimenopause as I was having my daughter, you know, and, and what does A DHD look like in those time periods? And so I think we're really just coming to a space as a community, like as a community, as a society where we're learning. Just how different it is for girls and women who have a DHD, how it looks different, how it feels different, and how it changes based on where you are in your reproductive life cycle. And also, um, where you are today. You know, and we were just talking about getting hormones tested and how there's no way to like just have a tested throughout the month, um, which would be amazing, right? Like if we could have like one of those glucose monitors, but it's like a hormone monitor. Um, and so even when we have testing done, like if we have a blood test drawn, you know, we'd have to do it like almost every day for a whole month to figure out what really is going on and who has the money or the time for that. Like literally nobody. And so, right, you hear about the Dutch test. I have friends who are like, the Dutch test is so great. And I'm like, cool. And then I'm like, wait, I have to spend$400 out of my own pocket to do this? And. Yeah, I mean, it's just, there's, there's no accessible option for most women who are in perimenopause and are noticing things like, you know, they say that, um, hot flashes are the number one, Symptom that a lot of women in perimenopause experience, but I, that's not what I hear. You know what I mean? From women that I work with or I talk to, it's the lack of sleep. It's the like irrational anxiety coming out of nowhere. It's the, the rage, the flying into rage for like the smallest thing that's happening and the number of times you have to apologize to the people who live with you. Oh my God. I know. I'm so sorry. I Yeah, yeah. You might remember I do IFS therapy and so I like literally have been working with my therapist with this part that I call, sorry About us. Like I'm always throwing into, sorry about us. She's like the cleanup crew. It's like, oh shit, I was just emotionally untidy in a public space. Uh, sorry about us. She's coming with her mop in her bucket. Like, let's just make Yeah. No, really like uhhuh cleanup crew. That's exactly right. But also when you talk about that, that that sort of emotional volatility, um. That's also an A DHD thing. So if we're already prone to emotional dysregulation, like it doesn't even matter, right? Like what, what's, where does perimenopause end in a DHD begin? How do we separate out these threads? And maybe there's not even a point. Well, and I, yeah, that, I mean, I think that, right. And so perimenopause changes every day, right? Like your estrogen, your progesterone levels will change. And sometimes, sometimes every day. Right? And sometimes, like I was saying, like you just don't know. You have a period every six weeks and then you have one two weeks after that. Who knows? It's, it's super helpful to drill, drill down that deep. But I do think it's helpful. I don't think a lot of people know that when you are in perimenopause and you have a DHD, like the wheels are gonna fall off the bus. Right. And that's okay. Do you think that's why so many women are getting diagnosed later in life? 100%. And you know what I actually think happens so much, so much of the time is that when you're young and you're single and you don't have a family and a mortgage and stuff like you can manage. And a lot of women are like, I can do this. I have all these systems in place. I do all this stuff. And, and a lot of us were like very successful kids. You know, like academically, of course we were. Mm-hmm. We were the good girls. We just did it all. Mm-hmm. And so I think all of that stuff works and then you like have a kid or two when you maybe, maybe you get married and then by, by the time you're in your forties, you are like hitting your career stride. You know what I mean? And so you probably have the most responsibility you're ever gonna have in your career. You, your kids are old enough that like. Big kids, big problems. So your kids are coming. Yes. Big kid problems. And most of us are in a time period where our parents are elderly. And like, I go to my parents' house every day because, um, they, I mean they, they help bring my kiddo home from school, which I super appreciate. But like, I'm making sure their trash is out. I'm making sure that the medication is correct in her like little med box. And you know, just little things like that. Because, because that's what we do, you know what I mean? And so, so all of these things altogether I think are too much anyhow for any person. Yes. Um, and especially women who carry the, like the mental load and the emotional load of the family too, most of the time. I mean, that's a huge ask. And then make your hormones go haywire and then on top of it make this like lifelong inattentive ness. Yes. So what were we supposed to do? You know what I mean? Yeah. So we, we are, we are managing so much, but our executive functioning is trash. Totally. Yeah. I mean, my family laughs at me every day because I have the worst. Word finding problems and I'm just substituting all kinds of garbage. Do you know how often I say thingy and I expect the people around me to know what I mean. And the kind of awesome thing is that frequently they do. I'm like, oh, you know the thingy that was on the, yeah. Okay, cool. You know, the thingy. I mean, my daughter and I will communicate across the volleyball with like, well, she's learning a SL so she'll sign to me and I'm like, I don't do that. So we're like gesturing and you know, we've got our own little secret language, but like, do we know where anything is in this house? Well, fuck no. And it's just the two of us. It is a, uh, pubescent and perimenopausal combination of A DHD females and like, oh my God, send a help. Please, please send help. Um, okay, this makes a lot of sense. And so, yes, so we've got executive functioning challenges and emotional dysregulation as it is. And now we've got this fogginess and this, um, volatility from perimenopause. Well, I mean, and, and if you think about, I, I, I know this is really cheesy, but I like to think about like the things that we have going on as a, like, things you throw in a backpack, you know? And so, like I said, you have a million things in your backpack. Your backpack is super heavy. And so I think of it for women in this period of life as like you're walking along and like shit is just falling out of your backpack, you know, because like it's over full and it's super heavy. And so every time you turn around, like something goes. And so, yeah, my kid showed up to soccer without her cleats. Sure she did. She sure did. And that was my fault. And she's gonna have to run practice without cleats and yeah, that's just all the rest to it. She's like, why can't you remember anything mom? And I'm like, I'm sorry babe. Like this is, this is the mama you picked. So this is the one you're stuck with. Well, and it's interesting it works both ways, right? I'll be like. Wait, you need the black T-shirt. And I'm I am running late. I have to get to Boulder. I'm producing a show tonight. Now I have to stop by the high school. And I said something snotty via text. I was like, do you think maybe in the next year we can try to not fuck something up? And I said, we, and in that moment I met her'cause she didn't have the thing she needed. But the fact is, I am just as likely to drop the ball. And also I am the, I'm the only adult here, right? Like, yeah, managing my kids. I mean, it's one of those things where it's like, I, it's embarrassing to even say it out loud because it's like, no, this literally is my job. But I'm like, I'm not, how am I supposed to manage like I'm getting alerts on my watch about her homework and her grades and, and I'm like, I'm fighting for my life here.'cause I'm a self-employed person. And you know, when you're a business owner, it, it is just, it's so much management. It's like I need a front brain manager. Well, and I think so many women who have a DHD are their own managers, their own, they have their own age, right? Because we are beautifully creative and like we have, we have so many things to offer the world, but you know, we don't maybe show up on time all the time. And sometimes we like showed up unprepared. And so it's best if we like just work for ourselves maybe. But at the same time, it never stops, right? Like you're getting checked 9:30 PM and you're like in your pajamas watching a scary movie. And you're like, I don't wanna, I don't wanna deal with this right now, but you, there's no option. You know, so. Right. Or it's like, I don't trust myself. I think that's, I have this obsession with like getting my, well, I won't say inbox zero, but unread zero. Inbox a a million. That is like an anxiety response for me. And people are like, no, listen, unplug, after this time, be present. Do this. I'm like, I'm gonna drop balls if I don't like, but then I think that's the, I think that's the thing that gets into us, into the habit where it's like, oh my God, I'm at a stoplight. What can I cross? Dude, you're driving a car. No. Stop it. Yeah. You like your email while you're driving a car? No. Like, like where? But I think that that hyper vigilance, um. The hypervigilance for me. I mean, I also had this very stressful life experience that I had to reteach myself how to watch a fricking TV show after my divorce because I felt like I needed to be managing something all the time or I couldn't rest. Right? Like, what can I fix? What can I clean? What can I do? What can I send? And I couldn't just be like, I'm gonna watch some shit tv. Totally. That, I mean, I think that that is a, it is a very common, um, like a commonality among women our age, because, especially women again, who have a DH adhd, because you just get to the point where you're like, I'm fucking everything up. You know what I mean? Right. So if I have a second of downtime, I'm gonna be making a list. I'm gonna be Yeah. Crossing things off this one email, this and that. And so, but then what happens is like, you work until 11:00 PM and then expect yourself to go to sleep at 1101 and that, that's it. That's not happening. No. I, like, I need two hours in between the last thing I do for work before I fall asleep. Right. So, um, I can do whatever I want in those two hours, but it doesn't, nothing work related. Um, but, so if I stop working at 11, I'm not going to sleep until one and then turn around and get up at six, you know? And so we have all these things as hyper vigilance that comes with a DHD and that's exactly what I was talking about earlier, that anxiety, that is like, it's like the monkey on your shoulders when you have a DHD. It's not, that's not the real problem is the hypervigilance or the, the, the anxiety. It just comes with the A DHD. And so like, let's try to focus on, on getting the A DHD addressed, and let's see if that monkey like takes a hop off for a little bit, you know? That is so perfectly expressed. Um, when I was talking to Amy Newman, she, she got a midlife, a DHD diagnosis, I think, uh, I think in her early fifties. And she was like, I don't need to take my anxiety meds anymore because we've got it managed with the A DH ADHD meds. And I, and I do think I still, you know, it's like that frenetic energy of the, like, am I forgetting something? Totally. I think that, and I think, you know, we talked about, we've talked about this a hundred times, that good girl thing that we all grew up with. We are smart, we were high achieving. Um, like, oh my, if a teacher would've yelled at me, I would've literally died. So that wouldn't have ignited my, my rejection since the RSD for days, four days. I would've been like, I'm so bad. Do you know that I still have in my like little inside out core memory of like, shame. My second grade teacher, I was in the, I was in the red reading group'cause that's the best one.'cause I was a very good reader and we were sitting there and she said to me, stop picking your nose. Now here's the thing, I was not picking my nose. I was picking at something on the side of my nose and I am 47. And I remember this 40 years later because a teacher, my beloved Mrs. Paulson, who was basically just like a walking womb, she said, don't pick. Your nose and number one, I was falsely accused. That was not precision of language Gretchen. Number two, like how humiliating. So I guess my point is though, we are like hardwired to avoid humiliation and I think for me at least, that means keeping a tight lid on. Don't let anybody know how hard this is for you. Don't let anybody know that you are fighting for your life, that you're wandering around the grocery store without a list that you are trying to pay attention to long division when you've literally just created a fictional landscape for the book you're writing in your head. Totally like that. Is that hyper vigilance? The, like, don't let anyone find out that that thing that Well, and it's, it's, uh, it's decades of that. Right. By the time you get to perimenopausal, I don't know if you've experienced that, but like, I am really letting that go. And that's part of me saying to like, pa like clients, when they come on board and they're gonna do a neuro ate assessment, I'm like, look, I'm a neurodivergent person. I'm gonna do my very best to remember literally everything. But I, if I forget, I apologize. And this is why. But I'm just putting that out there and I'm also forgiving myself for the little stuff. Right. Like, she, she's eight. She can run a soccer field without her cleats. It's fine. You know what I mean? Like, it's not like she, this is not an emergency. It's not the Olympics, you know, it's probably fine. Um, and she can be upset about it and we'll repair later, you know? Right. Um, and that's okay. It's okay. All of these things are okay. Um, and so, so the hypervigilance, I think, um, melts a little bit when you can get into a space where you're like, I'm gonna forget your shoes. You know? Right. There's no, there's absolutely no way I can remember them unless we like carve out a time the night before, put the, you know, the, all the stuff in the bag and then we get there and you're ready to go. But, um, well, and also the like, yes, the like pre forgiveness, like, I am going to make a mistake here. I accept it. And I, and that's not an excuse, that's not like being like, sorry I'm a spazz. I have a DHD. It's, it's not that. But it is anticipating and forgiving yourself ahead of time. That's exactly right. Um, but I think the other thing is like. You're not in danger right now. Like our little kids' selves. Yes. We believed that we were in danger and we were, because our primal fear of abandonment and rejection was triggered every time we had these moments. Yes. And so I think as adults we can at least zoom out and say, that is really annoying. Now I'm stuck in traffic. I had to make the stop. You don't have the thing you need. We're going to get in trouble. But it's like, wait, actually we're 47 and we are not going to get in trouble. No four, no trouble. Yeah. I mean, and and also I think something happened when I hit perimenopause, and again, I don't know if you've had this experience, but like I just realized somehow that like I'm not always wrong. You know what I mean? And so I used to walk around in the world just sort of like assuming that everybody else knew more than I did about stuff. And it's just, it's just not true. Yes. You know what I mean? So if like if I was driving and somebody honked at me, I would assume what I was doing was wrong. Right, because they like somebody honked at me, so they're trying to like correct me. Well, no, no. Maybe they're wrong. Maybe they don't know what they're doing. Maybe they're just being an asshole. I don't know, like whatever's going on with them, like I'm doing fine. Like they can have their own little moment somewhere else, but like them honking. I don't have to respond to that. I don't, this is brilliant. And yes, no, I can relate to that deeply because you know, we talk about how A DHD has some challenges, but also these beautiful gifts. We're creative, we're ambitious, we're all the things we are is the same with perimenopause. Like, oh my god, bleeding all the time, having my wanna scratch my face off in my sleep. Not cool night sweats. However we are at this moment of like, actually I am the fucking queen actually. Like I'm, I'm the sovereign force and I'm not wrong. I'm not always wrong. Yeah, absolutely. God, that's so brilliant. And I do think that that is the thing where I see midlife women coming into our power and having the courage to say, actually that way doesn't work for me. And it doesn't mean that I'm weak. A hypothetical man responding to my perimenopausal A DHD stresses might be like, grind harder, work harder, push through. I've just spitballing here. What a, a hypothetical man might say. And I am like, actually, fuck that. Yes, I love that. Well, actually, I mean, how many times have you been, well, actually, dude, dude, but it's like. Actually, I do not subscribe to grind and hustle culture. No, actually it's not better for me to work harder Right now. I have a woman's body and a woman's hormones and a neurodivergent woman's brain, and I fucking know what's best for me. Absolutely rest. And I think that there's the, we underestimate the value of rest. Uh, as women in this a, a, ADHD women for perimenopause, we underestimate rest and how important it is, and not only just yes. Rest with your body, because I think a lot of us can do that, but it's rest with your brain. And, um, like you said, you had to reteach yourself how to watch a show. I can't watch a show without like, doing some sort of like mindless activity on my phone, typically. Oh, that's what I meant. I meant watch a show and play wordle or watch a show and do something else. Who can watch tv Whatev Nobody can. Yes. I'll and my husband. Like we, we can't. Yeah, we can't. Yeah. Everybody else. It drives my oldest daughter crazy. She has a DHD, but she is like, I don't know what, she's eldest daughter just like me, but she's like, she's super organized and it drives her nuts when we're doing other things, when we're talking to her or watching tv. But my little one and I, it's like, no, trust me when I say I'm actually listening better. Yes. My hands need to do something else too. 1000%. And so I'm like, I'm playing the Pips, the Dominoes. And you love Pips. Oh my God. We are obsessed with pips. I, I am obsessed with Pips. I love Pips. Yes. We were up until midnight playing Pips. I got home at 10 o'clock from the show I produced, and she was still awake. I leaned in to kiss her and she was like, boo, I'm awake. And so we're like eating soup at 10:00 PM Then we're all wired, we can't sleep. So she comes into my bed, we're playing pips and I'm just like, there are things about this that I know are so like wrong. And yet I just revel in the beauty of like, we are two neurodivergent chicks living together in this house and we do things our way. You know, actually, you know what, Stephanie, as a person who has a doctorate in child and adolescent psychology, I'm gonna tell you that what you're doing is amazing and um, you. Uh, the whole time I've known you just been a real inspiration in terms of like how to have a teenager and be a woman who has a DHD. And so I, um, I'm looking forward to my kiddos teenage years. I mean, I'm gonna put that in scare quotes, looking forward to it. Mm-hmm. But, um, but like moments like that, like she's gonna be 41 day and be telling her kids, like my mom would come home and I'd still be awake and we would have soup and play pips, and that's gonna be such a special memory for her. And she probably felt like heard and seen and loved in that moment. And that's, that's gonna change her life for the better. So keep it up. Ugh, you're making me cry. Thank you. Um, and I think that that is a thing that a DHD moms do have as a superpower is we might not be the room mother and we might not ever make a homemade thing to bring unless, unless our superpower is, we like to hyperfocus on baking for a million years'cause we're interested in it. If we're not, we're gonna sign up for plates and cups every time and we might forget Spirit week and we forget the cleats and we don't have the right colored volleyball shirt and we fuck it up a lot. But I'm like, it's this deep connection. It's this. And that is my perimenopause gift. Like you were saying, the the like out of fucks. Like who is the person who has the we do not care club, like love her icon. Oh my God. And I think that that movement is actually giving a lot of us permission to be like, actually I'm gonna do it this way. And, and that I think is my gift where I don't have that self-consciousness about what I would look like as a mom. You know, there was one day we were driving to school, well we just pulled outta the driveway and my next door neighbor was watering. And I'm like, oh God, I hope their sprinkler gets my yard too.'cause I'm not sprinkling. And she looked at me and she's like, I love having a single mom. Oh. And, and I'm like, and I was cringe. And she's like, no, I mean it, like, I just love it. We just like, we do things our way. And you don't have to, you don't have to do them any other way. Right. Here's a question for you because this is, this is one of the things that pushes my buttons and when is when people start coming down on, um, getting diagnosed, doesn't everyone have a DHD? Does everything have to be pathologized? Well, those people don't say pathologized. They say stupid person should, um, but like, does everyone have to have a diagnosis, blah, blah. And this is like my soapbox that I endlessly get on because I know how transformative my A DHD diagnosis was. Can you speak to the importance of, and especially maybe midlife women getting a neurodivergence diagnosis? And I know there are a lot of autism diagnosis in this population as well. Right now I probably could stand to, um, have an evaluation for putting a pin in that We'll come back to that. Um. So, yeah. So the, the deal with diagnosis is this, is that if you don't need to be diagnosed, then you don't need to be diagnosed and don't worry about it, right? If you, if you don't with a capital N need it, then don't worry about it. But most women who I work with don't have to for any reason, but they need to for themselves, right? They just need to know because they, they wanna understand their body, they wanna understand their system, they wanna understand their brain and the way that all these things connect and they wanna understand. And like, we're, we're like, like I said, mid forties, like we've lived the first 40 years for everybody else in our life, right? And so now is the time to figure, to figure ourselves out. And if we can get, you know, some information about the way that our brains work, that will help us make the last 40 years of our life more peaceful, then absolutely friend. That is what I'm here to do, right? I'm here to help you. And so the way that I do testing, I rarely ever just do like, is this a DHD, yes or no? Because I just don't think it gives a lot of helpful information. I do have a comprehensive, um, and so what that looks like is we're looking at your cognition, your cognitive ability. We're looking at, you know, a continuous performance. So we're looking at your, sort of, the way your neurons are connecting, but we're also looking at personality stuff. We're looking at, at your, a clinical snapshot of, you know, sort of your, your clinical picture. And, um, you know, we're doing all kinds of stuff just to kind of figure out if it is an A, DHD, what is it? Because what I don't want is people to walk away without a path in front of them. And so that is what, that is what I do, right, is to help women who were sort of like, I don't know what's going on. I like, like, let's figure this out together. And so nobody ever walks away without, like, here are some suggestions on how to make life feel a little bit more comfy for you at this stage in your life. And the path forward. It's like sometimes we need a map to the path and, and if we've been reading the wrong map, no wonder, well, I can't read a map anyway, but like if we, if we're reading the wrong map, no wonder we feel terrible. And when you use the, like, the capital N need, like I did not take medication for A DHD for the first 45 years of my life. Do I need my Adderall? Well, my trip to the grocery store yesterday without it might suggest that I do, it really was like a fever dream. I was like, I'm gonna die here. Like, I don't even, I don't even know how to get to my car. But it's like I, I survived that period of time. But I look back at some of my most difficult, especially motherhood moments, and I think if I had had some medication, totally. I don't think I would've felt like that all the time. Absolutely. Absolutely. And I think that like the anxiety monster wouldn't be so big if, right. We knew this 20 years ago. You know what I mean? And if, you know, if I knew this when I was in school, then, you know, I, I just, sometimes I just shudder to think the way that my life would've been different if I know me too, if I got diagnosed at age eight like my kid is right now. You know what I mean? Right. So yes. So I do, my child's diagnosis was one of those stop time mountaintop experiences for me, because I felt like 12-year-old me Right. Was being spoken to with the wisdom and tenderness of someone who said, do you recognize yourself in this prototype? I recognize you. I see you. Yeah. There's like, oh God. It was, it was profound. That moment for me. It was the gift that I didn't get as a child that I needed. You know? Totally. I mean, when I, I, I never. Like really even considered this until my kid was in, um, kindergarten and they went in and the teacher was just like, she doesn't pay attention. She can't sit still. All these things. And I was like, oh. And I just had this weird like, um, this weird like deja vu moment where it was like, oh, I've heard all this before. And I walked home and I got out all of my like, school stuff that my parents had given me, you know, when they moved. Um, and I was reading through all of my old, like, report cards and it was like, won't stop talking. You know what I mean? Like, can't pay attention, careless mistakes. I had a third grade teacher that hated me. Mm-hmm. And she wrote a, an entire paragraph about how I could not, like, not make careless mistakes. She said the word careless mistakes like 17 times in this paragraph. And I was like, why did nobody notice this? Like, this is not normal. Right. Don't get me started on why did nobody notice this? Because also it's like, how did I make it 45 years with no, no doctor, no therapist. I mean, I know, I think I talk about this every episode, so I'll be quiet, but like my, do you know what my first report card said? My mom and I laugh about this endlessly, and you'll laugh too. Having known me now, Stephanie is a very quiet child and does not appear to enjoy working in a group. You're like, if you only knew, if you don't knew what my little brain was doing. I know, and I think I was just like. Just paralyzed by reality because everything happening in my brain was so distracting and disorienting. And I was trying to mask the fact that like, I couldn't understand the tangrams and I didn't actually know how to do the organ trail computer program. Okay. I was always gonna die of dysentery. I didn't understand the rules. That is a stressful experience for kids with a DH ADHD like this. I, I can't afford a river. What do you mean for a river? What does that even mean? I know. What does that mean? Oh my god. One, one more busting stigma thing. Taking a stimulant or medicating kids who are hyperactive. Like, what a monstrous thing to do to medicate. What are you trying to sedate them? What do we say when people think that like, uh, like Ritalin or Adderall is, is, is tantamount to giving your kid a sedative to make them calm. So, so I get it right in the nineties when Ritalin came out, like kids were just like, made little zombies by it. I totally get this right. And I under, like, I understand that we're all in our forties now, so we were like teenagers when this came out and all this was happening. So I understand the collective trauma that is leftover from, it's almost like the estrogen witch hunt of when we thought that that was gonna give us cancer. A hundred percent. 100%. And so what I would say now is that the evidence consistently and clearly tells us that kiddos who have a DHD who are uh, medicated, do less drugs. They have less sex. They get pregnant, when they're teenagers way less often, that they have fewer car accidents, that they get better grades, that they die by suicide way less often. That they report, you know, happier, healthier relationships with both their parents and their friends. Like there's just a plethora of, Randomized controlled trial, peer reviewed, research that is telling us that this is helpful for kids. There you have it. And I think also, you know, as, as an adult taking a stimulant, and I am an adult, I'm not a child, but, um, number one, it isn't like getting high and it doesn't make you amped up like you've, well, I never did Coke. Maybe if I had done Coke, I would've realized I had a DHD. I'd be like, this is so chill. What are you guys doing? Like pat's not taken. But I also know, like, have I, am I, am I a like super calm zombie under No, it hasn't. Like, it has not dampened my, my brightness. It hasn't like, it hasn't turned me into a little Stepford soldier. Right. It's like, I think it's like, if you don't actually know what you're talking about, maybe don't talk, don't, don't worry about it. Yeah. You can just, you can have your own thoughts and I understand like I, you know. Nobody wants to medicate a kid if you don't have to. But when we look at the long-term outcomes of, of what the medication can do, it's not really you. I mean, you have a choice, but look at the choice you're making. Does that make sense? Yeah, it does. And I think it's like, I don't really want to take metformin either. Like I would prefer to not have a predisposition for diabetes. Like I would love to not have to take anything, but like, that's wishing, that's like wishing you were born in a different body. Like totally. You didn't get that. Like this is, you didn't get that particular life wish. So are you gonna spend your, the rest of your life being pissed and trying to put yourself into this paradigm that wasn't designed for you? Or are you just gonna say, I'd like to feel better. I'd like the special person's menu, please. Like, sorry, I sound precious, but give me the gluten-free menu. Damnit.'cause I can't eat gluten. Um, always like, can I be a pretty princess and ask for Yeah. Whatever it is, right? Yeah. Special snowflake, like, oh my God. The way it was, the ways in which we degrade ourselves. Also, I don't believe I've ever heard a man. Apologizing like that for being a special snowflake, for requiring a certain modification. A hundred percent. Right. And, and when little boys have, um, medication and they just sort of like march down to the office to take it, you know, in the middle of the school day. But I have several girls on my caseload who are like, I don't want to, the short release, even though it's better for them because they don't wanna have to go to the nurse's office at lunch and take it because they're embarrassed about it. You know what I mean? Right. Absolutely. Yeah. It's so interesting. My daughter was, both of them, especially my youngest, super proud. She tells everyone she has a DHD. She, like, this friend has a, that friend has it. My boyfriend has it. Like, she's so proud. I love that. I mean, and this is, this is the new generation, right? And she should be proud. Mm-hmm. Mm-hmm. I mean, like a DHD has a lot of challenges that come along with it, but it also, I, I think it makes our brains beautiful. I really do. I think that it, like I said, we're creative and, and we're compassionate and like the interpersonal relations really shine through because we've had to rely on that Right. Our lives because we can't remember the fucking cleats. Yes, exactly. So we have to be like, oh, sorry. Mm-hmm. But you know what, the thing about medication is that if you try a medication and it makes you a zombie, then that's not the medication for you. Right. There are tons of options and there are different sort of like branches of options for a DHD medication. And so if one of those branches even isn't for you, that's okay. You don't have to go, you don't have to keep like taking other, like, leafs off that branch. You can try something completely different. Right. And um, that's what I was kind of, that kind of goes back to what I was saying is that. You have to have a practitioner who cares and listens, um, because you might go through 17 medications before you find the right one. Right, right. And you need somebody who's not gonna be like, oh my God. And like, treat you like you are a burden. You need somebody who's gonna be like, okay, that one didn't work. Strike, let's try something else. Right, right. And, and, and, and also, medication has been life changing for me. It's not the only reason to get a diagnosis. I, the fact that I know that I hate checking the mail and that it's going to be a thing for me means I have put different systems in place to ensure that my mail doesn't sit in the mailbox for three weeks. Right. Knowing the way that I operate means that I know how to structure my day to set myself up for success. It means I know when to outsource things to someone who's going to do a better job with, with something that I can't do well, yeah, girl. I am not a plumber, you know? Um, and I do not paint well clearly. Um, and so like, yeah, let's find somebody who likes doing those things and like, feels, you know, like good about when they do that. And I will pay that person to do those things because I do not wanna do them, you know? Right. Absolutely. You know what, and I think, um, uh, something that you just said reminded me, right now I'm doing, um, I'm a natural medicine and training facilitator. Yay. Oh, when you, when you're done with that, you need to come back and talk about that. Totally. Well, and specifically in Colorado, it's psilocybin for right now. Yes. It ketamine and fingers crossed that MDMA sometime becomes also right. Mm-hmm. Um, for therapeutic purposes. Um, and so it's all these other different sort of options. Um, oh, I cannot wait to talk to you about that.. Yeah, totally. And there's a, there's a huge and growing support, uh, again, empirical support for, for this, for women who have a DHD. I'm sorry, there's not a huge one right now, but there, that's it. It exists. So it's huger than we're used to, which is nothing. That's right. There's like a study, I'm sure out there somewhere about it, but there's, there's a lot of support that microdosing is helpful. Period. And so, um, let's see, let's see if, if we can find some support right. That it is helpful for women of a DH adhd. That's what I hear from women who microdose. Mm-hmm. Um, is that it can be really gone rounding and combing and like, yes, ing. Absolutely. And so, um, yes, with the emotional regulation piece, Totally. Yes. And so, so there are other options is what I'm trying to say. Right? Yeah. If the stimulants don't work for you, if the, like other classes of medication don't work for you, then like maybe natural medicine will, who knows? Right. Well, so for a parting thought there are no great fixes, but what would you say to a neurodivergent, perimenopausal woman right now? I, I would say, um, buckle up. Yeah. To be just like godspeed, like what is there totally buckle? Yes. And I would say, I think I would say a few things. I think I would say first of all, like this period of time is, is not forever. And studies show that women in post menopause are the happiest that they ever are. Oh my God. Aside from ages, like zero to 10, like we are happiest then if we have like a safe and secure childhood. That's it. But then like women over the age of 60 typically are happier than any other time period in their life. And so like, we're getting there. That is a beautiful thing. I have heard a lot of people say, you know, Hey, hang tight. Totally. Once I hit menopause, things got better. So a hundred percent. Mm-hmm. And women are, are, they're happy and they, they have the life that they, that they want. Right? And so like mm-hmm. So just hang on. Right. I would also say, um, get to know your own body, um, which sounds way sexier. That I mean it, right. I you thinking Kathy Bates and, uh, with the mirror and fried green tomatoes, but I, I mean internally, right? And so, yeah. So if, if you're having an off day, it's okay to have an off day. And it's okay to say like, I'm gonna work from home today because, you know, I'm having a hot flash every 15 minutes and this is really uncomfortable for me. Um, and also don't be afraid to find a practitioner that's a good listener and that is, is caring. Um, and. If you go in and see your, your practitioner and you say, I'm in perimenopause, and they're like, eh, then that's maybe not the right one for you. Right? So like, right. Keep looking until you find somebody that's gonna listen to you. And I would also say that there's a lot of really good things about being in perimenopause and having a DHD and I think that perimenopause heals some old wounds we have as women who, who I agree. And I think that's beautiful. And like I, I'm, I am loud and proud and proud to be a woman with A DHD and also proud to be in perimenopause. So I love that so much. And I love that like, like, hang on, buckle up. But that doesn't mean suffer. That doesn't mean, eh, you're screwed for the next decade. Absolutely not. So, no, that's, yep. You know what, and find community too, because like, we're all here together, like we're all doing this together. And sometimes, like, just like you said earlier, like just being in a room with other women who were like, have you like, holy crap, have you noticed this thing? And you're like, yes. What is that? What? Why do my ears. Itch inside my brain. Mm-hmm. Like, I can't, I can't, I can't find something to make it go away. Like why, why am I being tortured in this very special way? Um, and then having other people be like, yeah, me too. Like, okay, great. Well here we high fives. Yeah. Here we are together. Oh my gosh. Well, this definitely was not the last we've heard from Dr. Rebecca Richie. My forever favorite podcast guest. I love talking to you. You make all of us feel so seen. So next time we'll we'll talk about, natural medicine a little. So let's do it. I'm so excited. Thanks for being here. Together, we're going to make midlife neurodivergence less of a mystery.