How Estrogen and Brain Shame Affect Women with ADHD

How Estrogen and Brain Shame Affect Women with ADHD

Psychotherapist Sari Solden is a pioneer in the field of women with ADHD. Her new workbook with co-author Michelle Frank PsyD, A Radical Guide for Women with ADHD, shows women how to cultivate their strengths and learn to communicate with confidence and clarity. She and Ned talk about how hormones affect a woman’s executive function, why “brain shame” holds women back,  and why it’s never too late to be diagnosed with ADHD.

You can find Sari’s blog at ADHD Radical Guide.

To purchase one of Sari’s books go to SariSolden.com.

Check out all of the #NedTalks on TikTok! @drhallowell

Dr. Hallowell’s new book, ADHD 2.0, comes out January 12th. Pre-order Now!  Click here to pre-order your copy of ADHD 2.0.

Thanks to our sponsor, OmegaBrite Wellness! Dr. H takes OmegaBrite supplements every day and that’s why he invited them to sponsor his podcast. SAVE 20% on your first order at OmegaBriteWellness.com with the promo code: Podcast2020.

Click HERE to learn more about our sponsor, Landmark College, in Putney, Vermont. It’s the college of choice for students who learn differently. Dr. H has an honorary degree from Landmark!

Do you have a question or guest suggestion? Send an email with your thoughts to [email protected]stractionpodcast.com.

Distraction is created by Sounds Great Media. Our producer is Sarah Guertin and our recording engineer/editor is Scott Persson.

Check out this episode!

A transcript of this episode is below.


Dr. Ned Hallowell:
This episode is made possible by our sponsor, OmegaBrite Wellness. I’ve taken their Omega-3 supplements for many years, and so has my wife and that’s why I invited them to sponsor my podcast, I’m proud to have them. You can find all of their products online at omegabritewellness.com, and bright is intentionally misspelled B-R-I-T-E, omegabritewellness.com. This episode is also sponsored by Landmark College, another institution that I have warm personal relationship with in Putney, Vermont. It’s the college of choice for students who learn differently. Learn more at lcdistraction.org.

Dr. Ned Hallowell:
Hello, and welcome to Distraction, I’m your host, Dr. Ned Hallowell. We have a wonderful guest today, one of my oldest friends, oldest in the sense of we’ve known each other a long time, not that she is old. But we go back, we were just talking before we started, to 1993 at a little conference in Ann Arbor, Michigan where she lives, about the ADHD and opening it up to adults because back then people still thought of it as just a condition that children have.

Dr. Ned Hallowell:
And she is a true pioneer. Her name is Sari Solden, S-A-R-I S-O-L-D-E-N. And she’s just this wonderful, brilliant, kind, loving, smart, experienced person. And she really helped bring the whole conversation about ADD/ADHD to a female audience, because as I said, at the beginning, it was pretty much consigned to little boys, hyperactive little boys, and it took a long time to expand it. Well, the expansion happened in large part because of Sari Solden. She’s been a psychotherapist for over 30 years and is the best-selling author of three books, Women With Attention Deficit Disorder, that was the groundbreaking first one. And then, Journeys Through ADDulthood, and the words ADDulthood. And her most recent book, a wonderful book called, A Radical Guide For Women With ADHD, really, really good.

Dr. Ned Hallowell:
So for anyone who wants to understand ADHD and particularly for women or the men who would like to understand them better, get one of Sari’s books or even better get all three of them. She has a private practice in Ann Arbor, Michigan, where she and her team specialize in providing psychotherapy and consultation to women and men with ADHD. So thank you so much my wonderful friend Sari Solden for being here with us on Distraction.

Sari Solden:
No, it’s so exciting to talk to you again, Ned. It’s been a long time, I love talking to you and your audience.

Dr. Ned Hallowell:
Just give us the headlines, what’s special about women and their lives with ADHD?

Sari Solden:
Well, there’s lots of things special about women and women with ADHD. It’s difficult to get diagnosed, first of all, even now as a woman with ADHD, because often, like you said, we don’t meet that stereotype of a hyperactive, troublemaking little boy. And so that causes a lot of difficulty, not just with the diagnosis, but throughout life because your self image, because you didn’t know was sort of conflated with your unique brain wiring. So early on often little girls are the opposite of what you would think, they’re people-pleasing, they’re internalizing their difficulties, they’re often doing well in school, but they’re masked by support they’re often getting at home or structure or being smart. And often their diagnosis is delayed until they hit a wall either when they go to college or when they get married or when they try to do other things that other people at their own ability level can do, and then they’re often diagnosis depressed or anxious. So it takes many years often to untangle these things, and in the meantime, women are left feeling so confused and then with a distorted kind of sense of self about themselves.

Dr. Ned Hallowell:
What age do you see people getting diagnosed, women or girls?

Sari Solden:
Well, if you’re lucky, and you’re a girl and you’re acting out and you’ve come to someone’s attention you can get diagnosed. But often I have people from their early 20s all the way through, my oldest client, I think I diagnosed, actually [inaudible 00:04:49] at 80 and she died in peace at 85 and after knowing what she had struggled with her whole life. So it really runs the whole gamut. It just depends often if they have kids who are getting diagnosed, they find that out, or there’s so much more resources now, but really it runs the gamut. I would say, middle, perimenopause or right around there. A lot of women start to lose any kind of compensations they might’ve developed because of these extra difficulties and they start to seek some help.

Dr. Ned Hallowell:
Yeah, my daughter was one of the lucky ones. She got diagnosed in the third grade and she’s now 31 and is a marketing executive for the National Football League. [crosstalk 00:05:28].

Sari Solden:
Yeah, no, I heard you say that. And yeah, I mean, it’s funny to say lucky, but it is lucky because you can identify it, you get support, you know what’s going on in your own brain, even though you might be having difficulties. But you can imagine things smart and having all these amazing ideas and all these amazing characteristics and you can’t figure out why you can’t manifest it, why you’re so disorganized, overwhelmed, even though maybe you’re successful in other areas so nobody can understand you or believe you.

Dr. Ned Hallowell:
Mm-hmm (affirmative). I recently voyaged into the world of TikTok and it’s amazing, someone told me I should do it a month ago. And so I’ve posted, I think I’ve got about 15 or 16 60 seconds of posts on ADHD in TikTok. And much to my amazement, they’ve so far received about 4 million views. There’s a tremendous appetite for, I think that format the 60 second soundbite. You can say a lot in 60 seconds, but one of the questions that keeps coming up on TikTok is, is there a link between estrogen hormones and ADHD? And you’re the one to ask, so what about that?

Sari Solden:
Well, I’m not the one to ask, but I do know enough about it to know that whenever you’re hitting a particular hormonal challenge in your life, it’s going to affect your estrogen and your ADHD. So particularly around perimenopause, when you start to sort of withdraw from your estrogen, it’s going to also affect the dopamine, and so that’s why people start to have more difficulties. Premenstrually, at puberty, anytime you’re starting to lower the estrogen you’re also affecting the dopamine which is involved with these executive functions and the ADHD. So I’m not [crosstalk 00:07:23].

Dr. Ned Hallowell:
So would it make sense for a woman who is perimenopausal to combine estrogen supplementation with stimulant medication?

Sari Solden:
Well, I would definitely say to try to involve both doctors, your psychopharmacologist and your gynecologist, good luck, but hopefully they could talk. There’s more controversy about hormone replacement therapy these days, so not always a good idea for everybody, but often to increase your, or change your medication, you’d be the expert on that. But to up your dose even before periods, people start maybe needing to increase, at least if you know. The main thing, Ned, I think is, besides fooling around with the medication, which you definitely need to probably tweak around those times, is to know what’s going on, to know that this is happening, to know that you’re not going crazy, you’re not necessarily developing Alzheimer’s, which is what most women previously undiagnosed with ADHD or even with ADHD started to fear because their memories gets so much even more impacted around this time. So the fear takes over, and so you can adjust your life in many ways to make it work better for you. If you know you’re going into a period like this and you know what’s happening.

Dr. Ned Hallowell:
Mm-hmm (affirmative), mm-hmm (affirmative). So talk it over with your gynecologist or someone who understands hormones and with your ADD doctor.

Sari Solden:
Yeah, it’d be nice if everybody understood it and talked to each other, but sometimes you have to push a little bit and try to advocate for yourself, which is always hard for women. And that’s really what I’m about now with women, it’s not just about their ADHD now, I think what’s different in my new book is we’re just talking about a woman now who has brain wiring differences and difficulties, but certainly that’s not the only thing that’s defining her or by which she needs to measure her own worth. And so learning to speak, learning to move a little bit more into the center of your own life, learning to use your voice, learning to have power in the world, and in a relationship. So I guess our emphasis more now is for women not just to see themselves only through this lens, but to see themselves as all women need to, as powerful people in the world learning to live a fulfilling life.

Sari Solden:
And the ADHD is one track, it’s chronic, it’s your brain, it needs support, and medication, strategies, all that. And that’s chronic, but that has to be untangled from you as a woman, as a whole human being who has strengths and gifts and needs to move into a life. And the problem with women is that they don’t do that, they come in all wanting to be fixed, not wanting to wait until their ADHD has gone or until they’re perfectly organized. So I guess what I’ve been identified with, most of my writing, has been these gender role expectations that women, all women are subject to, but women with ADHD have internalize these expectations and idealized them. And so this idea that they carry inside of them about what a woman should be able to do, or why can’t they be like other women, these messages from the media, from growing up, from everything around them that they can’t do well that stays with them and really wounds them and haunts them.

Sari Solden:
And that’s a big part of the work is not just managing their brain, but really digging in much deeper. I guess, I think of it as healing more than curing, I think that’s a better way of thinking about ADHD because restoring a person, so this feeling of wholeness about themselves and viewing themselves much more accurately, not just viewing the difficulties. Or just the strengths, just as a whole person with who are you, your enduring traits, your resilience, your humor, creativity. I know you believe all this too, Ned, but just moving forward in your life and not waiting to get over… Like you say, you just have to be as organized as you need to be to move, but for a purpose to move towards something compelling, not just to get over, not to be perfectly organized.

Dr. Ned Hallowell:
Right, exactly, exactly.

Dr. Ned Hallowell:
Over the past few months, I’ve spoken to my friend, the founder and creator of OmegaBrite Wellness, Dr. Carol Locke, about the benefits of taking OmegaBrite’s Omega-3’s CBD, and other supplements. Here’s a clip from one of those conversations.

Dr. Ned Hallowell:
Could you tell us a little bit about the study, recent study that showed OmegaBrite reduced inflammation and anxiety in medical students?

Dr. Carol Locke:
Yeah, this was a great study, it was done at Ohio State and it was done on medical students, 68 medical students without any medical problems done over 12 weeks. And it was a blinded study, meaning the researchers and the students did not know if they were taking the OmegaBrite or the dummy capsules. And what it found was a 20% reduction in anxiety and a 14% reduction in the inflammatory cytokine IL-6. So that you had a very powerful benefit from the OmegaBrite shown in this study, and that’s something that people could use right now in their life, reducing their anxiety and stress and inflammation.

Dr. Ned Hallowell:
Distraction listeners, you can save 20% on your first order at omegabritewellness.com by using the promo code, podcast 2020. All right, let’s get back to today’s topic. Can you talk a little bit about brain shame and the patterns you’ve identified in the neuro diverse women you work with?

Sari Solden:
Oh, you must have read my essay. I wrote an essay called Brain Shame-

Dr. Ned Hallowell:
Yeah, exactly, exactly.

Sari Solden:
I should have reviewed that.

Dr. Ned Hallowell:
Imagine that, I would actually read something you wrote Sari.

Sari Solden:
Oh my God, I would have reviewed it had I known. Well, I talk about it as similar to body shame, and it’s important now even as we all get older. My mother when she was 85 said, “Oh, I feel so ashamed, I can’t remember something.” So we feel so ashamed about our brains no matter what age we are, and especially women with ADHD, they compare themselves. So it’s [inaudible 00:13:56] if you went to a doctor and they said, “Okay, well this week we’re going to measure success on how much weight you lose this week.” Versus, “Okay, how can you feel well and have wellness and feel good about yourself?” And instead of measuring your worth by becoming a size three, it’s the same thing with brain shame, women compare themselves in very toxic ways to other women who can multitask, and go to the gym, and take care of the kids, and work and take care of the house.

Sari Solden:
So executive function for women is so central to their functioning, they believe still. And it’s amazing, the women I work with in their 20s, you would think would feel differently. But in therapy, when push comes to shove, still this idea that they wouldn’t be able to cook, or clean, or do all these things well enough, or entertain, or do all the birthday cards and niceties of life, all the stuff women still feel is their job even now, and still have no way of communicating and measuring their worth and letting themselves be in one down positions in relationships because of this. Even if their spouses don’t blame them so much, they carry this with them and feel like they’re not equally valuable in a relationship, and that’s part of the big work in therapy [crosstalk 00:15:19].

Dr. Ned Hallowell:
And how do you help them with that, Sari?

Sari Solden:
I mean, I think there’s no substitute, first of all, is a therapist for really seeing your clients, seeing them, knowing them, listening to them. And it takes a long time sometimes depending on how much they devalue themselves. But when you’re working with a counselor or a coach or anybody who can really see you or other group members who have some of the same issues as you do, eventually those women start to internalize themselves or trust you enough to start taking small risks, moving slowly toward the edge of their comfort zone to start having new positive experiences of themselves, starting to do something new, go to a read at a poetry reading. I have one client, she joined the talent show at the latest conference after I encouraged her. Doing something new and getting other people to see you and value you for a larger picture than you’re ADD difficulties.

Sari Solden:
So that’s the hard part getting to a place where somebody through your view of them can start to see themselves in a new way. And once that happens… Instead of just starting out changing, berating yourself, instead of just accepting yourself, we always say in our book, only dogs and furniture need fixing. So getting people over that idea that they have to be fixed. You have to support your brain and get help for it, but for the purpose of you moving into new areas of success and you have to find people who can value you and see you. And sometimes you have to start out in ADD support groups with that and then move into other people who do other things that you do, creative people, adventurous people, other people who are like you, instead of always feeling like you’re different.

Sari Solden:
Women with ADHD, the biggest problem they have is not their ADHD it’s their hiding, and pretending, and moving away from people, and avoiding things and being inauthentic. And so through the book, especially our workbook, we try to help people develop a healthier relationship to their brain and to enter themselves and to understand what they learned about being different, how difficult the messages they got about that. These days to learn to be different, what else do we need in this world except to accept our differences, to celebrate differences, to unite with people who have other differences and to embrace all that. And this is a perfect time in the world for that message.

Dr. Ned Hallowell:
Yeah, yeah, really. And when you say a perfect time, because why?

Sari Solden:
Because of the world where everybody’s moving away from each other and there’s so much anger and hostility and differences. And we have to start to work toward accepting ourselves being a role models for… Sometimes people say, “How can I be a good parent, a good mother to my children when I have these problems?” And I always say, “Well, you can be a role model to your children by teaching that we all can accept ourselves with differences and that we accept other people who are different from us.” So whether it’s the racial differences in the world or the political differences, we’re not going to get anywhere until we all start to model that we can embrace our own differences and welcome other people’s differences and respect each other’s differences.

Dr. Ned Hallowell:
Yeah, no, so true. Where you and I work is in the realm of mental differences and brain differences, the sort of invisible differences, but they’re very real.

Sari Solden:
They’re very real, and neurodiversity is just a part of diversity in general. And that’s why I like to call it neurodiverse now instead of ADHD, which is such a stereotype now, and nobody understands it. But when you just say, “Hey, we’re all different. We’re all similar in a lot of ways, and we’re all different.” Everybody has differences, ADHD or other stuff, and you have to know your particular difference and work on it, but that’s not all of who you are.

Dr. Ned Hallowell:
Mm-hmm (affirmative), mm-hmm (affirmative). I want to tell you about Landmark College in beautiful Putney, Vermont. It is the best college in the world for students who learn differently with ADHD, for other learning differences or autism spectrum disorder. It’s fully accredited, not for profit, offering bachelors and associate degrees, bridge programs, online dual enrollment courses for high school students and summer programs. They use a strength-based model at Landmark, which as you know, is the model that I certainly have developed and subscribed to, to give students the skills and strategies they need to achieve their goals in life and really expand upon what they believe they’re capable of doing. It is just a wonderful, wonderful place, and I can’t say enough good about it. I, myself have an honorary degree from Landmark College of which I am very proud. Landmark College in Putney, Vermont is the college of choice for students who learn differently. To learn more go to lcdistraction.org, that’s lcdistraction.org. Okay, let’s get back to today’s topic. Looking forward, what do you see coming down the road in the world of ADHD?

Sari Solden:
Well, I think this broadening out to neurodiversity is important, also instead of just… I think it’s just become meaningless, it’s become stereotyped, it’s become people don’t take it seriously. And so really advocating for a broadening out of that. But I’m working now with a lot of professional women, neurodiverse professionals. Actually, I’m getting a lot of satisfaction out of… I did a long course on changing the conversation from pathology to humanism so that I’m trying to teach people across domains, whether they’re therapists, they’re doctors, they’re organizers, they’re coaches, podcasters, support group leaders like to look at people over a pathology or viewing someone as who they are self over symptoms. And we had a movement from character to the medicalization for awhile, but now we have to go back to humanism.

Sari Solden:
And I think, if we understand that you don’t treat people with ADHD as just a different breed of person. A lot of people just see ADHD people in therapy as, “Okay, that’s an academic problem. Or, “Get them over, get them accountable, whatever they want to say.” Versus saying, “Okay, here’s a human being and they have these particular difficulties, and this is who they are as a person. And this is their whole life.” So that’s part of what I’m trying to do is I change the conversation around people who have neurodiverse brains from something that they just have to get over, work on tips, tools, strategies versus, “Hey, this is who you are as a human being, work on this but you need to figure out…” You have a right and feel entitled, for women to feel entitled, to move to a more fulfilling life and fulfilling relationships because a lot of times women don’t feel like they’re entitled to that if they still have clutter.

Dr. Ned Hallowell:
Mm-hmm (affirmative), mm-hmm (affirmative).

Sari Solden:
[crosstalk 00:00:22:38].

Dr. Ned Hallowell:
I tell people I don’t treat disabilities, I help people unwrap their gifts.

Sari Solden:
Exactly.

Dr. Ned Hallowell:
Often it begins by convincing them that they have gifts to unwrap, the shame is so great that they-

Sari Solden:
Their shame was so great.

Dr. Ned Hallowell:
… yeah.

Sari Solden:
And yeah, and so the shame becomes my desk is messy, to I’m a mess, to I’m bad. I mean, the shame is very deeply in there. And so if you see their gifts then they’re able to believe that eventually, but no one is usually seeing their gifts. So sometimes what we do as clinicians with people like that is just see them, and I mean that’s a big gift in itself, so that helps. That helps.

Dr. Ned Hallowell:
Yeah, absolutely it is. Absolutely, it is. Well, I could talk to you for a long time but our podcasts have an audience that can’t pay attention all that long. So we should wrap up-

Sari Solden:
Correct, exactly.

Dr. Ned Hallowell:
To learn more about Sari or to purchase one of her books, go to Sari, S-A-R-I, Solden, S-O-L-D-E-N, sarisolden.com. And you can find her blog at adhdradicalguide.com.

Sari Solden:
Thank you.

Dr. Ned Hallowell:
It’s so nice to have you and go out and buy her books. The most recent one is The Radical Guide, and then the first one was Women With Attention Deficit Disorder, that was really such a groundbreaker. You can find Distraction-

Sari Solden:
Yeah, and you can find [crosstalk 00:24:07]… I just want to say that these groups I’m talking about, these mentoring professional groups for professionals who have ADHD, that’s on my website too, that I’m really excited about.

Dr. Ned Hallowell:
Oh, good. So they can find groups-

Sari Solden:
For professionals.

Dr. Ned Hallowell:
… mentoring professionals. Wonderful. Oh, that’s wonderful. And that’s at sarisolden.com?

Sari Solden:
Yeah, uh-huh (affirmative).

Dr. Ned Hallowell:
That’s a great thing.

Sari Solden:
Yeah, it’s exciting.

Dr. Ned Hallowell:
So for anybody professional, who wants to-

Sari Solden:
Who are neurodiverse, neurodiverse professionals who work in the field, I’m really excited about that.

Dr. Ned Hallowell:
Yeah, well see, I think we’re all neurodiverse so you could invite everybody.

Sari Solden:
You’re all welcome to come along, Ned. Stop by.

Dr. Ned Hallowell:
I’d love to join.

Sari Solden:
All right, go ahead and I’ll be quiet.

Dr. Ned Hallowell:
No, no, you can interrupt, this is the boring part. I read the close to the show but I have to do it.

Sari Solden:
Thank you for inviting me, okay.

Dr. Ned Hallowell:
Well, no, no, no, I’ll stay on and I’ll say goodbye. You can find Distraction on all the social channels and you can find me on TikTok. My username is @Dr.Hallowell. I’ve uploaded a bunch of ADHD related videos, 60 seconds a piece, and I’d really love to hear what you think. Send me a DM or email, [email protected], that’s [email protected] Distraction is created by Sounds Great Media. Our producer is the extraordinarily talented Sarah Guertin and our audio engineer and editor is the equally extraordinarily talented Scott Person. I’m Dr. Ned Hallowell, and thank you so much for joining me and my wonderful special guest Sari Solden.

Dr. Ned Hallowell:
The episode you just heard was made possible by my good friends at OmegaBrite Wellness. I take their supplements every day, and that’s why I invited them to sponsor my podcast. Shop online at OmegaBrite, and that’s B-R-I-T-E wellness.com.

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