← Hacking Your ADHD
Hacking Your ADHD
ADHD, Hormones, and the Female Brain: A Conversation with Kara Cruz
00:41:00
Hey Team! This week I’m talking with Kara Cruz, a licensed marriage and family therapist and Certified Perinatal Mental Health Professional with over 15 years of experience supporting women through life transitions. Kara’s work focuses on the...
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- [00:00]
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- [00:34]
Kara Cruz
2.
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Kara Cruz
3.
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William Curb
I use it.
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Podcast Host
5.
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Kara Cruz
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Podcast Host
Welcome to hacking youg ADHD. I'm your host William Curb, and I. On this podcast, I dig into the tools, tactics and best practices to help you work with your ADHD brain. Hey team. This week I'm talking with Kara Cruz, a licensed marriage and family therapist and certified perinatal mental health professional with over 15 years of experience supporting women through life transitions. Kara's work focuses on the intersection of ADHD and reproductive mental health, helping women navigate the complex terrain of hormones, identity and self trust. In our conversation, Kara and I dig into how ADHD symptoms can change and intensify across different hormonal stages, puberty, pregnancy, postpartum and perimenopause, and then what that means for real life functioning. We also get into how ADHD in women often goes underdiagnosed or misdiagnosed as anxiety or bipolar disorder, and how learning to track your cycle, protect your energy, and build realistic routines can make a world of difference in your ADHD management. And I also want to emphasize here that even if you don't have a cycle, there's still a lot to get out of this episode. When I was working on the top tips for this episode, I had to cut a few because I was like there's just too much good stuff here and not everything can be a top tip. I had a great time talking with Kara and learned a ton. I think you'll love this episode too. If you'd like to follow along on the Show Notes page, you can find that@hackingyouradhd.com 24 9. All right, keep on listening to find out how sometimes managing ADHD isn't about doing more.
- [02:30]
William Curb
All right, well, it's so great to have you here.
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Podcast Host
Can you tell me a little bit about yourself and a little how you.
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William Curb
Got into doing this?
- [02:36]
Kara Cruz
Yeah. My name is Cara Cruz. I'm a licensed marriage and family family therapist in California. Outside of that, my work as a therapist, I'm a mom, I'm a wife. And I also was diagnosed with ADHD at a very late age, later than, you know, the childhood age. However, lots of things pointing in the direction. You know, when I look back at comments on report cards and the things that I used to struggle with, it's very apparent and very obvious. It's almost like textbook out of the dsm, the behaviors and things that I would have. But as I went into my 20s, I loved school, and I also struggled in school at the same time. But that kind of led me into wanting to become a therapist. I loved working with kids. I loved working with people in the educational and, you know, psychology was an interest of mine. And that's kind of what guided me in the direction of where I'm at today. And as I was going through grad school and learning and working with my clients, I just became really interested in the topic of adhd, you know, whenever I could, even if I didn't have clients I was working with. On my caseload with adhd, I just was always interested in knowing about what is it, what causes it, what does it look like, how is it different for girls, for women, and just kind of evolved from there. And when I opened my private practice, I primarily, I moved from working mostly with children to working with adults, mainly with women and working with women. There's a lot of things that go into, you know, their mental health, hormones impact mental health, just life, you know, what we go through in life. And when somebody is a woman and has different things like hormones and life stressors in play and has an ADHD diagnosis or is not sure if they have an ADHD diagnosis, it can really kind of complicate things and make things kind of hard and challenging. And so it just became an area that I really wanted to learn about work in. And now I train, I host training for therapists on the topic. I work with parents and caregivers on how to kind of work with their kids who might be going through something like this. And yeah, that's kind of how I'm here and why I'm here.
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William Curb
It's so important that we start getting the information out there that there are differences in how not only how ADHD presents with between men and women, but also how hormones change things and how stages of life change things especially.
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Kara Cruz
Yeah, absolutely. You know what? One person who maybe, you know, is kind of like your neurotypical person, their brain kind of works. And I don't. It's not like a normal abnormal, it's just a difference. But a person's brain who's neurotypical would. Society is kind of set up for them to be more successful versus somebody who's got that neurodivergence difference in their brain. Society doesn't really work as well with those types of people or it's a little bit harder and more challenging. So you know, life stressors and just the way life work, school, how school set up our schedules really don't always promote, you know, success and a settled nervous system for those of us whose brains function differently.
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Podcast Host
Yeah. So I guess maybe we can start.
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William Curb
Here with talking a little bit about how ADHD kind of presents differently in women or how they have to deal with their symptoms in a different way.
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Kara Cruz
Oftentimes when we think of ADHD, we think of the 89 year old little boy in school who can't stay in a seat, who might kind of, you know, talk out of turn, interrupt maybe in line, kind of intrudes on the friend's space, you know, is maybe has trouble with impulse control. You know, maybe they're, you know, being really handsy and maybe in a playful way. But sometimes it's harder for them to kind of control those impulses or pick up on the cues from their peers that like, hey, this is kind of being annoying. This feels annoying, you know, and so it can cause social issues and things like that. With girls, it's not as typical. We don't always see the outward expression and if we do, it can look different. So if we have a, you know, impulsive, hyperactive girl, it might look like bossiness, talking out of turn, interrupting their friends. It might not be as physical, but they might experience a lot of internal anxiety and stress and internal hyperactivity where they have a lot of thoughts at once. They can't focus on one thing at a time because there's a lot kind of going on in their head. Sometimes they can be kind of, you know, physical and out of their seat, but sometimes it can look a little bit different. So they might be that student in class is getting out of their seat and going up to the teacher a lot. So they're out of their seat, but maybe they're not running around the classroom, they're getting out, they're wanting to help the teacher a lot. They're impulsively getting up and going over to a friend who might have a question and kind of intruding in their space. And as you know, a girl grows up, what that could look like is impulsive behaviors, not thinking things through, things like overspending, having trouble with executive functioning, so planning out things like planning out the meals for the week, the grocery list, what needs to happen, in what order, time management. They might overbook or over schedule themselves and not plan things like, you know, transition time, you know, drive time and be rushed with lots going on. A lot of the hyperactive symptoms most of the time can look, you might not see that, but the person feels it. So it could look like anxiety.
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William Curb
That is an interesting thing, too. How? Like, one of the reasons I think a lot of women go misdiagnosed or undiagnosed is they often like, oh, this is anxiety, or this is bipolar, or a host of other things where it's like, oh, this looks like the same thing. But if you don't account for what's actually driving the bus here, it makes it very easy to be like, well, it's just this.
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Kara Cruz
Yeah. And a lot of times, you know, with the anxiety, it's, you know, it might not be they have a lot of worried thoughts, but they have a lot of thoughts at once. But that can be misinterpreted for anxiety. Like, you know, racing thoughts, racing mind, or that can even look, like you said mentioned, bipolar. A lot of times women with adhd, especially if they're, you know, when I say functioning well and not as a judgment, but like, they're able to keep a job, you know, they have friends socially, they get along with people. But they might sometimes, you know, get into a place where they can't keep up with work or paperwork, or they miss deadlines and due dates or miss appointments. But for the most part, they're managing well. But they kind of are kind of in that it can sound like pressured speech. Like, with bipolar disorder, they're talking a lot, interrupting the impulsive spending. Impulsive behaviors can look like a hypomanic or manic state. I used to work in a hospital, and quite often I would see women who were diagnosed as bipolar because they're coming in with those presenting either looks like anxiety or looks like kind of a manic state. But really that's kind of their. Their default Setting, they're like, no, this is how I always function. You know, I always struggle with sleep. Because as soon as they say sleep trouble, people jump to the bipolar diagnosis as well. What's really happening is this is kind of like their, I call it like their default setting. They're kind of always like on high energy, anxious all over the place or talking a lot, interrupting, versus somebody with bipolar disorder, where that's going to come in phases, you know, it's going to. Maybe they're kind of like at a baseline or maybe some a depressed mood and then for four days, three to four days, they're not sleeping well at elevated mood. That kind of looks different than their normal behavior where someone might look at them and say, you seem a little like high energy or stressed or like you've had a lot of co. You know, there's something going on, you know, and with a manic episode, it's going to be a bigger, you know, they're going to see something much bigger. So when I'm working with somebody and trying to determine the difference, I'm really kind of going through their pattern. Is this kind of like how you are steadily, you know, this kind of on state, fast paced, talking a lot, interrupting, impulsive, or does it kind of come and go, you know, two to three times a year? Do you have an episode where this happens? What were you like as a child in school?
- [10:09]
William Curb
School.
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Kara Cruz
Those are kind of the questions I start with to get a sense of the pattern in the life history.
- [10:14]
William Curb
Yeah, that's absolutely. Because I know there's so many people that are like, oh yeah, everybody has this like little bit of adhd, but for really it's ADHD is this chronic state of like, this is how life normally is. It's not I lose my keys sometimes. It's. Unless I have a system in place, they will always be gone.
- [10:28]
Kara Cruz
Yeah, yeah. Learning like early on when I became a driver, losing my keys and like, you know, like going to the mall and setting them down, I was looking at T shirts and like all of a sudden I'm getting ready to get in the car and realize where are my keys? Or, you know, losing them at home. I learned real quick, like you put your keys in the same spot all the time and then that becomes a pattern. So then it doesn't seem like I lose my keys because I have this pattern that in this like, you know, routine that I've taught myself, you know, keeping a calendar, keeping a schedule, being really kind of like almost seemed ocd, like with the calendar and Schedule wasn't an OCD trade. It was like a. This is my safety to keep me kind of on track.
- [11:03]
William Curb
Yeah, absolutely. I know I've developed so many things over the years that I don't even think of as tools to keep me on track, but they're, like, absolutely essential with this. We also have. With this difference in symptoms, which we can. Absolutely. Having interacted with many people with adhd, it's like, yeah, this is. Can both have impulsivity, and it can manifest in many different ways. And even, like, when I'm like, looking at my own impulsivity and realizing, oh, yeah, clicking through 12 tabs, that's me being impulsive while I'm doing one thing. But there's also this lens of hormones that I think is really important that we start exploring, because as I've been hearing more about it, it is a huge issue for this, like, everyday management of adhd.
- [11:45]
Kara Cruz
Yeah, certain hormones for women are. Can be protective in terms of their mental health. You know, like progesterone, you know, is something that can be protective and decrease anxiety. So as a woman gets older or depending on where they're at in their cycle and what's happening with that pregnancy, postpartum, as that can impact, you know, a person, you know, where they have heightened anxiety, their distress tolerance drops, and then ADHD traits, characteristics, symptoms, whatever we want to call it, you know, then those are elevated because everything else is kind of, you know, the. The capacity to kind of manage everything is like, going down. You know, if your mood is changing, if you're not feeling well physically, estrogen plays a big part. So different times in a person's cycle or over their lifetime, depending on where they're at in phases of life, whether it be, you know, puberty, pregnancy, postpartum, perimenopause, menopause, you know, there's different things happening with hormones during those times, and that can impact mood, executive functioning, anxiety, sleep, just the capacity to. To kind of deal with life and just, you know, when you're kind of in a. I'm feeling good state and like, I've kind of figured out tools to manage the adhd, but when you. You're not feeling as well, you kind of lose the capacity to manage all that. That window, you know, gets smaller, that tolerance window.
- [12:56]
William Curb
Maybe we could kind of go through these changes that are happening. So, like, do we see distinct differences between, like, say the hormones increased in puberty versus pregnancy?
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Kara Cruz
When you're looking at different stages in pregnancy, different hormones are impacted. So if you look at what's happening during which stage and seeing, you know, you know, let's say, for example, we're at a period of time when estrogen is dropping. You might see things like brain fog, forgetfulness, an increase in depression and increasing anxiety, as well as, like, you know, other hormones, you know, progesterone and things like that. When they're decreasing and dropping, we're gonna, we can see an increase in some of those symptoms. And so when that happens, when, when we're more anxious, when we're not feeling well, just to kind of keep it in simpler terms, you know, when we're not feeling well, we're anxious, we're in pain, we're tired and sleep deprived. You know, our executive functioning, you know, our logic and reasoning, all those skills are going to kind of go out the window. We don't have access to, you know, that part of our brain that's intact to protect, you know, logical thinking, rational thinking. We kind of. And sometimes in the therapy world, we say it's kind of like when somebody feels like, when they say, I've, like, flipped my lid kind of thing, like, yeah, you, you've lost, you know, that capacity. So all those ADHD symptoms that the person might have already experiencing are just going to be exacerbated.
- [14:14]
William Curb
I mean, I remember my wife talking about pregnancy brain. That was before she was diagnosed. And so I can't imagine, like doubling up some of these issues that already are quite hard to deal with.
- [14:26]
Kara Cruz
Yeah. So you could see, you know, more dysregulated mood like during puberty for girls at adolescence, even before, you know, maybe in that mid to late elementary age. Of course, when they get into junior high, high school, there's also other things going on in their life that time too, that can impact it. But with pregnancy, during postpartum, you know, that fourth trimester, sleep deprivation. So there's sleep deprivation, then there's a huge shift in hormones after pregnancy and the postpartum stage. And so all of that all at the same time can really impact the person's mood, in particular with depression, anxiety, executive functioning.
- [15:03]
William Curb
So I see there is a value of just knowing that this is coming, but other than things that we can do to like or that women can do to help deal with these, their oncoming cycle and where they, you know, scheduling or other tools they might want.
- [15:16]
Kara Cruz
To use, I mean, there's a lot of different ways and everybody depending on, you know, what they want to do and what they're comfortable with. You know, because there's a, there's medication, you Know, I have clients who have ADHD who take medications, and I have some who have ADHD who choose not to. And most of them, I always just, you know, strongly encourage that they get a consultation and just a consultation because I'm, I'm not pushing it one way or another, but it's more so they know they can ask any questions they have. They know what their options are and they also have it in the back of their mind if they get through a different stage or phase of life and things kind of are harder, that they know what those options would be. So I always encourage that. But you know, medication of course, is one way that it can be addressed and that's through a psychiatrist or doctor. For women, I strongly recommend that they see a reproductive psychiatrist, someone who's a specialist in reproductive mental health. There's not as many of them out there, but they are out there because they're going to be able to know what to recommend, how to recommend based on pregnancy, postpartum, any other underlying issues. If there's ADHD and then, you know, perimenopause, things like that. They'll, they'll be able to kind of speak to, to all the aspects if they're not choosing to do medication or if they are, and that's helping, you know, lifestyle. You know, sometimes it's, and this is a hard one. It's, it's slowing down, doing less, protecting boundaries. That's a lot of what I do in session with clients is sometimes I have people I work with who like to say yes. They struggle with saying no. Sometimes they like to say, yeah, they want to do the extra things and they want to be involved in a lot of things, but it burns them out. And so we really have to look at protecting, affecting their energy. And even if we can just get creative around certain times of the day, the week, you know, being kind of strategic, their cycle, we, you know, I always have my clients track their cycles. Even if they're not having any kind of reproductive health issues or anything like that. We just track it and just see if we notice any themes and patterns. And particularly those with adhd. We tend to see, we tend to see shifts in mood and, you know, how much, you know, capacity they have to like, you know, one week they're really productive, taking on a lot. They're using kind of that hyper focused part of their brain that can feel good, you know, but then another week they're like, I have zero energy to do anything. And instead of looking at it like, well, you're depressed or there's something wrong. Could it just be that this week we need to protect your energy more and we need to think about really protecting your sleep, making sure basic needs are met, getting support when you need to, letting go of certain things, you know, whatever the extra tasks and things aren't going to get, you're not going to get to them this week. So some of it's strategy and it's going to be different from person to person depending on what they experience. But what I always recommend any of my clients is sleep is really important, particularly with hormones and with adhd, somebody with bipolar disorder, those are that sleep is always kind of like the first line of defense is making sure that you're sleeping, it's nighttime, you know, consistent sleep to keep your circadian rhythm restored. We're really watching things like what types of like alcohol substances things because that can impact sleep quality. And we're looking at body movement moving, not burning out, you know, protecting time and boundaries. So a lot of it's strategy and, but it's doable, you know. And so working with the therapist who knows kind of how the ADHD brain works, you can really come up with kind of a customized plan for your life and what looks right for you.
- [18:35]
William Curb
And knowing that you can do something is also I find incredibly helpful. When I'm feeling like burnt out and I'm just like, I don't know what to do and I'm like, okay, you can do something though. That always.
- [18:46]
Kara Cruz
Yeah. I really like to kind of help my clients get in touch with the nervous system in their body. And sometimes the people think that sounds really like weird and woo woo. But really with adhd it's like their bodies tell them a lot. Because a lot of people with ADHD have really, you know, a lot of sensory issues or they pick up when they're starting to feel tired or burnout. It's like they feel it when their battery's drained. They feel it. And so going into kind of the body and what's happening, especially those who kind of overwork, work a lot, they get really hyper focused and then they burn out. We're really paying attention to what are the cues that your body starts to tell you early on so that you can kind of pause and then disengage from that activity, even though it's hard. But we need to protect your energy, your rest, make sure that you're not that hyper focus or that energy isn't used against you and burning you out too.
- [19:32]
William Curb
Yeah. Cause I do find too the energy levels Often are just shifting just because if I'm doing too much one week, you know, the next week I. I'm essentially borrowing extra energy from my future self.
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Kara Cruz
Yeah.
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William Curb
Especially with hyperfocus.
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Kara Cruz
Yeah, well. And it can feel really good when you're doing something you enjoy and you're in it. You're in that zone and then there's just like this threshold that you cross where it's like. Then all of a sudden your brain starts to feel like mush and you're like, when did I eat last? Have I drank water? Have you used the bathroom? You know, you're not taking care of yourself. Have I got it, you know, moved around, walked around a little bit or have I been plugged into the computer or whatever it is you're doing, you know? Yeah.
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William Curb
It was funny. I was hearing someone describe hyperfocus the other day. It's like your body, it feels like hunger and needing to rest and something is happening to all to some other body. And I was thinking in my head, but it's not, it's still happening to you. You're just not noticing it anymore.
- [20:21]
Kara Cruz
Yeah, yeah. And so that being mindful and aware of the body and doing lots of, you know, check ins. I'll have some of my clients who really, they struggle when I say give me a, you know, just take a breath and just check in with your body and tell me what sens sensation you notice in your body. They go to their head. They're like, well, I think that I'm like, no, no, no, like let's check back in. Oh, I noticed that like I'm clenching my jaw. I'm noticing like my chest feels tight. I'm noticing that there's kind of like a, an achy feeling in my head right now. And so getting into that and noticing when it's like at a level 10 and you're like about to shut down and just throw yourself in bed or it's just kind of like whispering to you at a two and a three. And so I work with my clients and really learning when it's getting to that middle range that we can like step back a little bit and take care of ourselves. And then you'll have the energy to come back to what you need to versus burning out. And then you just, you know, you want to doom scroll or just shut down the rest of the night.
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William Curb
Yeah. When you're like. And then you get that to that stage where it's doing the things that would make you feel better are just incredibly hard to do where you're like.
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Kara Cruz
Oh, I need your energy, right?
- [21:21]
William Curb
I have like, my, my back is super tight and I need to stretch it out and I don't, I can't.
- [21:26]
Kara Cruz
Because your body, your brain, everything's just tired, you know?
- [21:32]
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- [22:05]
William Curb
One of the other places I want to hit here too is perimenopause, which I don't know a ton about. So can you speak on that for.
- [22:12]
Podcast Host
A little bit real quick?
- [22:13]
Kara Cruz
Yeah. So perimenopause is basically the leading up to the stage before menopause. If you think about it, in three stages, there's a leading up to menopause, which is perimenopause. Menopause is basically one day. So it's when a woman has gone 12 consecutive months without a menstrual cycle. And this is where they're at in life and that's. That day is considered menopause. So, so the, it's the end of their reproductive stage of life and then anything after that is post menopause. But perimenopause is kind of being talked about. This is like a, it's not new, but more people are talking about it now. It can start as early as 35, although there's information that's being shared out there that if you're 35, 40, you're too young, which is up. Absolutely not true according to the menopause experts. And that's who I'm getting trained and learning from. These are doctors, medical professionals, psychiatrists, therapists who are specifically trained in menopause. So perimenopause can start as early as, you know, 35. So you, some people are starting their families and still having children in 35. So postpartum pregnancy, perimenopause can overlap, essentially. Can you imagine that with ADHD? That sounds like a lot of fun at 35, up into the 40s, the average age for menopause. So that, you know, one day when there's been 12 consecutive months, no menstrual cycle, that is 51 to 52. So menopause, average age is 51 to 52, but a person can be in perimenopause for several years leading up to that.
- [23:35]
William Curb
And so in perimenopause you're having a shift in your hormones and stuff.
- [23:38]
Kara Cruz
Yeah. So what's happening is estrogen's dropping, progesterone's dropping, there's other hormones in play. But basically, you know, every month when a woman ovulates, she releases eggs. You're born with as many eggs as you're going to have your entire life after ovulating for so many years, that egg supply is diminishing and decreasing and eventually will be zero. And that marks the end of the reproductive stage of life, or menopause. And so what's happening is there's rapid shifts and changes in hormones. Hormones are dropping, the egg supply is dropping. We're nearing the end of the reproductive stage of life. So a lot of things are happening hormonally and that can cause physical symptoms like hot flashes, night sweats, joint pain. There's estrogen, estradiol receptors. And in the joints, estrogen is actually an estradiol. They're very protective in terms of like pain relief, anti inflammatory. And so when that hormone starts to drop, women can experience joint pain, frozen shoulder, their cholesterol and blood pressure can be impacted, they can have dental issues, hair thinning, hair falling out, dry skin, just all kinds of physical symptoms. But there's also emotional symptoms, psychological symptoms, so brain fog, irritability, rage, even anxiety, panic attacks. Someone who's never had a panic attack before can. There might not be any stressors happening. And all of a sudden they're experiencing panic attacks, insomnia, There's a whole list of it. I actually have a symptom checklist. If anybody listens to this, if a woman listens to this and wants to hear more and get my symptom checklist, it's a free checklist I give to women and therapists. They can kind of go down the list. And it has lots of resources on who to contact, what to do and where to get support if you're going through this. But that's essentially what's happening during perimenopause. And so it's those years leading up. A lot of times it starts for women with like a change in their menstrual cycle, where they'll still skip it, have it more frequently, more heavier, you know, just be really different and off from what they're used to. So they start to think that there's something maybe medically going on. You know, they start to. And we think the worst things, Right. We think of things like, you know, ovarian cysts or cancer or something else happening. And it really could be the body kind of saying, hey, like we're, we're getting towards the menopause stage of life.
- [25:47]
William Curb
Yeah, well, and I can see too, how would that be such a big impact on ADHD with, I mean, just the symptoms themselves being, you know, brain fog, insomnia, like that would absolutely be horrendous to deal with at the same time as having your normal symptoms. And then I also know that ADHD medication is often highly influenced by hormones.
- [26:07]
Podcast Host
So if your hormones are shifting, then.
- [26:09]
William Curb
Your medication's probably being less effective.
- [26:11]
Kara Cruz
Yes. Which is why it's really important if somebody's, they might have gone through part of their life, prescribed a medication from their PCP or their, anyone, but once they get to the stage perinatal or perimenopause and things are shifting and changing, it could be helpful to seek out a reproductive specialist psychiatrist who specializes reproductive mental health, because they're going to know more about the hormones and how the medications can be influenced and what medications might work better, especially if there's somebody with ADHD or bipolar disorder or something like that.
- [26:43]
William Curb
And then, so we have this transition and then you have this post menopause transition. I imagine that also has another effect on your ADHD as well. So it's this transition after transition where you have to keep recalibrating things.
- [26:56]
Kara Cruz
Yeah. And I just want to also point out there is a study done that, that showed that people with ADHD are two to three times more likely to experience mental health symptoms during puberty, pregnancy, postpartum, perimenopause, those stages of life. So if you have adhd, it's, you have a higher likelihood that you're going to experience these mental health symptoms during any of those hormonal stages of life. Which sounds obvious. Like when you say it you think, of course. But you know, I just like to share that as well because that's pretty significant.
- [27:24]
William Curb
It was funny with all the things that are like, oh, this is. Seems obvious with adhd. But then we just forget that ADHD does affect everything in our lives.
- [27:32]
Kara Cruz
I know for many men too, but many women aren't diagnosed until later in life and often it's either when their child is diagnosed and they're taking the family history of the child and then sometimes you'll get a doctor and they're just like, well, what about you? And that's what I've had friends that I know that, you know, colleagues and friends that are, you know, closer to me that had shared that, that, that that's how they got diagnosed. Because their child was in the middle of it and the doctor just kind of like did some extra, you know, asked some extra questions to the parent. And also during perimenopause, like 40s, 50s, that. That's more common as well. If they didn't get diagnosed when they're like, if their kids did or during that time, if it wasn't caught, then oftentimes it can be, you know, in their 30s and 40s.
- [28:08]
William Curb
Yeah. Because I have. Well, then I see, yeah. If ADHD is suddenly becoming this roadblock in life that, that was before manageable, at least. Probably not fun, but at least manageable to get through things. But then you have this shift in everything that it's like, oh, yeah, we need to look into something.
- [28:27]
Kara Cruz
And I think if there's other things going on too, if the person, you know, has a, you know, traumatic history or if they've kind of learned to self medicate through substances or alcohol things to kind of shut down their brain, sometimes, like, we kind of lose that. That's what. It's kind of like what's. Like what's the underlying thing happening? We start to focus on what are the behaviors. That's the problem. Whether it be, you know, substance use or the trauma responses or anxiety, we're focused over here when really like the underlying. That kind of, kind of started everything was that ADHD diagnosis. And not to say it's a, it's something wrong with the person, but again, our society is really tailored to a different type of brain. Yeah.
- [29:04]
William Curb
And I know like, for a long time I treated some of my ADHD symptoms purely through anxiety. So I was never late to anything. But it was highly stressful to me to like make sure that I was on time. And it's something I'm still working on because it's not exactly the best way to go about trying to be on time because then it leads to other things going on where I'm like, oh, I am not just stressed. I'm like angry at people for like being late and like, okay, this is not the way to do this.
- [29:32]
Kara Cruz
Yeah, the window of tolerance, the capacity. They're frustrated, yelling at partners or kids because it's just like, it's hard to manage that.
- [29:39]
William Curb
All I remember specifically, like trying to drive my daughter to preschool and I was like speeding and then it just like hit me and I'm like, I am speeding to get her to preschool on time. This is not the way I want to live.
- [29:50]
Kara Cruz
Right. Or just that rush, like rushing kids in the morning and then feeling like you're kind of like on, you know, anxiety's on. You're like kind of fight or flight yelling. And it's like, what's more. Yeah. Is it more important how like our nervous system is going into our day or that tardy. And you know, sometimes it's like the tardy can happen because like, you know, we're going to remember like that interaction with our parents, you know, forever. But it's, it's hard when you're in it. It's hard to kind of talk yourself down from that and settle when you're feeling honest. Especially if you had a history of. Most people with ADHD have some kind of history with getting in trouble for being late or getting in trouble at work or, you know, it is a pattern and they see it as a pattern. It's like a default. There's something wrong with you. But it's really just like people are just trying the best they can to kind of hold it all together and to do all the things in the morning. And, you know, so much goes into, you know, just getting ready throughout the day and getting the kids ready and getting things packed. Like all that executive functioning when you're tired. It's. It's really hard.
- [30:47]
William Curb
Yeah. And it's, it takes a lot more than just like, it was very helpful to have my realization like, oh, this is not how I want to live. But then I'm like, okay, then I need to put in things to practice to make sure that I'm not going to go back to that pattern when it's less when I'm late again.
- [31:05]
Kara Cruz
Yeah. And sometimes it's kind of a, the choice that people will make is I'm not gonna over commit myself. I'm gonna say no. I'm gonna maybe make some people upset by having different boundaries, by not staying at like the get togethers as long, by prioritizing my sleep. Because that means that something else, we have to take other things off our plate. It might, might mean you have a different type of job, you know, because the traditional, you know, corporate world, it's like, go, go, go. And there's so many demands. It doesn't work for everybody, you know. And so you see a lot of business owners, entrepreneurs, people in different types of jobs because it's more manageable.
- [31:40]
William Curb
So I'm just thinking about the ideas of like these life transitions and how we might want to try. Start trying to build that thought process into our head. Like, how do we. Are there ways that we can start thinking about, okay, we are going to. A lot of times with, I know with my ADHD is I try to visualize that I'm going to be doing something forever, which I know is not the way I want to be. This is not the way to actually do things. But in my head, I'm like, oh, I'm going to start this process. I'm going to do this forever. But I think it'd be helpful to also be starting to get into my head that, like, oh, there are going to be times in my life that I'm going to have to start managing my ADHD in a different way and that it's. Whatever I'm doing now isn't forever. And I need to figure to kind of plan for that and be cognizant of that life changes, and I need to be able to try and keep up with that, maybe plan ahead a little forward.
- [32:31]
Kara Cruz
I'm kind of thinking of when things change in terms of, like, work or family or as you age. What are you kind of thinking of?
- [32:42]
William Curb
Yeah, I was thinking kind of as I age, because I know, like, even though I'm not going to go through menopause or any of that, I am going to still have hormonal shifts, and it is going to be something that I deal with. And then I also have my. I mean, also with aging, I have my family, I have, you know, a daughter that will be in the next few years going through puberty, and a wife that will also be dealing with these things. And then my responsibilities and way I react are going to be important as well.
- [33:11]
Kara Cruz
And I think it's really knowing what. What you think you anticipate being most challenging as you get older. Would it be that, you know, slowing down? Would it be taking care of the physical health? Would it be saying no to things, taking things off your plate, you know, getting help, support, you know, with. With maybe extra tasks in your business, you know, so it's really having. I think it can be kind of individualized depending on the person, you know, going forward. I think, like, particularly with women, it is just knowing that this stage of life can come up. And so when it happens, not being caught off guard and having, you know, I see them going like, this other direction, thinking there's something completely different going on, not even considering that it could be hormones, but when you have some awareness that, yeah, my, you know, my forgetfulness might increase As I get older, I might need more sleep. I might not be able to take on as much as I get older. And when you start to kind of get towards that point and knowing that your tolerance and capacity is, like, feeling like it's kind of shrinking, that might be a good time to kind of see if adjustments need to be made. You'll start to feel that I'm not able to kind of keep up with this like I once was. Could this just be, you know, kind of just a natural part of aging, or could I be in a different stage of life that's requiring more, you know, maybe, you know, there's like, the sandwich generation, where you have adults taking care of children and then, like, they're also taking care of their aging parents. And finances, you know, can get more stressful in the 40s and 50s because. Not say, I don't know how old you are, but like, the 40s and 50s. That's when, you know, kids start to get older and require more, you know, different kind of attention. You know, there's more finances. There's different things. So really just anticipating what's coming up and what might be supportive. But when I'm working with my clients, it's really just listening to, like, when something starts to feel off. Could we be approaching something new and how do we plan for it? Not thinking too far ahead, though, because I think if we think too far ahead, then that puts us kind of in an anxious state of anticipation and you don't know what's going to come. Right. You could actually get to that next stage in life and things might feel better.
- [35:09]
William Curb
Yeah, because, yeah, it's interesting with, like, yeah, as my kids get older, I'm like, oh, yeah, they do need different attention. But it's, you know, there's goods and negatives. You know, there's the.
- [35:18]
Podcast Host
The more hormonal outbursts.
- [35:20]
William Curb
But then there's like, oh, yeah, we can. We can play serious board games now. This is great. And different responsibilities and changing and it. And I do like this thought, too, because of when I talk to people about, like, you know, if they have ADHD or not, is to try and think, like, if you are struggling, there's a reason that you're struggling, and it's not because you're a bad person. There's something underneath going on.
- [35:43]
Podcast Host
And so maybe it is adhd, maybe it isn't.
- [35:46]
William Curb
But it's worth trying to get the help to look and the reflection to see what's going on.
- [35:51]
Kara Cruz
More of what I work with my clients on is not the ADHD symptoms, surprisingly. It's the impact that growing up with it had on them. And usually that has to do with beliefs about self. Self esteem, confidence, anxiety, depression. We are. It's like those second. We're dealing with all that and the realization sometimes of ADHD is like a. Well, no wonder. It's almost like a relief. You know, for some, there is a little bit of, like an adjustment or there might be grief, they might have beliefs about it, and there's education that I provide. But for the most part, there's almost a sense of like, well, there's an explanation for why it wasn't just that I wasn't trying hard enough. I was lazy. So we're working on all that stuff, you know, that's all the stuff we have to, like, undo these beliefs about self and unlearn. The person feels like they're, you know, unworthy or bad or a failure or whatever it is. It's like, no, it's. It's not even about the. ADHD is a, you know, like a disorder. It's like, it's a difference. And so how can we plan your life around your difference, Ignore and kind of throw out all of, like, what society says we should and have to do. And, you know, there are some things, obviously we do, you know, most of us need to work and do certain things, but how can we kind of like, sort out what really needs to be happening and what we think others are expecting of us? External pressures versus, like, what we, you know, what's in alignment with our values and how we want to live our life. And so we're doing a lot of that work. We're not sitting there doing, like, executive functioning, planning, and like, let's manage the ADHD symptoms. We're undoing all this other stuff.
- [37:19]
William Curb
Yeah, there's that built up shame and the response to our symptoms, maladaptive coping strategies like anxiety and addictions. Oof. And yet often that is the far more damaging side I see.
- [37:33]
Kara Cruz
Especially when I would work with kids, the one thing that they would always talk about is how they felt like they were bad or they were annoying or nobody likes them. And it wasn't like, oh, I get distracted or I want to, like, you know, run around the room. Like, let's. That's not what they wanted to work on. They would come in and talk about, you know, I'm a bad friend or I'm a bad kid or it's my. All my fault. That's the theme of what we would be addressing in session.
- [38:00]
William Curb
Yeah. And I could definitely see how addressing, like, being inattentive, you could be like, oh, yeah, we're going to help you be a better friend. But it is because oftentimes it's the story we're telling in our head. It's not always reflective of what's actually going on.
- [38:12]
Kara Cruz
And we are, yeah, we're, we're definitely teaching skills and working on impulse control and, you know, doing little cues to ourselves and little, you know, we're working on those things. But really, kind of the deeper work that I try to prioritize is the impact it had on them emotionally and because that's going to kind of determine how they kind of navigate life moving forward. You know, just if anybody, you know, has any other questions or wants to learn more, there's so many different organizations out there. There's a lot of, of resources that offer, you know, free trainings and books and just if you're feeling like this is something you're going through, you're not sure. I think that's usually where I get most of the questions is, well, if I think this might be happening for me, what do I do next? And it really is, you know, finding somebody who can talk with you about the symptoms, do some screening. So whether that be a therapist who specializes in ADHD or a doctor or psychiatrist, getting the diagnosis has been life changing for a lot of the clients that I work with, and knowing what's going on so that they can learn how to kind of navigate their life moving forward.
- [39:12]
William Curb
Awesome. Yeah, I'll keep a link in the show, notes for people for the perimenopause symptoms.
- [39:17]
Kara Cruz
Yeah, checklist.
- [39:17]
William Curb
Yeah, yeah, checklist you mentioned. So I'll make sure I keep that in there because I'm sure there's a lot of people that'll be interested in that.
- [39:23]
Podcast Host
And thank you so much for coming on.
- [39:25]
William Curb
I really appreciate it.
- [39:26]
Kara Cruz
Thanks for having me.
- [39:31]
Podcast Host
Thanks again to Kara for coming on the show, and thank you for sticking with us all the way to the end. Before you go, let's do a quick rundown of today's top tips. One, ADHD symptoms don't exist in a vacuum, and hormones can crank them up or turn them down. And this can be greatly impacted depending on your stage of life or if you have a cycle and then where you are in that cycle. Two, Burnout is often a side effect of saying yes too many times when your brain and body are already maxed out. Protecting your energy starts with noticing when your capacity dips and giving yourself permission to scale back. It's important to create these boundaries so that you are protecting the version of you that you still want to be at the end of the week.
- [40:08]
William Curb
3.
- [40:09]
Podcast Host
A big takeaway from Kara's work is that your body will tell you what's up. Tight shoulders, clenched jaw, fatigue, restlessness are all early warning signs that your system's running on fumes. Building quick body check ins into your day can help you catch burnout at a 3 instead of waiting for it.
- [40:24]
William Curb
To hit a 10.
- [40:25]
Podcast Host
4. Managing ADHD isn't only about planners and meds, it's also about repairing your relationship with yourself and the shame that can build up from ADHD struggles. That means recognizing how years of undiagnosed or misunderstood ADHD may have shaped your self esteem through shame and self blame and learning to separate your symptoms from your self worth. And with that last tip, I just want to remind everyone that yes, you are enough. Alright, that's it. Thanks for listening. I'd love to hear what you thought of this episode. Feel free to connect with me over@hackingyouradhd.com if you'd like links or to read this episode's transcript, you can find those at the show notes page@hackingyouradhd.com 249 and if you'd like even more hacking your ADHD, be sure to sign up for my newsletter any and all distractions, which comes out every other week.
- [41:09]
William Curb
In it, I give out my best.
- [41:10]
Podcast Host
Distractions of the week, either what I'm reading, what I'm playing, what I'm watching.
- [41:14]
William Curb
Or just something I found online.
- [41:15]
Podcast Host
I also try to give out a few bits of actionable advice in each newsletter, although your mileage is going to vary there. If that sounds like something you're interested in, head on over to hackingyouradhd.comnewsletter to sign up. I also wanted to let you know about the Patreon, which you can easily find@hackingyouradhd.com Patreon. It's a pay what you want model, meaning you receive all the same stuff regardless of what you pay. You can pay $0 or $2 or $10 and it's all the same and you get access to the Hackinger ADHD discord. So if either of those things sound like something you're interested in, head on over to hackingyouradhd. And also, don't forget to subscribe to our YouTube channel, which you can find@YouTube.comadhackingyouradhd. and finally, if you'd like another way to support the show, the best way to do so is to tell someone about the show, especially if you think a particular episode would resonate with them. Just click the Share button on your podcast player. And now for your moment of dad. You know, it takes guts to be an organ donor.
- [42:18]
William Curb
It.