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Navigating Adult ADHD
#167 When Your Body Joins the Chaos - ADHD, Chronic Pain, Headaches & Fibromyalgia
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You are listening to the Navigating Adult ADHD Podcast with your ADHD coach and expert, Xena. Hello, hello, hello, my friend. Welcome back. We're navigating some adult ADHD today and this is an episode that I've actually had requested a few times now, and honestly, I probably should have done it sooner, but here we are, we are talking about pain today. Chronic pain, headaches, migraines and fibromyalgia as well, because I know so many of you are living with this and you've been asking me for this one for a while, so here we are. This one is for you, my friend. Now, if you're not familiar with fibromyalgia, this is a long term condition that involves widespread pain in the body, okay? And that pain happens along with fatigue, so you get very tired. It can also have sleep issues that come along with that and also impact memory and mood and something called fibro fog, which I'm going to talk about a little bit later in the episode. Okay? Now if you are thinking, Xena, I came here for ADHD stuff like, what does this have to do with adhd, my friend, Strap in, because by the end of this episode, I think a lot of things are probably going to make way more sense. And you might also feel a little bit pissed off, to be honest, that nobody connected these dots for you a little bit sooner. So I want to start with something that I think is really important for us to understand because once you get this, it makes heaps and heaps of sense. Okay? So your nervous system is running the whole show. Your nervous system is the body's command, control and communication network. It's kind of like a supercomputer, okay? So your nervous system is responsible for thought, sensation, movement, and automatic functions like breathing, okay? So it consists of the brain, the spinal cord, and all of those like that web of nerves all throughout your body that send high speed signals and messages right throughout your body, okay? So basically your nervous system runs the whole body and that also includes how you experience and process pain. And most of us, we were never taught this, so we've heard a lot of things like just push through, drink more water, get more sleep, sleep. Meanwhile, your nervous system is saying, hey, look, best I can do is a full panic and attention headache, okay? Because in the ADHD brain, our nervous systems work differently, okay? And our nervous systems are more sensitive, they are more reactive. So when pain enters the picture, your brain and body are not handling it in the same way that a neurotypical person would. Your brain and body are not experiencing it in the same way that a neurotypical person would. So here's an analogy that I really like for this. If you were to imagine that your pain system is a smoke detector, and in most people the smoke detector goes off when there's actual smoke, right? A real appropriate response to what is happening. Okay? But for those of us with adhd, that smoke detector is super sensitive. It goes off when somebody burns toast, when your neighbour Frank lights a candle, when you think you smell something. And honestly, it goes off just for shits and giggles sometimes, right? And once it's on, it is not a polite little beep. It is aggressively loud. It can be so loud that it's impossible for you to think and impossible for you to function. Okay, my friend, this is not a weakness. It's not like you're simply being dramatic. This is how our brain, brain and our body is wired to respond to pain. So let me bring a little bit of research in because I'm not just making this up. There is a brand new study that came out this year, 2026, and it came from the University of Tokyo, screened 958 adults who were being treated at a specialist chronic pain center, or they were different centres rather across Japan. And this was people whose pain wasn't responding to the standard typical kind of treatments. So what did they find? They found that around 17% of those patients screened positive for ADHD. So that's already 2.4 times higher than the general population. And among people who reported the highest possible pain levels, or more than one in four of them, it was 28% screened positive for ADHD. Okay, so let that sink in. We're not imagining it. Our bodies are working harder. And feeling more. And feeling more isn't just something that we talk about in the emotional sense. Yes, we feel more deeply, more intensely, more loudly. We feel more when it comes to pain, we feel it more intensely, more deeply, more loudly. Okay, so let's start with headaches because, oh my God, headaches. This is something I personally have struggled with my entire life. So let me paint you a very normal picture of an ADHD day, right? You wake up tired because your brain just didn't want to switch off last night. You forget to eat breakfast. You have a coffee, maybe you have two coffees. Maybe we just don't count how many coffees you have. You push through at work, you're overstimulated, you're stressed, you're definitely sitting really weirdly in your chair. You ignore that first tiny whisper of A headache. And by 2pm it is no longer a whisper. You have a full blown, cripplingly intense, I can't focus. Kind of a headache, that one, you know, feel it behind your eyes that ADHD is a significantly more likely to experience headaches and migraines. And when you understand why, it's kind of like a perfect shitstorm, shall we say? So let's run through why this is number one. There is the sheer exhaustion of living and existing and functioning in a neurotypical world. Right before any of us were diagnosed, we spent years, sometimes decades white, knuckling our way through life, compensating, masking, working twice as hard, trying to keep up. That is chronically stressful. And chronic stress doesn't just live in your brain, it lives right throughout your body. Like often, it very literally lives in your head, in your neck, in your shoulders. Second piece of the puzzle, the anxiety and mood piece. Okay, so anxiety disorders, depression, emotional dysregulation, these are things that often go hand in hand with adhd and they are also independently linked to an increase in headaches. So when you've got all three of those things running in your body, in your system, my friend, you have basically created a headache subscription service that you did not wish to sign up for. Now, number three, and this one kills me, pisses me off is probably a better way to say it. Our medication, yes, the stimulant medication that is supposed to make our life easier. It can cause headaches. That is a side effect that we can experience. All right, the irony, I know, right? This thing that is designed to help our brain work can actually have our body responding in a way that hurts us. Not so great. I know. Number four is the vicious cycle, adhd. So our symptoms make headaches worse, headaches make ADHD worse, which makes you overwhelmed, which makes you more stressed, which makes your nervous system louder, which gives you another headache. And round and round and round we go. Number five is sleep. Because of course, right, sleep is already a whole thing for those of us with adhd, our brain might not switch off. It might wake up in the middle of the night and be wide awake. We might have a delayed circadian rhythm and not be able to go to bed early and struggle to get ourselves into bed. All the things, right, our brains don't exactly do a smooth, graceful wind down into sleep at the end of the day. And what happens with a disrupted sleep is it makes our ADHD symptoms worse. And again, that contributes to headaches. And number six is we've got to Talk about the sensory element here, sensory sensitivity. We are more sensitive to sensory input, so that could be that we're more sensitive to light, to sound, to smell. The fluorescent. Fluorescent lights that maybe don't. Sure what word that is. Bother. I was going for bother, my friend. The fluorescent lights that do not bother your coworker sitting next to you are quietly, like, attacking you. The perfume that somebody sprayed in the lift is still in your nose three hours later, and you just can't get it out. Like, these aren't just little annoyances. They can genuinely trigger headaches and migraines for us. Our brains are wired to experience the world differently. We are wired to experience the world more intensely. And sometimes our head pays a price for that. Now, this is part of the ADHD experience, and, my friend, I think it deserves to be taken seriously because this can be very hard for us to live with, to navigate. We definitely deserve plenty of compassion and support for this. So next we need to talk about fibromyalgia. What the heck, actually, is this? And why is there so much overlap with adhd? So fibromyalgia is a chronic condition involving widespread pain throughout the body, and it's not necessarily in one specific joint or area. It can be right throughout the whole body, or you may have it contained to more of a specific area. It also comes with fatigue, with sleep problems. And here's the one that ADHD is like. We recognize this one immediately. Fibro fog. So that is the thick, slow, cotton wool kind of feeling in your head where thinking is hard and words just, you know, munch themselves together, slip away. You can't find the thing you are literally just holding. Right. Does that sound familiar? Because it should. Okay. Fibro fog and ADHD brain fog, they look almost identical. Difficulty concentrating, forgetfulness, mental slowness, trouble, you know, tackling what you were just doing or finding what you were just doing. This is also why fibromyalgia can get missed or dismissed in people with adhd. Right? These symptoms blend together, so it can be really hard to know what is what. Now I know. So many of you listening have been living with fibromyalgia for years. And for many of you getting that diagnosis and then, you know, later on perhaps getting your ADHD diagnosis, I can imagine that there was a complicated mix of feelings there. I remember living in London at one stage. I moved into a flat with one of my besties. Her name is Loony. Not because she's Loony. I mean, to be fair, she kind of is. I mean, she's friends with me, of course, she's a bit. A bit loony, but her last name is loony. Okay. So I'm living with one of my besties, Loony. And after a couple of months of us living together, I learned that she had, or has, rather, has fibromyalgia. Because she was suffering with these terrible, like, this kind of crippling neck and shoulder pain. I remember it affected her sleep. She would get up and wander around in the middle of the night. She couldn't get comfortable sitting. Like, if we were sitting on the sofa trying to watch a movie, she just couldn't get comfortable sitting or lying. And she would often have her hands and just be rubbing that area. Some days she would literally be in tears over this. Like, I also know that she had some ridiculously strong pain relief, the kind of stuff that made me sick and that still would not take away her pain. It was so hard to watch somebody you love and care about being in that much pain. Oh, now she didn't. She had known about her fibro for a number of years, but at that stage, we were living together probably. What Was this, about 2015? She had no idea that she had ADHD. That had never been mentioned to her. In fact, she got her diagnosis about a year before I did. So it was at least 10 years later until she finally. Not. Sorry, not 10 years later. I'm not doing good math there, am I? I don't know. Let's go with about seven, seven or eight until she got her diagnosis. Right? And like so many of you, nobody ever connected those dots or mentioned, hey, there is a real strong connection between fibromyalgia and adhd or, you know, if you've already got your ADHD diagnosis and you're struggling with a lot of pain throughout your body. Hey, there's also, if you have adhd, a strong likelihood that you might have fibromyalgia. Like, these things often go together. Now, while researching this, I actually found. I found a lot of really interesting things. All right, you guys know I'm a science nerd, right? Like, I love me some research. Some science fires me up. So what I discovered is that both ADHD and fibromyalgia involve changes in two of the same key brain chemicals, okay? Dopamine and norepinephrine. Okay? So these are two massive players for adhd, but they also show up as massive players in fibromyalgia. These are the chemicals that are involved in pain processing, in attention, decision making, emotional regulation. So it's no coincidence that these two Conditions keep turning up together. Some research also showed that found rather that higher levels of impulsivity are present in women with fibromyalgia compared to women without it. Okay, Impulsivity, that's an ADHD trait. So women who have fibromyalgia have high levels of impulsivity, which is one of the key ADHD traits. Okay, so if that's showing up in a chronic pain population. Right. Hello. There is a very deep connection here. Now there's also something I think is really, really important to understand, especially if you are in pain right now as you listen to this. Chronic pain is cognitively expensive, right? When your body is constantly hurting, it demands a lot of mental and emotional bandwidth. It's not just a physical thing. It is mentally and emotionally draining. So if you're trying to write an important email, it's kind of like having somebody sitting next to you at your desk banging a drum up in your face. It's exhausting. So some of the brain fog, the attention issues, the difficulty focusing, it's not necessarily just adhd. That's your brain trying to cope with this relentless loud demand of pain. You are not, it's not that your brain is broken, my friend, okay? Your brain isn't broken. It's just trying to do two full time jobs. It's trying to manage the ADHD and it's trying to manage the pain on a system that's already, let's be honest, a little bit spicy. Okay? Of course you're going to be tired. Of course, that's exhausting. So please, please, please, my friend, be kind to yourself. Give yourself a little bit of space. Here's another stat that stopped me in my tracks. A Norwegian study followed people with ADHD for nine years. It's so funny when I say this because I always picture, and I've had some of you guys, the listeners reach out to me and say, are you following me around with a tiny camera? Because it feels like you are or like you're in my head. That's what I picture when I think of this study, right? A Norwegian study following people with ADHD for nine years. But here's the thing, it's nine years of data. Nine years, okay? 76% of women with ADHD reported chronic pain compared to only 45% of women without ADHD. Three quarters, three quarters of us are dealing with chronic pain. That is not a coincidence. That is a pattern, my friend. A pattern that we need to be talking about. This is something that I think I would really like to see people understanding this as part of adhd. Because if our workplaces, for example, understood this, that this is often a large part of living with adhd, then perhaps this could be something that we talk about when it comes to accommodations. That was the word I was looking for, accommodations in the workplace. So, all right, what can we actually do about it? Because I'm going to be straight with you right here. I am going to be straight. There is no magic fix. I'm not going to give you some 10 step system to eliminate chronic pain. That's not, that's not how it works, my friend. But what I can give you are a few things that can, that, that are grounded in research. You guys know I love me some research, right? But some things that can actually help you to better understand how your brain works and what might actually help. Okay? So number one, know your triggers. This is one of the highest leverage things that you can actually do. And it's very ADHD friendly because it's about noticing patterns. And we're often quite good with pattern recognition rather than, you know, following rigid rul rules. So common headache and migraine triggers might include things like changes in sleep or eating patterns or strong smells or bright lights or, you know, a new, a new system introduced at work or, you know, temperature or humidity changes, medication, side effects, even things like artificial sweeteners impact some of us. I know they impact me, that's for sure. Alcohol, caffeine. So having like a really basic trigger log, even if it's just like a note on your phone, that can help to you to see the patterns. And it's so important that we capture these and write them down because we don't want to ask our ADHD brain to remember them. Okay. We want to work with our brain here. So give yourself an external system. And again, knowing those triggers can help us to better navigate, mitigate, manage the headaches and the pain. Number two, is addressing the anxiety and the depression piece. Now, I am not saying just fix your mental health, it's super easy. No, no, no, no, no. But the research is really clear that anxiety and depression are also, you know, amplified. Sorry. They also amplify chronic pain. Okay. And also they are often linked with adhd. So when we can help to treat the anxiety and, or the depression, whether that's through therapy or medication or coaching or a combination of these things, it's not separate from treating the pain. This is helping to treat the pain. Okay, so CBT in particular, which is cognitive behavioral therapy, which is what I've woven into my coaching, but this has decent evidence here. There is really good evidence around cbt, okay? And how that can help to support pain management. Understanding how your ADHD brain works, having emotional regulation skills, building self compassion, that's just not fluff, all right? That's not just shitty, fluffy stuff. That is actually going to change how you experience your pain at a neurological level. Okay? When we have emotional regulation tools, when we have self compassion, instead of turning the dial up on the intensity of the pain, we are able to turn it down, right? When we have emotional regulation skills, we're able to turn down the intensity on our nervous system and help to calm our body down, which in turn, like, releases the grip on the pain. So super important. Number three, understand what is happening in your brain, my friend. You know, this is something I talk about a lot and it's a huge kind of core component of the Adulting with ADHD program that I have. But just knowing that your brain amplifies pain and here's how and why. Like, once you relate to that, it doesn't make the pain disappear, but it does take away the extra layer of shame, of judgment that we have of what the hell is wrong with me? And that layer itself can be very exhausting, very tiring, very mentally and emotionally draining. So this kind of makes way for creating a softer place to land, a safer place to land, a more compassionate and supportive place to land, which of course makes navigating the pain easier. Number four, move your body if and when you can. Now, I say that knowing full well that when you are in pain and when you are exhausted, that's the last thing you want to hear. Like somebody telling you to exercise. Like, I'd be giving them the double middle finger. Let's be honest. And I hear you. Now, I'm not saying go train for a triathlon. Hell no. Gentle movement, that's all okay? Like whether it's a walk, some stretching, swimming. There is actual evidence behind this. Again, there's the science, the research that supports this, that for both chronic pain as well as anxiety and depression, that doing this can help to turn down the volume on that pain. It can help to support pain management, pain relief, okay? So whatever your body can manage, and on some days, if you can't, that's okay too. But just be mindful that that is something that can support, okay? Now this one, I mean it. Even with every tool, every strategy, every tracker in the world, you cannot always control how your body responds to pain, okay? You're not failing when you can't run at full capacity because Your body isn't cooperating, my friend. And please know that your worth is not dependent on your productivity. Okay, let's detach those things. They are separate. You are worthy regardless of what you do or don't do in a day. Okay? You are good enough as you are, regardless of how much shit you get done. Now, that is true every single day, and I want you to know it. Especially on the days where you are in so much pain, it becomes hard to function. All right, my friend. I'm very passionate about this one. I feel like I could keep going, but let's wrap up because I know you've got stuff to do and your brain has probably already wandered up 3, 4, 5 times during this episode and come back, which is totally fine. Come back as many times as you need. That's what the rewind and replay button is for. So until next time, please go easy on yourself, go easy on your body. And remember, it's not that you don't know what to do. It is that your brain is running on a very different system, a different program, a very sensitive program. And it deserves to be understood, to be supported. It deserves compassion, and not just to be pushed harder. Okay? Huge, huge love to you. I'm sending you out lots of hugs today. All right, I'll speak to you next week, my friend. Hey, friend. If you want some more help navigating and thriving with ADHD and some help applying everything that you're learning here on the podcast, then head over to our website, navigating adultadhd.com com.