The Tamsen Show: ADHD or Perimenopause? The Signs You’ve Been Missing

Host: Tamsen Fadal
Guest: Shauna Pearson, ADHD Coach
Date: September 3, 2025

Episode Overview

In this episode of The Tamsen Show, host Tamsen Fadal sits down with renowned ADHD coach Shauna Pearson to untangle the complicated—and often intertwined—web of perimenopause, menopause, and ADHD in women. With diagnoses rising later in life and symptoms often mistaken for anxiety, depression, or “just getting older,” this conversation offers a roadmap to understanding what’s really going on in women’s brains and lives. The episode dives deep into diagnosis myths, symptom overlap, practical strategies for daily life, and the emotional realities many women face—highlighting what’s different about ADHD in women, especially in midlife.

Key Discussion Points & Insights

Defining and Demystifying ADHD in Women

[03:48-05:56]

• ADHD vs. ADD:

  • ADD is now an outdated term. "ADHD" covers all types, with “ADHD-I” (inattentive) being the most common for women.
    • “You can have zero physical hyperactivity and then be diagnosed with ADHD I, which is pretty common for a lot of women.” – Shauna Pearson [04:08]

• Late Diagnoses:

  • Many women develop workarounds for their undiagnosed ADHD, only to have symptoms worsen or become unmanageable during perimenopause or menopause due to hormonal shifts that affect dopamine.
    • "Perimenopause and menopause are when a lot of women go get diagnosed because their life just falls apart." – Shauna Pearson [08:03]

The Emotional Reality: Misdiagnosis & Misunderstanding

[07:03-08:03; 21:14-24:15]

• Misdiagnosis:
  • 30-50% of Shauna’s female coaching clients had previously been misdiagnosed—with depression or anxiety—resulting in mismedication.
  • “They were told they had depression...most people would just take antidepressants, but then you feel even worse because what you're doing isn't working.” – Shauna Pearson [22:14]
• Assessment Tools:
  • Standard GP self-assessment questionnaires (GAD-7 for anxiety & PHQ-9 for depression) overlap heavily with ADHD symptoms but do not probe the emotional overwhelm unique to ADHD in women.
  • “The ADHD self-assessment that they give you in your doctor's office hits a lot of the productivity, but it doesn’t hit the overwhelm… and that’s ADHD for women.” – Shauna Pearson [23:50]

The Modern Context: Increased Overwhelm

[12:29-13:22]

• Changing World:
  • The high-stimulation, never-off nature of modern life (social media, smartphones) makes self-management much harder for today’s women with ADHD compared to a decade ago.

What ADHD Really Looks Like in Women

[10:15-11:58]

• Not Just Hyperactive Boys:
  • Stereotypes obscure how ADHD shows up in adult women—chronic overwhelm, inability to compartmentalize, and feeling “out of sync.”
  • “We're constantly living in this deluge of everything all at once right now.” – Shauna Pearson [11:26]

Genetics and Family Patterns

[16:00-16:28]

• ADHD is highly genetic.
  • “It’s almost 100% of the time, if you are diagnosed with ADHD, somebody very closely related to you has it.” – Shauna Pearson [16:00]

Strategies, Tools, and Coping Techniques

Simple Daily Practices

[27:06-32:44]

• Physical Action:

  • Shauna advocates for physical actions (writing by hand, especially with the non-dominant hand) to “get out of your head” and break the spiral of overwhelm.
    • “…write it out with your non-dominant hand… you have to focus so intently… while I'm writing this… it's completely registered.” – Shauna Pearson [29:41]

• Three-Item To-Do List with Visual Boundaries:

  • Write down only two or three tasks, then draw a thick box around them—to create a visual, “impenetrable wall” of focus.
    • “If you only had three things, that's my saying. Keep it to three and you're free.” – Shauna Pearson [32:32]

The Power of Physical State Change

[35:42-37:35]

• Changing physical state (move your body, eat a mint then drink cold water, go outside, listen to music) can jolt the overwhelmed brain into a more productive or calmer state.
  • “The best way to get out of your head is to get into your body.” – Shauna Pearson [37:25]

Managing Social Media

[40:09-42:30]

• For many with ADHD, social media = kryptonite; Shauna avoids it entirely to prevent distraction and comparison traps.
  • “For me, it would be like if I were a recovering alcoholic and I went to sit in a bar… Just don't do it.” – Shauna Pearson [40:27]

Relationships and Communication

[42:34-46:39]

• ADHD deeply affects relationships via forgetfulness, impulsivity, overwhelm, and emotional reactivity.
• Communication and mutual understanding are critical.
  • “If your partner doesn’t know you have ADHD, you’re gonna be faulted.” – Shauna Pearson [45:23]
  • Write down and visually box in a single commitment to help keep promises: “Commit to one thing that you said you were gonna do. Write it down. Put a big wall, a big box around it.” – Shauna Pearson [46:27]

Morning Routine & “Mood Scheduling”

[47:23-48:27]

• Leverage high-focus times: tackle one tough task first, then do self-care.

Notable Quotes & Memorable Moments

• On Overlap of ADHD, Anxiety & Depression:
  • “Eight of the nine [depression] questions that women with ADHD would respond, either a one or two or three to.” – Shauna Pearson [23:43]
• On Confidence:
  • "That's what it impacts… you grew up feeling like the square peg trying to fit into a round hole and you never could—and it affects your confidence. It affects everything." – Shauna Pearson [33:37]
• On “Superpower” Rhetoric:
  • “ADHD is not a superpower. It’s not… there are some positives, but let’s not minimize how hard it is.” – Shauna Pearson [50:03]
• On Medication:
  • “ADHD medication… helps you focus. It doesn’t help you focus on the right things though.” – Shauna Pearson [52:28]
• On Misdiagnosis Rates:
  • “30 to 50% of our female clients have also been misdiagnosed with depression and mismedicated.” – Shauna Pearson [14:14; 22:00]
• On Invisible Symptoms:
  • “The female symptoms of ADHD are not noticeable…a woman who’s overwhelmed and is just sitting there like daydreaming—you can’t see it. So our symptoms are invisible.” – Shauna Pearson [53:35]

Timestamps for Key Segments

• [01:18] – Does ADHD impact women’s confidence?
• [03:48] – Definitions: ADHD vs. ADD and why women’s symptoms are missed
• [07:03] – Shauna’s journey to diagnosis & story of misdiagnosis
• [10:15] – Breaking stereotypes: how adult women experience ADHD
• [14:16] – Does career choice matter with ADHD?
• [21:14] – Misdiagnosis: Anxiety & depression tools miss the mark
• [27:06] – Real-world coping tools: physical action, writing exercises
• [32:32] – Three’s the magic number: limiting to-dos to reduce overwhelm
• [35:42] – Physical state changes and body-mind connection
• [40:09] – Social media: friend or foe for ADHD?
• [42:34] – Navigating marriage and partnerships with ADHD
• [47:23] – Morning routines that work for ADHD brains
• [55:47-58:43] – Audience questions: Reset tools, ADHD vs. menopause, follow-through struggles
• [59:47-62:20] – Rapid-fire round: Myths and truths about ADHD

Listener Questions and Rapid Fire Myths

[55:47-62:20]

• Reset tool: Move your body, put on a song, do anything physical. [56:53]
• ADHD vs. Menopause: Both can lower dopamine, treatment and practical tools overlap.
• Following through: Difficulty is typical in ADHD; planning is easy, execution is hard due to overwhelm.
• Rapid-fire Myths:
  • ADHD is not caused by screens.
  • Not everyone “has a little ADHD”; it's lifelong, not just modern life.
  • Planners do work, if you use them.
  • ADHD medication helps, but doesn’t “fix everything.”
  • Hyperfocus does not mean you can't have ADHD.

Final Takeaways

• If you feel chronically overwhelmed, “out of step,” or if standard treatments for anxiety/depression haven’t worked, you may need assessment for ADHD—especially if difficulties increase during perimenopause or menopause.
• Diagnosis for women requires a provider who understands gender differences in symptoms.
• Coping tools include physical movement, limiting to-do’s, and making commitments visible.
• ADHD is not just about forgetfulness; it’s a deeply emotional and often invisible struggle, but effective management and support are absolutely possible.

Resources:

• Shauna’s coaching: adhdcoaching.com
• Shauna Pearson’s book: "Invisible ADHD"
• For personalized care: See a specialist, not just a primary care doctor.
• More from Tamsen Fadal: @thetamsenshow on social media

“You’re not broken and you’re not lazy—you’re most likely underserved, misunderstood, and overdue for support.” – Tamsen Fadal [62:20]