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- [00:00]
Wix Advertiser
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- [00:28]
Bill.com Advertiser
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- [01:30]
Jess Hagan
My job, lost my housing, lost that partner. Like everything, it was just rock bottom. And at that point it was really a I will die because this is not living. Like I cannot keep doing this or I have to figure something else out. And that's when I discovered that PMTD existed.
- [01:55]
Katie Weber
Hello and welcome to the Women and ADHD Podcast. I'm your host, Katie Weber. I was diagnosed with ADHD at the age of 45 and it completely turned my world upside down. I've been looking back at so much of my life, school, jobs, my relationships, all of it with this new lens and it has been nothing short of overwhelming. I quickly discovered I was not the only woman to have this experience and now I interview other women who, like me, discovered in adulthood they have ADHD and are finally feeling like they understand who they are and how to best lean into their strengths, both professionally and personally.
- [02:35]
Podcast Producer/Assistant
Hello.
- [02:37]
Katie Weber
It's so good to be back.
- [02:38]
Thank you for joining me.
- [02:39]
Podcast Producer/Assistant
And before we begin, I'd love to.
- [02:41]
Katie Weber
Share with you this review from a.
- [02:43]
Podcast Producer/Assistant
Listener named Wheeze Girl on the Apple Podcast Platform it's entitled what an amazingly helpful podcast. Just dropping in quickly to send Katie and all her guests a big thank you for this vital podcast. After a random encounter with a Geena Davis interview clip, I realized I might have been dealing with ADHD my whole life. A few months later, I've been tested and diagnosed and have been looking for resources wherever I can find them to help me figure myself out. I've been working through the backlog of these podcasts and I get more out of them with each listening. Thank you again. Oh, and you know that question that's always asked at the end about what guests think would be a good new name to replace adhd? Well, I just thought of one. Hyperactivity and Attention Regulation Disorder, or HARD as an acronym, because living with this can be hard. I could not agree more.
- [03:30]
Katie Weber
Wheeze girl.
- [03:31]
Podcast Producer/Assistant
Great acronym, and thank you for taking the time to write that review. I'm so glad these interviews have been a helpful resource to you, and I love that we have amassed such a large back catalog at this point.
- [03:42]
Katie Weber
And I love each and every one.
- [03:43]
Podcast Producer/Assistant
Of the guests that I've had on this show from so many different countries and so many different walks of life, from experts in the field to newly diagnosed guests just trying to figure themselves out. Because that's who I was when this podcast started.
- [03:57]
Katie Weber
And I am so grateful for all.
- [03:59]
Podcast Producer/Assistant
Of you who have come along for this ride. And if you're a relatively new listener of this podcast and you've found these interviews to be helpful, the best way to pay it forward is to leave a review so that other women like you can find this podcast and these conversations and know that they're not alone and they're not simply lazy or depressed or broken. But they have adhd. You can head to Apple Podcasts or Audible, and you can now leave feedback on individual episodes on Spotify. And if that feels like too much right now, you could also just quickly hit those five stars. In fact, why don't you just pause right now? Go do it. I promise we'll all wait for you. Okay. Can you believe it? Here we are at episode 188 in which I interview Jess Hagan. Jess is a nutritional therapist and a board certified integrative menstrual health educator and coach. She is the founder of her Mood Mentor, a virtual premenstrual clinic. Her own experience of living with misdiagnosed and undiagnosed premenstrual Dysphoric Disorder, or PMDD and ADHD has fueled her determination to help others reclaim their lives from hormonal mood symptoms. A PMDD is a severe form of premenstrual syndrome that can come with significant emotional and physical symptoms that typically occur during the luteal phase. Now, anywhere from 3 to 8% of menstruating adults have PMDD, but roughly 46% of women with ADHD also experience PMDD. Jess and I talk about her personal diagnosis journey, starting with a diagnosis of bipolar disorder at the age of 17. She shares about her later diagnoses of PMDD and ADHD and how medical research has been slowly connecting the dots when it comes to how our hormones and menstrual cycles affect our adhd.
- [05:40]
Katie Weber
We also get all fired up over.
- [05:42]
Podcast Producer/Assistant
The lack of education on a lot of these topics that relate to women with adhd, as well as the challenges we face navigating the medical system in general with adhd. Finally, just discusses some of the amazing holistic treatment options available for anyone who struggles with hormonal mood symptoms. Also, all of the studies that Jess talks about throughout this interview are linked in the episode show notes, so make sure to check those out.
- [06:05]
Katie Weber
And I did want to give a.
- [06:06]
Podcast Producer/Assistant
Trigger warning because throughout the episode, Jess mentions her experiences with suicidal thoughts during pmdd. So if that is a subject that is a difficult one for you, you might want to sit this episode out. All right, without further ado, here is my interview with Jess.
- [06:21]
Katie Weber
Hi, Jess. Thank you for joining me finally. I'm so glad we could make this happen.
- [06:27]
Podcast Producer/Assistant
So welcome.
- [06:28]
Jess Hagan
Thank you, Katie. I'm so excited to be here.
- [06:30]
Katie Weber
All right, well, let's get started. I feel like you have a very long journey with a sousa of diagnoses, as I also did have over the years. So where should we start? Let's start with your ADHD diagnosis. How long ago were you diagnosed?
- [06:47]
Jess Hagan
Just recently. Just last year. I could have been diagnosed much earlier, but there was a lot of just. I don't think it was denial. I just didn't have the awareness. Same kind of thing. When we get into the pmdd, it just. It takes me a long time to become aware of things that are very obvious, it seems.
- [07:05]
Katie Weber
Well, I. I feel like it's sort of similar to some of the stuff that we talk about around hormones and, and even, like me now going in, you know, in perimenopause. I've been in perimenopause. I'm about to turn 50 this year, so I'm, like, looking. Doing a lot of research on menopause and hormones and all of that. And, you know, there's always that feeling of like, why is nobody talking about this? And like, people are talking about this. There's a lot of people talking about this. It's just that I wasn't. Nothing clicked for me until I needed that information. And I feel like that sort of happens with ADHD too, where it's like, it's there, people are talking about it, but it's like we each need our own moment where it really just like the light bulb goes off where you're like, oh, this explains everything. So what were some of those things where you started seeing traits or facts about adhd where you were like, oh yeah, this explains a lot.
- [07:55]
Jess Hagan
Well, moving into the work that I've been doing and working with a lot of other clients and students with adhd, it started to become pretty obvious to me, right? Because I think I just kind of had that old adage of like, well, I'm not really hyperactive, so I can't have adhd. It's just a lack of education around how these symptoms present in the female population. And as I started learning more about it, I started learning more about the overlap between PMDD and ADHD or hormonal mood symptoms, worsening emotional symptoms premenstrually. And it just all kind of started to become clear through the work that I was doing with people and then through additional research. And then I just recently taught a workshop on ADHD and female hormones where I had to do, you know, it was like a three month research project. And through that I was just so mind blown to really get into the data and get into the history and be able to see. Wow, I had no idea. So of course I didn't realize how much this was affecting me or the ways that it was affecting me because I just didn't understand the differences in male and female presentation. Something that came up with some of my clients was really the difficulty in goal setting and kind of figuring out how to get from point A to point B and really having to break that down into actionable steps and really like, really dig into the basics of that. And as I saw them grappling with that, I kind of could look back and realize, wow, I had to go through that same process. And it is, it's just things that seem like they should be easy are so much more challenging. Many things like that also just like the level of inability to respond versus react, like emotionally. I think that's something the more I was learning about adhd, the emotional symptoms, the inability for our brains to really kind of navigate emotion, that's something that I, I so often just aligned with a mood disorder. Like it's just the mood disorder, right? But the more I learned about adhd, the more I learned, wow. No, actually this is a part of adhd, especially in females. So much so that in the year in Europe, they part of their diagnostic criteria includes that an emotional aspect that hasn't been added into our diagnostic process. And that was just when I learned about that too. I was just floored to connect those types of things. And there's, I mean, so many of them. But it just kept piling on and piling on, which is not surprising because the research with PMDD and ADHD, there was a 2020 study and it was a small study, there were like 200 plus people in it, but 45.5% of the females in that study showed that they had a much higher proclivity to severe premenstrual symptoms, postpartum depression, like mood disorder style of symptoms around their hormones when they also had adhd. So when you start to kind of get into it, it's hard to separate. Now, now I'm kind of like, is this, you know, not to put everything in a box, but you're trying to look back at your life and you're trying to kind of understand how things played out and trying to see the patterns and it's, it's kind of hard to tell the difference in some of these symptoms.
- [11:27]
Katie Weber
It really is. And I, I feel like I've been talking about this non stop for almost four years now. And I'm like, no closer to the truth. I just feel like there's more red string on my wall, all the different things that connect and especially talking about like trauma and our nervous systems and hormones and autoimmune, like, it's just, just, it's so frustrating how little it's been studied and how many question marks there are. And I just, yeah, there's just so many more like rocks to look under be like, oh, okay, now this is all connecting. And yeah, like you said, there's nothing about emotions. I mean, ADHD in the DSM is considered a neurodevelopmental disorder of childhood. Like, that's how the vast majority of clinicians are thinking about and treating and diagnosing adhd. And it's like, I can't, like, I have asked hundreds of women at this point, what was it that you related to about adhd? And it's always comes down to like the emotional stuff, right? Like, very few people are like, wow, I was just really hyperactive and couldn't sit still. Like, yeah, there was a part of it, but it's really about the, like that deep, deep hurt and depression that comes from that feeling of like, what's wrong with me? Why am I this way? The huge question mark that we are to ourselves. And I think it's all like summed up in our menstrual cycle. And how many of us are like, why is the world ending? Oh. And then the next day you're like, oh, I got my period. That's why. Right. Like that feeling of just of moving through the world without a compass and having things just kind of hit you and you're just playing whack a mole all the time. I feel like our menstrual cycle is like the metaphor for everything in terms of people with ADHD tend to walk through life. So let's backtrack a little bit. So you were first diagnosed with bipolar, is that correct?
- [13:28]
Jess Hagan
Yep, when I was 17.
- [13:30]
Katie Weber
At 17. Okay, so what was going on then? You, I know you had a very sweet video that I'm, I'll link to in my show notes, the video with your dad talking a little bit about kind of life as a young teenager. But, but if you don't mind sharing here, like, what, what was going on that led to that diagnosis and kind of what. I guess it's a two part question because then I also want to know through the lens of adhd, what has changed for you about that?
- [13:59]
Jess Hagan
Yeah, so since I first got my period at around 12, 13, kind of right in the middle there, I was experiencing these really intense mood symptoms and my mother had a cycle, my grandmother had a cycle. And they were, you know, kind of like. Well, my grandmother could relate a lot more, but my mother was like, this isn't. I lived that and I didn't live this experience that you're having. So what's going on? So from like 13, 14, she was taking me to gynecologist kind of being, asking, you know what? She basically turns into a monster of some form, like what is happening? And they were kind of, kind of just said, you know, it takes time. This transition can take 8 to 12 years. I've now learned through puberty for your hormones to kind of regulate. It'll. It'll even itself out, it'll be fine. And it just never did. And it just got worse and worse. And now looking back, I can see a lot of the driving factors of that. Diet, you know, stress, trauma, things like that. But at the time, we didn't have any language, we didn't have any understanding of any of that. So it just worsened and worsened and worsened. And then it was from taking me to gynecologists, to counselors, to psychologists, to psychiatrists. And bipolar is the most common misdiagnosis for pmdd. So it's not surprising. The, the mood symptoms are all the same. The pattern of presentation is just different.
- [15:29]
Katie Weber
Right.
- [15:29]
Jess Hagan
Bipolar is, it just kind of comes and goes whenever PMDD and cyclical mood disorders that are related to the reproductive system are very predictable to the day, you know, like along your menstrual cycle. So my family didn't really feel like it. That diagnosis fit, but we, we didn't have any other framework. So I was treated with antipsychotics as a child, you know, starting at 16, 17, and before that was on birth control very early because they were just trying to do anything that they could to contain me. It was, it was really scary for them. I was self harming. I was just crying for hours on end like someone had just died, like inconsolably. I would get really angry and lash out. You know, it was just a series of behaviors that follow a mood disorder. And I think a lot of people, we hear mood disorders that it's just kind of like, oh, that sounds bad. Like I don't really know what that means, but, but we're experiencing people with moods every day. You know, live with a toddler and it's like living with a person with a mood disorder. That's what it's like, only they're larger and can do more damage as adults. So looking back, I also do think that my ADHD symptoms have gotten worse as I've gotten older, as I'm kind of trying to integrate that diagnosis into my understanding of my past. But one of the things that really led me to getting an ADHD diagnosis was my dad's discovery of his own. Which is comical that he's discovering this because he is the most hardcore textbook case of adhd. When you learn about adhd, it's just like everything is clear now, you know, I mean, oh my goodness. And my grandmother as well. So there is this like, I've been living in this just bubble of people with adhd. So I also didn't have the really understanding of what that looks like aside. And he told me, you know, he was like, as he was learning and getting his diagnosis, he was like, oh, you, you've had adhd? And he like told me all these stories about when I was a kid, like, no question, but yet I couldn't really like, not that I couldn't accept it. I just couldn't see it. I couldn't understand it.
- [17:49]
Katie Weber
Well, that makes sense, because I think a lot of us, like, for the most of our especially diagnosed in adulthood, like, you don't know what's normal and what isn't. Right? Like, especially when many of your family members are the same way. So, I mean, I had that experience, too. I'm, after my diagnosis, looked at my brothers, and I still do, like, every time I talk to them, being like, I might want to get that checked out, you know, like. But I think there's this feeling of just sort of like, this is just who we are and how we think. And then it's quirky, like, it's not pathologized a lot of the time for ourselves. And we don't look at a diagnosis necessarily as a pathologized diagnosis. It's mostly just like, oh, this is really interesting information about how my brain works and why I've been diagnosed with all these other things. And, like, it's more just such an interesting element to explain who we are and why we are and why we had all of these seemingly unrelated struggles that all come together. Yeah. So, okay, well, that's really interesting. I'm glad you had that conversation with him and that you've been kind of going through this together. So then. Okay, so you were diagnosed with bipolar, and then what was your kind of journey through PMDD and sorting all of that out? Yeah.
- [19:05]
Jess Hagan
So PMDD wasn't actually added to the DSM until 2013.
- [19:09]
Katie Weber
You hear that, people? Sorry, I'm just, like, right for the U in the back. That's crazy.
- [19:15]
Jess Hagan
Like, last year, basically, in my mind. So before that it was called late luteal phase dysphoric disorder, something like that. And.
- [19:23]
Katie Weber
And before that, it was called hysteria.
- [19:26]
Jess Hagan
Oh, yeah. It just goes on and on.
- [19:28]
Katie Weber
Right.
- [19:29]
Jess Hagan
So when I was reaching out for support from these physicians, you know, they didn't really have the context or the language or the understanding. It was just like, bad pms. That's what it is. So it kind of makes sense that I wasn't able to get an accurate diagnosis because I was 28, that was 2017 or 18, that this was all playing out, that I was able to get that accurate diagnosis. But it led me getting the diagnosis came from a rock bottom moment. It was. I've been living with this. I stopped taking the antipsychotics, moved away from kind of the bipolar diagnosis, and just kind of went at it on my own, continued to go Back for support. Try different SSRIs, try different birth controls to manage, because those are the two primary treatments that are offered through gynecology even now still for pmdd. Again, this was all before PMDD existed in a way. And a lot of times those medications made things worse. But I didn't really have any framework of understanding, right? I didn't. I just thought, this is who I am. Something's like wrong with me. I don't really know what it is. I just have these really severe moods so many times I couldn't recognize that it was linked to my cycle. I would be having these breakdowns, wanting to leave college, quitting jobs, breaking up with partners, moving to different states, self harming. And I would be on the phone with my mom just in shambles and she would be begging me, just hold on, just a few more days and your period's going to come. And it's like how many times we have to have this conversation before I realize, hey, I can kind of predict that I'm going to lose myself in despair and fatigue and anxiety for this window. And if I could kind of preventatively be aware of that, it wouldn't just pull the rug out from under me every single cycle. But I think that's where a diagnostic criteria can be so transformational because it does at least provide, you know, there's some pitfalls with it, of course, but it kind of provides a understanding where you can now do something with it instead of just flailing like I don't really know what's happening or why. And so I had been off the medications and was just kind of going at it alone, using alcohol, using drugs to cope, and was trying to rectify a relationship that I had broken over and over and over over the course of like five to six years. He was going to move to the state that I was currently in. We were going to try to go at it had been long distance for real. And I went back to my physician and said like, look, I can't keep messing this up. And it's because my cycle is so gnarly that I'm wrecking all of these relationships. Oh, we'll put you back on the birth control that you were on. Because that seemed to work well. Our bodies change, you know, So I don't know if my body just reacted completely differently or if the entire time I had been on that birth control before it had been impacting me in the same way. But I went from not great to suicidal 30 days of the month for three months and they were just like, just stay on it. It's going to sort itself out, you know. And I lost my job, lost my housing, lost that partner. Like everything. It was just rock bottom. And at that point it was really a I will die because this is not living. Like I cannot keep doing this. This has been 17 years at that point that I had been going through these cycles or I have to figure something else out. And that's when I discovered that PMTB existed.
- [23:27]
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- [23:55]
Bill.com Advertiser
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- [24:56]
Mint Mobile Advertiser
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- [25:04]
Katie Weber
2.
- [25:05]
Mint Mobile Advertiser
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- [25:07]
Katie Weber
3.
- [25:08]
Mint Mobile Advertiser
No big contracts.
- [25:09]
Jess Hagan
4.
- [25:09]
Mint Mobile Advertiser
I use it.
- [25:10]
Jess Hagan
5.
- [25:10]
Mint Mobile Advertiser
My mom uses it. Are you. Are you playing me off? That's what's happening, right? Okay, give it a try@mintmobile.com Switch upfront.
- [25:18]
Katie Weber
Payment of 45 for 3 month plan 15 per month equivalent required New customer offer first 3 months only, then full.
- [25:22]
Jess Hagan
Price plan options available, taxes and fees extra.
- [25:24]
Katie Weber
See mintmobile.com how has your treatment, I mean, I obviously you're not on antipsychotics anymore, but what is kind of that.
- [25:31]
Podcast Producer/Assistant
First line of treatment?
- [25:33]
Katie Weber
You know, because one of the things that we talk about a lot when it comes to these cycles and you know, understanding our hormones and our menstrual cycles for people who menstruate is, you know, how with ADHD our interoception is almost non existent and keeping track of our calendars is a real struggle. And so, you know, it's not a surprise that this is constantly creeping up on us and that we're constantly feeling adrift. So what was sort of what are some of the things that I guess you've put in place, some of the strategies that you've put in place in your own life or that you work on with clients that help mitigate the intense mood swings that end up with misdiagnoses?
- [26:19]
Jess Hagan
So within allopathic medicine there are various treatments, right? Depending on which modality of medicine we're looking at in allopathic medicine. So basic Western medicine, the treatments are the same. And so that was extremely frustrating to finally get the accurate diagnosis and then be told these are your same options that you've been trying for 17 years. And there are two SSRIs and hormonal contraceptives. And the hormonal contraceptives have the risk of worsening the mood symptoms. So but that's never told to you. And then SSRIs have the potential to come with side effects, of course, and you know, worsen suicide, dality. And that's really never told to you. So at the point that I got the diagnosis, I was so traumatized by my medical experience at that time that it was a stark like, no, like I am not, I am not seeking any support from an allopathic minded practitioner moving forward because I nearly lost my life. The physicians I were working with weren't as compassionate as I needed needed at that point. And so there was a lot of trauma there. And so I shifted to initially education, which is not what you would expect. We don't really expect that so much in treatment. But that's a huge part of ADHD treatment is education. And that's not really something that your doctor that's not their job to provide that. So where do you get that type of education? So I kind of went off on my own. And once I realized it was linked to the menstrual cycle, it was like, well actually, what is that? You know, I don't Know what that really is? I get a period. That's pretty much all I know. I go crazy before my period. I can't keep my life together. That's pretty much all I know what else is going on. And now it's so funny to look at it through that because obviously you wouldn't go out and work on your vehicle without knowing how a vehicle works. But there I was for 17 years trying to figure this out without any understanding of how my body even functioned because we just didn't get that reproductive health education. So that was a really big. The most foundational switch for me on my path was starting to learn about the menstrual cycle, the phases, the stages of the reproductive continuum, kind of what to expect, what's normal, what's not. And there is a lot, there's, I mean, years, like three years of my life was education on female physiology. And that laid a foundation of understanding and opened the door to some compassion for what I had been going through. And then through that, I was able to start looking at, okay, well, how does nutrition impact female physiology? How to sleep, you know, how to endocrine, disrupting chemicals, like what, what other things are playing a role in these moods? And same with adhd, right? Looking at that now, I can see that there are certain things with my ADHD that make it way worse that are up to me to some degree, like, I can make choices to manage. And so then I kind of moved into that realm of using integrative medicine protocols to learn to reduce and manage symptoms. And then there was kind of another stage of the coin of like, okay, now I can reduce symptoms because within three months on that path, I experienced my first symptom free period. So 17 years of wanting to die for two weeks or more, actively suicidal before my period, like wrecking my life to having a symptom free period for the first time. And that was a beautiful and really heart wrenching moment because in that clarity of like, my period just came. Wow. And I didn't, you know, leave my partner or like, get fired from my job. It was, oh, this is how people have doctorate degrees at my age. You know, this is how people are married and have kids and, like, own homes. You know, I was like, on food stamps and like, couldn't function. And so it was beautiful and, like, painful to see that difference of how badly I had been suffering. It's like, you don't really know how sick you are until you feel better. You don't have the contrast.
- [30:48]
Katie Weber
Yeah.
- [30:49]
Jess Hagan
So that's a lot I'm kind of on a tangent there, but, yeah, no.
- [30:53]
Katie Weber
And it is really interesting to me to just sort of think about a lot of the parallels with that and an ADHD diagnosis. Like you said, like, when you are struggling so hard, you don't even know what. You can't even stop and think about what life might be like if you weren't struggling. Right. Or all the things that you're missing out on. And so one of the sad parts of that, the grief that is experienced after an ADHD diagnosis is that realization of, like, oh, now that I'm at a place where I've kind of come to the shore and can take a breath, now I'm seeing all of these ways in which my life could have been different had I known 10 years ago or even one year ago. Now, you had mentioned when you had reached out to me, that there's really high comorbidity between neurodivergence and premenstrual symptoms. What is that comorbidity? And what's your theory as to why that is?
- [31:51]
Jess Hagan
Yeah. So that harkens back to that 2020 study that I mentioned, where they found a overlap that was 45.5% in a study of 200 people. And they don't really go into, like, why, but there was a big overlap between PMDD specifically and ADHD and postpartum depression as well, which I think is even, you know, I don't know. In certain circles, people are talking about postpartum depression, but people aren't talking about in the context of ADHD that I've seen very frequently. So I think that's a really important tidbit in that study as well. And then there was a smaller study, very small study, but that was in 2008, which is kind of crazy. That linked autism to PMDD at 92%. So we need more studies. But, like, even in a small study, a 92% coming out of that, linking autism and PMDD within the neurodivergent community. That's pretty wild. One of my thoughts on that is that both of these are brain sensitivity conditions, PMDD and adhd, autism. So it's not really surprising. Also, especially if we're more sensitive, we're probably going to be more sensitive to our own biochemicals. That's the biggest thought that I have on the convergence of comorbidities there.
- [33:26]
Katie Weber
Yeah, I know. I feel like I've got a million theories on neurodivergence and just pain threshold and our nervous system and just the way in which our Bodies communicate with us, I think, in a very unique way that, again, like you said, is so aggressively unsupported in the medical community and from our individual clinicians that we end up traumatized just by visiting our doctors and just in these health journeys that we go in. They do more damage than good, I think, in terms of these misdiagnoses and just feeling so dismissed as women. Yeah, you're getting me on my. I'm, like, getting really emotional right now thinking about how prevalent and how common it is for so many of us to have had that conversation with our doctors about depression and just like, low. Lower your expectations, get a good night's sleep. And like, all of this head patting that so many of us experienced when we were having really deeply troubling symptoms and pain and experiences. Like, you know, you had mentioned that, like, you know, the suicide attempt rate is not insignificant. It's 34%. Right. Isn't that what.
- [34:36]
Jess Hagan
Attempt? Yeah, NPMTD.
- [34:38]
Katie Weber
Like, this is really, really serious stuff. And I just feel like anytime you talk to another woman about how they've been dismissed by medical professionals, they're just like, yep, I've been there. And how do we even figure out what that trauma is doing to our bodies? Right. In terms of the pain we feel, the pain we hold, and how that pain then manifests in autoimmune and nervous system issues and hormonal dysregulation and like, oh, God, it's. I just. Like, I'm so. I'm so, like, overwhelmed and frustrated.
- [35:15]
Jess Hagan
It's a vicious. Yeah, unfortunately a vicious cycle.
- [35:18]
Katie Weber
It really is. I know. But I do feel like, obviously we are having these conversations and we are, you know, making people are making these connections, which I think is. Is tremendous. And, you know, the fact that it's been. So much has been studied, even though it's been relatively recently, I think that, you know, there are a lot of researchers who are zeroing in on this stuff, thankfully.
- [35:42]
Jess Hagan
Yeah. Even just the communication, I mean, the fact that people are talking about it more sometimes I think that's more powerful than the research. Right. Because research isn't perfect. There's so many things with it. But, like, getting people in the conversation. And what you're saying about perimenopause, how many women in parent. Females in perimenopause are being, you know, put on SSRIs for depression, for anxiety, that is ADHD, moving out of that sub threshold into a clinical range because of the hormone changes. Like when you get into ADHD and studying it as you Know, with the perimenopausal transition, it is mind blowing how much estrogen protects our neurochemicals. And when that estrogen is starting to recede or going, you know, up and down in the perimenopausal transition, a lot of these females who have been undiagnosed with ADHD and just kind of pushing through now move into that clinical range, and then they're just told, well, this is just a stage of life. Like, you're just gonna have to get through it. Like, this is just a normal thing. And that is so, so damaging to be told. And how many of us are told that over and over in our late 30s, 40s, and 50s? I mean.
- [36:54]
Katie Weber
Oh, yeah, yeah, exactly. And, you know, through motherhood, through newborns, through postpartum, like, there's so many of those phases in life where you're like, just grin and bear it. That's my prescription for you. So now I want to get back to this symptom free period. You had so magic, right? Like, I guess I'm saying, like, if for somebody who's listening and is feeling so overwhelmed by, like, the literature and the. Just the terminology and, like, all of the question marks around this, like, what would you say is the first line of defense in terms of starting to turn this ship around?
- [37:34]
Jess Hagan
Yeah, that's a great question. So I'm. I'm going to be biased just because I am. Well, I'm an educator. And that was such a big part of my TR Transformation is just getting some basic reproductive health education to start, right? To start to learn about the menstrual cycle, to start to learn about the changes in your body. Because what. What I see is that I could, you know, first of all, everybody's body's different, so the drivers behind each person's symptoms are going to be a little bit different. But when we get into hormone health, you know, there are really only so many ways to support hormone health. Now, PMDD isn't necessarily a hormone imbalance. It's believed to be more of a hormone sensitivity. But that doesn't mean you can't have hormone imbalances. And most of my clients do have hormone imbalances that are driving some of these symptoms. Now, a hormone imbalance, even unless you're in perimenopause or, you know, postpartum or at some of those pivotal points of the reproductive continuum, a hormone imbalance isn't a root cause. Right. It would be what's driving that hormone imbalance that would be a root cause. If you're in perimenopause, a hormone imbalance is more of a root cause because your hormones are really changing during those times. But, you know, a client could come to me and say, you know, what do I need to do? And I could give them, you know, five steps. And those steps might really be powerful and might actually help if they adhere to them. But why are they going to adhere to them if they don't understand why they're doing them?
- [39:11]
Katie Weber
Oh, absolutely. Yeah.
- [39:13]
Jess Hagan
So I think that's where the foundation of education is really important, because it helps you stay motivated to make behavior change. Especially when we're dealing with a convergence of ADHD and these hormonal mood changes, like behavior change and consistent consistency is really hard, much harder for us. So I do think that that education, first the, like, cerebral education of I'm learning why this matters, and then to do the things and experience the changes within your body that, like, compounds another layer of adherence to those protocols. Because now, you know, what's hap. You know, for. Let's use blood sugar balance as an example. So you can't address mood symptoms without addressing hormone balance or without addressing blood sugar stability imbalance. So mood changes, irritability, anger, rage, crying spells, mood swings in general. The first thing we need to look at is blood sugar regulation. That's going to be a major driver behind those mood symptoms. What does that even mean? So we need to start to understand what is blood sugar, what, you know, what is glucose, what is insulin, what does that mean? How does that impact my brain and my mood? And once you learn that, then you start to make some daily changes which are going to look different for different people. But one example would be increasing protein. To keep your blood sugar stable, you have to have quite a lot of protein, and you have to look at macronutrient balance. So then you're starting to make that change, and you might notice in your body, wow, I have more energy. I have a more stable mood. And that kind of zooming out and looking at, okay, I'm dealing with these challenges. These are my symptoms. List them all out. Gonna need, like, two pages, probably. And then start to understand there are physiological drivers behind these symptoms, which is so exciting because when we feel like I just have these symptoms, my body's attacking me, I'm a victim in my own body. I'm. I'm helpless. There's nothing I can do except for take these medications, which do help some people, but might make my symptoms worse, might give me some side effects that I can't tolerate. And ultimately aren't addressing any of those physiological drivers. We can only get so far with those treatments. So there are certain things with hormone balance and PMDD that we really. Some foundational things that we really have to prioritize and address. And that requires changing behavior. So you don't want to do that, take that on all at once. It's helpful to have a practitioner to work with who can do some assessments and say, hey, where are you in these areas? What. What are some of those drivers? And then you decide what the next step is going to be for you. For me, it was nutrition. That was the first step. And that's what led me to that symptom. Free period was really digging into the way my body was nourished and the way I worked on micronutrient support. I worked on blood sugar balance, I worked on hydration. You know, just basic foundations where you think, how could drinking water, mineral rich filtered water really impact my symptoms that much? These like, I'm going to kill myself 14 days of every month, kind of like severe psychological symptoms. Well, when you make a Venn diagram like I do, and you see the overlap between dehydration symptoms and there are various stages of dehydration, but. And pmdd, your. Hey, your jaw would be like. I could show you. Your jaw will drop. Like, what Dehydration is going to lead to severe fatigue and mood swings and so many of these hormonal mood disorder symptoms. And that doesn't mean that dehydration causes pmdd. That's not what I'm saying. But we just want to make sure that some of these foundational things are. Those boxes are checked and that's not further driving your symptom presentation.
- [43:30]
Katie Weber
Yeah, and that's one of those moments where I feel like it's really difficult to articulate how debilitating executive dysfunction can be in these situations for people with adhd. Because there's that part of. There's like that voice in the back of our head which is like, yeah, of course I'm going to throw everything at the wall. I'm going to start keeping track. I'm going to keep a calendar, I'm going to do all the checklists and like, we overwhelm ourselves before we've even begun. But then also recognizing that, like, this is really challenging for somebody with ADHD to do a lot of the things that are required alone. It's not that it's impossible, it's just to recognize that I just need to read another book. I just need to Start over with my calendar. Like all those I just need tos that we're hearing in our voice. It should be an indication if you have adhd, that you need support, you need to work with somebody, you need to reach out. This is not something you're going to be able to do on your own. And it's not because you're lazy, it's not because you're not trying hard enough. This is where the disorder part comes deeply into play. So I'm curious, do you know anything about the overlap with ADHD medication and menstrual tracking or not menstrual tracking, but just like living with a period, have there been any studies to say it helps or doesn't help?
- [44:48]
Jess Hagan
Yeah, so there was actually a 2020, a 2023 study that showed that medication, ADHD medication is not as effective during the luteal phase of the menstrual cycle or during those other phases in the reproductive continuum, perimenopause, menopause, where estrogen is low. Estrogen has that protective effect on the brain. And when we're losing that, our ADHD medication is, is not as effective. Which is so fascinating, not fun to live through, but really helpful information and education to again, bring some compassion, kindness to yourself of like, why is this happening? Like, why am I struggling so bad right now? Oh, if you're on ADHD medication, it's not working as well, you know, as it's going to. And so there are a lot of physicians modifying the dosages for people where they're upping their doses during those periods of time and then lowering them. And something else I will say here, Katie, which is super fascinating, is the first study on females and ADHD was done in 1979, but there wasn't a study on the menstrual cycle and ADHD until 2017.
- [46:04]
Katie Weber
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- [46:34]
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- [47:06]
Well, and that's one of the things I find is most frustrating about perimenopause is just like I will go months without my period now and so I have no idea what phase I'm in. And so I'm kind of shit out of luck when it comes to space tracking. But I'm also, you know, having so many hormonal fluctuations because of perimenopause that I'm like, maybe it'll work, maybe it won't work with my medication. Like it's. But I feel like at this point I'm just riding the waves. Like one of the things I like about or one of the things I'm grateful for about my ADHD diagnosis is the fact that I just have, like you said, a lot more grace with myself and a lot less frustration around my own inability to function days, my low functioning days where I'm just like, it is what it is, right? Like that I'm just going to have grace with myself. But one thing I am curious about and was wondering if you knew anything about hormone replacement therapy, if you've done any studying about that. I know it's kind of outside of some of the stuff we had talked about, but I was just curious, just thought I'd throw that in there. Asking for a friend.
- [48:11]
Jess Hagan
Yeah. So I'm doing actually a deep dive and a certification into perimenopause and menopause to support my clients better and also to prep me because I am now moving into that those stages potentially I'm at the age at least. And so there has been, and I think we're going to start to see this discussed more now publicly than just in the integrative medicine community. But there was a. And you know about this, I'm sure a WHI Women's Health Initiative study that came out, I believe it was in the 80s or 90s, that basically took hormone replacement therapy from being the number one drug in the United States, like top drug, to gone, like it disappeared. Hormone replacement therapy. So we now have 12 generations of females who have moved through the perimenopause and menopause stages without hormone replacement therapy and they retracted that study. There were so many flaws in that study. And now with all of this data, we're finding that hormone replacement therapy is actually very valuable and much safer than the fear that was garnered by that study that has been retracted. And so I kind of have the same kind of thing with the ADHD where I had this mind of like, oh, well, yeah, like hrt that's, you know, dangerous. Like, everybody knows that. Will you start to get more into the actual information now? And in this study that I'm doing, and that is not the general consensus now, at least in the integrative medicine community, I think HRT is very protective. There are lots of different considerations. Health, family history considerations. The way it's administered is really important. Oral estrogen therapy, hormone replacement therapy has a lot more risks than topical. And so there's some nuances there. But I do think, I haven't looked at this specifically in the context of adhd, but I guarantee that this is going to be, hormone replacement therapy will be supportive to females dealing with ADHD because of the estrogenic protective effects. And we're just, if you just lose that, it's going to make that transition with ADHD way, way more challenging, impossible for some of us. So I would like to see some data on that specifically, but I don't, I don't know if there is any. I mean, there's so little data just on ADHD and females in general right now.
- [50:53]
Katie Weber
I know. Well, and I, yeah, this isn't something I know very much about. And so I'm just sort of talking about, you know, anecdotally and from conversations I've had with other women. But like, topical progesterone and estrogen are like, you know, you can get them at your local pharmacy outside of the us, Outside of North America. I don't actually know about Canada. If somebody, if a Canadian's listening and wants to fill me in on, on whether or not you can get this at your local shoppers drug mart, shout out to shoppers. But like, I was amazed at how it, like, it feels like it's much more heavily regulated in the US than in Europe, which always makes me wonder, like, follow the money. Right, yeah. In terms of these studies and why things aren't available. But yeah, interesting. That's probably going to be one of my next hyperfocus as, as I, as I get older because, yeah, like, I knew about the study being retracted and how it's like all of that information has been debunked. But I also don't feel like it's like my doctor hasn't recommended it to me yet. It's not a conversation that my doctor has brought up. So it's like once again I'm left to my own to do my own psychoeducation and then go and try to convince my doctor what I want and what I don't want. And then they roll their eyes and say, oh, look at you Googling again. Like it's just this vicious cycle of gatekeeping and feeling left out to dry in the wind. I was so angry.
- [52:20]
Jess Hagan
Totally, totally. Yeah, and you should be. But I think this overlaps too with the. The reason why so many females were not diagnosed with ADHD is because there was a lapse in education for those physicians. Right. So you're a physician likely was trained during that 20 year period or whatever it was. And so they were indoctrinated to a belief system and they haven't revisited that. Right. They're doing their job what they were taught. But medicine changes, science changes. And this is the same kind of thing with so many of us not getting diagnosed with ADHD because those physicians were trained in the more male presentations of the of ADHD presentation, the gender bias. Right. And so I think a lot of people are suffering and you're suffering in this case, same scenario where your doctor is not going to prescribe those things because they're scared. They were kind of taught that information. They don't know how to prescribe that. So you really need to find somebody who isn't in that headspace, try to access someone who is more up in the know of these types of things. And I'm happy to give you. I'm not sure where you're located, but a lot of these physicians that I'm learning through my training have telehealth clinics and so I'll share some of their contacts if you're interested in finding someone because there are a lot of them out there.
- [53:47]
Katie Weber
Yeah, right. It really is you. You just sort of luck on a lot of the time it's just luck and word of mouth in terms of hearing this. And like you said, it's hard to find who to blame in these situations because like I just finished up my psychopathology course and you know, you talk about bipolar in the dsm. The only diagnosis that meets the criteria of intense mood swings is bipolar. And so no wonder so many women are misdiagnosed with bipolar when they are having extreme emotional Dysregulation, which, as we mentioned before, is one of the number one, like, symptoms that we recognize in ourselves when we are first, like, coming to our ADHD self diagnosis is the extreme emotional dysregulation. There was zero to rage. Why is everybody walking on eggshells? Why can't I stop crying? Right? I just want it all to end. Like, all of those emotions that we have that so many of us, if not all of us, relate deeply to rejection, sensitive dysphoria. I mean, everybody knows exactly where they were with the first time they heard that term because it just hits you in the pit of your stomach. And then again just be like, well, okay, so now you. Now I'm going to give you an antipsychotic, which is a very, very, very different treatment plan than treatment protocol than working with adhd. And so, yes, I am a big proponent of psychoeducation. I think it really is the number one way, you know, the number one, like, treatment protocol for adhd. But I think, you know, not surprisingly, for most symptoms and keeping a more holistic view and having these conversations and putting the pieces together where we all, you know, have our. We're all putting these puzzle pieces together 100%.
- [55:35]
Jess Hagan
Well, so much of the time we feel like we have no options, right? Like, we're at a dead end. Even with the self advocacy and perimenopause that you're dealing with now and me and my fertility challenges, like the level of time and energy and finances and self advocacy that's required for you to get the care that you want and need when you're dealing with adh, like, I'm just like, never mind, I won't have a baby. Like, this is too much work to try to figure out what's going on here and get the right support. And then when you are in many of those meetings, a lot of the suggestions take an antipsychotic. Like, well, any other. Any other options that I have, like, are there any more? And a lot of the times it's no. Like, I met for 17 years. Like, I said that that roadblock of SSR, SSRIs, you know, hormonal contraceptive. That's it. That's it. And then it left me out to dry because I tried so many of those, right? And they didn't work. So I guess that's it for me. Like, here I am. And then to learn and to experience that symptom free period, to learn that I did have so many other options. There were so many other things that I could do What a relief. But also like grief coming with that of like, oh, it took me nearly losing my life to learn that I could work on my diet and that that matters and I have some agency there. And it's not a cure, but it can take me from a 10 to a 5, which is life changing. It's kind of shocking. And I think now the more I'm in this work, the more I'm like, we actually need to be teaching people how to advocate for themselves.
- [57:21]
Katie Weber
Yeah, well. And I think one of the things I'm grateful for as an ADHD quality is that like passionate advocacy and empathy that so many of us are like, all right, I figured this out. If I need to save the others. Right. You're just like, if I can save one other woman from going through this experience, it will have been worth it. Let's talk about some of the things that you offer your clients. And I'm also curious about the, oh.
- [57:49]
Podcast Producer/Assistant
The functional lab testing because I thought.
- [57:51]
Katie Weber
That was really interesting. It's not something I'd seen. So just quick, I want to say like, what are. Some of the people are going to go to your website because you're amazing and I want to like, where should we put them to the supplemental directory, the supplement directory. Is that kind of the first place to start? Yeah.
- [58:05]
Jess Hagan
So we have a number of free resources. We have a doctor's appointment and prep form that helps with some of that self advocacy that I was talking about. We have a supplement, supplement directory specifically for hormonal mood symptoms. And I have a symptom mapping kit. So when you get in there, you just pick one and I'll send you all three of them because I want you to have them all. So those are some free resources and that's where I like to start. All of my clients is looking at micronutrient support and ideally through food, but in mapping their symptoms in an ADHD friendly way where you can really see on paper what is happening throughout the month, throughout your cycle with your symptoms. And then I'm a nutritional therapist and board certified menstrual health coach. So the work that I'm doing with people is really based in lifestyle and diet medicine. So we're running functional labs and the more you get into the ADHD research and work and work, you're kind of like, hey, there are some genetic snips that point to adhd. There are some gut microbiome stuff there, some thyroid function stuff. There's like a lot physiologically that can drive your symptoms to be more Difficult. Same with pmdd. So I recently started incorporating functional labs where we're looking at micronutrient balance, we're looking at heavy metal exposure, we're looking at the gut, we're looking at your hormones to just kind of integrate that where we feel it will be helpful and necessary. And so often it's just so validating for clients to have been told over and over, oh, your labs are normal. And then to see very clearly on paper, like, your cortisol curve is doing some wild stuff. And that's really going to be impacting the rest of your life. So. And, you know, other metrics. But yeah, so much work courses, workshops, workbooks, like, lot going on. I've been at this now for six years, so. So I'm finally to this place where I really feel like, wow, I do have a lot to offer because I've just been in practice long enough that I've been able to build up my education and my kind of resource library for people.
- [60:22]
Katie Weber
And you're able to sort of have that more holistic point of view, right, where you're able to connect the dots, which I think is amazing. And something that can be so helpful. I think about, like, Kaylin Johnson, who is a pharmacist, but she works. She also coaches women. I've interviewed her on my podcast of just like she interviews. You know, she just looks at so many different parts of who we are and how we operate, but also recognizing that if you are neurodivergent, you likely are feeling things more deeply than what might be considered within the range of normal. Right. So even if your blood labs are saying that you're within the range of.
- [60:59]
Podcast Producer/Assistant
Normal, you still need to, like, trust.
- [61:01]
Katie Weber
Your own gut and your own lived experience. Experience. And nobody in your life is probably telling you to do that. So find people who are going to be able to read between the lines with a lot of this stuff. So it's amazing. This is so great. And I'm so fired up, as I'm sure you must always be. All right, so I'm going to hopefully find all of these studies that we talked about, but I'll probably reach out up to you and see if there's anything else, because there's so many. So if we were talking about studies and you're listening and you want to check the episode show notes, I will have links to as many as I possibly can, as well as Jess's website and also your YouTube with your sweet video with your dad. Now, I'm curious, do you have a different name for adhd, if you could call it something else.
- [61:54]
Jess Hagan
I really want to call it attention excess, because I don't. I really. In my experience, I don't. It's not a lack of attention. I have lots of attention. It's the ability to focus the attention, at least in my experience. But I also kind of want to call it toddler brain because I really feel like a little child sometimes in the way that it's presenting and like, being around toddlers. You're just like, I get you. Like, I totally get you right now. I want to have a tantrum too. Yeah. So I can't decide.
- [62:31]
Katie Weber
Maybe we can combine them. Be like, attention, excess, toddler brain, or I like it. Yeah, I definitely relate to toddlers, for sure. Especially when I'm like, I just, you know that, like, I'm not tired, I'm not tired, I'm not tired. And then you just fall asleep. That's kind of how I feel a lot of the time. Well, this was awesome.
- [62:51]
Podcast Producer/Assistant
Thank you, Jess.
- [62:52]
Katie Weber
You're amazing. And I love that this is something that you are offering people and that this is your line of work. And it's so fascinating to hear your own journey from, like, rock bottom, as you put it, to being in this place of empowerment and advocacy and that you're able to pass that on to other women is so important and such a gift. So thank you for all that you. You're doing.
- [63:17]
Jess Hagan
Thank you, Katie. It's been a wild ride, but it's nice to come out of it with some purpose.
- [63:24]
Katie Weber
Awesome. Well, thank you again for. For sharing your story here.
- [63:28]
Jess Hagan
Yeah, thanks for having me.
- [63:35]
Podcast Producer/Assistant
There you have it.
- [63:36]
Katie Weber
Thank you for listening and I really.
- [63:38]
Hope you enjoyed this episode of the Women and ADHD podcast.
- [63:41]
If you'd like to find out more.
- [63:42]
About me and my coaching programs, head over to womeninadhd.com if you're a woman who was diagnosed with ADHD and you'd like to apply to be a guest on this podcast, visit womeninadhd.com podcastguest and you can find that link in the episode show notes. Also, you know, we ADHDers crave feedback and I would really appreciate hearing from you, the listener. Please take a moment to leave me a review on Apple Podcasts or auto.
- [64:07]
Podcast Producer/Assistant
And if that feels like too much.
- [64:08]
Katie Weber
And I totally get it, please just.
- [64:10]
Podcast Producer/Assistant
Take a few seconds right now to.
- [64:12]
Katie Weber
Give me a five star rating or share this episode on your own social media to help reach more women who maybe have yet to discover and lean into this gift of neurodivergency. And they may be struggling and they.
- [64:23]
Don'T even know why. I'll see you next time when I.
- [64:26]
Interview another amazing woman who discovered she's not lazy or crazy or broken, but she has ADHD and she's now on the path to understanding her neurodivergent mind and finally using this gift to her advantage.
- [64:38]
Podcast Producer/Assistant
Take care till then.
- [64:44]
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