Podcast Summary: Women & ADHD

Episode: Jes Hagan: ADHD, PMDD & Hormonal Mood Symptoms
Host: Katy Weber
Guest: Jes Hagan, Nutritional Therapist & Menstrual Health Educator
Release Date: July 1, 2024

Episode Overview

This episode dives deep into the intertwined experiences of ADHD, Premenstrual Dysphoric Disorder (PMDD), and hormonal mood symptoms in women. Host Katy Weber and guest Jes Hagan discuss Jes’s personal journey of navigating misdiagnoses (bipolar disorder, ADHD, PMDD), the huge overlap of hormonal and neurodivergent symptoms, the frustration with medical misconceptions, and the empowerment of education and holistic approaches. They also address the lack of research and support for women’s experiences with ADHD, PMDD, and hormonal changes—especially during puberty and perimenopause.

Trigger warning: The episode contains mentions of suicidal thoughts during PMDD.

Key Discussion Points & Insights

Jes’s Diagnostic Journey & Family History

• First Diagnosis (Bipolar):
  • At 17, after years of severe mood swings and emotional struggles tied to her menstrual cycle, Jes was diagnosed with bipolar disorder.
  • Quote: “Bipolar is the most common misdiagnosis for PMDD. The mood symptoms are all the same. The pattern of presentation is just different.” — Jes, [15:28]
• ADHD Discovery:
  • Diagnosed as an adult (the previous year), prompted by her own research and her father’s late-in-life ADHD diagnosis.
  • Family history of undiagnosed ADHD; she realized her own symptoms only after seeing patterns in clients and family.
  • Quote: “It started to become pretty obvious...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.” — Jes, [07:54]

PMDD and Its Intersection with ADHD

• Understanding PMDD:
  • PMDD is a severe form of PMS with intense emotional and physical symptoms that occur predicatbly during the luteal phase.
  • Misdiagnosis & Stigma: Long misunderstood; only added to the DSM in 2013.
  • Quote: “PMDD wasn’t actually added to the DSM until 2013...Before that, it was called ‘late luteal phase dysphoric disorder.’” — Jes, [19:04]
• Personal Impact:
  • Years of being misdiagnosed, prescribed birth control and antipsychotics, pervasive self-harm, and recurring life disruptions.
  • Jes’s “rock bottom” moment: after a particularly intense period of suicidal thoughts and destabilizing life changes, she realized PMDD existed, which was a turning point.
  • Quote: “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 or I have to figure something else out. And that’s when I discovered that PMDD existed.” — Jes, [01:30 & 23:06]

Education, Self-Compassion, and Holistic Approaches

• Empowerment through Education:
  • Jes prioritized learning about the menstrual cycle and bodily changes as the foundation for healing.
  • Quote: “Education…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.” — Jes, [26:19]
• Key Strategies:
  • Understanding reproductive health basics.
  • Nutrition (especially blood sugar regulation and hydration): Jes experienced her first “symptom-free period” after 17 years by focusing on holistic and nutritional changes.
    • Quote: “Within three months on that path, I experienced my first symptom-free period…And that was a beautiful and really heart-wrenching moment…” — Jes, [29:34]
  • Micronutrient supplementation, sleep hygiene, and eliminating endocrine disruptors.
• Grief & Perspective Shift:
  • Both Katy and Jes discuss the profound grief for all the years lost to misunderstanding and unsupported suffering:
    • Quote: “You don't really know how sick you are until you feel better.” — Jes, [30:47]

Medical System Challenges & Gender Bias

• Dismissal of Women’s Symptoms:
  • Both speakers highlight enduring patterns of clinicians dismissing women’s reports of pain and intense mood symptoms, telling them to “lower expectations” or “just get more sleep.”
  • PMDD sufferers experience astoundingly high rates of suicidal ideation (34% attempt rate).
  • Quote: “They do more damage than good, I think, in terms of these misdiagnoses and just feeling so dismissed as women.” — Katy, [34:08]
• Comorbidities & Gaps in Research:
  • High overlap between neurodivergence and hormonal mood disorders:
    • 2020 study: 45.5% of women with ADHD had severe premenstrual symptoms or PMDD/postpartum depression.
    • Small 2008 study: 92% link between autism and PMDD in a tiny sample.
  • Soviet research lag: First study on menstrual cycles and ADHD wasn't until 2017!
    • Quote: “There wasn’t a study on the menstrual cycle and ADHD until 2017.” — Jes, [46:03]

Perimenopause, Hormones & Medication Efficacy

• Perimenopause’s Impact on ADHD:
  • Estrogen stabilizes brain chemistry; drops during perimenopause/menstruation worsen ADHD and PMDD symptoms.
  • Many women’s ADHD “moves into clinical range” after decades of managing undiagnosed.
  • SSRIs often prescribed, but hormone replacement therapy (HRT) may prove more protective — though access is still controversial due to outdated studies.
    • Topical estrogen/progesterone seems more effective with fewer risks than oral.
    • Doctors often have outdated training and are hesitant to prescribe HRT.
  • Quote: “Hormone replacement therapy is actually very valuable and much safer than the fear that was garnered by that study that has been retracted.” — Jes, [48:10]
• ADHD Medication & Menstrual Phases:
  • Stimulant efficacy drops during the luteal phase and with low estrogen; dose adjustments may help.
    • Quote: “There was actually 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…where estrogen is low.” — Jes, [44:48]

Advocacy, Resources & Hope

• Holistic & Integrative Support:
  • Jes provides resources and coaching focused on micronutrient support, functional lab testing (gut, hormones, heavy metals), and support for self-advocacy.
    • Quote: “I have a number of free resources…doctor’s appointment prep form…supplement directory for hormonal mood symptoms…and a symptom mapping kit.” — Jes, [58:04]
  • Importance of practitioners who acknowledge lived experience even if lab values are “normal.”
• Call for Psychoeducation & Self-Advocacy:
  • Both speakers emphasize education as the first line of defense, especially for ADHD women navigating hormonal health.

Notable & Memorable Moments

• "It's not a lack of attention. I have lots of attention. It’s the ability to focus the attention." — Jes, on her preferred ADHD label: “Attention excess, or…toddler brain”, [61:53]
• On Grief & Loss:
  • Realizing how dramatically life improves with symptom control leads to gratitude but also grief for lost years, relationships, and opportunities.
• On Systemic Gaps:
  • The recurring theme: systemic ignorance and gender bias mean women must often self-educate and self-advocate to survive or thrive.

Timestamps for Key Segments

• [06:46] — Jes’s delayed ADHD diagnosis; lack of awareness & education.
• [13:28] — Early struggles; misdiagnosed as bipolar; family history.
• [19:04] — PMDD and changing definitions in the DSM.
• [23:06] — Hitting “rock bottom” due to undiagnosed PMDD & treatment impacts.
• [26:19] — Importance of education and functional understanding of menstrual cycles in treatment.
• [29:34] — Jes’s first symptom-free period after holistic changes.
• [31:50] — High comorbidities between ADHD, PMDD, and neurodivergence.
• [34:08] — Dismissal by medical professionals & system trauma.
• [44:48] — ADHD medication efficacy & menstrual phases.
• [48:10] — Hormone replacement therapy, medical bias, and perimenopause.
• [58:04] — Jes’s resources, supplement directory, symptom mapping.
• [61:53] — Jes’s alternative names for ADHD.

Resources & Where to Start

• Free tools from Jes/Mood Mentor: Symptom mapping kit, supplement directory, doctor’s appointment prep form.
• Advocacy: Seek practitioners who practice functional/integrative medicine and can offer hormone-focused lab work.
• Education: Start with understanding your own menstrual cycle and hormonal influences; prioritize blood sugar stability and hydration.

Final Thoughts

This episode underscores the pressing need for research, recognition, and support for women experiencing both ADHD and hormonally linked mood disorders. Jes’s journey is both cautionary and hopeful; her story illuminates the life-changing impact of accurate diagnosis, self-education, and holistic management. Katy and Jes model the importance of empowerment, validation, and compassionate advocacy—both for oneself and others navigating similar journeys.

[For show notes, links to studies, and free resources, visit the episode page or Jes Hagan’s website.]