Jes Hagan: ADHD, PMDD & hormonal mood symptoms
Aug 02, 2024
Powered by RedCircle
Episode 188 with Jes Hagan.
“The first study on women and ADHD was done in 1979, but there wasn’t a study on the menstrual cycle and ADHD until 2017.”
Jes is a nutritional therapist and 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 (PMDD) and ADHD has fueled her determination to help others reclaim their lives from hormonal mood symptoms.
PMDD is a severe form of premenstrual syndrome (PMS) that can come with significant emotional and physical symptoms that typically occur during the luteal phase. Anywhere from 3-8% of menstruating adults have PMDD, while roughly 46% of women with ADHD also experience PMDD.
Jes 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.
We also get all fired up over 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 with ADHD.
Finally, Jes discusses some of the amazing holistic treatment options available for anyone who struggles with hormonal mood symptoms.
TRIGGER WARNING: Throughout the episode, Jes mentions her experiences with suicidal thoughts during PMDD, so if that subject is a difficult one for you, you might want to sit this episode out.
Website: hermoodmentor.com
Instagram: @hermoodmentor
Additional links:
Save 10% off any of the following courses with code KATY:
FREE Premenstrual Supplement Directory
A father's perspective on PMDD (Youtube video with Jes’ dad)
Additional references:
Prevalence of hormone-related mood disorder symptoms in women with ADHD (2021)
Prevalence of Premenstrual Syndrome in Autism: A Prospective Observer-rated Study (2008)
Female-specific pharmacotherapy in ADHD: premenstrual adjustment of psychostimulant dosage (2023)
Sex differences in childhood psychopathology: A review. (1979)
Reproductive steroids and ADHD symptoms across the menstrual cycle (2018)
Jes Hagan 0:00
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.
Katy Weber 0:26
Hello, and welcome to the women and ADHD podcast. I'm your host, Katy 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. Hello, it's so good to be back. Thank you for joining me. And before we begin, I'd love to share with you this review from a listener named wheeze girl on the Apple podcast platform is 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 Gina 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 listen. 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 with girl 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 catalogue at this point. And I love each and every one 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. And I am so grateful for all of you who have come along for this ride. And if you're a relatively new listener of this podcast, and you 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 interviewed Jes 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, 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, PMS that can come with significant emotional and physical symptoms that typically occur during the luteal phase. Now anywhere from three 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. We also get all fired up over 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 just talks about throughout this interview are linked in the episode show notes, so make sure to check those out. And I did want to give a 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 set this episode out. Alright, without further ado, here is my interview with Jess. Hi, Jess, thank you for joining me finally. I'm so glad we could make this happen. So welcome.
Jes Hagan 4:59
Thank you Kate. I am so excited to be here.
Katy Weber 5:01
All right, well, let's get started. I feel like you have a very long journey with a su saw 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? Just
Jes Hagan 5:18
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 PMDD. It just, it takes me a long time to become aware of things that are very obvious, it seems.
Katy Weber 5:36
Well, I feel like it's sort of similar to some of the stuff that we talked about around hormones and, and even like me now going in, you know, impairment. I've been in perimenopause, I'm about to turn 50 this year. So I'm like looking at 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 it, 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. Well,
Jes Hagan 6:26
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 is 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, premenstrual Lee, and it just all kind of started to become clear through the work that I was doing with people in that do 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 of 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 eat so much so that in the year in Europe, they part of their diagnostic criteria includes that 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 their 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 a 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 kind of hard to tell the difference in some of these symptoms.
Katy Weber 9:57
It really is and I I feel like I've been talking about this nonstop 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. Different things that connect and especially talking about like trauma and our nervous systems and hormones and auto immune like it's just, it's so frustrating how little it's been studied and how many question marks there are, and I just yet, 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? That 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 moving through the world. Without a compass and, 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
Jes Hagan 11:57
bipolar? Is that correct? Yeah, when I was 17, at 17.
Katy Weber 12:01
Okay, so what was going on? Then? You I know, you had a very sweet video that 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 go through the lens of ADHD, what has changed for you about that?
Jes Hagan 12:30
Yeah, so since I first got my, my period, at around 1213, kind of right in the middle of 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 live with that. And I didn't live this experience that you're having. So what's going on? So from like, 1314, she was taking me to gynecologist kind of been 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 eight 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, distress, 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 just worsened and worsened and worsened. And then it was from taking me to gynecologist to counselors, to psychologists to psychiatrists, and bipolar is the most common misdiagnosis for PMDD. So it's not surprising that the mood symptoms are all the same. The pattern of presentation is just different, right? 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 meet to the day, you know, like long 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 anti-psychotics As a child, you know, starting at 1617. 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 wait to hear mood disorders. It's just kind of like, oh, that sounds bad. Like, I don't really know what that means. 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 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 cleared out, 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's like, as he was learning and getting his diagnosis, he was like, Oh, you have ADHD. And he, like, told me all these stories about when I was a kid, like, no question. But yeah, I couldn't really like not that I couldn't accept it. I just couldn't see it. I couldn't understand it. Well, that makes sense.
Katy Weber 16:21
Because I think a lot of us like the most of our especially diagnosed in adults, but 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 have that experience to 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 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 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, it's, it's more, it's just such an interesting element to explain who we are and why we are and why we, you know, had all of these seemingly unrelated struggles, that that all come together. Yeah, so Okay, well, that's really just glad you had that conversation with whoever that you've got 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?
Jes Hagan 17:35
Yeah. So PMDD wasn't actually added to the DSM until 2013. You
Katy Weber 17:40
hear that people? Sorry, I just like right from the you in the back. That's crazy. Like last
Jes Hagan 17:46
year, basically, in my mind. So before that, it was called late luteal phase dysphoric disorder, something like that. And
Katy Weber 17:53
then before that, it was called hysteria. Oh,
Jes Hagan 17:57
yeah. It just goes on and on. Right. So when I was reaching out for support from these positions, 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 anti-psychotics 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, your periods gonna come and it's like, how many times we have to have this conversation before I realized, hey, I can kind of predict that I'm gonna 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 the there are 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 out 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 wreck wrecking all of these relationships. Oh, we'll put you back on the birth control that you were on. Because that seems to work? Well, if 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 gonna 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 have to figure something else out. And that's when I discovered that pm TV existed.
Katy Weber 21:59
How has your treatment? I mean, I obviously you're not on antipsychotics anymore. But what is kind of the first line of treatment? You know, because one of the things that we talk about a lot when it comes to the cycles, and you know, understanding our hormones and our menstrual cycles for people who menstruate is you know, how with ADHD, or 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 put in place in your own life or that you work on with clients that help mitigate the intense mood swings that lend end up with misdiagnosis?
Jes Hagan 22:52
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 suicidality. 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 need to be 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 wasn't 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 like 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's a lot there. 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 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 then that clarity of like, my period just came, wow. And I didn't, you know, leave my partner or, like, get fired for 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. Yeah. So that's a lot. We're kind of on a tangent there. But,
Katy Weber 27:25
ya know, and it is really interesting to me to just sort of think about a lot of the parallels with that and 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 would 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 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, or even one year ago. Now you had mentioned, when you had reached out to me that the there's a really high comorbidity between neuro divergence and premenstrual symptoms. What what is the comorbidity? And what's your theory as to why, why that is? Yeah,
Jes Hagan 28:24
so that harkens back to that 2020 study that I mentioned, where they found a overlap, that was 45.5%, and 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 are 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 a small study and a 92% coming out of that linking autism and PMDD, you know, within the neurodivergent community, that's pretty wild. My one of my thoughts on that is that both of these are kind of 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. Yeah.
Katy Weber 29:59
I know I feel like I've got a million theories on 100 origins and just pain threshold, and our nervous system and just the way in which our bodies communicate with us. And 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, are there, they do more damage than good, I think in terms of these misdiagnosis 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 lower your expectations, get a good night's sleep, and like all of this head padding that so many of us experience 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? It's not like,
Jes Hagan 31:09
attempt Yeah, and PMDD. Like,
Katy Weber 31:12
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 auto immune and nervous system issues and hormonal dysregulation and like, Ah, god, it's just like, I'm so I'm so like, overwhelmed and frustrated.
Jes Hagan 31:47
Yeah. It's a vicious. Yeah, unfortunately, a vicious like,
Katy Weber 31:51
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 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. Yeah,
Jes Hagan 32:16
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 pair and females and 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 setting it, as you know, with the pre menopausal transition, it is mind blowing, how much estrogen protects our neuro chemicals. And when that estrogen is starting to recede are going, you know, up and down. And the peri menopausal 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 horrible. This is just a stage of life, like, you're just gonna have to get through it. Like this is just a normal thing that is 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, oh,
Katy Weber 33:27
yeah, yeah, exactly. And so, 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 what now, I want to get back to this symptom free period you had So Patrick, right, like, I guess I would say like if for somebody who's listening and is feeling so overwhelmed by like, the literature and the and 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 the ship around?
Jes Hagan 34:07
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 training transformation is just getting some basic reproductive health education to start, right. So 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 is 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 I do have hormone imbalances that are deriving some of the 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 imbalances in 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? Oh, absolutely, yeah. 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 consistency is really hard, much harder for us. So I do think that that education, first, the, like cerebral education of unlearning, why this matters, and then to do the same as 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 adjusting blood sugar, stability, and balance. 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, I'm 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 micronutrients 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 their various stages of dehydration, but and PMDD, your pain 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 for They're driving your symptom presentation. Yeah.
Katy Weber 40:03
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 the part of there's like the voice in the back of our head, which is like, yeah, of course, I'm gonna throw everything at the wall, I'm going to start keeping track, I'm going to keep calendar, I'm going to do all the checklists, and like, we overwhelm ourselves before we even began. But then also, we're 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 recognize that I just need to read another book, I just need to start over with my calendar, like all those I just need to is 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 gonna 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 a 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 or doesn't help?
Jes Hagan 41:21
Yeah, so there was actually a 2020 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 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, wow, 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.
Katy Weber 42:38
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 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 gonna have grace with myself. But one thing I am curious about was wondering if you knew anything about hormone replacement therapy, if you've done any studying about I know, it's kind of outside of some of the stuff we had talked about, but I was just curious, I just thought I'd throw that in there asking for a friend.
Jes Hagan 43:43
Yeah, so I'm doing actually a deep dive and a certification into perimenopause and menopause to support my clients better and also to grab me because I am now moving into that those stages. Potentially, I'm of the age at least. And so there has been and I think we're gonna 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 W. H AI 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 a disappeared hormone replacement therapy. So we now have one two generations of females who have moved through the perimenopause and menopause stages without hormone replacement therapy, and they've 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 And the fear that was garnered by that study that has been retracted. And so I kind of same kind of thing with ADHD where I had this mind of like, oh, well, yeah, like HRT that's, you know, dangerous, like, everybody knows that we start to get more into the actual information now and this study that I'm doing. And that is not that the general consensus now in the, at least in the integrative medicine community, I think HRT is very protective. There are lots of different considerations, health, family history considerations. And 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, when 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. Why 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. I
Katy Weber 46:25
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 is 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.
Jes Hagan 47:51
So I agree totally, totally. Yeah. And you shouldn't 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 your 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. Yeah,
Katy Weber 49:19
right. It really is. 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 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, those zero to rage. Why is everybody walking on eggshells? Why can 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 the of your stomach. And then again, just be like, Well, okay, so now you now I'm going to give you an anti psychotic, which is a very, 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 world putting these puzzle pieces together.
Jes Hagan 51:07
100% Well, so much of the time, we feel like we have no options, right? Like we're at a dead end, even with a self advocacy in 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 ADHD, like I'm just like, nevermind, 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 taken anti-psychotic like, well, any other any other options that I have, like are there anymore. 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 matters. And I have some agency there. And it's not a cure. But it can take me from a 10 to a five, 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.
Katy Weber 52:53
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, alright, I figured this out if I need to save the others, right, you're just like, if I can save one other woman for 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, the functional lab testing, because I thought 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 gonna go to your website? Because you're amazing. And I want us to like Where should we put them to the supplemental directory as a supplement directory? Is that kind of the first place to start? Yeah, so
Jes Hagan 53:37
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 help 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 and 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 we're in work, they're kind of like, hey, there are some genetic snips that point to ADHD. There's 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 a lot going on. I've been at this now for six years. So I'm finally to this place where I really feel like, wow, I have a lot, 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.
Katy Weber 55:54
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 is amazing. And something that can be so helpful, I think about like Kailyn Johnson, who is who is a pharmacist, but she works she also coaches, women I've interviewed her on my podcasts are 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 neuro divergent, 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 normal, you still need to like trust your own gut and your own lived 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 I'm so fired up, as I'm sure you must always be. Alright, so I'm going to hopefully find all of these studies that we talked about, but I'll probably reach 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 shownotes I will have links to as many as I possibly can as well as just as website and also your YouTube with your sweet video with your dad with it. Now I'm curious, do you have an a different name for ADHD, if you could call it something else?
Jes Hagan 57:26
I really want to call it attention excess. Because 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 or just like I get you like, I don't really get it right now. I want to have a tantrum too. So I can't decide.
Katy Weber 58:03
Maybe we can combine them the 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. Thank you, Jess, you're amazing. And I love that this is something that you are offering people and that this was 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 is so important and such a gift. So thank you for all that you're doing. Thank
Jes Hagan 58:49
you, Katie. It's been a wild ride, but it's nice to come out of it with some purpose.
Katy Weber 58:56
Awesome. Well, thank you again for for sharing your story here. Yeah, thanks for having me.
There you have it. Thank you for listening. And I really hope you enjoyed this episode of the women and ADHD podcast. If you'd like to find out more about me and my coaching programs, head over to women and adhd.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 women and adhd.com/podcast guest and you can find that link in the episode show notes. Also, you know, we ADHD ears 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 audible. And if that feels like too much and I totally get it. Please just take a few seconds right now to 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 nerd of urgency and they may be struggling and they don't even know why. I'll see you next time when I interview another amazing one. And 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 take care till then
Transcribed by https://otter.ai
