Episode 68 – Perimenopause & PMDD: The Hormonal Rollercoaster of Neurodivergent Women

Jane McFadden:

ADHD meds is one of the most complex, tricky elements of ADHD diagnosis. Even after appointments with psychiatrists or pediatricians, I see so many ADHD mums left with unanswered questions, on the Facebook groups, trying to find clarity, or hope, or some kind of answer because they can’t get back in for another three months. Often they’ll be Googling at 3am only to end up down some rabbit hole with the worst case scenarios.

And that’s why I created the ADHD Guide to Medication. It is the resource I wish I had when I first tiptoed into the world of stimulants, side effects, and sceptical family members who think that medication is just a lazy parenting shortcut. It is terrifying to start ADHD meds for yourself or your child.

This guide tackles those overwhelming questions. What can I ask for? What options are available? How do I manage side effects without waiting three months for another appointment? It also talks about how to talk to your doctor, how to talk to your specialist, what can you push back on, how to advocate for timing changes, what to do when you don’t agree with the recommendations, and also what to expect from the moment that the meds kick in.

Whether you’re giving it a go or whether you’re clinging to your third coffee for the day, this guide has your back. Grab your copy now at ADHDmums.com.au and all of the links will be in the show notes.

Hello and welcome back to ADHD Mums. In this podcast, we tackle the tough, often unspoken realities of motherhood, neurodiversity, and mental health.

Hello and welcome to ADHD Mums. Today we have a big episode, one of the most requested on hormones, and I have brought in an expert, Dr. Miranda Robinson. And how are you, Miranda?

Dr. Miranda Robinson:

I’m good, thank you.

Jane McFadden:

So Dr. Miranda was referred to me a number of times on Instagram as someone who’s just so knowledgeable and influential in Australian female health. Because we’re on video, I can see Miranda kind of grimacing with the bio. People hate their bios.

I was wondering, Miranda, did you want to give us a little bit of an idea of your background before we get started?

Dr. Miranda Robinson:

Yeah, sure. So I’m an obstetrician and gynecologist. I originate from New Zealand. I came to Australia in 97 and started my training here in ONG. It kind of was the last thing I thought I would end up doing, but it was when I was doing my diploma in ONG at the Women’s here in Melbourne. It was a couple of people who took me under their wing and I just really fell in love with the field, looking after women.

I guess I’ve always had issues throughout the years where I’ve had some mental health struggles myself, which have been put down to depression and anxiety, and I guess feelings of overwhelm. But it wasn’t really until I had children myself and the layers of stress that come with that, and then quite a difficult separation and divorce and becoming a single parent, and then trying to keep all my balls in the air as a single parent and continuing to have quite a stressful career, going through another episode of depression, and then finding out that one of my children was neurodivergent, that I started to question myself because I saw a lot of my own struggles in him.

And then throughout the last five or six years, throughout the pandemic, actually really finding myself in burnout and realising that was neurodivergent burnout. And the final piece of the puzzle was my daughter being diagnosed at 12, when we returned back to the classroom, that she was found to have auditory processing disorder, and really that was ADHD. That was the final piece of the puzzle because she and I are very similar. I went and got myself diagnosed.

That’s really the short version. The bigger version really was through my patients. I was seeing a lot of connections between neurodivergence and a number of medical complaints, which I’m sure you’re aware there is a lot of crossover into many medical conditions, which I see in my gynaecological practice.

So some of the conditions that I see, things that are really multifaceted in the sense that these women that are hypermobile, and they will have a lot of many medical conditions that relate to that hypermobility—so migraines, irritable bowel syndrome, and chronic pain conditions. And a lot of them were coming back with diagnoses of ADHD. I started to actually put together a screening tool for neurodivergence for these women.

And most of those women are coming back with diagnoses of either ADHD or autism or complex PTSD. And I think if this had been five years ago, I think there would have been a very different reaction to that idea. But I think we’re in a different time now where people are much more open to the idea of neurodivergence as being the answer to their distress and to their medical and body complaints.

Yeah. So I’m sorry, it’s a really long answer to your question, but I just find it just such a fascinating time to be in women’s health because when I see a new patient, I’m not really there to ask what their presenting problem is. I just really want to hear their stories because often their stories tell me the answer to what the problem is.

Because it’s really just about getting to know a person, you know, because so many times I’m hearing people not being heard and they’re not being listened to for so many years. And their trauma is all the way through and we’ve re-traumatised them in the medical profession so many times over. In regards to like, it’s just anxiety or it’s just menopause or, you know, it’s just being a teenager.

Jane McFadden:

Is that what you mean?

Dr. Miranda Robinson:

Yeah. Or that’s just normal or, for example, someone’s not really given time and space. You know, GPs are expected to give a lot for nothing and very little time to spend with complicated problems and patients are getting more and more complex in their presentations.

The system is really not geared towards people with complicated needs. So I think patients, they get told, as you say, they come in and I had a patient only last week, she was in her thirties and she clearly has been dealing with perimenopausal symptoms for about five years. Yeah. And it’s pretty much been since she weaned off breastfeeding. She’s been having hot flushes. She’s been having high levels of anxiety and body aches.

Her mother went through menopause by the age of 40. So if someone had just actually listened to her, then, you know, it would have been clear what her needs were. Yeah.

Rather than just saying, well, you’re 25, so you can’t be in menopause yet. Yeah. But maybe for her, she was in perimenopause.

Jane McFadden:

That’s a great point. Yeah. So why is it that ADHD and autism traits often worsen in hormonal shifts?

Dr. Miranda Robinson:

Well, I think that the estrogen is such a powerful co-regulator.

Dr. Miranda Robinson:

So for many reasons, as we know, we are very sensitive when it comes to our external world, but also our internal world. We can be hypersensitive and we can be hyposensitive when it comes to the external sensory system. So we can be misophonic, but at the same time, we sometimes get told that we have selective hearing loss.

And that’s not that we do. We’re not deliberately not hearing someone. It’s just, we may have auditory processing issues.

So I’m the same. I have misophonia. I cannot stand the sound of people chewing or certain types of music playing when I just grind my gears. But at the same time, if I’m super hyper-focused, I literally cannot hear someone talking to me unless they literally come up to me and tap me.

But it’s the same with our interoceptive world. When our estrogen is in a lowered state, it actually is a co-regulator in the prefrontal cortex. And it actually lowers the ability for dopamine to work in the prefrontal cortex, which is why women with ADHD are much more prone to have PMDD—premenstrual dysphoric disorder.

So for me, when I see that alongside things like migraines or anxiety or postnatal depression on a referral letter, it’s like a little ding ding. I wonder if this woman’s ever been screened for ADHD or if they’ve got a history of trauma.

It’s often a time when we all feel a bit down in the dumps and a little bit dysregulated, but if they’re actually having major issues with dysregulation to the point of a diagnosable mental health concern in that time in the luteal phase of their cycle, then they’re much more likely, I believe, to be diagnosable with ADHD or maybe complex PTSD or autism. So that’s when I would think about screening.

But it’s also a powerful co-regulator for pain. So if you are feeling more disgruntled, you’re feeling more on edge, you’re more sensory, and your dopamine is not working as well in your prefrontal cortex, you’re much more likely to be feeling the effects of pain than if you’re feeling better. You’re going to be sleeping better, you’re going to be feeling more able to regulate yourself if you have a noxious stimulus come into the body.

It’s the same when—it’s the spoon theory, right? If you’ve all wigged out, too many spoons being used up, you can’t deal with that one more thing that’s coming in. So this is why women who have ADHD or autism are much more likely to have period pain and are much more likely to be diagnosed with endometriosis than women who aren’t.

Because the rate of endometriosis is not higher amongst neurodivergent women than other women. It’s just we’re more likely to find it because I believe—this is just my belief around it—that our interoceptive needs are higher because of our dysregulation and our hormonal requirements, especially if we’re undiagnosed.

Jane McFadden:

I did a solo episode, I think it was a couple of months ago, about PMDD. And I’m clearly not an expert, a medical expert. It was more around, if you feel like this, this may be what it is.

And I said at the end, I felt quite bad doing the episode because at the end of it, what you could do about it—the strategies, what your options were—weren’t great. And I said, I’m really sorry, these are the options that I can see. If anyone knows anything different, let me know. And no one did.

However, I got an outpouring of people that said, thank you for the episode. This was so important, and I definitely have that. But yet there wasn’t much there in terms of PMDD and perimenopause, those kinds of things that a lot of us are experiencing.

What are some things—or is there none—that you can actually do?

Dr. Miranda Robinson:

Oh, I think there’s a lot that we can do.

Jane McFadden:

I thought you were going to say there was nothing and I was like, oh.

Dr. Miranda Robinson:

No, no, there’s a lot. There’s a lot. I think it really depends on what the woman’s wanting. I think just recognition that it exists—and not going crazy, you know? Because I think a lot of women have been told that it’s normal to feel a bit down, which is true.

And I think it’s the drop in estrogen in the luteal phase and the rise of progesterone. It’s normal to feel a little bit down, a little bit like you want to eat a lot of ice cream and you feel bloated. Those things are very normal.

But PMDD is a diagnosable mental health condition under the same criteria. So it’s a very different condition than just plain PMS. This is a condition that can take days out of a woman’s month—sometimes, for some women, up to two weeks—of feeling very down, suicidal. It can disrupt their working life, it can disrupt relationships, can end relationships with their children.

It can cause them to become quite violent. I’ve had some patients where, you know, they are actually, you know, can be quite threatening towards members of their family. So there are lots of options.

Sometimes we need to put women on hormonal contraceptives because the only way to stop the ups and downs of their hormones is to do that. If they’re a younger woman, if they’re perimenopausal, their PMDD gets worse because their underlying estrogen levels are starting to wane over time. So their drop in estrogen in the second half of the cycle is even more profound.

So going on to a small amount of estrogen throughout the month can help. But if they’re diagnosed with ADHD, they can talk to their psychiatrists—if they are understanding, some psychiatrists are not—about if they’re already on Vyvanse, for example, they can ask about getting a smaller dose of Vyvanse that they can use on those days because they need more on those days.

If they are tolerant of the stimulants, they can talk about getting some extra dexamphetamine that they can use, or whatever it is that they’re using—Ritalin or Concerta or whatever.

Or we can talk about using some estrogen and then using a little bit extra estrogen in those days. Sometimes a Mirena can be very useful. So Mirena is a type of IUD.

Quite often, your periods are starting to get heavier as well. And one of the theories around why you start to feel so much worse in those days leading up to your period is the release of certain histamines and prostaglandins. These really inflammatory hormones are being released into the body, which make you feel really edgy.

They may go through some pathways in your brain called the GABA pathways, which are really to do with your mood and to do with pain receptors in the brain. They make you feel edgy, moody, just not yourself. They are to do with the change in neurotransmitters in the brain.

So if we can manage those levels with prostaglandins, even maybe trying some antihistamines, they may be useful. And also some vitamin supplementation may be helpful—things like omega-3 fatty acids.

I’ve started taking NAC. I don’t know if you’ve heard of NAC, N-acetylcysteine, which is an amino acid supplementation. I’ve found that really useful for me in terms of that sort of foggy brain feeling, which we think may be to do with some of those inflammatory markers in the brain really just making you feel just a bit blah, like your cognition’s really off.

But I think one of the things that I find about the menopause—and a lot about this time of life—it’s not just about hormones. It’s also about that feeling that you’ve got these children that are becoming, especially if you’ve got neurodivergent children, they’re coming to a stage of their life where they’re coming into their own.

I’ve got adolescent children. I’ve got ageing parents that are undiagnosed neurodivergent. So you’ve got difficult people and you’re being sandwiched between them.

And then you’re going through your own shit that, you know, hasn’t been dealt with. And I’m finding there’s a lot of women who are sort of coming into themselves, into their neurodivergent selves, especially when you’re feeling especially fractured at that time of the month.

It’s a lot of this unsolved, undealt with micro trauma from your life. And I think that if you have got a trauma-informed psychologist who’s really good at somatic work—and what I mean by that is like polyvagal theory, you’ve heard of polyvagal theory—so doing lots of meditation, deep breathing, because what we’re talking about is a system that’s very hypervigilant.

So women getting very teary, very anxious, very angry, very ragey, or the worst case, sometimes very dissociated—you know, it’s a body in trauma. And when the hormones are not working, it’s like all your chickens have come home to roost.

It’s a time of life where everything’s catching up. I mean, I’m only really talking about my own personal experience of a lot of things in my life that I’ve actually dealt with in the last year, you know, and working in medicine and a system when you’re a very sensitive person who kind of went into medicine to try and help people in a system that really doesn’t sometimes.

And yeah, just been getting a lot of good therapy, and that’s really helped a lot with some of these changes that, you know, life throws at you to help me stay regulated in times when I’m feeling dysregulated. Yeah, that’s been really helpful. So EMDR has been really, really helpful for me, which is a type of therapy.

Jane McFadden:

I’m not sure whether you’ve talked about it in any of the episodes. I think before this one comes out, there’s going to be a personal experience on EMDR that comes out, and also a personal experience on being in perimenopause and the person not knowing that they were for quite a while. So that will come out before yours, so people will know what EMDR is.

If they don’t know what EMDR is, they can always go to the show notes and I’ll put the episode link and a link to what that is.

What I did have a burning question for you was, in the episode where I interviewed the everyday Aussie mum—that’s going to come out before yours—it was her personal experience of being in perimenopause and having multiple doctors tell her that it was all normal until eventually she found a specialist that diagnosed her and she started HRT, which drastically changed her life.

And now she’s like a foghorn all over the nation about how amazing it is to know if you’re in perimenopause. She keeps telling everybody, she’s like, “Oh my God, oh my God, oh my God! And I’m sleeping and I’m mad.”

She just emailed me so intensely, like, “Please, can I just share, so if anyone else feels like this, they can seek help.” And it was such a great episode. But one thing that I did ask her, which I felt that she wasn’t clear on because she’s not a medical professional, was—she was really wanting to talk about how great the HRT had been for her.

And I said to her, from a very amateur, not-knowing-anything-about-the-body place, “The way that you’re talking about it, if you are a neurodivergent woman and you’re approaching perimenopause, should we all just go and get HRT? Like, is it for everybody? Is it not?” Because she talked about it so intensely, I was like, “I just want to get some.”

Dr. Miranda Robinson:

Yeah. Well, I think neurodivergent brains definitely benefit from HRT, but we can’t be saying it’s the panacea for everybody because we need to individualize all medical care, right?

Because some women are not going to want to have hormones. I have a lot of patients that are wanting to be natural. I’ve got a lot of patients with ADHD who have never gone onto stimulants because they don’t want to be on medication—and that’s absolutely fine.

Even though the longitudinal studies tell us that women who are on stimulants, their long-term quality of life and pain scores are far better than women who don’t take stimulants. So, I mean, the evidence is now out there.

And we know that the long-term studies on women who take HRT show that quality of life scores and longevity and mortality and morbidity are lower. But of course, there are going to be women who have had breast cancer. There are women who have medical conditions where it’s just not appropriate for them to be on HRT for whatever reason.

But if you don’t have a contraindication to HRT and you’re going through mid-perimenopause, there are definitely going to be huge benefits. And the really important thing is seeing someone who understands that most women who are neurodivergent are going to need—almost certainly—higher doses than the average woman, or may do.

And that there’s also maybe some benefit in also going onto testosterone for many neurodivergent women. Not all, but I’ve probably used a lot more testosterone in the last 12 months than I ever have before, because it does seem to be a huge cognitive benefit for neurodivergent women that I’ve seen.

Jane McFadden:

One thing that’s really tricky, I think, is we really have to see a psychiatrist to get access to the stimulant medication that a lot of us really rely on. But then, you know, someone like yourself seems so knowledgeable and I’m like, “Wow, wouldn’t it be amazing to go and see…”

I’m sure you’ll get a lot of people that will email you and probably want to try and book in with you right from this session, because I’m like, wow.

The problem is that then I’m thinking I still have to get the ADHD medication over from the psychiatrist. But at the moment, to be honest, I have to go to a GP to go and get an antidepressant because I can’t get the one that I want from the psychiatrist, because he continues to give me SSRIs that don’t suit me and I don’t like.

So I have to take the dexamphetamine, go off to get a different GP to get an antidepressant—which is the only one I’ve ever found that helps—and I’m thinking to myself, “I’m going to have to—where do I go to get HRT? Like, who is overall looking at our care?” Like, this is just such a head fuck.

Dr. Miranda Robinson:

I know. I find it actually extremely ableist and very frustrating, considering Ritalin was invented in the 1930s. Why the hell is it still an S8? You know, why are we still being treated like Muppets?

Jane McFadden:

I agree. And why is Ritalin still the first point of call? Even for people who have tried it—it doesn’t work—we’re still giving our children that because we’ve got no other choice. You have to try it first.

Dr. Miranda Robinson:

Yes. I mean, having said that though—actually, I forgot to mention that before—was actually like, that was a clincher for me. I tried my son’s Ritalin and I was like, “Oh.”

Jane McFadden:

Oh, I’ve tried Ritalin too.

Dr. Miranda Robinson:

I was like, “Oh my God, oh my God, oh my God.” My head is at peace. I just felt the comedown was like coming off a cliff on the other side of it.

Jane McFadden:

Yeah. I guess I just didn’t know any better, but I just was like, “Oh my God, this is amazing.” Like, I went out to a social function. I could actually concentrate on talking to somebody for the first time without getting distracted and overwhelmed.

And I’d always thought that I was someone who had social anxiety, but it wasn’t that—it just felt completely overwhelming. Too many thoughts.

Dr. Miranda Robinson:

Too many. Like, just, yeah—just too many thoughts. And almost like I could pick up the vibe of the room. Like, you know, who’s had a bad day, who’s not had a bad day, who’s going through shit at home. It’s just like, “Oh no, there’s too much. I can’t deal with this.”

Jane McFadden:

Yeah. So back to HRT for a second. Because I know there’ll be a lot of women—so I love what you said about individualized care, because what we are talking about is extremely individualized. And I love that you brought that up.

All women who listen and they’re like, “Wow, I actually do need to see a specialist or I do need to do something about this,” where do women go if they think they are experiencing PMDD or they may be in perimenopause? Where do we go?

Dr. Miranda Robinson:

So, and obviously it depends on where you are in Australia or New Zealand or wherever you’re listening from. There are a number of people who specialize in PMDD or perimenopause.

For example, in Melbourne, there are a number of GPs who specialize in women’s health. You’ll often find your local family doctor is not the best person—which is a shame because, you know, a lot of local family doctors insist on doing a blood test to diagnose you in menopause, which is very frustrating, because a lot of women need hormones before their last period.

You know, menopause is when your periods finish for more than 12 months, but women may have symptoms for a decade before that happens. And the suffering—not in silence, because I’ve often seen two or three or four doctors before they finally get the help they need—and they’re still cycling, still having regular periods.

We know that often the first sign of the perimenopause are mental health side effects of the perimenopause—anxiety, sleeplessness, depression—before they get physical side effects.

And especially in neurodivergent women, women who may not even know they’re neurodivergent. So before they get hot flushes, before they get night sweats, before they get the body aches and the migraines, they’re getting these psychological side effects of the perimenopause, but they’re told that they’ve got anxiety. So they get put on an antidepressant, which will work to a certain degree, but it’s not the right treatment.

Jane McFadden:

Yeah.

Dr. Miranda Robinson:

It’s a second-rate treatment for people who can’t take hormones.

Jane McFadden:

Yeah. It’s kind of like if you have ADHD and you’re given an antidepressant, not a stimulant—you’re kind of treating a symptom, but you’re not really getting to the heart of it.

Dr. Miranda Robinson:

That’s right. And we do know that some SSRIs or SNRIs are actually very useful for some ADHD symptoms, but not really, as you say, getting to the heart of it.

Yeah. I think going to a GP who specializes in women’s health—and I think advocating for yourself to say, “Look, I’ve done a lot of reading and I’ve listened to this podcast. I’ve listened to Dr. Miranda Robinson, who is a specialist gynecologist in women’s health and in the perimenopause, and I feel that a lot of the symptoms she was talking about align with what I’m experiencing, and I think that I’m in the perimenopause and I don’t believe I need any blood tests. I would like to try some hormones for a month or two. And if it works, then that’s the experiment that I need to go through. I don’t need blood tests to be defined as perimenopausal.”

Jane McFadden:

I agree. The lived experience we had was similar—that she mentioned the blood testing to being not right, or that she came back fine and she wasn’t.

I did want to ask—was, you know how you talked about taking Ritalin and then it became very clear to you that you had ADHD because you treated it and had such a drastic result? If you took HRT or a hormone and you weren’t in perimenopause versus you were, what would be the different effect from taking it?

Dr. Miranda Robinson:

Well, you wouldn’t notice any improvement.

Jane McFadden:

Okay. So you wouldn’t have an adverse effect.

Dr. Miranda Robinson:

Yeah. I mean, I’ve got a patient who’s got significant PMDD. She’s not 100% better from taking hormones—I’ve given her some estrogen to take and that’s part of her cycle—she’s not 100% better, but she’s noticed a massive improvement. So she needs other treatments.

She’s got ADHD, she’s on her stimulants. She’s got a lot of trauma. I’ve started her on an SNRI as well, I think because she’s got a lot of insomnia and a lot of anxiety-related symptoms, and she’s getting nightmares. So I think she’s got a lot of PTSD side effects, and I think that’ll be helpful.

And I’ve asked her to go and see someone to get EMDR. But I think it’s made a difference. And then when it’s for the menopause, you will notice some improvement. It may not be yet the right dose, but you will notice an improvement in symptoms.

We’re always going to have placebo effect no matter what, but I think if you’re getting a massive improvement in symptoms without side effects, then I don’t really see what the harm is.

Jane McFadden:

What’s the harm? Well, that’s what I was going to ask you, which is what I was confused about. I was like, it actually seems very similar to ADHD medication. It’s kind of like, you have to prove that you have it, you often get a bit of gatekeeping, you know, in the process of medical gaslighting or whatever it is.

And then what was the harm in taking a dexamphetamine or a Ritalin? Like, where’s the harm? Why is it so hard to get to that point? The same with HRT and hormones. I’m not sure why there’s the blood test and why there’s this whole “that’s normal, that’s being a woman, that’s being a mum.”

You know, I had a psychiatrist recently tell me, he goes, “Oh, why don’t you want antidepressants? Because you’ve got three children with additional needs. You need to have the heaviest dose of antidepressants. That’s what all mums need.”

Like, whoa—that’s a big statement. “That’s what all mums need.”

Dr. Miranda Robinson:

Yeah.

Jane McFadden:

Well, it was an interesting conversation to say the least, but like this—I’m sorry, I just need a quick drink for that one—being a mum with kids with additional needs, that’s going to be pretty shit. So you probably should really take a heavy dose of antidepressants.

Like, what is the risk to taking a hormone or HRT to see if you are not sure? Is there any risk?

Dr. Miranda Robinson:

Well, most of the HRTs that we recommend these days are going to be low risk in the short term. The main risks with HRT are in the long term.

So the HRTs that I usually start with are transdermal—so they’re like gels, usually, that you rub into the skin. The most common side effects that you might have would be maybe some minor headaches, maybe some breast tenderness.

I guess in the past when they were oral treatments, there were some concerns around increasing risks of blood clots, strokes, heart attacks. But there were more with women who were either right in the thick of it or after the menopause with a lot of associated risks—already had high blood pressure or cardiovascular risks.

So women who’d already been through menopause. This is data from the WHO trial, which is 20 years old now. We mostly use transdermal estrogen these days, which has minimal to no risk of those kinds of side effects.

So really very little in the way of side effects, and most women just get benefit. And if they’re not getting any benefits, then what you’re talking about is not relating to menopause—it’s other stuff going on in their life.

Jane McFadden:

Yeah. I think this is something that’s so powerful for us to understand because we’re going through such a perfect storm as mothers with additional needs. Whether you’re neurodivergent or you’re parenting neurodivergent kids, there’s this period of life where you’re going through so much.

And you’re also maybe working, you’ve got a household to run, you’ve got social relationships that are often dwindling, and then you’ve got this feeling like you’re drowning in life. And then someone says, “That’s just motherhood,” or, “That’s just hormones.”

And we end up gaslighting ourselves, thinking we’re just not coping or that we’re not resilient enough, when really it could be something chemical or medical that we can support.

Dr. Miranda Robinson:

Absolutely. And that’s where I think compassion and understanding come in—both for ourselves and for others.

Because if you think about it, we’ve spent our whole lives masking, surviving, compensating, pushing through, over-performing, taking on everyone else’s emotions, managing everyone else’s stuff, and ignoring our own needs.

Then we hit this hormonal cliff, and it’s like the mask just falls off. Everything that we’ve used to keep ourselves functioning doesn’t work anymore.

That’s why I see so many women being diagnosed with ADHD in perimenopause. It’s not because it suddenly appeared; it’s because the hormonal regulation that used to keep everything together has dropped out.

Jane McFadden:

That makes so much sense. It’s like the scaffolding that was holding everything up just collapses, and then you’re standing there going, “Oh my God, who am I?”

Dr. Miranda Robinson:

Exactly. It’s like the veil lifts, and suddenly you see yourself clearly—sometimes for the first time ever.

And that can be confronting. But it’s also incredibly freeing, because now you can start living as yourself, not as the version that’s been trying to survive.

Jane McFadden:

Yeah. And then you add motherhood and kids’ diagnoses into that, and you’re right—it’s a perfect storm. It’s such a big thing.

And I think what’s so great about what you’ve said today is that there is help, there are options, and it doesn’t have to feel so hopeless. It’s about finding the right people to support you and not stopping until you do.

Dr. Miranda Robinson:

Yes. And finding people who listen. I think that’s the biggest thing.

Because you’re not crazy, you’re not lazy, you’re not broken. You’re just a woman whose hormones, nervous system, and neurotransmitters are all talking over each other right now. And it’s confusing.

But once we start to untangle that, things can get so much better.

Jane McFadden:

Yeah. I love that. That’s so well said.

I just want to say thank you so much for coming on, Miranda. This episode has been incredible. You’re so knowledgeable, and I think so many mums are going to take away real hope and understanding from this.

Dr. Miranda Robinson:

Thank you so much for having me, Jane. It’s been such a privilege to be able to talk about this, and I really hope it helps women feel seen and heard.

Jane McFadden:

It really will. And to everyone listening, I’ll pop all of Miranda’s details in the show notes so you can follow her, find her work, and learn more.

And as always, if you loved this episode, please share it with another mum who might be struggling or trying to make sense of her hormones, her diagnosis, or just herself right now. You are definitely not alone.

Thank you so much for listening, and I’ll see you next week on ADHD Mums.