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Who Stole My Brain? The Hormone - Brain Function Link

Wow! It’s May already! It’s my birthday month, and it’s a big one this year, marking half way through my 4th decade. In honor of this significant number, I’d like to share with you a 4-part blog series in May about how to be 40 and better (anyone noticing the theme here?!)

Fabulous 40s?

Our 40s are meant to be fabulous. There certainly are fabulous elements to this decade for me. My kids are growing up, the stresses of young motherhood are fading and I’m more sure of myself. I’m more comfortable in my own skin, more accepting of my weaknesses and more aware of my strengths. Sounds pretty fabulous, right?

And then this happened… Perimenopause! I won’t go into too much detail, but along with physical symptoms, mild depression and anxiety that came out of nowhere, I literally felt like I was losing my mind. Now I find myself walking into a room and not remembering why I went there. I put things away and forget where I put them. I find myself jumping from task to task more than before and I often experience this new kind of brain fog when it comes to planning and prioritizing. This is particularly frustrating, because I feel like I am beginning a stage in my life where I can start to focus more on my goals and less on the nitty-gritty of raising young children.

Around the same time that these symptoms started, I began studying ADHD coaching and I found that all the strategies we were learning (how to organize, plan, prioritize, focus) were really useful to me. I started to suspect that maybe I was “developing” ADHD, or worse, early onset Alzheimer’s.

Executive Function Weakness – The What, Why and Who

ADHD has been described as a disorder of Executive Functions. Executive Functions are the brain circuits that basically help you get things done – organizing and prioritizing, regulating motivation, getting started, staying focused throughout a task, managing frustration. Like a business executive who manages a company, these brain functions help you to effectively manage what you are doing.

ADHD isn’t the only condition where executive functions are impaired. Other learning disabilities, autism spectrum or head injury to the front of the brain also impair them. So can emotional disorders such as depression. And recently, it has been noted in perimenopausal and menopausal women. Perimenopausal means the 5-10 years before you stop menstruating, when estrogen levels fluctuate wildly. At menopause, they settle but at significantly lower levels.

The Estrogen – Executive Function Link

Dr Thomas Brown, one of the world’s leading ADHD specialists, tells the story of how he got interested in the link between executive functions and estrogen. He would be reading through ADHD symptoms to mothers of children he was treating , and more than a few of the moms would say something like, “You know, I never had any trouble growing up. I did well in school, I’m accomplished, I have a demanding career that requires a lot of self-management. But recently, the past year or two, I’ve had a lot of trouble with managing myself. I’m wondering whether I had ADHD all along, and no one ever noticed, or whether I have early onset Alzheimer’s.Frankly, it’s terrifying.”

After he heard this story from a few women with:

  • no earlier history of ADHD

  • considerable success as an adult

  • a sudden onset of these ADHD-like symptoms, particularly short- term memory, difficulty prioritizing and difficulty getting started on things,

he looked for a common thread and saw that many of the women who were saying this were between 45 and 55 years old. Then he remembered that estrogen aids the release of dopamine in the female brain. And dopamine plays an important role in executive function (it’s what is hard for ADHD brains to regulate). Following this discovery, Brown conducted studies with ADHD medication on these women, and they reported that the meds were quite helpful to them.

There are other times when estrogen is in decline – before your period, after giving birth. You may remember feeling great during pregnancy then experiencing brain fog after birth. Or you may notice that it’s harder to be productive when you are premenstrual.

What We Can Do About It

There are two ways to deal with executive function difficulties related to estrogen decline. One way is to directly get more estrogen. The second way is to learn strategies to support these typical weaknesses. Since I am hardly a medical professional, I’ll stick with the latter.

So stay tuned! This 4 part blog series will deal with the strategies we can use to support the most common of these weaknesses for women aged 35+ :

  1. Working Memory

  2. Task Initiation and Sustained Attention

  3. Time Management

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