ADHD Explained

A little education for those who don’t know what ADHD is or what the causes of our difficulties are. Yes folks, it is real. We aren’t just jumping on a bandwagon. We’ve had our eyes opened after a lifetime of masking who we really are, trying to fit in, trying so bloody hard to fit in and for some of us, never getting anywhere. Successful ADHDers (and we can be hugely successful) are the lucky ones

ADHD is a nerodevelopmental condition where the brain is literally wired differently, affecting executive function, emotion regulation and attention. There are three subtypes of ADHD: Hyperactive, Innative and Combined. Specific brain structures affected are:

• The Prefrontal Cortex which regulates behaviour, emotions and attention. People with ADHD tend towards hyperactivity, inattention and poor decision making as a result.

• The Basal Ganglia responsible for motor learning (picking up skills through repetition), also helps regulate behavior, emotions, and the ability to plan, focus, and multi-task; all of which are affected by ADHD.

• The Default Mode Network (DMN) is active when we are at rest enabling daydreaming. In an ADHD brain, the DMN has difficulty switching off. Where normally it would relay messages to the Prefrontal Cortex to switch tasks, in ADHD the process is slow and therefore we can get stuck daydreaming or in undesired mental wandering.

• The Limbic System is a set of brain structures including the hippocampus, hypothalamus, thalamus and amygdala:

  • The hippocampus is responsible for memory formation and spatial navigation; your ability to know where you are, where you want to go and plan to get there. People with ADHD suffer from poor working memory and a poor sense of direction.

  • The hypothalamus controls the autonomic nervous system and hormone release. People with ADHD can be stuck in sympathetic dominance (fight-flight mode). They have difficulty managing stress as the Hypothalamic-Pituitary-Axis (HPA), responsible for the stress response is dysregulated. They are affected by dysregulated cortisol affecting their ability to wake up.

  • The amygdala is the brain’s emotional alarm system. In ADHD it can be smaller resulting in altered connectivity with the prefrontal cortex, the result of which is an overactive amygdala which explains the difficulty in emotional regulation, rejection sensitivity dysphoria and impulsivity.

  • The thalamus relays sensory signals to the cortex. It can be reduced in volume in people with ADHD causing inattention and difficulty switching tasks, hence our ability to occasionally hyper-focus but comorbid with emotional dysregulation, if you try to drag someone away from a task on which they are hyper focused, they can have an emotional outburst.

Research shows that these brain structures and regions can be supported by various Yoga and Mindfulness practices which will be the subject of future posts.

In the meantime, why not read A Day in the Life of a Woman with ADHD to understand how it affects me.

A Day in the Life of a Woman with ADHD

I only learned about ADHD when ‘slow processing’ was suggested as the cause of my son’s difficulties at college. I began to look into ADHD and grief set in for the child I had been. ‘This is me,’ I realised. ‘This is my life, this is why I struggled so much at school, failed exams because I would misinterpret the question or not be able to memorise the answers. This is why I have failed at courses in spite of being passionate about the subjects. This is why'… and so it goes on. I am still on a path to learn all I can but I know, despite not yet having a diagnosis, that I have ADHD.

The world isn’t set up for people like me. And while I am today, in the mood to laugh at myself, I am often in tears of frustration, low mood or needing to retreat from the world; I really struggle to be me at times. But I thought that writing about a day in my life (while making myself feel vulnerable), might resonate with some of my readers and encourage others to be more understanding of those who struggle with the condition.

Waking up:
It’s 4, or 5, or 6 a.m. I am nowhere near ready to get out of bed. I am wide awake and yet still really tired. My slightly arthritic back is stiff and I can feel that staying in bed isn’t helping. So I place a pillow between my knees and using Ujjayi breathing, I move my pelvis this way and that until my back eases. Sometimes, this so relaxing that I fall asleep again, especially if I’ve had a bad night.

Getting up:
I go to the bathroom and wash. My husband tries to speak to me but I can neither respond nor speak. My brain is still so sleepy but it doesn’t stop thoughts from racing:

• What should I wear?

• Should I go outside first (to get daylight into my pineal gland and help reset my circadian rhythm because surely this will help me sleep better)?

• I’ll put my mucky jeans on.

• No, I’ll do some Yoga first. I have to teach this morning.

• But I haven’t done a workout yet this week. I feel guilty. Maybe I should go to the gym. No, it’s too late for that.

• I’ll go for a walk.

I take too long on the walk, getting distracted by the beauty and serenity of nature. I am soothed by it but now I am in a rush.

Quick, breakfast:
I used to be good at planning what to have for breakfast the previous day. Protein. But for some reason, this is difficult now. Is this a day for coffee? Real coffee or decaffeinated? If I have real coffee, I might stay awake tonight (and get verbal diarrhoea and possibly get hyper too). Decaf. I’m now cooking something that I have to rush down my throat 15 minutes before teaching. Darn it! I forgot to take my pills. (Hyper-mobility is frequently comorbid with ADHD and gut sensitivity. I am supposed to take digestive enzymes before breakfast). I’ll take them at lunchtime. Crikey, it’s 9.15 and my clients will be here soon.

In the bathroom:
Urgh, I look awful. I want to put my full face on. There’s no time! Just hurry up! Your clients are arriving - I can hear the door opening.

Teaching:
I’m in my calm place. I win at this, (unless my sleep has been really bad and then I get my lefts and rights muddled up, or I just can’t find the words). I’ve forgotten that student’s name. She’s been coming for years, what’s her name? I feel ashamed and embarrassed. I have a hot flush. We’re meditating now. My mind’s all over the place. Racing with this thought or that. I want to look at my phone. I mustn’t. We’re meditating for goodness sake. Is everyone okay? No one’s looking troubled. Close my eyes and start again.

Class over:
What’s next? Shopping. Write a list. What do I need? I had loads of things in my head last night. I can’t think right now. Remember that washing that needs doing? Put it on. What was I doing before? Shopping! Where’s my phone? I must have left it upstairs. Nope. Did I go to the loo? No. I just remembered something I needed. Where’s my damn phone? 10 minutes lates… it’s on top of the laundry basket! Right, shopping list. What was that thing I needed to put on the list? It’s gone. Let’s check the fridge. I’m staring into space. Completely blank. Suddenly aware that I’ve glazed over. What was I doing? Shopping. Check the cupboards. I’d really like a cup of tea. Kettle’s boiling. Get the shopping bags. Well done. Shall I put the tea in a flask and take it with me? Where’s the flask? I swear I put it away last night. Where is it? Another 10 minutes later… it’s still in my gym bag! I hate shopping. I really don’t feel like going today. Do I have to go? Could I put it off until tomorrow? I’d much rather do something creative. Nah, let’s not go shopping.

Do you notice that I’ve changed the format? I was using bullet points and now I’m writing long sentences. I could remedy that. The perfectionist in me really wants to but I know it’ll take me ages and for the sake of demonstrating what it’s like to be in my head, I won’t. But it’s really niggling at me. It feels unprofessional.

Lunch time:
What can I make for lunch? Stare into the fridge. No leftovers. Oh, I know, I’ll make… Eating. Damn it! I forgot my digestive enzymes again. Double damn it, these vegetables were meant for supper. What am I going to make for supper now? Ohhh, I should have gone shopping!

Later that day… Bedtime:
I am falling asleep at 9.30. I know to slow down an hour or so before bed. Preferably with subdued lighting and no screen on. But this show is so good. I’ll just watch another episode. My head is nodding. Go to bed. In bed. I’m wide awake now. I’ll try focusing on my breath. Nope, not working. I’ll do a body scan. Focus your attention on your left big toe… zzz. Awake. What time is it? It must be morning, I’m wide awake. It’s midnight. Start again. Listen to a story… zzz. I need a pee. It must be morning. It is, it’s 2.30, 3.30 or if I’m lucky 4.30. But I’m too tired to get up. Listen to a story… zzz. 6.30 My husband gets up. It’s too early. I’m so tired. I’m really stiff. I REALLY need a pee. I drag myself out of bed. Don’t speak to me. Arghhh!

At post menopause every symptom of ADHD has been magnified especially Rejection Sensitivity Dysphoria (RSD). The bad day I described above can be a lot worse. I can procrastinate to the point where I do nothing. I can be very cruel to myself. I’ve just finished a floristry course but I’m holding myself back from setting up in business because I’m scared of rejection. I’m not good enough. I hate getting feedback. I am unable to regulate my emotions especially if I’m triggered by some comment that was misinterpreted. I explode and cry. I feel ashamed and foolish.

I know I should promote my business on social media. I should share all the knowledge that I can’t remember at this precise moment. But I don’t want to show up. I feel a fraud. But I need to tell people how I can help them. I need to explain why I am the Yoga teacher they should work with. I need them to know that I am the best at what I do, that I will have their back, that I will transform their mental and physical health. But I can’t, I’m no good. Put someone in front of me and I will know precisely what they need. But I don’t know what to say in a social post. I can’t think what to say. Which photo would I use? I should sort my photos out. I should stop bloody ‘shoulding’ all over the place! Why is should spelt with an L?

I am frozen. Stuck in a pit of shame and guilt and remorse and grief that I could have done so much better, I could have been so much better if only I’d known about ADHD when I was young. I’m 55. What do I have to show for it? What the hell am I going to do for the rest of my life? How on earth am I going to survive? Who can help me? No one. No one can help you. You haven’t got any friends. Your family don’t care about you. Who would want to bother? You’re too negative, you interrupt all the time, you’re too much. There must be someone I can call on. Who can I call? No one. Feel the shame. Feel the guilt. Feel the remorse. Sit with the grief and the loneliness. Get on your Yoga mat and feel all the horrible, shameful emotions you are going through.

Are you kidding? Why would I want to do that?

But I do that. I need to be present. I need to be self compassionate more than anything. And so I breathe. And I move. And I do the strong stuff because it brings me into my body, makes me grounded helps me to feel strong on the outside as well as the inside. Right now, it is hard for me to be introspective. At the time of writing, my life feels topsy turvey. I have a husband who, two years after a serious motor bike accident, still has broken bones because he too has ADHD (full disclosure, we are both undiagnosed but you know what you know). He uses smoking and sugar to soothe his nervous system. Smoking blocks the bone building receptors and sugar causes inflammation.

I am furious! I am holding a lot, carrying a lot and all this is not helping my ADHD.

I don’t know if I really want to share this post. I don’t want people to pity me, or reject me for oversharing. I want people to understand. People close to me just don’t understand. No one’s ever understood. I don’t even understand! I’m overwhelmed. Exhausted. I might delete the post. I need a rest.

Finally, you should know that I have been working on this post for 5 days. It took 5 hours to write initially and it has subsequently undergone a number of edits. Such is the life of a woman with ADHD.

If you want to understand more about ADHD; what it is and how it affects various brain structures, read this article.

How Mindfulness and Yoga can Help Alleviate Stress

How Mindfulness and Yoga can help

Mindfulness and Yoga have emerged as powerful tools in managing stress, offering a holistic approach to wellbeing that integrates the mind, body, and spirit. At their core, both practices aim to cultivate a state of awareness and presence, allowing individuals to navigate life's challenges with greater ease and resilience.

Mindfulness, a practice rooted in ancient meditation traditions, involves paying attention to our thoughts, emotions, and bodily sensations in a non-judgmental way. By fostering an attitude of curiosity and acceptance, mindfulness helps to interrupt the cycle of stress reactivity. This shift in perspective enables individuals to respond to stressors more thoughtfully rather than reacting impulsively. Regular mindfulness practice has been shown to reduce symptoms of anxiety and depression, improve attention and concentration, and even enhance overall physical health.

Yoga, on the other hand, combines physical postures, breathing exercises and meditation to promote mental and physical wellbeing. The physical practice of Yoga helps to release tension and stress accumulated in the body, while breathing techniques (pranayama) encourage relaxation and mental clarity. The meditative aspects of Yoga support mindfulness, helping practitioners to develop a deeper awareness of their internal states. Together, these elements of Yoga contribute to a reduction in stress levels, improved mood, and a sense of inner peace.

Incorporating mindfulness and Yoga into daily life can offer a sanctuary from the stress of modern living, providing tools that empower you to manage stress proactively. Whether it's through a dedicated class, a few minutes of meditation each day, or simply practicing mindful breathing during a break, these practices invite a return to balance and harmony within ourselves.

Take a pressure sabbatical.

Taking a full sabbatical from work is a luxury few of us can afford. But how about taking a sabbatical from pressure?

I’ve realised that expecting too much of myself causes me to suffer and burn out. When I allow perfectionism to dominate, nothing is good enough, and am my own worst critic. But I am the one putting pressure on myself, allowing the ‘shoulds’ to govern me.

So why do we pressure ourselves? Is it because we want recognition? Perhaps we want to do better, be the best, crave attention, want the next best thing, long for, lust after, covet, yearn. Do these actions make us happy? The things that really make us happy are those that fulfil our human needs: friends, family, community, health, nourishment, sleep, shelter, safety, enough wealth to survive and a little more to thrive. Enough.

When we feel stressed, it is often our own expectations getting in the way; the pressure we pile onto ourselves. We could be our own best friend instead of our own worst enemy. What would you do if your best friend told you they felt pressured and that it was making them sick? What advice would you give? Make a list and see what comes up as you read it through.

Here are some ideas I’ve had while taking a pressure sabbatical:

• Stepping away from social media. I’m not missing out on life because life’s right here… now.

• I’ve learned that I don’t have to make an excuse or give a reason when saying NO.

• I’m only doing the bare minimum.

• I’ve let perfectionism go. Enough is good enough.

• I step away as soon as I begin to feel overwhelmed. Space brings perspective. Time spent in nature soothes our nervous system so I feel even better for a walk.

• I am easily bored so instead of pressuring myself to focus on just one job, I have a few on the go at once. When I start to feel dullness or boredom, I switch jobs. This has been a revelation to me because I actually get more done!

• I have learned to ask for help and accept it when offered. Pride doesn’t get me anywhere.

• Timetabling is great for brain fog! it means I can tick off the jobs!

• Regular rest breaks are essential. Pushing on is pushing into burn out. Rest can be 3 minutes of pranayama, a little weeding, movement of any kind.

Remember, as Brene Brown says, “you are always doing the best you can,” so why pressure yourself to do more?

Leave a comment if you have any good ideas for easing pressure.

Brain Fog - Yoga can help.

If you are finding that you’re forgetting the names of people you know, why you went into a room, what you were talking about mid sentence, if you’re unable to find a word, feeling empty headed or confused, you are not alone. Brain fog effects many women during peri-menopause and menopause but for most, it will pass.

I recently attended an educational workshop on menopause with functional medicine practitioner, Tanya Borowski who is exceptionally knowledgeable. I am also reading a book called Hormone Repair Manual by Lara Briden. These two sources suggest ideas that may help you keep your brain healthy:

Oestrogen therapy. To really benefit, we would be better starting it 5 years before our final period or at menopause at the latest. If the average age of menopause is 51, the best time to start is 46. Neuroscientist Roberta Diaz Brinton suggests in Briden’s book, that taken after menopause, oestrogen therapy may actually contribute to dementia, however more research is needed.

Progesterone is also important for brain health. It supports GABA receptors in the brain. GABA is a mood enhancing neurotransmitter. Together oestrogen and progesterone support many brain functions, including the hippocampus (the memory centre) so it is worth discussing a combination of hormones with your health practitioner when considering HRT.

Diet and lifestyle. Tanya Borowski, says we cannot simply replace hormones without adapting our lifestyle. Both Briden and Borowski recommend that you:

• Reverse insulin resistance (with a Ketone diet).

• Soothe your nervous system.

• Develop healthy sleep habits.

• Minimise alcohol and drink more water.

• Engage in movement of any kind but strength training in particular.

• Take supplements - in particular magnesium and taurine, B12, choline and MCT oil.

The good news from the perspective of Yoga and Mindfulness is that many of the practices we engage in at Birchwood Yoga support brain function. GABA receptors are usually supported by progesterone so when this hormone is lost, we experience raised levels of anxiety and stress. Research by Chris Streeter et al, shows that GABA is released when we practice Yoga. GABA helps promote relaxation and reduces stress, anxiety and even symptoms of PMS according to Lisa Mosconi, author of The XX Brain. Meditation improves brain structure and function and the pace of Slow Mindful Yoga helps build physical strength and mental resilience. In combination with the breathing practices and long savasanas your nervous system gets soothed. Win, win!

Lessons learned from holding on too tightly.

If I could use one word to describe the way I’ve been feeling lately, it would be discombobulated. It’s been two years since we were in full lockdown in the UK. Life has changed for us all and whether we know it or not, it’s affected us on a tissue level. The fear, anxiety and stress went deep because we had to brace ourselves and now we’re living with constant uncertainty from the virus, the economy, the climate and the war in Ukraine.

I didn’t realise until my back went into spasm, just how much I had been holding on; quite literally bracing myself. I leapt from one crisis to another - the pandemic, the death of my father in law, the stress of starting a new course, deadlines and learning difficulties, keeping my business afloat and family issues; it all led to my becoming dissociated from myself.

I had known I needed to put the breaks on. I needed to stop, recentre and ground myself. I needed to feel what was happening on the inside, but my course exams were looming and I kept saying “not yet.” So my body floored me! That’s how it works energetically. “Now you’re listening aren’t you,” it said.

It’s been a humbling experience, not least because I know that what I do (or rather, don’t do) affects others. As Brene Brown would put it, I’ve been doing my best. And as I type this, the little gremlin in the back of my mind just said, “Yes, but your best isn’t good enough is it?” My job now is to silence that gremlin with kindness and self compassion.

The tools I learnt studying Yoga Therapy for the Mind will help me. As I say to my clients who take the De-Stress your Mid-Life course, these tools are life long skills that we will return to over and over again. To be human is to be fallible. But the most important thing is that we learn from our mistakes. And my mistake was not prioritising self care.

So lessons learned are:

• Doing your best is good enough.

• Taking time every day for self care is not selfish, but invaluable.

• Celebrate every success, no matter how small.

• Ask for help when you need it.

• The boys are capable of looking after themselves, so let them!

I hope in some way, you resonate with some of this and find it useful to hear my story.

Cholesterol - friend or foe?

Have you been for your mid-life health check recently? Many women at this time of life are diagnosed with high cholesterol. There’s good reason for this and it’s important to understand why.

Cholesterol is manufactured in the liver. It is responsible for repairing damaged tissue. Steroid hormones such as oestrogen, progesterone and cortisol are derived from cholesterol. As oestrogen levels are lowering at mid-life, it is not unlikely that we will have raised levels of cholesterol which is more of a problem in conjunction with high blood pressure, diabetes, obesity or a genetic tendency to gain weight around the middle.

Cortisol is one of our stress hormones and its main role is to modulate inflammation. The body is unable to metabolise the amount of cortisol circulating when chronically stressed. Cortisol then becomes dysfunctional and the result is actually increased inflammation. Not only is cholesterol needed for greater cortisol production but also to repair any damage to the tissues as a result of inflammation.

Food intolerances are inflammatory and are common in women at mid-life. Arthritis and rheumatism are inflammatory conditions also. Higher levels of cholesterol is necessary for the body to derive cortisol whose role is to modulate inflammation in these circumstances. Remember that cortisol is our friend until it gets out of control.

Stress is often the root cause of dis-ease and disease and this certainly needs to be addressed. Downregulating an overactive nervous system and developing skills to manage stress can reduce cortisol and thereby lower cholesterol.

If like me, you prefer to find a natural solution before going down a medical road, consider whether there is a source of inflammation that could be the cause of high cholesterol. Address that and you may find your cholesterol levels lower. It is important to get them checked again to take a different course of action should it be sensible or necessary.

References:

https://www.uscjournal.com/articles/menopause-cholesterol-and-cardiovascular-disease-0#:~:text=Menopause%20is%20associated%20with%20a,%2Ddensity%20lipoprotein%20(HDL).

https://www.health.harvard.edu/heart-health/how-its-made-cholesterol-production-in-your-body

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263906/#:~:text=Cortisol%20is%20a%20potent%20anti,survival%20and%20avoidance%20of%20danger.