Not Mad, Not Bad, Just Perimenopausal with ADHD

Sara-Louise Ackrill has spent years understanding her neurodivergent brain, building a life around what works for her. Then came perimenopause. The hormonal sequel nobody asked for. 

What followed was a crash course in sensory overload, brain fog and anxiety on overdrive. 

But she’s not here to moan about it. She’s here to help other women feel seen, supported and, well, a bit less like they’re losing the plot. Plus, she’s shared her story and some really great practical guidance points for you lot reading this…

So, let’s get to it shall we?

In short, she’s doing the kind of work that changes lives. Especially for women who’ve spent years feeling unseen, unheard or just plain exhausted from having to explain themselves.

Sara-Louise hit perimenopause at 45 and the combination of that with autism and ADHD left her feeling frightened, disempowered and vulnerable. She tells all, in her own words.

Where it began

Ever since I was quite young, I had always been fearful of becoming perimenopausal. Yet, the only representation of perimenopausal women I experienced while growing up in the 90s came from TV soaps, the Daily Mail and mum’s women’s magazines. 

The prevailing image of perimenopause conveyed by popular culture back then was unnecessarily derisive and scaremongering. I imagined I would act in a shameful way I couldn’t control, and that people would dismiss whatever dark or scary physiological changes were happening to trigger my behaviour. It was the isolation that scared me.

But in 2023 when perimenopause crept up on me, I was living with a 7-year-old autism diagnosis and a fledgling ADHD diagnosis that I hadn’t factored into my perimenopause fears.

To be honest, I would have struggled to meaningfully connect the dots. I had never worked in enlightened workplaces offering wellbeing talks. 

It wasn’t something I had much experience with, and a lot of my friends are late-diagnosed neurodivergent women who’ve only recently discovered either their perimenopause or their neurodivergent status. 

They were mostly busy with their own overwhelming processes of elimination, let alone how peri and ND intersect.

Here are a few things that might help you spot some of the lesser-known ways perimenopause and neurodivergence can overlap in your own experience:

• Bone pain and sensory overload: Peri bone pain (which I only found out was a thing thanks to an interview with Kate Winslet) is weird and painful, sure. I sometimes need painkillers just to walk around the house. But when you are neurodivergent, it adds to the sensory overload and can make you much more prone to meltdowns.
• Executive dysfunction with an extra layer: We already struggle with Executive Function as ADHDers. Things like task initiation, working memory, planning and emotional regulation. But perimenopause and brain fog add a thick layer over it all, making my functioning that bit harder to access than it normally would be.
• Anxiety in overdrive: Around 80 percent of neurodivergent people already live with everyday mental health challenges like depression and anxiety. But perimenopause takes that and ramps it from 0 to 60 on the Anxiety-O-Meter. The fight or flight kicks in like I am being ambushed. Not the slow-building dread I was used to with pure ADHD. The speed of it can be genuinely alarming.

Women often do not realise they have ADHD until they reach perimenopause. 

This is not about new symptoms appearing. You are born with ADHD, you do not acquire it. 

But many of us have lived our whole lives developing coping strategies, often without even realising. When peri shows up, those strategies suddenly stop working because the context has changed.

One of the unsettling things about being neurodivergent is that it can feel like your traits are getting worse. But more often, something in your life has simply shifted. A breakup, a new job, a child getting diagnosed. These changes can bring everything into the light, whether you are ready for it or not.

The chance of clinicians recognising this correlation or knowing what to do with it is sadly scant. 

The 3 to 10 Year Waiting Game

I have variously been told in my recent women’s health journey in Primary Care that a male doctor wasn’t trained in this “because obviously I am a man”, that “this isn’t my area, you need to speak to my one colleague who we sent on the course”, and “it’s a 20-month wait for a Colposcopy under General Anaesthetic, and once you’ve had that we’ll check you’re on the right HRT.” 

When we’re not even on the starting blocks with perimenopause, and ADHD and autism assessment waitlists range from 3 to 10 years in the UK public health system, it’s clear we’ll be waiting a long time before GPs get proficient in the peri and ND double whammy.

A&E Meltdowns and Pregnancy Phobia

Physiological changes weird us out.

No, it isn’t just you I promise. I once screamed down an A&E ward because I was constipated. I cannot have smear tests without General Anaesthetic. I had therapy for my pregnancy phobia just to cope with becoming an aunty. 

I have bitten, kicked and sworn at doctors who tried to examine me, with no trauma in my history other than not being able to connect that my head is attached to a body. When someone checks that body in a clinical setting, I dissociate. Even a cold used to make me panicky and anxious until I worked on it.

It’s a lot, I know. But there are things that can help. Here are a few that have made a real difference for me.

These are not magic fixes, but they’ve helped me feel more in control when everything else felt a bit much. Try whatever speaks to you.

1. Try some neurodiversity coaching and/or therapy: For some psychoeducation, strategies, and the chance to work on emotional regulation and whatever is lying underneath and aggravating your combination of peri and ND symptoms.
2. Be vigilant: Perimenopausal women are heavily targeted as a niche market for all kinds of products now (aka ‘meno-washing’), and you might get bombarded with offers, ads and promotions that are not helpful to you but that trigger impulsiveness and challenges like prioritising and medium-term budgeting.
3. Ditto with the weight loss industry: If you need to lose weight, ask medical professionals. Weight is an extremely complex issue and people are full of advice from the last Insta post they read.
4. Get talking: Try keeping less to yourself, because if you do not bring worries out into the open, you can bet that Peri and ADHD will rip the plaster off and give you a more exaggerated problem to deal with later down the line.
5. Tackle any complex (small ‘t’) trauma: Brainspotting, Hypnotherapy and EMDR are all proven therapies that work with your subconscious and take the load off your nervous system, leaving you with more bandwidth to handle the day to day. You can do these online or in person with a trained and experienced practitioner. The benefit is usually that people have far less intense reactions to whatever is triggering them, helping them feel more confident and in control.

A huge thank you to Sara-Louise for sharing what so many women feel but rarely gets the air-time. 

Her honesty, insight and practical advice offer exactly the kind of support that is missing from so many conversations around perimenopause and neurodivergence.

This Is Bigger Than One Story

These experiences are not niche. They are just not widely recognised yet, and that needs to change. 

What Sara-Louise so clearly lays out is how deep the disconnect still runs in our health systems, our workplaces and our everyday understanding of what it means to be a neurodivergent woman going through midlife.

Why We Are Here

At Valerie, we believe no woman should have to push through this alone, misunderstood or unsupported. The combination of perimenopause and neurodivergence deserves proper attention, better care and real-world solutions. 

Whether that starts with a conversation, a diagnosis or simply recognising your own experience in someone else’s words, it matters. You matter.

This is exactly why we do what we do.

If you’re busy navigating the chaotic plot twists of perimenopause with a neurodivergent brain that already feels at capacity, know this. You’re not broken.

And you’re definitely not alone.

Daily Essential was created to support women exactly like you. With nutrients that target the overwhelm, the fatigue and the fog, it is your daily reminder that feeling better shouldn’t be a mystery.

Check out Say Its Name: Let’s Talk About “P” Girlfriend… by Sophia Cleverly, Midlife Women’s Coach and Mentor.

Because sometimes the best thing you can do is start the conversation — especially with your best mate.