Sarah West I Certified ADHD Coach, Exeter (2026)

31/03/2026

Every month I talk to women who thought they were going crazy.

They weren't. They were going through perimenopause with ADHD, and nobody had explained that the two were connected.

Oestrogen is essential for how the brain makes and regulates dopamine. When it drops during perimenopause, it does not bring just the symptoms everyone already knows about.

For women with ADHD, it can unravel everything that had been keeping the brain functional.

-The focus goes.

-The emotional regulation disappears.

-The anxiety that was manageable becomes anything but.

-Sleep disappears.

-The strategies and routines that worked for years stop working.

Women spend months, sometimes years, being told they are depressed or anxious, when what is actually happening has never been explained to them.

Tomorrow from 12-1pm I am presenting my monthly ADHD UK webinar on exactly this.

What is happening in your brain during perimenopause, why it affects ADHD so significantly, and what changes when you finally have the right explanation.

Understanding what is actually going on is the first thing that helps.

If you have ADHD and perimenopause is making everything harder to manage, come and join me.

Registration is through the ADHD UK website. Link is in the comments.

30/03/2026

RSD tells me lies.

That people do not like me. That I have no real friends. That I am not as good as everyone else. That the whole world is getting on fine and I am the only one who is not.

I know, rationally, that none of this is true. But when it hits, rational does not come into it. It feels real. And it is exhausting in a way that is almost impossible to explain to someone who has not lived it.
Rejection Sensitive Dysphoria is arguably the most debilitating part of ADHD that nobody talks about enough. The intense emotional pain triggered by the feeling of being rejected, criticised, or not measuring up. Not the reality of it. The feeling of it.

This is why so many women with ADHD spend years being treated incorrectly for anxiety or depression. The symptoms overlap. The misery is real. But the cause is different, and the treatment needs to reflect that.

When RSD hits alongside the impulsivity that comes with ADHD, it can become dangerous. Decisions get made from a place of absolute certainty that everything is ruined.

Relationships end. Jobs get left. Messages get sent. And then a few days later, the storm passes. The world did not end. But the damage might already be done.

It turns so many of us into people pleasers. Always trying to stop the rejection before it arrives. Always adapting to avoid the risk of disapproval.

It is not weakness. It is neurology.

Have you ever made a decision in the thick of it that you wished, a week later, you could take back?

26/03/2026

Most of the women I work with have sat in a GP's office and been told nothing is wrong.

Normal bloods. Probably depression. Come back if things get worse.

What if the GP in that room had understood what they were actually looking at?

Last year I delivered a training session for forty GPs on ADHD in women and the perimenopause. The lady who organised the day fed back that it gave clinicians a clear insight into the topic, rated excellent or good across the board, and that she would want to book another session for GPs and non-medical referrers in the area.

The clinicians who attended will now support their patients with more confidence. That is what changes when the right information reaches the right people. Not one woman, but every woman who walks through that door looking for answers she has probably been waiting years for.

Women with undiagnosed ADHD are being missed in primary care every day. Not because their GPs do not care, but because the training is not there.

That is the gap I work to close.

One clinician who understands the overlap between ADHD and perimenopause can change the course of a woman's life.

If you want a speaker or clinical educator for a primary care team, a GP practice, or a healthcare organisation, I would love to hear from you.

https://calendly.com/sarahwest-adhd-coaching/speaker-enquiry

23/03/2026

A few years ago I came dangerously close to becoming a statistic.
Perimenopause hit my undiagnosed ADHD brain, and nobody had warned me what would happen.

Nobody had told me that oestrogen is essential for how we make and regulate dopamine. So when it drops, it takes with it the very things a neurodivergent brain relies on. My anxiety. My RSD. My emotional regulation. All of it spiralled. I had no idea there was a reason why, or that with a clinician who understood how perimenopause and ADHD impact each other, it is highly treatable.

For women with ADHD, perimenopause does not just bring the symptoms everyone talks about. It amplifies everything that had already been hard for years. Research now confirms what so many of us have lived: rates of depression and suicidality rise sharply during perimenopause, especially when underlying causes go unrecognised and incorrectly treated.

That is why I now coach women who are right where I was. Why I present on this for ADHD UK every month. Why I talk about it on stages, on podcasts, in every space I can get into.

No woman should have to come as close as I did before someone explains what is happening to her brain.

If this is your experience, or you think it might be, come and find me.

20/03/2026

I spent most of my life failing at being a good girl.

And for a long time, I thought I knew exactly what that looked like. She was organised and calm and consistent. She fitted in without it costing her anything. She didn't lose things or say the wrong thing or have to work twice as hard just to look 'normal' (whatever that actually is). I looked at women who seemed to have it together and I thought: that is what I am supposed to be.

So I tried. For years, I tried.

I tried to be quieter, more consistent, more together. And when I kept falling short, the story I told myself was always the same. That I was the problem. That everyone else had figured something out that I simply couldn't get right. That I was failing at something that should not even be hard.

The shame of that. The years of it.

And then I found out I had ADHD. And it all made sense. Because the good girl I had been trying to become was neurotypical. And I am not. I had spent decades chasing a version of myself that was never actually available to me.

I was not failing at being a good girl. I was a zebra trying to be a horse. A neurodivergent brain in a neurotypical world. And nobody had told me.

You were enough. You always were. You were just a child in a world that was not built for your brain. And the story you told yourself about failing was never the truth.

How long did you spend trying to be a version of yourself that was never really yours?

18/03/2026

My cat brought me four dead mice this morning.

Not lined up neatly. Just distributed around the house. One by the back door. One in the hallway. One I nearly stood on in the kitchen. One outside my daughter's room.

I did not ask for this. I did not need this. And I then had four dead mice to deal with before I could even make a coffee.

I stood there looking at them and thought, this is exactly what my ADHD brain does.

It brings me things I did not ask for. Memories from 2009. A brilliant idea at 11pm. Every possible worst-case scenario for a conversation I have not had yet. A sudden overwhelming urge to reorganise something that was absolutely fine. All of it delivered with complete confidence. All of it presented as a gift.

For a long time, I thought something was wrong with me because my brain would not stay where I put it. I would be in the middle of something important and it would wander off and come back with four things that had nothing to do with what I was trying to do.

What I understand now is that the ADHD brain is not broken. It is just running a very different operating system. It is being exactly what it is, which is pattern-seeking, connection-making, endlessly generous with things you never asked for.

That does not make the 11pm ideas or the uninvited memories less exhausting. But it does change how you relate to them.

He is not misbehaving. He is doing what cats do.

Does your brain bring you things you did not ask for? What does yours show up with?

17/03/2026

Mother's Day is beautiful for some people. For others, it is one of the hardest days of the year.

Social media fills up with the most beautiful tributes to mums. Mums who are adored, mums who are missed, mums who meant everything, and that is a really lovely thing to see.

But for some of us, our story is different.

I had a difficult relationship with my mum. I won't go into that here, but for a long time Mother's Day was a reminder of what I didn't have. The warmth, the safety, the kind of mum that so many people seem to take for granted. My feelings have softened over the years and I've made my peace with that, not because it didn't matter, but because carrying those feelings wasn't serving me.

What I did with that grief was change the narrative, because I wanted to be the mum I never had.

This doesn't mean I've got it all figured out, because believe me, I am far from being the perfect mum. I am neurodivergent, my children are neurodivergent, and we have had some really challenging times. Parenting is not a performance of perfection. It is showing up for the people you love, again and again, even when it is hard.

This Mother's Day I got flowers, a big bar of chocolate, and handmade cards, (which are my absolute favourites). And what struck me, sitting with my girls, was not just that I love them unconditionally, but also that I genuinely like them as people, and they are such lovely human beings to be around.

If you had a complicated Mother's Day too, I just want you to know that grief and joy can exist together. And you are allowed to feel both.

16/03/2026

I got my ADHD diagnosis and someone told me “everyone feels like that”.

I had been so excited. Suddenly I could join the dots. All those years of struggling with things other people seemed to manage so easily, all those times I told myself I was just not good enough, not trying hard enough, not capable enough. There was a reason. There had always been a reason. And having that validation, finally having a name for something I had lived with my entire life, felt enormous.

So I told someone.

And they said "oh, everyone's a bit like that."

I cannot fully describe what that did to me. Years of struggling. Years of being treated for anxiety and depression with support that was designed for a neurotypical brain and not knowing why they didn’t help me. CBT and therapies that were not wrong in themselves, but were not what I actually needed. And in one sentence, all of that was dismissed.

The diagnosis did not just explain my struggles. It explained why so much of what I had tried had only ever partially worked. My brain was not broken. It was just a brain that needed different support, and nobody had ever told me that.

If someone minimised your diagnosis, or made you feel like you were making something out of nothing, I want you to know that your experience is real. The years of struggling were real. And you deserved answers a long time before you got them.

Did anyone ever say something like that to you after your diagnosis, and how did you react?

14/03/2026

I walked into a room last week where I barely knew anyone.

For most of my life, that would have been the start of a very long, very anxious evening. I read rooms. I always have. And what I have read, more times than I can count, has told me to stay quiet, stay careful, stay small.

I know what it feels like to mask so hard you come home exhausted from simply existing in a space.

But something was different last week. I cannot fully explain it, except that if you have ADHD, you might already know what I mean. We have a sixth sense for when a room is unsafe. And we have it for when it is not.

Within minutes I felt it. The absence of performance. The absence of judgement. And without even deciding to, I let myself be me. No editing. No monitoring. No version of myself filed down to fit.
I had the best evening I have had in so, so long.

I kept thinking about it for days. About how rare that feeling actually is. And about how much it matters.

Because in the work I do, trust is not a nice extra. It is the whole foundation. Without it, the women I work with arrive as the version of themselves they have learned to present. The one who takes up less space. And that version cannot grow, cannot heal, when the room does not feel safe enough to take the mask off.

When trust is there, something else becomes possible. The real stuff comes out. And that is when extraordinary things happen.

Do you know what becomes possible for you when you finally feel safe enough to stop managing how you come across?

12/03/2026

I nearly sent an email that would have damaged a friendship.

I read something from a friend and I was ready to fire back. I was certain I knew what she meant. I could feel the irritation rising before I had even finished reading it.

But something made me stop. I do not know what it was exactly, maybe just enough self-awareness in that moment to know I was activated. So I left it. Came back to it about an hour later.

And when I read it again, it said something completely different.

Not different as in she had changed it. Different as in I had misread it entirely. The wording I was so certain about was not there. The tone I had felt so sure of was not there. I had constructed a whole version of events that existed only in my head.

This is one of the things nobody tells you about ADHD impulsivity. It is not just about acting fast. It is about being absolutely convinced you know the full picture when you are only seeing the one your nervous system decided on in about four seconds.

The pause did not just save me from sending a bad email. It saved me from a conversation I would have had to unpick for weeks, with someone I genuinely care about.

If you are late diagnosed and you are still learning what your ADHD actually looks like in real life, this is one of the most valuable things you can practise. Not suppressing your reaction. Just creating enough distance between the feeling and the send button to let your brain catch up.

Have you ever nearly responded to something and then realised you had completely misread it?

11/03/2026

I sat in that training room certain I was the only one who had no idea what was going on.

Everyone else looked composed. Confident. Like they belonged there in a way I clearly didn't. My brain was running a very convincing commentary in the background, telling me I was out of my depth, that I'd somehow ended up in a room full of people who were sharper, quicker, and better equipped than me. Classic imposter syndrome. And my ADHD perimenopause brain? It was absolutely here for it.

The cognitive load of trying to process new information while that internal noise is running is exhausting. What I know, both as a nurse and as someone living this, is that when oestrogen drops it affects dopamine and noradrenaline, the very neurotransmitters that ADHD brains already struggle to regulate. So the processing slows down, the self-doubt amplifies, and suddenly a training course feels like evidence of everything you feared about yourself.

I nearly said nothing.

I nearly sat there nodding and hoped nobody noticed.

Instead, I put my hand up and said I didn't understand.

And do you know what happened? Others said the same. The room exhaled. The course leader was warm, reassuring, and we arranged a breakout session to go over it together. The version of events my brain had constructed, the one where I was uniquely struggling and everyone else was sailing through, was not real. It was a story. A very loud, very persuasive story, but a story nonetheless.

This is what our ADHD brains love to do. It is not a character flaw. It is neurochemistry. But knowing that doesn't always stop the lies from feeling like facts.

What has your brain been telling you lately that probably isn't true?

10/03/2026

I sat in that GP appointment and listed every single symptom.

Exhaustion that sleep didn't fix. A brain that felt like it was wading through wet concrete. Anxiety that came from nowhere. The feeling that I was somehow failing at being a functioning adult.

And I was told I was depressed.

This happens to women like us more than it should, and it isn't because the doctors are bad people. It's because the entire diagnostic picture for ADHD was built around hyperactive little boys who couldn't sit still in class. Not around the women who sat very still, said all the right things, held it all together on the outside, and were absolutely falling apart on the inside.

And then perimenopause arrives.

And suddenly the coping strategies that just about kept you afloat for decades stop working. The lists, the routines, the sheer force of will, none of it is enough anymore.

So you go back to the GP. And sometimes you're told it's your mood. Or your age. Or that this is just what being a woman feels like.

It isn't.

What's actually happening is that falling oestrogen affects dopamine and noradrenaline, the very neurotransmitters that were already working differently in your ADHD brain. So this isn't you falling apart. This is a biological and neurological collision that nobody joined the dots on. Often not even you.

If you have been dismissed, misdiagnosed, or told you were anxious or depressed when something else was going on, I want you to know that your instinct that something wasn't right was correct. You weren't too much. You weren't imagining it. You were just in a system that wasn't designed with you in mind.

That can change. And it starts with someone finally asking the right questions.

If you want to start joining those dots yourself, I have a free download that walks through the overlapping traits of both ADHD and perimenopause. It is not a diagnostic tool, but for a lot of women it is the first time they have seen their experience written down somewhere. I have popped the link in the comments below.

Sarah West I Certified ADHD Coach

31/03/2026

30/03/2026

26/03/2026

23/03/2026

20/03/2026

18/03/2026

17/03/2026

16/03/2026

14/03/2026

12/03/2026

11/03/2026

10/03/2026

Address

Website

Alerts

Contact The Practice

Shortcuts

Share

Category