Sarah West I Certified ADHD Coach

11/11/2025

Is the general understanding of dopamine and its effects on ADHD completely wrong?

Many people still believe ADHD is simply caused by “low dopamine.” But recent evidence points towards something more accurate and far more helpful.

Rather than a blanket shortage, research suggests that the dopamine system in ADHD is dysregulated (Badgaiyan et al., 2015, Sikström and Söderlund, 2022, MacDonald et al., 2024).

The baseline signal, known as tonic dopamine, can be lower, and the task-related bursts, known as phasic dopamine, can be more uneven or less well regulated (ADxS.org, n.d.).

A useful analogy is thinking of the brain’s dopamine system like a Wi-Fi connection. The signal is there, but it can be unstable, dropping in and out, or spiking at the wrong times. ADHD medication does not add dopamine, it helps the signal stay more consistent so the brain can use it more effectively (Badgaiyan et al., 2015).

This model feels more accurate and compassionate, especially for women in perimenopause and menopause, where fluctuating hormone levels create a double whammy, as not only is dopamine production affected, but also how it is used, taken up, and regulated in the brain (MacDonald et al., 2024).

Do you think this model makes more sense than the generalised “low dopamine” explanation that is often shared online? I would love to hear your thoughts.




References
Badgaiyan, R.D., Sinha, S., Sajjad, M. and Wack, D.S. (2015) ‘Attenuated tonic and enhanced phasic release of dopamine in Attention-Deficit/Hyperactivity Disorder’, PLoS ONE, 10(3), e0117530. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4589406/

MacDonald, H.J., Kleppe, R. and Szigetvari, P.D. (2024) ‘The dopamine hypothesis for ADHD: An evaluation of evidence accumulated from human studies and animal models’, Neuroscience and Biobehavioural Reviews, 156, pp. 318–330. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11604610/

Sikström, S. and Söderlund, G. (2022) ‘Stimulus dependent dopamine release in Attention-Deficit/Hyperactivity Disorder’, Psychological Review. Available at:https://www.gu.se/sites/default/files/2022-11/GS%20Psych%20Rev.pdf

10/11/2025

Is burnout more common in those who are neurodivergent?

A couple of years ago I hit a level of burnout that stopped me completely.

I had been holding too much for too long while working as a senior nurse, supporting my two neurodivergent children, running a home, and clearing the house of a close relative who had recently passed away. From the outside I looked organised. Inside everything was collapsing. Eventually my GP signed me off work and it took me months to recover.

Burnout is now recognised as a major issue and research shows neurodivergent adults experience it more frequently and more intensely than neurotypical adults.

One UK survey found that half of neurodivergent employees reported burnout compared with 38 percent of neurotypical workers (WTW, 2023). Another study found that more than 40 percent of neurodivergent workers were already experiencing burnout (Our Community, 2024).

Autistic burnout is increasingly understood as severe, long lasting, and linked to chronic stress and a mismatch between demands and available resources (Raymaker et al., 2020, National Autistic Society, 2023).

For women with ADHD the story is more complex. Masking, emotional load, late diagnosis, and hormonal changes all appear to increase burnout risk, though large scale studies focusing specifically on women are still missing (Hull et al., 2020, Nadeau, 2020, NICE, 2024).

Recovery can take months or even years for neurodivergent adults (Raymaker et al., 2020). The lack of large scale data makes it difficult to quantify exact timelines but the lived experience shows that it is not a quick fix.

Does any of this resonate with your experience? Have you lived through burnout yourself or seen it in someone close to you?
What helped your recovery or what support do you wish you had at the time?



References

Hull, L., Petrides, K. V. and Mandy, W. (2020) ‘The female autism phenotype and camouflaging’, Review Journal of Autism and Developmental Disorders, 7(4), pp. 306–317.

Nadeau, K. (2020) Understanding Women with ADHD. Washington DC: American Psychological Association.

National Autistic Society (2023) Autistic Burnout Guidance. Available at: https://www.autism.org.uk

NICE (2024) Menopause: diagnosis and management (NG23). London: National Institute for Health and Care Excellence.

Our Community (2024) Burnout Risk for Neurodivergent Workers Report. Available at: https://www.communitydirectors.com.au

Raymaker, D. M. et al. (2020) ‘Having a hard time is not unique to autistic people but the cause is: a qualitative analysis of autistic burnout’, Autism in Adulthood, 2(2), pp. 132–143.

WTW (2023) Global Benefits Attitude Survey. Available at: https://www.wtwco.com

05/11/2025

I’m really chuffed to have been asked back again by ADHD UK to continue running my monthly webinars on ADHD and the perimenopause throughout next year.

It’s such a privilege to collaborate with an organisation that’s doing so much to raise awareness and support people living with ADHD. I’m genuinely grateful to know that the sessions I provide are making a positive difference to people’s lives and that my work is appreciated.

If you’d like to join either my future webinars or any others provided by ADHD UK, you can find the details in the comments section below

30/10/2025

Reflecting on ADHD awareness month and World Menopause Day

With ADHD awareness month and World Menopause Day both in October, I’ve been reflecting on how much more awareness is still needed on how closely ADHD and perimenopause overlap.

For me personally, finally understanding what had been behind so many of my lifelong challenges, and realising how much perimenopause amplified my ADHD, helped me make sense of myself, find the right support, and realise that these weren’t personal failings, but biology and brain wiring I simply hadn’t known about or understood before then.

It’s encouraging to see growing awareness and understanding in this area, with so many brilliant advocates leading the way in education and change.

Yet, for me, it also feels bittersweet. I can’t help but think of the countless women who have been misdiagnosed, misunderstood, and let down for decades, and sadly, how for some, this continues to this day. Understanding can’t change the past, but it can shape what happens next.

I’m grateful to now have the knowledge to better understand myself and to support others on the same journey. Awareness of both neurodivergence and it's interactions with hormones is growing, and that gives me hope. I’m also encouraged by the many other practitioners who share my passion for raising awareness, offering support, and empowering others to self-advocate and access the help they not only need but have always deserved.

27/10/2025

Perimenopause, neurodivergence, and the risk no one talks about

We often hear about hot flushes and night sweats, yet rarely about the emotional and cognitive impact of perimenopause.

For neurodivergent women, especially those with ADHD or autism, this can be a time of deep vulnerability.

Hormonal changes can amplify challenges with mood, focus, and emotional regulation, leaving many women feeling as though they’re losing themselves. As writer Bridgette Hampstead puts it, “Perimenopause feels like dementia in an AuDHD brain, and no one warns you.”

Research shows that rates of depression and suicidality rise during perimenopause, particularly when symptoms are misunderstood or dismissed (Hendriks et al., 2025; Martin-Key et al., 2024). Which I know only too well as when my own perimenopause and AuDHD collided a few years ago, I came dangerously close to becoming one of those statistics.

For thousands of women, timely recognition and appropriate support are not luxuries, they are lifelines.

Does this resonate with you? Have you noticed changes in your ADHD and/or autism during perimenopause? I’d love to hear your experiences or thoughts in the comments.



References
Hendriks, O., McIntyre, J.C., Rose, A.K., Crockett, C., Newson, L. and Saini, P. (2025) The mental health challenges, especially suicidality, experienced by women during perimenopause and menopause: A qualitative study, Women’s Health (London), 21, p. 17455057251338941. Available at: https://pubmed.ncbi.nlm.nih.gov/40626330
Martin-Key, N.A., Funnell, E.L., Barker, E.J. and Bahn, S. (2024) Examining suicidality in relation to the menopause: A systematic review, PLOS Mental Health, 1(6), p. e0000161. Available at: https://journals.plos.org/mentalhealth/article?id=10.1371%2Fjournal.pmen.0000161
Hampstead, B. (2024) Perimenopause feels like dementia in an AuDHD brain, and no one warns you, LinkedIn, 15 September. Available at: https://www.linkedin.com/pulse/perimenopause-feels-like-dementia-audhd-brain-one-you-hamstead-ms-59hfc

There is a moment, often around age 38 or 42 or 45, when a late-diagnosed autistic and ADHD (AuDHD) woman finds herself unable to think. Not just the usual difficulty focusing, not just a rough week or a bad sensory day, but something else.

09/10/2025

Feeling very proud today!

I’ve just found out I’m a finalist in three categories at this year’s Devon Women in Business Awards! The winners will be announced in November at Sandy Park Stadium in Exeter.

When I started my business less than two years ago, my goal was simple — to make a real difference for women navigating ADHD and the perimenopause. It’s been a steep learning curve, but one of the most meaningful things I’ve ever done.

Leaving my career as a nurse to follow my passion wasn’t easy, but failure was never an option. I’ve worked hard to overcome self-doubt, and I’m proud to show my daughters that anything is possible with determination, hard work and belief in yourself.

Running a business isn’t always linear, but my drive to support women with a late ADHD diagnosis and in the perimenopause has kept me moving forward, even on really hard days. And I’m so grateful for the supportive, inspiring people I’ve met along the way.

I may not win on the night, but to even be recognised for the work I care so deeply about means a great deal.

Devon Women in Business Networking Group 💖

02/10/2025

October is ADHD Awareness Month!

ADHD affects people of all ages and genders, yet it continues to be widely misunderstood. For many, the difficulties associated with ADHD have been present throughout life, and challenges with focus, organisation, time, or emotional regulation can feel relentless.

Without understanding or recognition, these difficulties can lead to shame, low confidence, and exhaustion.

Awareness matters because:
-ADHD is not a weakness or a character flaw, it is a neurodevelopmental condition that is highly treatable

-It can present differently in different people, which means it is often overlooked or misdiagnosed

-Hormonal changes, stress, and life transitions can amplify symptoms and create new challenges

-Late diagnosis is still common, leaving many people unsupported for years

Yet ADHD is not only about struggles. With the right recognition and support, the very traits that once caused difficulty — creativity, curiosity, energy, hyperfocus, problem-solving — can become powerful drivers for change and achievement.

This month is about visibility, understanding, and compassion, while also recognising the potential that comes when people with ADHD are truly seen and supported.

30/09/2025

Why can simple tasks feel so exhausting when you’re neurodivergent?

ADHD, perimenopause and the spoon theory

A theme that comes up often in my coaching sessions is energy. For those of us with ADHD and/or autism, energy doesn’t always feel steady. It can disappear suddenly, and things that look small from the outside can be unexpectedly draining.

This links back to executive function challenges like planning, prioritising, starting tasks, managing time, and regulating emotions. Add sensory overload, masking, or rejection sensitivity, and our “spoons” run out fast.

For women in the perimenopause, the impact can be even greater. Hormonal changes affect sleep, memory, mood, and focus, so we may begin the day with fewer spoons. A broken night’s sleep, brain fog, or a dip in confidence can leave us running on empty before the day has even begun.

The spoon theory, created by Christine Miserandino, explains this well. Spoons represent units of energy. Neurotypical people may not need to think about them, but for those of us who are neurodivergent, and especially during perimenopause, spoons are limited and every demand can take its toll.

That might mean:
-Managing several tasks at once feels disproportionately draining
-Preparing for an appointment takes more energy than expected
-Unexpected changes can wipe out the last spoons we had left

When spoons run out, there is nothing left to draw on, which can affect not just energy but also confidence and self-esteem.

Understanding this helps us:
-Explain hidden exhaustion in everyday language
-Set realistic boundaries
-Validate that ordinary demands can take extraordinary effort
-Practise self-compassion and pacing, rather than pushing towards burnout

Recognising how spoon theory applies to ADHD and perimenopause can help us protect our energy and put support systems in place that truly work.

I’d love to hear your thoughts, does spoon theory resonate with you, and has it helped you explain or manage your energy?

18/09/2025

Unmasking after an ADHD diagnosis can be hard

For so many of us who are diagnosed with ADHD later in life, the process doesn’t end with the diagnosis. In many ways, it’s just the beginning.

We have often spent decades masking, moulding ourselves into what we thought we should be, or what society expected of us. We became experts at hiding our struggles and working twice as hard to keep up.

A formal diagnosis brings clarity and understanding of why we have struggled so much for all our lives, but what we don’t expect is that after years of masking we are now faced with the question: Who am I?

Unmasking can be both liberating and unsettling. It can feel like peeling back layers to rediscover the parts of ourselves that have been hidden for years. It’s not always comfortable. Sometimes it feels raw, uncertain, even frightening. But it can also be the start of living more authentically, with greater self-understanding and self-compassion.

Learning to lean into this process takes time. It can mean exploring what things in life you really enjoy, what feels aligned with your values, and giving yourself permission to stop being who you think you should be in order to please others.

Unmasking is not about becoming someone new. It’s about finally allowing yourself to be who you have always been.

13/09/2025

The grief that often follows an ADHD diagnosis

Finally receiving my ADHD diagnosis brought an enormous sense of relief. Things began to make sense. I finally had an explanation for why I'd struggled for decades, and it felt as though life might at last begin moving forward.

But in reality, that sense of clarity was short-lived.

For me, and for so many others in a similar position, what followed was grief and anger:

-For the years spent feeling “different” without knowing why.
-For the opportunities missed.
-For the times our struggles were attributed to other conditions, such as anxiety or depression (both of which commonly co-exist with ADHD and other forms of neurodivergence).
-For the wasted years in therapies and treatments that were not neuro-affirming and therefore less effective, when ADHD was the missing piece all along.

Looking back can be painful. Many of us wonder what life might have looked like if we had understood ourselves sooner. It can feel heart-breaking, and it is a very real part of coming to terms with an ADHD diagnosis.

With time, this grief does begin to soften. Slowly, the focus shifts from what could have been to what can be. We start to build self-knowledge, develop self-compassion, and move forward with greater clarity.

Grief is often part of the journey, but with the right support and strategies, it is possible to move from looking back with pain to looking ahead with hope.

Has this affected you on your ADHD journey? I'd love to hear your thoughts in the comments.