You’re Not Failing, You’re Full: A Therapist’s Guide to ADHD, Motherhood, and Menopause

By Abby Neuberg

The Overlap No One Talks About

ADHD in women has been under-recognized for decades. While boys are often diagnosed young for hyperactivity, women tend to fly under the radar. Many are socialized to mask — to people-please, to overcompensate, and to push toward perfectionism that is exhausting to maintain.

Motherhood turns the pressure up. The expectation is to create structure, but that’s exactly where the ADHD brain struggles. Guilt piles on with every forgotten appointment, every morning meltdown, every day that ends in snapping and shutting down.

Then, midlife hits. Perimenopause and menopause change the game. Estrogen plays a key role in dopamine regulation — which means as hormone levels fluctuate and drop, ADHD symptoms can spike dramatically. Even women who managed their ADHD well before may suddenly feel like they’re unraveling. It’s not just hot flashes and night sweats — it’s brain fog, forgetfulness, mood swings, and a deep emotional unease that can make daily life feel harder than ever.

When the Nervous System Is Always “On”

With ADHD and hormonal changes, the nervous system often lives in overdrive. Feelings of being wired, anxious, or close to tears can appear for no obvious reason. Therapists call it the window of tolerance — the range where someone can function without being overwhelmed — and that window can shrink dramatically during this stage of life.

The good news: there are ways to compensate for the tax on the nervous system. Grounding techniques, mindfulness, breathing exercises,  short movement breaks, and even guilt-free alone time can help widen tolerance again. Small, consistent shifts can be surprisingly powerful.

Finding Systems That Actually Work

Yes, the structure of calendars and one to do list can help, but the systems that stick are the ones that match how the ADHD brain actually works. That might mean “anchoring” a habit to something already done daily (like unloading the dishwasher while coffee brews), using visual reminders around the house, or relying on gentle accountability from friends or partners.

For some, restructuring the day to match natural energy flow makes a world of difference — boosting both productivity and mood while easing pressure.

Emotions on High Alert

Midlife ADHD often comes with emotional intensity — irritability, rage, and sadness can rise fast and hard. This isn’t a moral failing. It’s the brain and body reacting to real chemical changes. Learning to pause, breathe, and let emotions move through the body (rather than bottling them up) can prevent blowups and shame spirals. Sometimes emotions for people with ADHD feel more like a riptide than a wave. Here people learn to “swim sideways” with the pull of emotion by engaging another activity or being more patient with the time it takes to reregulate.

Sometimes it’s as simple as having a go-to script: “I’m at capacity right now, I need 15 minutes.” That pause can protect relationships in overwhelming moments.

You Don’t Have to Do It Alone

Asking for help isn’t weakness — it’s wisdom. Support might mean therapy, ADHD coaching, hormone care, or medication. It might mean hiring help at home or saying no more often.

When meeting with a doctor, try writing down your symptoms and one example of how each affects daily life. (Mary Clair Haver offers a free and short guide on her website.) This keeps the conversation focused and actionable.

Letting Go of the “Ideal” Mother

One of the hardest parts of this journey is releasing the “ideal” mother in the mind — the one who always has healthy snacks, never loses her cool, and somehow works, socializes, and self-cares flawlessly. That mother doesn’t exist.

Self-compassion isn’t indulgence. It’s the oxygen mask that keeps everything else running. A helpful reframe: What would I say to a friend who felt this way? Then, say it to yourself.

The Second Half Is Yours

Midlife isn’t the end. It’s a doorway. The biggest prize most women earn, is the right to take breaks, step back, let go, and give few f*cks.

Once women understand what’s happening in their brains and bodies, they often reclaim energy, creativity, and voice in ways they never imagined.

This is the stage of life where new careers begin, books get written, paintings return to canvases, friendships deepen, and joy comes back into focus. Remember this slow process that usually starts by taking a break, tuning in, cutting away what is not a priority, and letting go of “shoulds” and “oughts” that may have been controlling us our whole lives.

A Final Word

If nothing else, remember this: You are not behind. You are not failing. You are becoming.

The combination of ADHD, motherhood, and menopause is intense — but it’s also survivable and even transformative with the right tools, support, and perspective. It is possible to put down the bricks you’ve been carrying. You are enough, exactly as you are.