Sarah West I Certified ADHD Coach, Exeter (2026)

03/02/2026

Does your brain sometimes lie to you?

A few years ago, a friend told me about something called Rejection Sensitive Dysphoria, or RSD, and it perfectly described something I have struggled with all my life.

Of course, no one likes rejection or criticism, yet this is on another level. RSD is now recognised as one of the hardest aspects of ADHD for many people. It is an overwhelming, all consuming feeling that you have been criticised, judged, or rejected, whether it actually happened or not.

It can show up in so many ways. People pleasing and saying yes when you want to say no, avoiding situations or people where rejection might happen, reacting too quickly when you feel criticised, pulling away from relationships to protect yourself, or making impulsive decisions in the heat of the moment that you later regret.

It is also that horrible spiral where you replay conversations, analyse every email or text, or assume you have upset someone because they have not replied. You start looking for evidence that you have done something wrong, and before you know it everything snowballs and feels catastrophic. It feels visceral and painful, like your world is falling down around you.

You start telling yourself stories that simply are not true. You convince yourself that people are annoyed with you, that they do not like you, or that you have failed in some way. The brain fills in the gaps, and none of the explanations are kind ones.

Hormones can make this even worse. During the luteal phase of your cycle or during perimenopause, when oestrogen is fluctuating and dopamine regulation is inconsistent, the intensity can increase dramatically. Things you might normally manage suddenly feel completely overwhelming, and this emotional pain can feel unbearable.

The hardest part is that most of the time, the only person we are really hurting is ourselves. That mix of emotional pain and ADHD impulsivity can lead to decisions we would never usually make, walking away from jobs, damaging relationships, or shutting doors simply because in that moment everything feels too much.

RSD is not something we can just get over. It is intense, painful, and incredibly isolating. There are ways to manage it, and ways to talk back to those thoughts, but if I am honest, it is hard. Sometimes the most helpful first step is simply recognising what is happening and thinking, this is my RSD, this is not the full truth. That awareness allows you to pause, delay decisions, and put small supports in place to help you ride it out.

What I have learned, both personally and through my work as an ADHD coach, is that we can learn tools to navigate these moments differently. We can pause before reacting, question our thoughts, build self awareness, and practise self compassion, so we are not ruled by the fear of rejection.

Does this resonate with you? I’d love to hear your thoughts in the comments.

02/02/2026

If you are in perimenopause and trying to tackle your ADHD, it is essential to look at your hormones first.

Our oestrogen is instrumental in how we produce and use dopamine.

And dopamine is central to attention, focus, motivation and emotional regulation, which are the very things we struggle with in ADHD.

So when oestrogen levels are fluctuating, dopamine is fluctuating too and this will always have a knock on effect.

When everything starts to feel inconsistent, from medication to the strategies you rely on, it is often because hormones and ADHD are intrinsically linked.

Getting your oestrogen levels as stable as possible, in a way that is right for you, gives your brain a much steadier foundation.

Then we can actually start working on your ADHD symptoms properly, the overwhelm, emotional dysregulation, motivation, boundaries, routines, and all those executive functioning skills that make everyday life feel more manageable.

And I'm here to help you with that.

30/01/2026

Do you know the different signs and symptoms of ADHD, perimenopause, and how they overlap?

Many women find themselves trying to explain a wide range of challenges without the clarity or language they need. When symptoms are clearly defined it can make these conversations easier and help you feel more understood and better supported.

Understanding how hormones influence ADHD can also help you make sense of your own experiences, especially when things feel unpredictable or difficult to pin down.

I have TWO FREE RESOURCES which you can download from my website that offer clear, accessible information.

Free downloads:
• ADHD, perimenopause and menopause, symptoms checklist and diagnosis guide
• ADHD, perimenopause and menopause, understanding your hormones

These guides can help you recognise patterns, organise symptoms in a clear way, and prepare for appointments so you can access the right support. They can also help you explain what you are experiencing in a more straightforward way to give you confidence and clarity.

Link to find them in comments:

29/01/2026

For many women and girls, ADHD was never even considered.

Instead, they were diagnosed with anxiety, depression, bipolar disorder, or borderline personality disorder, sometimes collecting several diagnoses over the years. With each label came another treatment plan, another medication, and another round of hoping this one might finally be the thing that helped.

Many spent years in a cycle of trial and error, taking medications that did not really work, or that helped a little but never touched the real problem, because in reality something important was being missed.

What we now understand much better is that for many of these women, the missing piece was ADHD, not the stereotypical version we were taught to look for in young boys, but the masked, internalised presentation that is far more common in girls and women.

When ADHD is not recognised, its effects are easily mislabelled. Low mood can become depression. Rejection Sensitivity Dysphoria can be mistaken for depression or anxiety. PMDD, with its severe cyclical mood changes, can be misdiagnosed as depression or even borderline personality disorder. Emotional dysregulation can be labelled as a personality disorder. Exhaustion and overload can be called anxiety. Fluctuating energy and emotional intensity can be called bipolar disorder.

Sometimes these diagnoses are part of the picture, but often they are not the root cause.

For many women, a later ADHD diagnosis is not about discovering something new, but about finally understanding what has been there all along, and why so many treatments never quite worked.

Better awareness means fewer women spending decades believing they are broken, or feeling that they are failing at life, when in reality how their brain is wired was simply never properly understood or supported.

28/01/2026

Did you know that ADHD is highly hereditary?

One of the parts of being diagnosed with ADHD later in life is what happens next.

You start to see it everywhere.

Not in a social media trend kind of way, but in a deeply personal, family history kind of way, you start to look at your parents and family members and suddenly so much begins to make sense.

The hyperfocus that could last for hours, the chronic disorganisation and time blindness, the big ideas that never quite became finished projects, the emotional intensity, the patterns that have always been there, but were never named or understood.

Which means for many of us, it has been within our families for generations, unnamed and misunderstood.

And when you finally recognise it in yourself, you often start to see it in the people who raised you too, sometimes with compassion and understanding, sometimes with grief or frustration, and often with both.

Nothing about this is about blame.

It is about understanding, and finally being able to see your own story, and your family’s story, more clearly.

27/01/2026

Do you remember at school there was always someone who could do the splits, bend their fingers backwards, or turn their arms into party tricks?

What many of us did not realise then is that this kind of flexibility can be a sign of hypermobility, where the connective tissue that helps hold the body together is more stretchy and less stable than usual. For some people this is mild. For others, it can be part of a condition such as hypermobile Ehlers-Danlos syndrome (hEDS).

There is growing evidence, including work by UK researcher Dr Jessica Eccles, that hypermobility and connective tissue differences are more common in neurodivergent people, including those with ADHD and autism. The brain, nervous system, and connective tissue are more closely linked than we once thought.

This can show up as things like:

• frequent joint pain, sprains, or injuries
• feeling physically fragile or easily exhausted
• headaches, dizziness, or gut issues
• having always been “bendy” as a child or adult

Many people live with these kinds of symptoms for years without realising they might be connected, but if you have ADHD and this sounds familiar, it may help explain some of the physical struggles you have had over the years.

I’d love to hear your thoughts in the comments if this is something which has affected you.

26/01/2026

I love hearing from my clients, and one of the best parts is helping them uncover the amazing strengths and skills they already have but might not see yet.

Every one of us has unique talents. Specialised support can transform how we recognise and harness them

When we work together we’ll explore proven strategies to help you to achieve your goals and develop long-term approaches that let you work with your ADHD, not against it.

Ready to unlock your potential with the help of an ADHD coach? I have one coaching slot coming up in March.

Contact details in comments if you want to discuss this further.

🌟🌟🌟🌟🌟🌟

👋🏻 Hi, I'm Sarah, a fully certified ADHD coach.

🧠 I help guide, empower & support people with ADHD.

😊 So you can make the changes you want in your life and thrive!

22/01/2026

There is a particularly cruel timing to ADHD and perimenopause, because for many women they collide at exactly the point in life when you are already carrying more responsibility than ever, supporting children, worrying about ageing parents, running a home, holding down a job, and being the person everyone else relies on.

As hormones begin to change, the coping strategies and frameworks that once helped you get through each day can suddenly stop working, and things that used to feel just about manageable can start to feel overwhelming, with executive functioning becoming harder, motivation dropping, anxiety rising, and confidence quietly slipping away.

At the same time, many women begin to realise that ADHD explains their whole life, and that realisation brings with it a huge and often invisible emotional load, as you find yourself replaying your childhood, your work, your relationships, the burnout, the misdiagnoses, and the years of thinking you were the problem, while trying to grieve, reprocess, and rewrite your story, all while still getting up each day and trying to function.

And often all of this is happening while you are also trying to access help, HRT, formal assessments, and support for your children, filling in forms and fighting systems at exactly the point when your capacity is already stretched to its limit, which means that what you are carrying is not just mentally exhausting, but physically exhausting too.

If this is you, you are not broken. You are dealing with a perfect storm of hormones, neurodivergence, and an already overloaded life. This is not weakness or failure, it is your body and brain going through profound change. And you deserve understanding, compassion, and proper support, both now and for the future.

21/01/2026

I’m adding a new section to my website with recommendations for books, podcasts, and other resources on ADHD, hormones, and perimenopause.

If there are any podcasts, books and/or resources you would recommend, I would love to hear them.

20/01/2026

I did not discover I had ADHD until I was in perimenopause.

By that point, I was a senior NHS nurse, a parent to neurodivergent children, and trying to hold everything together. When perimenopause and ADHD collided, my confidence disappeared, anxiety and imposter syndrome took over, and life started to feel far heavier than it ever had before.

Getting the right support completely transformed my life.

I’m Sarah, a UK based ADHD coach, a registered nurse, and the founder of Sarah West ADHD Thrive Together.

I spent over twenty years in the NHS before retraining, and today I specialise in supporting women who are late diagnosed, or who suspect they may have ADHD, particularly in perimenopause and menopause.

I work in a neuro affirming, strengths based way, helping women understand their brains, their nervous systems, and build lives that actually work for them, not against them.

My work is rooted in compassion, lived experience, and evidence based practice. I do not believe in fixing people (does that even exist?). I believe in helping you reconnect with your strengths, your energy, and your sense of self.

If you are navigating perimenopause, hormones, burnout, or a late discovery of ADHD you are not alone.

I share a monthly newsletter, regular blogs, and free resources about ADHD, hormones, and perimenopause. The link is in the comments if you’d like to take a look.

18/01/2026

Understanding your stress hormones and ADHD

Cortisol is your body’s main stress hormone. It is released to help you wake up, focus, and deal with pressure or threat. In short bursts, it helps and protects us.

The problem is when stress becomes chronic and our cortisol stays elevated or dysregulated.

When this happens, it can show up as:

• Feeling wired but exhausted
• Poor sleep or unrefreshing sleep
• Brain fog and memory problems
• Increased anxiety and irritability
• Feeling overwhelmed more easily
• Difficulty concentrating and thinking clearly

For people with ADHD, the nervous system is already more sensitive to stress. A chronically activated stress system can make emotional regulation, focus, and executive functioning much harder.

In perimenopause and menopause, hormonal changes can reduce the brain and body’s resilience to stress. This does not mean cortisol is “the problem hormone”, it means the stress system becomes more reactive and less buffered.

So many women in midlife with ADHD are dealing with a more sensitive stress system on top of an already sensitive nervous system and this is where burnout can appear.

What actually helps is supporting the stress system, not pushing harder:
• Proper recovery and sleep
• Reducing chronic overload
• Gentle, regular movement
• Eating regularly and avoiding long gaps without food
• Learning to spot early stress signals
• Building in pauses and boundaries

This is not about doing more or trying harder. It is about understanding and working with your nervous system rather than constantly fighting it.

And for many women with ADHD in midlife, that change alone can be genuinely life changing.

15/01/2026

Why “everyone’s a bit ADHD” misses the point

We’ve all heard that lovely saying, “Well, everyone’s a bit ADHD.”
Everyone loses their keys sometimes. Everyone forgets things. Everyone feels overwhelmed now and then.

That is true.

But ADHD is not about sometimes.

ADHD is about this being your every day.

It is about your brain never really switching off. It is about constant mental noise, constant effort, constant juggling. It is about working twice as hard to do things that look easy for other people.

It is about exhaustion, emotional overwhelm, burnout, shame, and years of thinking you are too much or not enough.

If it was just about being a bit forgetful, people would not be having their careers, relationships, mental health, and self worth so deeply affected by it.

So yes, everyone can relate to some ADHD traits.
But not everyone is living with a nervous system and a brain that works like this all the time.

And understanding that difference really matters.

Sarah West I Certified ADHD Coach

03/02/2026

02/02/2026

30/01/2026

29/01/2026

28/01/2026

27/01/2026

26/01/2026

22/01/2026

21/01/2026

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18/01/2026

15/01/2026

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