Sarah West I Certified ADHD Coach, Exeter (2026)

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.

05/03/2026

You are doing everything you can to manage your ADHD. And then perimenopause arrives, and suddenly nothing works the way it used to.

What if part of the answer was something as unglamorous as what you had for breakfast?

After an overnight fast, your brain needs fuel. A breakfast with enough protein supports dopamine production and helps keep blood sugar steady, which means fewer crashes, less brain fog, and better emotional regulation through the day. Including protein across your other meals and snacks can help too, supporting more consistent energy and reducing those sudden cravings that derail everything by mid-morning.

This is not about dieting or rigid food rules. It is about giving your brain and nervous system what they actually need, at a time when your hormones are already fluctuating and your body is working hard.

Sometimes the basics, done consistently, make more difference than we expect.

Take a look at your breakfast this week. Does it include a meaningful source of protein? If not, that might be the simplest place to start.

What does your typical breakfast look like? I would love to know in the comments.

04/03/2026

If you have ADHD and you are in perimenopause, and things that used to feel manageable now feel almost impossible, you are not imagining it. And there is now research that begins to explain why.

For years, women have been describing this experience. The strategies that used to work, suddenly not working. The brain fog that feels different to anything before. The emotional reactivity that catches you off guard. The exhaustion that no amount of sleep seems to touch. And very little data to back up what they were living through.

A recent population based study has started to change that. Researchers compared women aged 35 to 55 who reported having ADHD with those who did not, and the findings were significant.

Women with ADHD had considerably higher overall perimenopausal symptom scores. They were almost twice as likely to experience symptoms rated as severe. And the differences were most pronounced in the 35 to 39 age group, which suggests some women may start to feel this earlier than expected.

There is an important biological reason for this.

Oestrogen supports dopamine signalling in the brain. When oestrogen begins to fluctuate and decline during perimenopause, it affects the very neurotransmitter pathways that are already working differently in a brain with ADHD. So the difficulty concentrating, the emotional dysregulation, the overwhelm, the sense that your usual coping strategies have stopped working, these are not personal failings. They are the result of two significant neurological and hormonal processes intersecting at the same time.

The research also identified that rates of trauma were higher in the ADHD group, which is a reminder that our health experiences are rarely explained by a single factor and why women with ADHD often carry more than people realise.

If you are navigating ADHD and perimenopause, what you are experiencing is increasingly being recognised and investigated. It is worth having an informed conversation with your GP about both your ADHD and your hormonal health together, not separately. And if you are a clinician or professional supporting women in this age group, this research is worth reading.

Reference in comments

03/03/2026

I spent nearly ten years working as a specialist respiratory nurse, confident that I understood obstructive sleep apnoea.

It turns out I had been taught to look for it in the wrong people.

Like many clinicians, I saw sleep apnoea largely through the lens of weight and lifestyle. The classic picture was clear in my mind: overweight, middle-aged men, loud snoring, witnessed apnoeas. That was the lens I had been trained to look through, and I had no real reason to question it.

That changed when I started training as an ADHD coach.

I came across research I had never encountered in my nursing career. Rates of obstructive sleep apnoea rise significantly during perimenopause. And it overlaps with ADHD far more than most clinicians realise.

For women with ADHD who are entering perimenopause, there is a possibility that three separate but overlapping things are happening at once. ADHD, often undiagnosed for decades.

Perimenopause, changing everything hormonally. And obstructive sleep apnoea, quietly developing in the background. None of which may be fully recognised or treated.

ADHD and sleep apnoea share so many features: exhaustion, poor concentration, mood changes, irritability. Add in the hormonal changes of perimenopause, which reduce upper airway tone and increase sleep apnoea risk, and the picture becomes genuinely difficult to untangle, even for healthcare professionals who are looking closely.

In women, sleep apnoea rarely looks like the textbook version. It is far more likely to show up as persistent fatigue, broken sleep, insomnia, or low mood. Symptoms that are very easily explained away as something else entirely.

As oestrogen and progesterone decline, upper airway tone decreases. This is not a lifestyle issue. It is a hormonal one. And it means that women who have spent years managing ADHD symptoms, perhaps without even knowing they had ADHD, may find things becoming significantly harder during perimenopause, not only because of the hormonal changes themselves, but because something else is developing underneath, undetected.

If we are only treating one piece of the picture, we will keep missing the rest of it.

If you are a woman with ADHD in perimenopause and something still does not feel right despite treatment, sleep apnoea is worth asking about. You do not have to snore. You do not have to fit the classic profile. Speak to your GP and ask for a referral to a sleep clinic. You deserve to get answers.

We need more awareness around this, both within the clinical community and for the women living with it every day.

Has this resonated with you or someone you know? I would really like to hear your experiences.

Sarah West I Certified ADHD Coach

23/03/2026

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