Ever feel like you’re always forgetting where you put your keys? Or, you’re constantly walking into a room, pausing, and asking yourself what you went in there for? If this sounds familiar, trust us, it’s not just you.
Brain fog is a hallmark symptom of menopause that can sometimes present similarly to attention deficit hyperactivity disorder, or ADHD. This can make things confusing. And diagnosis? Tricky. We’re here to break down the key differences and similarities between the two, and to outline some ways you can improve concentration during the menopause transition.
Brain fog vs ADHD: what’s the difference?
Brain Fog
There’s no sugarcoating it: menopausal brain fog is very much a thing. In fact, a whopping 60% of women report difficulties concentrating — along with other cognition issues — during perimenopause. Fortunately, we can take comfort in knowing that these changes are temporary.
So what exactly causes this inconvenient symptom? Hormonal changes – you guessed it! Specifically, as estrogen levels drop during menopause, the metabolism of glucose in the brain drops (glucose being the brain’s primary fuel). This may well be why you might feel “off your game.” Additionally, cognitive function is related to other common symptoms experienced by menopausal women: sleep disturbances, mood swings, fatigue, and hot flashes – all of which may affect our mental performance.
Menopausal brain fog is characterized by forgetfulness, difficulty concentrating, mental confusion, and feeling foggy or mentally sluggish. These symptoms may fluctuate in intensity and may be accompanied by other menopausal symptoms. And while this pesky symptom may persist for a few years, it’s ultimately short term compared to something like overall cognitive health, which is more of a long-term consideration. ADHD symptoms, on the other hand, present a bit differently…
ADHD
When we think of ADHD, we often think of adolescents and children struggling with concentration in school, but this condition also impacts adults. In fact, diagnosis of adults with ADHD are increasing four times faster than diagnoses of children.
ADHD is a neurodevelopmental disorder that typically begins in childhood and often continues into adulthood. The exact causes and risk factors for ADHD remain unclear, but studies suggest that genetics may play a role. Symptoms of ADHD typically include impulsivity, distractibility and inattention, and difficulty organizing or completing tasks.
For adult women, ADHD can present a bit differently than in males and may include:
- Difficulties with time management
- Trouble keeping track of belongings
- Difficulty concentrating and finishing tasks or over-concentrating on tasks
- Racing thoughts
- Impulsive shopping and interrupting
- Irritability and sensitivity
What do hormonal fluctuations mean for women who already have ADHD?
While we don’t understand a lot about brain fog and why it happens, we do know that for women with existing ADHD, the hormonal fluctuations during menopause can worsen the condition. We also know that women are very much underdiagnosed with ADHD, and some can experience an onset during adulthood. For many, this onset coincides with the menopause transition, due to the hormonal changes unmasking it. We hope that as healthcare further evolves to encompass women’s health, we will have a keener understanding of the exact interplay between existing ADHD and menopausal brain fog.
READ MORE: Neurodiversity and Menopause
How is ADHD treated?
There are several ways of treating and managing adult ADHD, but here are some of the most common:
Medication
Methylphenidate and amphetamine are commonly used stimulant medications for ADHD treatment. They both work by targeting dopamine and norepinephrine, neurotransmitters that affect a person’s attention and concentration. There is currently one non-stimulant medication approved by the FDA, Atomoxetine, which boosts levels of norepinephrine and poses less risk of chemical dependence.
While they are not specifically approved to treat ADHD, antidepressants may sometimes help manage ADHD symptoms. These medications typically target levels of serotonin — a neurotransmitter that impacts sleep, mood, and appetite — and may be helpful in cases where a patient also has a mood disorder or other mental health conditions.
Therapy
There are dozens of different types of therapy, but Cognitive Behavioral Therapy, or CBT, is one of the most common for ADHD. CBT focuses on the interconnections between behaviors, feelings, and thoughts, and can help with identifying thought patterns and feelings that may impact behaviors. This form of therapy can also help to promote relaxation and general wellness. (Who doesn’t need a little more of that?!)
When is it time to see a doctor for ADHD?
Even though brain fog and ADHD present differently, that sliver of overlap between the two can complicate the diagnosing process. Typically, if the symptoms in question can trace back to childhood, it’s less likely to be menopause-related. However, sometimes treatment is necessary to arrive at a formal ADHD diagnosis.
If you find that your symptoms are disrupting day-to-day functioning, we recommend speaking with a healthcare professional -– they may determine that psychiatry (and ADHD medication) is the best course of action and can provide a referral.
What can I do about concentration and brain fog?
Brain health is dictated by many lifestyle behaviors such as sleep, nutrition, exercise, and stress management — and no, it’s never too late to start making changes! In addition to directly benefiting brain health, lifestyle can also indirectly benefit us by impacting cardiovascular factors (e.g., hypertension, diabetes, and high cholesterol), which scientists believe are also linked to cognition.
Nutrition & Diet
Diet plays a clear and integral role in every aspect of brain function. And although there’s no one best diet for everyone, the Mediterranean diet has been associated (correlation, not causation) with better cognition, as well as better sleep and cardiovascular health.
READ MORE: 8 Foods (& Drinks) That Help With Menopausal Brain Fog
Hydration
The brain is composed of 80% water, and it’s necessary for energy production. Even small amounts of dehydration can cause symptoms such as brain fog, fatigue, dizziness, confusion, and brain shrinkage (you read that right…your brain can actually shrink!). So stay hydrated! A good rule of thumb: drink enough so your urine is clear or pale yellow.
Single-tasking
Although we may be conditioned to multi-task, as humans, we’re not hardwired to excel at this. Contrary to popular belief, it’s actually been shown to take longer, as well as result in more errors. Research also indicates that “media multitasking” (watching TV while scrolling through your emails, for example) affects memory. Instead, prioritize doing one thing at a time.
Supplements
While we believe that nutrition should be the primary source of brain healthy ingredients, we recognize that supplements are sometimes necessary. We’re big fans of vitamin B-12 and magnesium, both of which can target brain fog and concentration, as well as Brain Factors by Thorne.
READ MORE: Elektra Guide to Supplements For Menopause
What about hormone replacement therapy?
HRT for brain fog
Unfortunately, current data does not show that the use of hormone replacement therapy (HRT) clears brain fog. Results are mixed, and the reassuring thing is that while hormone therapy may not directly HELP with brain fog, it will not worsen it either.
A related (and exciting!) area of research is currently examining HRT as a way to stave off future cognitive changes. At present, it is still unclear whether hormone therapy use around the time of menopause will prevent dementia. Because of that, hormone therapy is not recommended at this point solely for preservation of cognitive function and Alzheimer’s prevention. For ADHD, on the other hand, HRT can play a role…
HRT for…ADHD?
Were you today years old when you learned that HRT can help manage ADHD? You’re not the only one. For women with ADHD who are already taking stimulant medication but find that their symptoms are worsening during the menopause transition, an addition of HRT can be a great option as it may amplify the stimulant effects.
The bottom line
Changes in hormone levels, and decreasing estrogen levels in particular, are responsible for a whole lot of menopause symptoms, including brain fog. And even though this symptom is generally temporary, brain fog can be frustrating and impact general well-being. Plus, the overlap between symptoms and impairments of ADHD can cause confusion around when to worry. If in doubt, it’s always worth speaking to a provider about.
Interested in care? Learn more and book a visit with an Elektra provider.
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