On my way to my car from the hairdresser’s today, I noticed two people walking towards me. One was a youngish woman in her early thirties, the other a shortish man in his fifties. The woman was walking fast, and as she passed the man, he declared loudly in her direction, “…I wondered who this woman was and why she was walking so fast…” He chuckled, implying what? That he was safe? Unfortunately, she felt the need to respond, as if she owed him an explanation. “I’m just running late, that’s all,” she replied. There was a world of accompanying nonverbal cues, including an increase in her pace. She also did not turn her head towards him, knowing that she would be met with the expectation that she did. This all happened in a matter of seconds, and I had an overwhelming urge to stop him in his tracks and say, “She does not want to occupy the same street as you, let alone speak to you!” But I didn’t, because I didn’t want to speak to him either.
I noticed all of this for a multitude of reasons, not least because, along with 15-20% of the population, I have a biologically based personality trait known as sensory processing sensitivity (SPS). Also known as Environmental Sensitivity (ES) and referred to in everyday language as being a highly sensitive person (HSP). It describes someone who processes sensory inputs in more parts of their brain. Initially coined by Elaine Aron, who conducted most of the early research, this concept has contributed to the rapidly growing body of knowledge surrounding neurodiversity.
What it means is that the information being delivered via our senses is processed quickly, and the lay of the land is established pronto. This is both a superpower and a destabiliser of epic proportions, due to its stunning accuracy, as well as the potential for sensory overload and emotional overwhelm. In short, it is a sweet addition to neurodiverse traits that many of us are identifying with these days. And, as with many things that already existed, it becomes amplified during menopause! This wee pearl means that, unfortunately, it often bumps us into the destabilised section of the pie graph of the HSP experience.
As an example, think of the rage we’re all currently giggling about that pervades our forties, and the seemingly inane triggers for it; someone chewing too loudly, our children whining at the wrong pitch, our partners bumping a pot against another one in the dishwasher, to name a few. For a menopausal sensitive, these inconvenient sounds feel downright ototoxic.
oto·tox·ic ˌō-tə-ˈtäk-sik. : producing, involving, or having adverse effects on organs or nerves involved in hearing or balance
I have always had a body-consuming reaction to a revving Harley Davidson, which causes me to utter unspeakable profanities under my breath. During menopause, my response took on murderous proportions, but now I just jam my fingers in my ears as I ‘sense’ them approaching from miles away. I don’t care how that looks; it spares my nervous system untold. And that, I realise, describes the transitions we traverse through life in a couple of cute sentences. We spend forty-odd years getting to know ourselves, essentially being the lead in our own film that we don’t start actually watching until a few decades in. Once seen, we can’t unsee, but then menopause turns up and lights a fuse under all of the things we’ve only just got a handle on. I think managing menopause is about focusing on the fuses, and then at some point, we realise that they’re no longer there.
My rage has subsided. I notice things that once would have inflamed me in a nanosecond (like the presumption of the bloke in the first paragraph), and I understand that I can now choose not-rage instead. Not in an avoidant way, but in a “pick your fights” kind of way.
The rewiring of menopause is gratefully near completion, and renews me afresh with the desire to reassure my neurodiverse kin that the unmanageable becomes manageable again.
There is a line outside my clinic door of women who have lived with their high-functioning, undiagnosed ADHD and its cousins, their entire lives. They weren’t born to a generation whose awareness of such things enabled pharmaceutical intervention; they just made the most of their own private shit show. However, for many, menopause has declared itself with the amplification of their cognitive discomfort, ripping the wheels off their magically held together vehicle.
We know that the hormonal flux that occurs perimenopausally is responsible for many of the symptoms, essentially meaning the brain and body short-circuit due to an unstable supply of estrogen, and to a lesser extent, progesterone and probably testosterone. Our brain is littered with estrogen receptors that, at an increasing frequency, remain empty; therefore, they are unable to help maintain consistent cognitive function. This turns up as brain fog, memory lapses, low energy, anxiety, mood swings and impaired executive function. For someone with ADHD or autism, some of these things were already a challenge, and what’s worse, the superpower part of their neurodiversity, like hyperfocus, fails them. It’s multi-injurious!
Many women are desperately trying to access our broken health system to acquire a diagnosis of ADHD that then enables them to be prescribed methylphenidate or similar (which the country keeps running out of). The medico-legal process requires that the assessment be overseen by a psychiatrist or psychologist, and a special authority for the medication be endorsed by a psychiatrist. It has led to the system being in complete overwhelm in both the public (practically non-existent for adults) and private systems. There is a planned change next year, where specifically trained GPs can conduct the assessment and apply for the medication special authority without a psychiatrist’s endorsement. However, this training will likely be onerous and take more GPs away from an already dwindling pool.
I know this sounds like doomsaying, but this is our reality, and knowledge is power after all. What matters is what we do with this information, and the first thing is to use it to help create awareness. There is a significant amount of discussion and work currently being done around menopause and the workplace, and understanding how menopause affects neurodiversity will contribute to this effort.
The other essential action is communion; gathering and think-tanking together, and giving ourselves and each other permission to identify, regardless of whether a formal diagnosis has been made or not. If you think you are neurodiverse, then you probably are. It is that simple. We’ve made it way too complicated. It is yet another example of what our biomedical paradigm has inferred for the past few centuries: you don’t need to know what is going on for you because we will tell you. This, to my mind, is responsible for the current state of our public health systems around the world. The reality is, you will know what is “wrong” or “going on” on some level, but we need to turn our intuition back on to access that knowing.
So, in light of limited access to pharmaceuticals, what else can we do?
- Know yourself – read up on every suspicion that you have. I don’t mean consulting Dr Google and freaking yourself out. I mean, engage your intuition. Follow your nose and speak to a professional you can trust to “hear you out”.
- Prepare – learn about menopause and all the things you can do to minimise the impact of symptoms. For example, move your body, take care of your gut, and prioritise sleep.
- Seek help and support – find your tribe that also includes health professionals you trust to support you in the way that resonates for you, and that helps you feel safe and cared for.
The goal is empowerment (it always is for me), and anything that enables that makes it less likely you will wake one day and realise shit has gotten so bad you can’t even leave the house. I don’t want this outcome for the sisterhood. We have too much precious life to do!
Keep thriving,
Melissa