ADHD Chatter Podcast"ADHD gets worse with age, unless you do THIS' | World Leading ADHD Expert, Dr Jo Perkins
CHAPTERS
Why ADHD can feel harder with age: rising demands, less scaffolding
Dr. Jo Perkins explains that ADHD doesn’t inherently “worsen,” but life often gets more complex: responsibilities increase while external structure (school, family scaffolding) falls away. This mismatch puts extra strain on executive functioning and can amplify emotional dysregulation and mental health risks.
The compounding effect: years of setbacks, self-esteem, and burnout cycles
The conversation turns to how repeated boom–bust patterns (jobs, relationships, projects) can accumulate into hopelessness and a harsh self-narrative. Dr. Perkins describes how chronic stress, shame, and overcompensation can become debilitating and feed self-medication or avoidance.
“I’ve coped this long—why change?” Late insight, self-compassion, and empowerment
Alex asks whether older adults may dismiss ADHD changes because they’ve survived so far. Dr. Perkins notes that some people genuinely have workable strategies; for others, diagnosis can be liberating even without major behavior change because self-understanding reduces internal pressure.
AuDHD and aging: routines vs novelty, friends or foes
Adding autism changes the picture: stronger needs for predictability and ritual can intensify with age, sometimes stabilizing ADHD and sometimes clashing with novelty-seeking. Dr. Perkins describes “wild swings” between high control and chaos, and how hard it can be to re-enter routines after disruptions.
When safety behaviors shrink life: anxiety, avoidance, OCD-like control, and agoraphobia patterns
They explore how intense anxiety about change can lead people to design lives that minimize uncertainty—sometimes resembling agoraphobia or OCD. Dr. Perkins explains the vicious cycle: the less you do, the less confident you feel, and the tighter the rituals become.
ADHD memory vs dementia: why working-memory slips feel scary as you age
Alex raises fear about cognitive decline when ADHD forgetfulness persists into midlife. Dr. Perkins distinguishes ADHD’s intermittent working-memory failures (often due to not encoding information) from progressive neurodegenerative decline, and offers practical communication strategies.
Impulsivity and aging: less reckless, still disruptive—or a catalyst for reinvention
They discuss how impulsivity can change form with age: it may become less dangerous than in youth, but still causes conflicts and logistical chaos. At the same time, it can fuel bold decisions, creativity, and positive risk-taking.
Physical aging with an ADHD brain: frustration, identity loss, and adapting outlets
Alex asks about the mismatch between a high-energy mind and a declining body. Dr. Perkins frames this as a human challenge but highlights ADHD strengths: problem-solving, innovation, and finding new stimulating outlets when old ones aren’t possible.
Aging gracefully with ADHD: acceptance, self-knowledge, and letting go of perfectionistic control
Dr. Perkins defines “aging gracefully” as psychological wellbeing: understanding yourself, dropping unrealistic “shoulds,” and building a life aligned with strengths. They also address control as a safety strategy, and how shifting from control to management and trust can reduce pressure.
Future anxiety and ‘living in the now’: when planning feels abstract or phobic
They explore how ADHD’s present-focus can make long-term planning feel unreal, boring, or terrifying—especially as mortality and responsibility become more visible. Dr. Perkins notes different reactions: avoidance and denial vs optimistic overconfidence, and even phobic avoidance of mortality-related topics.
Shame, RSD, and people-pleasing: how these patterns can soften with age and awareness
Dr. Perkins explains shame may not vanish, but it’s triggered less often when life is better aligned and self-understanding grows—especially with diagnosis and compassion. They unpack how people-pleasing can backfire into overcommitment, burnout, resentment, and more rejection experiences.
ADHD and perimenopause/menopause: hormones, brain fog, anxiety, and sleep disruption
They discuss why many women receive ADHD diagnoses around perimenopause/menopause, as hormonal changes can intensify executive-function and emotional regulation challenges. Dr. Perkins notes common misattribution (e.g., “just anxiety” or “just aging”) and the importance of tailored support.
Preparing for menopause: tracking, education, and foundational health scaffolding
Dr. Perkins offers practical preparation: track symptoms and cycles, learn how hormones interact with ADHD, and build sustainable routines. She emphasizes sleep, nutrition, exercise, saying no, and moderating stimulants as protective scaffolding.
You’re never too old for an ADHD diagnosis + Agony Aunt: externalize time and build tiny habits
Dr. Perkins argues there’s no age limit for diagnosis if you want it, highlighting advantages in healthcare settings and self-advocacy. In the “agony aunt” question about planning for the future, she recommends externalizing time, focusing on essentials, and creating small automatic habits—sometimes using AI tools to reduce friction.
Closing reflections: three rules to live by
The episode ends with a short reflective segment where Alex shares a letter from the previous guest. Dr. Perkins reads three guiding principles and agrees with the emphasis on quality and values.
