ADHD Chatter Podcast"ADHD gets worse with age, unless you do THIS' | World Leading ADHD Expert, Dr Jo Perkins
CHAPTERS
- 0:00 – 0:21
Cold open: ADHD working memory hacks to reduce conflict
Dr. Jo Perkins opens with a practical explanation of ADHD working-memory lapses—especially the kind where you don’t even know what you’ve forgotten. She offers a simple relationship/work strategy: only share important information when full attention is available, and externalize instructions in writing.
- •Working memory issues are common in ADHD and can be invisible in the moment
- •Life responsibilities increase mental load, making memory slips feel worse with age
- •Set clear communication agreements (e.g., sit down, full attention for important info)
- •Use written step-by-step instructions to prevent self-blame and errors
- 0:21 – 2:00
Meet Dr. Jo Perkins + why this episode matters
Alex introduces Dr. Jo Perkins and frames the conversation around ADHD and aging—an under-discussed topic. He also shares a brief channel message about the purpose of the podcast and inviting listeners into community and learning.
- •Dr. Jo Perkins’ background and role in ADHD psychology
- •The episode focus: how ADHD interacts with aging and life stages
- •Podcast mission: expert-led answers and community-building
- •Transition into the main discussion
- 2:00 – 5:01
Does ADHD get harder with age? Responsibilities rise as scaffolding disappears
Dr. Perkins explains why ADHD can feel harder over time: demands increase while built-in structure from school/home reduces. Periods of change can expose weaknesses in planning, organization, and multitasking, and increase vulnerability to burnout and mental health strain.
- •Adult life increases commitments and executive-function load
- •External structure decreases, raising the independence requirement
- •Transitions disrupt routines and coping strategies
- •RSD, masking, anxiety/depression risk can rise under pressure
- •Executive function and emotional regulation worsen together in a stress cycle
- 5:01 – 8:34
The compounding effect: regret, rumination, and self-medication risk
Alex compares ADHD escalation to addiction: unaddressed patterns accumulate over years, building internal pressure. Dr. Perkins describes how chronic stress and overcommitment degrade sleep and emotional regulation, reinforcing executive-function difficulties.
- •Unmanaged ADHD can ‘compound’ via accumulated stressors and regrets
- •Executive dysfunction and emotional dysregulation are tightly linked
- •Sleep loss and burnout intensify symptoms
- •Greater exposure to rejection/selection processes can trigger RSD and low self-esteem
- 8:34 – 13:57
Common midlife ADHD struggles: menopause, sleep, career chaos, relationship strain
Dr. Perkins outlines the recurring ‘midlife’ pain points she sees: cumulative failure narratives, worsening anxiety, sleep disruption, and the sense of “I should have sorted this by now.” She highlights how perimenopause can amplify brain fog and working-memory challenges, often misattributed to “just aging.”
- •Cumulative (real/perceived) failures can amplify anxiety and hopelessness
- •Perimenopause often goes unrecognized and can heighten brain fog and anxiety
- •Sleep issues become more common and destabilizing
- •Job-switching/boom-bust cycles can intensify without awareness
- •Stable relationships and social connection may become harder to maintain
- 13:57 – 16:09
‘I’ve got this far—why change now?’ Late diagnosis as compassion, not disruption
The conversation explores why some older adults may resist changing established coping strategies. Dr. Perkins emphasizes that diagnosis can be liberating even if behaviors don’t change much—because self-understanding reduces shame and brings psychological calm.
- •Some coping strategies genuinely work; not everyone feels a need to change
- •Late diagnosis can be empowering and validating
- •Self-compassion and self-awareness may be the biggest immediate benefit
- •Fear and avoidance can also keep people from exploring ADHD as a factor
- 16:09 – 19:05
AuDHD and aging: routine vs novelty—friends or foes
Dr. Perkins describes how autistic traits like predictability-seeking can become more entrenched with age, sometimes clashing with ADHD novelty-seeking. When balanced well, routine becomes scaffolding that helps ADHD thrive; when unbalanced, it can produce control/mess ‘swings’ and difficulty re-starting after disruptions.
- •Autistic routine/ritual needs can intensify with age
- •ADHD novelty-seeking may conflict with predictability needs
- •When aligned, routine scaffolds ADHD and reduces chaos and dysregulation
- •When misaligned, ‘control then collapse’ patterns can appear
- •Disruptions (holidays, change) can be unusually hard to recover from
- 19:05 – 23:38
When safety behaviors shrink life: anxiety, avoidance, OCD-like control, agoraphobia patterns
They discuss how rigid routines and fear of change can become limiting, especially when life demands travel or social flexibility. Dr. Perkins explains how anxiety can evolve into avoidance cycles and controlling rituals that resemble OCD/agoraphobia—even if they don’t meet formal diagnostic criteria.
- •Rituals and “safe zones” can become survival strategies but also restrictive
- •Life changes can force anxiety-provoking breaks in routine
- •Avoidance can reduce socializing, travel, and opportunities
- •Less exposure lowers confidence and tightens rituals (vicious cycle)
- •Control strategies can look OCD-like: “If it’s not done this way, I can’t cope”
- 23:38 – 25:09
Sponsor break: Tiimo and the ‘notebook fallacy’
Alex shares an ad about Tiimo, positioning it as a neurodiversity-friendly planning tool that reduces decision paralysis. The emphasis is on quick capture (voice to plan) and simplifying tasks into actionable steps.
- •The ‘magic notebook’ myth vs practical systems
- •Tiimo’s neurodiverse-first design and interface
- •AI planning assistant and voice transcription for fast capture
- •Reducing decision paralysis and improving follow-through
- 25:09 – 30:59
ADHD forgetfulness vs dementia: why it feels scary and how to tell the difference
Alex raises fear about memory decline as he ages; Dr. Perkins validates the anxiety while distinguishing ADHD’s intermittent working-memory lapses from progressive cognitive decline. She explains the “conveyor belt” problem—information never gets encoded when attention is split—and gives practical solutions for partners and workplaces.
- •ADHD working-memory lapses are often encoding/attention issues, not storage
- •Multitasking makes it easy to ‘look’ attentive while not absorbing information
- •ADHD memory issues tend to be intermittent and stress-dependent
- •Dementia/cognitive decline is typically progressive over time
- •Practical fixes: sit-down attention, written steps, asking for leaflets/notes
- 30:59 – 35:25
Impulsivity and physical aging: disaster, reinvention, or both
Dr. Perkins explains how impulsivity can ‘shape-shift’ with age: less reckless than youth, but still disruptive (last-minute projects, detours) or energizing (new ventures, spontaneity). They also discuss the psychological challenge of physical decline when the mind remains highly driven, and how ADHD ingenuity often finds alternative outlets.
- •Impulsivity may become less dangerous but still disruptive in adult life
- •Can resemble ‘midlife crisis’ decisions—sometimes harmful, sometimes freeing
- •Physical decline can remove key outlets, increasing frustration and mental hyperactivity
- •Loss of physical capability can threaten purpose/meaning and emotional stability
- •ADHD strengths: innovation, adaptability, finding new stimulating activities
- 35:25 – 39:52
Aging gracefully with ADHD: acceptance over perfectionistic control
Dr. Perkins defines “aging gracefully” as psychological well-being: self-knowledge, self-permission, and kinder internal standards. They explore perfectionism as a safety strategy and the relief that comes from managing what you can while letting go of what you can’t control (including time).
- •Aging well = understanding yourself and reducing self-torture (“shoulds”/“musts”)
- •Permission to do life differently lowers stress and dysregulation
- •Perfectionism can be a safety mechanism rather than a true preference
- •Shift from control to management, awareness, and self-trust
- •Finding a meaningful ‘thing’ to feed the brain reduces rumination
- 39:52 – 45:27
Future anxiety, avoidance, and ‘mental agoraphobia’ around planning
Alex describes ADHD ‘now-focus’ and the fear of an abstract future; Dr. Perkins explains how aging confronts people with frailty, finances, and mortality, making avoidance harder. They discuss how some people respond by shutting down conversations (phobic avoidance), while others lean on optimism and perpetual reinvention.
- •ADHD present-focus can undermine planning and future-oriented decisions
- •Aging introduces unavoidable reminders: caregiving, pensions, health risks
- •Some respond with avoidance and topic shutdown (phobic patterns)
- •Others cope via optimism: “I’ll always be doing something”
- •Avoidance can extend to funerals, doctors, or mortality-themed media
- 45:27 – 52:52
Does shame and people-pleasing decline with age? RSD, boundaries, and self-respect
Dr. Perkins argues shame can soften with self-understanding and fewer triggering situations, while aging often reduces concern about others’ opinions. They explore how people-pleasing backfires (overcommitment → burnout → resentment) and how boundaries and “pause” tactics reduce RSD-driven spirals.
- •Shame may activate less often with better coping and self-understanding
- •Aging can reduce investment in others’ judgments
- •People-pleasing often creates the very rejection it tries to prevent
- •Boundaries (saying no, delaying responses) build confidence and reduce RSD impact
- •Not overcommitting can paradoxically improve reliability and relationships
- 52:52 – 59:46
ADHD and menopause: why symptoms spike and how to prepare
Dr. Perkins explains how hormonal shifts interact with ADHD brain wiring, often worsening memory, sleep, and emotional regulation—especially for undiagnosed women who may be misdiagnosed with “just anxiety.” Preparation focuses on tracking symptoms, education, and strengthening foundations like sleep, nutrition, exercise, and reducing alcohol/caffeine reliance.
- •Hormonal changes can exacerbate executive dysfunction, mood, and memory issues
- •Perimenopause can be long and subtle; many don’t realize they’re in it
- •Misdiagnosis risk: treated for anxiety without addressing hormones/ADHD interaction
- •Preparation: track cycle/symptoms, educate yourself, stay flexible with routines
- •Prioritize sleep, exercise, nutrition; reduce alcohol/caffeine; limit over-pleasing
- 59:46 – 1:03:33
You’re never ‘too old’ for an ADHD diagnosis: advocacy, care settings, and grief/relief
Dr. Perkins states there’s no age limit—if the person wants the diagnosis and understands the emotional complexity. She highlights practical benefits in healthcare contexts (communication needs, being interpreted fairly) while acknowledging possible grief and “if only” feelings that can accompany late discovery.
- •No upper age limit—motivation and informed consent matter
- •Diagnosis can improve self-advocacy in medical and care systems
- •Helps professionals interpret agitation/impulsivity through an ADHD lens
- •Practical accommodations: written info, leaflets, bringing support to appointments
- •Emotional reality: liberation plus potential grief/remorse
- 1:03:33 – 1:10:41
ADHD Agony Aunt: planning for ‘future you’ with tiny habits and externalized time
A listener asks how to care about a future self that doesn’t feel real; Dr. Perkins normalizes this and recommends “externalizing time.” The solution is to build small, automatic habits (money, health, relationships) rather than waiting for motivation—using tools, AI, and direct debits to reduce decision-load.
- •Many people struggle to visualize their future self—especially with ADHD
- •Externalize time: imagine someone else (or a proxy) who needs stability
- •Start with essentials: home, money, health, relationships; bank small habits
- •Avoid overwhelm: do one change at a time; consistency beats intensity
- •Use automation and tools (direct debits, apps, AI) to reduce friction
- 1:10:41 – 1:11:17
Closing ritual: the ‘three rules to live by’ letter and farewell
Alex delivers a letter from the previous guest containing three guiding principles. Dr. Perkins reads and reflects briefly, and they close the conversation with appreciation and a warm send-off.
- •“Focus on what’s truly right” as a guiding principle
- •“Empathize with those around you” as relational grounding
- •“Impute/apply quality in everything you do” as a standard worth keeping
- •Episode wrap-up and gratitude
