"ADHD gets worse with age, unless you do THIS' | World Leading ADHD Expert, Dr Jo Perkins

1. 0:00 – 2:13

   Trailer

   1. JPDr. Jo Perkins0:00

      Anyone ADHD will experience the working memory challenges, and often you don't know what you've forgotten. But what happens as we get older, there's a lot more mental load going on with all of the life responsibilities that we've been talking about, and work, and children. If you know you're ADHD and that's what's happening with your memory, say to your partner, "Don't tell me anything important unless we're actually both sitting down, I'm fully with you, I'm actually tuned in."

   2. APAlex Partridge0:21

      Dr Jo Perkins is a pioneering psychologist in the ADHD space with 23 years experience. Using her deep knowledge of psychology- She specializes in optimizing your ADHD across all aspects of your life

   3. JPDr. Jo Perkins0:34

      Women won't know that they're in perimenopause, because even when people talk about it, it's different for different people. There's not a sign that you're necessarily in it. That working memory can really be challenged as you're going through perimenopause, and you're just being told, "Yeah, it's 'cause you're getting older." A lot of women will get their diagnosis, as we know, as they're going through perimenopause and menopause. The hormonal interaction can make it more exacerbated, that sense, alongside all the other s- demands.

   4. APAlex Partridge0:57

      Do you think somebody can be too old to be diagnosed with ADHD? Loyal listeners and viewers, I can't thank you enough for tuning in to ADHD Chatter, where we ask world-leading ADHD experts the hard questions, to give you access to the most cutting-edge information on the topic. If you've ever felt broken or different, I hope this helps in your search for information, answers, and community. And do you know what would really help me in return? By clicking the follow or subscribe button wherever you're listening. It might not seem like much, but at ADHD Chatter, it means a huge deal, and with this, I can book more incredible guests and keep the self-discovery fire alive for all of us, including myself. Just one click of a button goes a lot further than you think. We'll promise to listen to your feedback, and book the guests you want on topics that matter to you. And remember, you're not broken, just different, and you have always been enough. [upbeat music] Dr Jo, welcome back.

   5. JPDr. Jo Perkins1:58

      Lovely to be back. Thanks for having me, Alex.

   6. APAlex Partridge2:00

      ADHD and aging. Um, it's a topic I haven't covered before, but it's something-

   7. JPDr. Jo Perkins2:05

      Mm

   8. APAlex Partridge2:05

      ... that's been on my mind. Um, specifically, does, do the traits of ADHD get worse

2. 2:13 – 8:36

   In what ways can ADHD get harder to manage as you get older?

   1. APAlex Partridge2:13

      with age? What do you think? Do you think ADHD gets harder to manage as you get older?

   2. JPDr. Jo Perkins2:18

      It can definitely feel a lot harder to manage, as anyone watching with ADHD will testify to, but I think it's, it can be complex. And a lot of the time, it can also get easier to manage. It's really about, you know, a range of different things, Alex, and obviously your personal circumstances, whether you have a diagnosis, what treatment, if any, you've had, what, what, what management you're doing. But I think that inevitably as we get older, you have increasing responsibilities, increasing demands on your time, all the executive functioning that we need to do, the planning, the time management, the commitments that we've got. And typically, that's going up while the structure and the scaffolding that have been provided through school, being at home, is decreasing. We're expected to be more independent.

   3. APAlex Partridge3:11

      Mm-hmm.

   4. JPDr. Jo Perkins3:11

      So actually, not only is there a genuine increase o- on, on us and, and anyone's, you know, brain as we grow up, but particularly for an ADHD brain, it really puts pressure on that planning and organization, and, and, and managing multiple things at once. And like I say, it's when that scaffolding's re- being removed.

   5. APAlex Partridge3:31

      Mm-hmm.

   6. JPDr. Jo Perkins3:31

      And of course, that just increases as we go through life. So the, it will feel more difficult at periods of change, quite likely, when our routines or our coping strategies that worked once are not fit for purpose or adapted to, to the new thing that we're doing. So again, that can be one of the things that, that make it feel harder to manage as we get o- older. And the other thing, all of the, the kind of increased pressures, and y- you know, the, the, the challenges that can put on anyone, but particularly when we're ADHD, it just means that we're working so much harder-

   7. APAlex Partridge4:05

      Yes

   8. JPDr. Jo Perkins4:05

      ... to do that-

   9. APAlex Partridge4:07

      Mm

   10. JPDr. Jo Perkins4:07

       ... to keep up. And the feelings of s- low, low self-esteem, we're being more exposed to things that can activate our rejection sensitivity dysphoria.

   11. APAlex Partridge4:19

       Yes.

   12. JPDr. Jo Perkins4:19

       So, you know, relationships-

   13. APAlex Partridge4:21

       Mm

   14. JPDr. Jo Perkins4:21

       ... job interviews, tests, passing things, selection processes, rejections in the real sense, as well as the perceived and in the many different settings that can come from. So that can really increase our, you know, risks of mental health conditions like anxiety, depression, masking.

   15. APAlex Partridge4:41

       Mm.

   16. JPDr. Jo Perkins4:42

       Adapting to t- to, to fit in can increase burnout. So it, it, it can get difficult in and of itself, but those challenges then can also r- increase the risks-

   17. APAlex Partridge4:54

       Mm

   18. JPDr. Jo Perkins4:55

       ... of other factors that make it harder as well.

   19. APAlex Partridge4:59

       Yeah, it's so-

   20. JPDr. Jo Perkins4:59

       And, you know, go through life.

   21. APAlex Partridge5:01

       It's so interesting. Before I got my ADHD diagnosis, I knew I was an alcoholic, and-

   22. JPDr. Jo Perkins5:06

       Mm

   23. APAlex Partridge5:06

       ... alcoholism took me to Alcoholics Anonymous meetings. And in those meetings, people who were older than me in the rooms were telling me that alcoholism gets worse with age, uh, if you don't-

   24. JPDr. Jo Perkins5:19

       Yeah

   25. APAlex Partridge5:19

       ... essentially get a handle on it. And I didn't understand that. I thought, "How can my compulsion to drink," which was, which was already at that stage terrible, "how can it get worse?" And I think now I look at life with a wider lens, and you can see essentially your, the, the pot of thoughts that you have to ruminate over, the, the, the, the impulsive things you've done, the, the, the list of things you maybe regret, are constantly growing. And that can compound over years and years and years to create this, this pressure cooker that is in your mind-

   26. JPDr. Jo Perkins5:52

       Mm

   27. APAlex Partridge5:52

       ... getting fuller and fuller and fuller all the time, unless you put systems, tools, management techniques in place to relieve some of that pressure.

   28. JPDr. Jo Perkins6:00

       Yeah.

   29. APAlex Partridge6:00

       You can quite easily see, I think, how something like alcoholism, which I personallyPut hand in hand with my ADHD could get worse with age. So I suppose, do you think the executive functioning challenges of ADHD can get significantly worse, or do you think the emotional regulation aspect of ADHD can get em- significantly worse?

   30. JPDr. Jo Perkins6:26

       For me, they go hand in hand.
3. 8:36 – 13:57

   Common mid-life ADHD challenges

   1. APAlex Partridge8:36

      awareness, if someone's not at that stage yet, do you see any common woes with people who have ADHD who may be at midlife?

   2. JPDr. Jo Perkins8:45

      Yeah, I think there's, um, things you mentioned earlier, Alex, is that cumulative effect.

   3. APAlex Partridge8:52

      Hmm.

   4. JPDr. Jo Perkins8:52

      You know, you, you know, if you're racking up experiences and, and real and perceived failures-

   5. APAlex Partridge9:01

      Hmm

   6. JPDr. Jo Perkins9:01

      ... because again, there will be real failures, 'cause every human has them. But also anyone struggling will have things that they have broken, not succeeded at, lost, um, been kicked out of, et cetera. Um, and of course there's that amplified sense of failing even when we haven't.

   7. APAlex Partridge9:18

      Mm-hmm.

   8. JPDr. Jo Perkins9:18

      And that compounds as you go through life. So that really builds as we get more years on the clock, as it were, and more experiences. So that definitely is a, is a common woe. But that again, the offshoot of that is more anxiety, more other mental health conditions, and then you've got menopause and hormones and the perimenopause.

   9. APAlex Partridge9:40

      Hmm.

   10. JPDr. Jo Perkins9:40

       So again, as we're going into our 30s, 40s, it's interesting, a lot of people won't even know, women won't know that they're in perimenopause because even when people talk about it, it's different for different people. There's not a sign that you're necessarily in it. But your anxiety can start really becoming exas- exacerbated then. That can be very scary. You don't know where it's coming from, especially if you're not diagnosed and you're not sh- aware of where that's coming from. You can feel more exhausted. The brain fog, that, that working memory can really be challenged as you're going through perimenopause and you're just being told, "Yeah, it's 'cause you're getting older or because, you know, you've got a lot on." And you assume it is.

   11. APAlex Partridge10:20

       Hmm.

   12. JPDr. Jo Perkins10:20

       It's you not coping very well, which of course is, is a common feature that gets worse as we get to, to middle age. And then the other woes I see a lot of as well is that, you know, more sleeping issues that, that, that come in, and people feeling that they should have had it together by now.

   13. APAlex Partridge10:37

       Hmm. Yes.

   14. JPDr. Jo Perkins10:37

       So feeling, "I should have cracked this by now. I've been doing this for a long time." Whether that be relationships, budgeting, their job. Um, and I think as well a lot of people can find that... Some people I will work with will s- stick with something, and then because they think, "I can't do this," and if they're not diagnosed, they may then switch jobs, and they might go from different thing to different thing. Partly maybe impulsivity, partly kind of novel-

   15. APAlex Partridge11:03

       Hmm

   16. JPDr. Jo Perkins11:03

       ... but also trying the thing, find the thing that they're better suited to, but repeated failures, and it can just lead to quite chaotic, disjointed sort of traits-

   17. APAlex Partridge11:13

       Hmm

   18. JPDr. Jo Perkins11:14

       ... and, or common experiences as we go through life. Um, and if one of the challenges that you experience is that connecting with others and, and, and having stable relationships, that can be quite a common feature as well. Yes.

   19. APAlex Partridge11:28

       If someone is experiencing that and they've had years of evidence behind them of failures, essentially-

   20. JPDr. Jo Perkins11:36

       Yeah

   21. APAlex Partridge11:36

       ... they've started things, businesses, relationships, hobbies, and that boom and bust cycle has happened time and time again-

   22. JPDr. Jo Perkins11:42

       Hmm

   23. APAlex Partridge11:43

       ... what can be the sort of, the compounding mental health consequences, how someone feels about themselves, their self-worth? How can that compounding pattern affect someone?

   24. JPDr. Jo Perkins11:52

       Oh, it, it, it can be debilitating-

   25. APAlex Partridge11:58

       Hmm

   26. JPDr. Jo Perkins11:58

       ... and, and overwhelming and all-consuming. If you have had a life where, again, whether you have actually failed but perceive you've failed, and you've had one thing after another, and you believe it's your fault-And you've been told that as well plenty of times-

   27. APAlex Partridge12:16

       Yes

   28. JPDr. Jo Perkins12:16

       ... from, from a young age. And you can point to things that you just didn't do right or didn't do well enough, and, and they- they're true, but... And you are in your head with that, and you're in, you know, your, your life's not where you want it to be or actually a real mess. That is... You know, it can leave people feeling huge despair, very little hope for the future and their ability to, to make a change, and there's, you know, that sense of hopelessness and helplessness. Again, the anxiety can be huge, huge, and, and it can often as well... I'll see people that are really, like I say, burnt out because they'll just keep running-

   29. APAlex Partridge12:53

       Mm

   30. JPDr. Jo Perkins12:53

       ... trying harder to not, you know, fail, make it work this time, whatever the it is. Um, and of course, that, the, the shame, the humiliation, um, anxiety, and, and it can affect people in so many different ways. Obviously, there'll be the self-medicating aspects-
4. 13:57 – 16:09

   "I've got this far with my ADHD, so why change now?”

   1. APAlex Partridge13:57

      Could there be a risk that someone who may be, say, in their 60s, 70s, really whatever age, they could have the opinion that, well, they've got this far, and they've coped through whatever strategies they've put in place, maybe unhealthily, some healthily, that they might hear about ADHD and think, "Oh, I don't need to bother researching that, making changes, because I've, I've, I've coped so far," and therefore that could lead them down a path that might not be optimal compared to if they did take ADHD seriously and, and make some changes?

   2. JPDr. Jo Perkins14:30

      Yeah. So everyone will have a version of coping, and if, if something's working, and as they're getting older, it's working better than it's ever worked because of the self-awareness, again, not because of they know they've got ADHD, but they've just learnt, and they've managed to get to a point where they're okay, I can absolutely see why that, that might not feel like something they need to involve themselves with, albeit they may benefit from it. You'd also get people, I think, that have gone, "Do you know what? I've... I, I appreciate where I do function well. I'm harnessing that." And that can be super empowering, and for them, they may just not genuinely see the benefit of it because, "What, what would it do for me?" Now, it could, but again, it's a s- it's a subjective thing-

   3. APAlex Partridge15:16

      Mm

   4. JPDr. Jo Perkins15:16

      ... isn't it? Whereas if things aren't working, and you're thinking, "This is really the best it can be," and you've convinced yourself this is coping, and then there may be a fear around this ADHD thing, you know, if you're not diagnosed, obviously.

   5. APAlex Partridge15:29

      Mm.

   6. JPDr. Jo Perkins15:29

      Um, but I... The... One something I've noticed is that when people are diagnosed, um, particularly later in life, and they've got coping strategies that are working, this can be a real... re- really empowering, really liberating, and yeah, it's like, "Well, I'm not gonna change now."

   7. APAlex Partridge15:46

      Mm.

   8. JPDr. Jo Perkins15:46

      But they are, they probably are tweaking, but that compassion and that self-awareness and understanding is, is enough to kind of psychologically calm down and appreciate themselves. So they may not necessarily choose to do anything, but just the awareness of it, like do anything differently, but the awareness can be quite dramatic in terms of what it does to help.

5. 16:09 – 21:39

   How AuDHD changes with age

   1. APAlex Partridge16:09

      Mm. And what about AuDHD? If we throw autism into the equation-

   2. JPDr. Jo Perkins16:15

      Mm

   3. APAlex Partridge16:15

      ... how does that go up against the strains of aging?

   4. JPDr. Jo Perkins16:18

      Yeah. Well, again, just as with ADHD, but perhaps even more so with AuDHD, the different manifestations of that, depending on, on each individual will vary, and of course, how it goes through life and in what bits are activated and, and how they interact, um, for each individual. But in, in sort of broad terms, what happens quite often when you're aging is the, let's say, the predictability and ritual-seeking and, and, and, and sort of routine trait that, you know, an au- an autistic trait that, that, that, that's there can be get more entrenched. That, that, and that's often incompatible with the ADHD, you know, desire for novelty-

   5. APAlex Partridge17:08

      Yes. [laughs]

   6. JPDr. Jo Perkins17:08

      ... and stimulation-

   7. APAlex Partridge17:10

      Mm

   8. JPDr. Jo Perkins17:10

      ... and, you know, change. And those things can either be at odds or could be really helpful, a scaffolding. So it can keep the ADHD traits in check-

   9. APAlex Partridge17:27

      Mm

   10. JPDr. Jo Perkins17:27

       ... and allow them to thrive through having the kind of routine, the predictability, because I would always say to all of my clients, and, and, and live by this myself, when you've got that scaffolding in place, which can be a real struggle for the ADHD person, um, when you've got it in place, it, it, it changes your life, and you can just thrive. You're designing out a lot of the things that really cause the stress, anxiety, and chaos and, again, the emotional dysregulation-

   11. APAlex Partridge17:55

       Yes

   12. JPDr. Jo Perkins17:55

       ... that can make our lives so hard.

   13. APAlex Partridge17:58

       Mm.

   14. JPDr. Jo Perkins17:58

       So when it's working well, the AuDHD combination can be really helpful. Um, but it can also really be incompatible.

   15. APAlex Partridge18:08

       Mm.

   16. JPDr. Jo Perkins18:08

       And actually, what I see, you know, i, i- in clients, um, you know, you can get this... Certainly a lot of my clients, you know, they're, they're in business. They're running. They've got big pressure jobs, and there's a lot of disciplineThat's required for that. So there can be the thriving aspects of that because they're very disciplined, they're ritual, they'll do what needs to be done, but then they could, that can be complete control, and then it can be complete mess on the outside.

   17. APAlex Partridge18:36

       Mm.

   18. JPDr. Jo Perkins18:36

       So you can get these wild swings, which can be really, huh, disorienting, anxiety-provoking, and, um, really hard to-

   19. APAlex Partridge18:45

       Mm

   20. JPDr. Jo Perkins18:45

       ... regulate from when someone's like, "I'm, I'm like this all week. I've got..." And then I just kind of blow it at weekend.

   21. APAlex Partridge18:51

       Mm.

   22. JPDr. Jo Perkins18:51

       And not even that I've done anything bad, but it can be really hard to come back or get back on track after a holiday, for example, and then get back into the groove. But, um, so yeah, it can play out in different ways, I think. But, um, they can be friends or foes.

   23. APAlex Partridge19:05

       It must be quite hard if you are someone who, who has had many years of, of your life and you've got your certain habits in place, you, you lean towards habitual behavior, you, you crave your comfort zone, and then you've discover that you have ADHD or autism or AuDHD, and that, in itself, maybe requires you to make changes in order to live a happier, more optimal life. But that might contradict and clash with your, clash with your internal desire to stay within your known territory and your known habits and behaviors, even if they're damaging to your wellbeing.

   24. JPDr. Jo Perkins19:42

       Mm. Yeah, and it's, it's... So I think it's probably useful to say those rituals and safety behaviors are not... They may appear quirky. They may appear, um, nonsensical to someone who's not in your world or living with you who doesn't get the routine and can find it quite restrictive. But for someone autistic, AuDHD, even ADHD, they're survival skills and strategies and, and of course, they can get more hardwired and embedded so we can be... our world can become smaller potentially.

   25. APAlex Partridge20:18

       Mm.

   26. JPDr. Jo Perkins20:19

       Um, but having a diagnosis in and of itself doesn't mean we may have to make any of those changes.

   27. APAlex Partridge20:25

       Sure. Mm.

   28. JPDr. Jo Perkins20:25

       And I think, uh, obviously, you know, so I find that if people are wanting to make changes, that can be very helpful. I think the things that can really, um, be the challenge as we get older is that those safe zones and those rituals that we've developed to make our safety zones may not be compatible with the life we're living. So it might not work for the rest of our family, or a partner, or the job. You know, if you're expected to travel somewhere and you're like, "Mm, that, that requires me to do this." Now, that will come up with a load of reasons why you can't do that because actually that can be hugely anxiety provoking, and that's where, for me, when I'm working with people, that can be where the real challenge lies because it's, it's not compatible with change. We can become very fearful of change. That creates huge anxiety. So I think that it, it's, it's a desire to try and keep those rituals malleable-

   29. APAlex Partridge21:20

       Mm

   30. JPDr. Jo Perkins21:21

       ... as much as we can, and, um, because change is part of life, isn't it?
6. 21:39 – 23:38

   The truth about ADHD and OCD & Agoraphobia

   1. APAlex Partridge21:39

      can that anxiety create other issues like OCD or agoraphobia?

   2. JPDr. Jo Perkins21:45

      Absolutely. Absolutely. And it's, again, it will take different forms. And a lot of the time my clients that I work with or, or people may not recognize it as being an agoraphobia or OCD, and it may not meet the criteria, so they're not gonna... 'cause they're not getting a diagnosis. But actually, I will see people talking in very, um, anxious terms, something's coming up, and they'll be worrying about things, you know, what they're gonna wear, what they're gonna pack, and then they've got to do this. And again, the, the ADHD brain's kind of thinking of all these multiple things-

   3. APAlex Partridge22:14

      Mm

   4. JPDr. Jo Perkins22:14

      ... which can be incredibly overwhelming. And actually, a lot of people, like, you know, will, will say, I, they might actively start seeking a job or reasons why not to travel, for example. It can very much become problematic for them. So they may start designing their lives to be less needing to do those things.

   5. APAlex Partridge22:38

      Mm.

   6. JPDr. Jo Perkins22:38

      And that, what might not start off as an agoraphobia may not end up there, but again, it's certainly reducing the times you have to step out of the comfort zone. Um, it might be that when you're being invited to go somewhere, if it's not the time that works for you or it's in a place that you're not familiar with or it, it will break your routine, you may stop socializing, you may stop reaching out to people, going to things, and become socially withdrawn. And then it's a really vicious cycle because it's the rituals and the safety seeking that maybe prevented you in the first place because it felt too scary to go out.

   7. APAlex Partridge23:13

      Mm.

   8. JPDr. Jo Perkins23:13

      But then it becomes harder to go out because the less you're doing something, the less confidence you have, and the tighter your rituals become.

   9. APAlex Partridge23:20

      Mm.

   10. JPDr. Jo Perkins23:20

       So that can be both a sort of an agoraphobia, um, where you're fearing to go out and do certain things, but also the OCD bit. It's just like, now I've got to control everything in my life, and if I don't do it this way, I c- I can't

7. 23:38 – 25:23

   Tiimo advert

   1. JPDr. Jo Perkins23:38

      cope.

   2. APAlex Partridge23:38

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   3. JPDr. Jo Perkins25:16

      Mm

   4. APAlex Partridge25:16

      ... traits of ADHD, can they create anxiety within someone, especially as they age?

8. 25:23 – 28:54

   The truth about ADHD and memory loss diseases

   1. APAlex Partridge25:23

      For example, many people on this podcast, they come on, and they purport to have short-term memory loss. Um, I, I'm certainly a, a victim of that. Um, hence the washing machine of woes is my ADHD item.

   2. JPDr. Jo Perkins25:33

      Yes.

   3. APAlex Partridge25:33

      I always forget my laundry in the machine. But a- as I get older, um, and I start forgetting things, I could, could quite easily catastrophize and think that I've got quite serious-

   4. JPDr. Jo Perkins25:46

      Mm

   5. APAlex Partridge25:46

      ... memory issues j- just due to serious cognitive decline that I know is likely as, as someone gets older. So is it possible with someone who has ADHD, who has short-term memory loss, as they're aging, to almost panic as they experience short-term memory loss and think that it's a, a worrying sign of aging when, in fact, it could just be their ADHD?

   6. JPDr. Jo Perkins26:09

      Absolutely. Yes. And of course, anyone ADHD will experience the, the, the working memory challenges. And often, you don't know what you've forgotten, but you do know that you don't remember everything.

   7. APAlex Partridge26:22

      Yeah. [laughs]

   8. JPDr. Jo Perkins26:22

      And things catch you by surprise.

   9. APAlex Partridge26:23

      Yeah. [laughs]

   10. JPDr. Jo Perkins26:24

       Um, so again, it's, it's a lifelong feature typically for, for someone with ADHD because of the executive function-

   11. APAlex Partridge26:30

       Mm

   12. JPDr. Jo Perkins26:30

       ... aspects. But what happens as we get older, and as you say, as we're getting into sort of the middle age a- a- and beyond, obviously, there's a lot more mental load going on with all of the, the, the life responsibilities that we've been talking about and, and work and children and everything else. So the brain's working harder than it's ever worked. Then we've gotta do something with any information. So whether you're neurotypical or neurodivergent, it's only a memory when something's happened to the piece of information. And in very simple terms, sorry, all the neuroscientists-

   13. APAlex Partridge27:02

       [laughs]

   14. JPDr. Jo Perkins27:02

       ... out there, there's obviously a lot more complex description. It's you've gotta always take it from somewhere and put it into your brain.

   15. APAlex Partridge27:08

       Mm.

   16. JPDr. Jo Perkins27:08

       And if you don't do that, it's a bit like a conveyor belt. It's gone off. It hasn't gone into your brain. So an example, if your partner says to you, "Oh, I'm going off to that thing tomorrow," and you literally blank and go, "What? Uh, what thing?" And they're like, "We've, we've talked about this. I've told you five times. We talked. We had a whole conversation about this a month ago.

   17. APAlex Partridge27:28

       Mm.

   18. JPDr. Jo Perkins27:28

       It's in the diary." And that can be really terrifying. And I'll have many a client sit with me, and again, you know, I can relate to it myself. You're like, "I trust this person, so I know they're not pretending they've said to me. There's no ulterior motive here. I... It's terrifying. I have no recollection whatsoever." And that's true, and that's the scary bit. But if you were having that conversation, and you were maybe cooking something, the radio's on, you're in your head thinking about something else, you may well have had the conversation, but you didn't do anything with that information because you weren't really tuning in. The person telling you that-

   19. APAlex Partridge28:03

       Yes

   20. JPDr. Jo Perkins28:03

       ... doesn't actually know that-

   21. APAlex Partridge28:04

       Yes

   22. JPDr. Jo Perkins28:04

       ... 'cause you're looking like you're listening.

   23. APAlex Partridge28:05

       Yeah.

   24. JPDr. Jo Perkins28:05

       And they would maybe be able to do that multitasking and hear and do something with it. So it can cause problems because actually there will be, when you're particularly busy as well, 'cause you're, you're bit maybe, you know, again, the, the inattentive aspects of, of ADHD and the distractibility will mean that you're not always gonna be tuning into the right things, and you will be picking up stuff, as any ADHD will know, that you didn't want, but it somehow ended up in your head-

   25. APAlex Partridge28:29

       Mm

   26. JPDr. Jo Perkins28:29

       ... taking up space, but the bit you did want didn't go in. So it can get quite scary because those things start to become very real in your life. You might forget that there was a children's party. You might forget that you said you'd go and meet your friend somewhere, but actually you're also going somewhere else, and you just think, "Oh my God. I don't know how I've got myself into this mess. This... I must be losing my mind." So you do start-

   27. APAlex Partridge28:53

       Mm

   28. JPDr. Jo Perkins28:53

       ... to believe it.

9. 28:54 – 30:59

   The difference between ADHD and dementia

   1. JPDr. Jo Perkins28:54

      But the difference with ADHD and dementia or, or, you know, the cognitive decline is with ADHD, it will be intermittent, and you will still be able to hold memories of other things-

   2. APAlex Partridge29:06

      Mm. Sure

   3. JPDr. Jo Perkins29:07

      ... and not a progressive.

   4. APAlex Partridge29:09

      Mm.

   5. JPDr. Jo Perkins29:10

      Whereas if it is actual cognitive decline, whilst it will be intermittent and sharp in different ways, certainly in early stages, it will get worse progressively over time at different rates for different people.

   6. APAlex Partridge29:22

      Mm.

   7. JPDr. Jo Perkins29:22

      Whereas ADHD, when we're not so stressed, not so much going on, our memory's probably back to the way it was before, which is not necessarily brilliant in terms of the working memory because it, again, it, it will just get lost.

   8. APAlex Partridge29:35

      Mm.

   9. JPDr. Jo Perkins29:35

      So, you know, and a, a tip to working with that, especially if you're with someone in work or a partner, if you know you're ADHD and that's what's happening with your memory, say to your partner, "Don't tell me anything important unless we're actually both sitting down, I'm fully with you, and I'm actually tuned in." And I'm telling you I, I... And again, a lot of the clients I'll see at work, if, you know, they'll say, "They were telling me how to do this project, and I have no... I can't remember how to do it. I must be thick. I've got..." You know, really negative language about themselves. So-I will say make sure you get the step-by-step instructions, make sure it's written down, and then it's not a problem-

   10. APAlex Partridge30:13

       Good to know

   11. JPDr. Jo Perkins30:14

       ... as long as you can do it. Yeah

   12. APAlex Partridge30:14

       Good to know. So I don't-

   13. JPDr. Jo Perkins30:15

       You, you, you haven't got-

   14. APAlex Partridge30:15

       As long as I don't forget my laundry every day-

   15. JPDr. Jo Perkins30:17

       No

   16. APAlex Partridge30:17

       ... I don't have dementia. [laughs]

   17. JPDr. Jo Perkins30:18

       No. Exactly.

   18. APAlex Partridge30:19

       Pretty much

   19. JPDr. Jo Perkins30:19

       As long as you're remembering enough things.

   20. APAlex Partridge30:20

       Yeah.

   21. JPDr. Jo Perkins30:21

       And you can test it. You know, if you, you are, you doing something with the information-

   22. APAlex Partridge30:26

       Sure. Yeah

   23. JPDr. Jo Perkins30:26

       ... you won't be able to recall it.

   24. APAlex Partridge30:26

       I guess as you get older, you've basically got more-

   25. JPDr. Jo Perkins30:29

       More

   26. APAlex Partridge30:29

       ... crap to ruminate over, more stuff to be stressed about, that it's going to interfere with your-

   27. JPDr. Jo Perkins30:33

       Exactly

   28. APAlex Partridge30:34

       ... executive function, short-term memory.

   29. JPDr. Jo Perkins30:35

       Yeah. And of course, as well, there's a lot of women-

   30. APAlex Partridge30:38

       Mm
10. 30:59 – 35:27

    Ageing and impulsivity, a recipe for distaster?

    1. JPDr. Jo Perkins30:59

       Yeah.

    2. APAlex Partridge30:59

       What about aging and impulsivity? Is that a recipe for disaster? [laughs]

    3. JPDr. Jo Perkins31:05

       Oh, it could be. It can be. And again, I think that it's, it's not necessarily. So I would say, so sometimes I think the impulsivity when we're younger, impulsivity before our brain has developed, can be really reckless in nature. It can be, um, dangerous and, and harmful to ourselves, to others, and that gradually shifts as we get older, and life teaches us stuff all the time, so it can diminish. But impulsivity in, in, in what I see, um, as people get older, and again, how this, whether this is damaging or not, will depend on what the, the kind of follies and impulses might be. But, um, it can be... You know, I'll have clients say to me, "I decided to do that thing, like paint the front of the house." So then, you know, went off and bought all the paint. Like, "But you were meant to be doing something else."

    4. APAlex Partridge31:54

       Mm.

    5. JPDr. Jo Perkins31:54

       They're like, "Yeah, so I had a fight with my wife because then I wasn't there," or, "I was meant to be on that flight, but I did that thing just before I was meant to go." So impulsivity can take a different form. It's, it's always gonna be part of ADHD, but it will just shape-shift. Um, and obviously, those impulses can be harmful. You know, you can make decisions that just could look like a midlife crisis-

    6. APAlex Partridge32:15

       Mm

    7. JPDr. Jo Perkins32:15

       ... but maybe are, is that desire to do something different, break out of, of something. But it can also be one of those things where, because you're not thinking about it so much, people will start that business. They'll go, "Do you know what? Why not?"

    8. APAlex Partridge32:26

       Mm.

    9. JPDr. Jo Perkins32:26

       "Let's go on that holiday."

    10. APAlex Partridge32:27

        Yes. Yeah, yeah.

    11. JPDr. Jo Perkins32:28

        "Let's, let's do that thing rather than sit around thinking about it." So it can be a recipe for disaster, but it can be a recipe for fun, success, great business ideas. So it'll have many, many manifestations potentially.

    12. APAlex Partridge32:42

        If you, if you age, and hopefully not, but if you are someone who... Well, I suppose we all do, right? We'll all lose our physical ability over time.

    13. JPDr. Jo Perkins32:52

        Yeah.

    14. APAlex Partridge32:53

        Um, but if you are someone who has a lot of internalized or even physical hyperactivity, and you are d- you are a person that likes to be physical, and that, and then you also experience this decline physically, can that almost be quite torturous for the person who might be, have this mind wanting to do loads of stuff-

    15. JPDr. Jo Perkins33:11

        Mm

    16. APAlex Partridge33:11

        ... but a body that doesn't let them anymore?

    17. JPDr. Jo Perkins33:13

        Yeah. And I think that, I mean, that's a very human thing, isn't it? It's, it's hard for any of us as we have diminished capacity and capability.

    18. APAlex Partridge33:23

        Mm.

    19. JPDr. Jo Perkins33:23

        And I think that one of the things with an AuDHD physical decline that, that I would see at least, is the frustration and, uh, that things that would have kept them safe, well, as an outlet, are, are less accessible.

    20. APAlex Partridge33:41

        Mm. Right.

    21. JPDr. Jo Perkins33:41

        Whether that be helping others, doing sport, you know, getting out and doing. And that can be really, really challenging to then be, depending on, again, the nature, if it's more sudden a decline for whatever reason, or from an accident, that can lead to all sorts of challenges, you know, because you're stuck in your head, and the h- hyperactivity can be more thought-based then, which might be new. I mean, it's not unusual-

    22. APAlex Partridge34:08

        Mm

    23. JPDr. Jo Perkins34:08

        ... for, for many people, particularly women, to have that hyperactivity in, in, in, in their mind. But obviously, if you've been used to the physical, that might have kept your mind quiet. So for then, that can just activate. But also, the things that might have given you meaning and validation and sense of purpose may be gone if that was that physical thing. So it's about adjusting and finding ways.

    24. APAlex Partridge34:33

        Mm.

    25. JPDr. Jo Perkins34:33

        But it, but yeah, it's gonna be challenging. But in my experience as well, people with ADHD, they'll find a way to overcome despite the challenge.

    26. APAlex Partridge34:41

        Yeah. They'll come themselves.

    27. JPDr. Jo Perkins34:42

        They'll go, "Right. I'll galvanize people to do that, or I'll, I'll do it in this way."

    28. APAlex Partridge34:46

        Mm.

    29. JPDr. Jo Perkins34:48

        So again, I think that that ingenuity and that ability to innovate and the zest and the energy-

    30. APAlex Partridge34:54

        Mm
11. 35:27 – 45:27

    How to age gracefully

    1. APAlex Partridge35:27

       how, any advice on how to age gracefully? Um, tips on acceptance and riding that aging wave?

    2. JPDr. Jo Perkins35:35

       Well, um, I think for me, the aging gracefully from an ADHD perspective, and anything in life, it's, for me, aging gracefully is aging well psychologically, and for me, aging well psychologically means understanding yourself, cutting yourself some slack, acknowledging what you're good at, what you're not great at, what you don't enjoy, giving yourself permission to go, "Do you know what? I'm gonna stop torturing myself and others with this, and stop pushing through these things and telling myself I should be able to do this, and I should like this." That, for me-It takes a lot of the pressure off when I see people with that. It relieves a lot of the stress. And so aging gracefully is about acceptance, understanding, and permission to do things d- differently, but also then kind of caring enough about yourself to, to keep yourself well-

    3. APAlex Partridge36:28

       Hmm

    4. JPDr. Jo Perkins36:29

       ... rather than abusing yourself in whatever ways those might be, and, and being kinder to yourself across the board. And that's, for me-

    5. APAlex Partridge36:38

       Hmm

    6. JPDr. Jo Perkins36:38

       ... how we can age gracefully a- a- a- as an ADHD and, and become calmer, but leverage the energy, leverage the strength. And, and often that comes through understanding what it is-

    7. APAlex Partridge36:51

       Hmm

    8. JPDr. Jo Perkins36:51

       ... that's going on, and that's a journey in itself, as we know, with lots of different bits, and there's, um, you know, diagnosis in and of itself is not the key that, that does that because that can be quite painful as well, and it's what goes on beyond that. And even if you don't have a diagnosis, but you, you are... you'll have developed strategies, and if you're someone that can just kind of learn to accept yourself and how you are in the world, and have been, I say, lucky because it... even with awareness and trying lots of different things, some people still don't find their thing. But I think if you can find your thing that keeps your brain occupied and fed, it's unbelievably helpful, and it's a privilege when you've got that because your brain is directed in a healthy way.

    9. APAlex Partridge37:34

       Hmm.

    10. JPDr. Jo Perkins37:34

        It feels satisfied, so it's less likely to ruminate on the negative, harmful thoughts and the what-ifs, you know, the, the, the bad stuff that we say about ourselves. So that's all really painful aging versus aging gracefully.

    11. APAlex Partridge37:50

        The thing I'm worried about, Jo, I think is aging and losing control.

    12. JPDr. Jo Perkins37:56

        Hmm.

    13. APAlex Partridge37:56

        I think particularly someone like myself and many people I've spoken to, we, we like to have control over many areas of our lives, particularly because the standard that I like to keep is, is so high. It's almost that perfectionist inside me, and I feel like as I get older, I'm gonna lose the ability to maintain that standard through maybe physical decline, mental decline. But do you think to ease that panic almost, it's, it's better to almost accept that time is the only thing that is in control?

    14. JPDr. Jo Perkins38:29

        For me, what's... I think there's a, a giving up to the forces that we can't do anything with, and, and I'll often say to my clients, "Look, control healthily what you can. Just let go of everything else," which of course we know we can't just let go. But when we relinquish control, 'cause of course control, Alex, can take different forms, but you know, that perfectionism, a lot of that is a safety mechanism, isn't it?

    15. APAlex Partridge38:53

        Yes, yes, yes.

    16. JPDr. Jo Perkins38:53

        Because you, you have to do that to rely on yourself and design-

    17. APAlex Partridge38:56

        Hmm

    18. JPDr. Jo Perkins38:56

        ... out all the things that could go wrong and destabilize you, um, and keep you well. So that you won't and don't have to lose control of, but actually, the, the, the time bit, there's a comfort almost to going, "Do you know what? Whatever I do, that's happening." And there's something very humbling about that. And, and when we stop trying to control, things get easier actually. So that for me is, um... it becomes much healthier and easier, less pressure, and it's not control we need. It's management, awareness, and trusting ourselves.

    19. APAlex Partridge39:39

        Hmm.

    20. JPDr. Jo Perkins39:40

        Like, y- you can trust yourself that you're gonna do things to a higher standard.

    21. APAlex Partridge39:44

        Hopefully. [laughs]

    22. JPDr. Jo Perkins39:44

        Again, whether we believe we can trust ourselves-

    23. APAlex Partridge39:46

        Yes

    24. JPDr. Jo Perkins39:46

        ... and a- again, it's another thing.

    25. APAlex Partridge39:48

        Hmm.

    26. JPDr. Jo Perkins39:48

        But, um, yeah, I think it can be quite liberating. Uh, yeah.

    27. APAlex Partridge39:52

        It's interesting. I think because I almost always live in the now, it's what's in front of me is my hyperfocus. If something's out of my sight, it's, it's out of my mind and sort of ceases to exist. I've, I've mentioned this before, and for me, the future or the idea of the future is so abstract. I find it incredibly difficult to plan for the future, and therefore, to me, the, the, the thought of aging and going into that unknown is quite terrifying.

    28. JPDr. Jo Perkins40:25

        Hmm.

    29. APAlex Partridge40:26

        Do you think there's a fear there of people with ADHD, many of whom I know relate to this concept of living in the now, do you think there's this fear of getting older because they find it so hard to plan for the future?

    30. JPDr. Jo Perkins40:38

        Yes. [laughs]
12. 45:27 – 48:12

    Does shame decrease with age

    1. APAlex Partridge45:27

       What about shame? Does that wear off as you age? I- do you stop caring as you get older what other people think?

    2. JPDr. Jo Perkins45:37

       Yes, so I think the shame for anyone, I mean, shame generally, it, it's, it's, it's always there. I think the way of describing it and if I think about clients and, and, and any of our own experiences, you know, myself included, it's, it's there, but it... as we get older and certainly understand ourselves, and this is where with ADHD as well, a diagnosis can kind of shift that from being shame to through understanding and compassion-

    3. APAlex Partridge46:04

       Mm. Sure

    4. JPDr. Jo Perkins46:05

       ... to going, "Ah, I don't need to be ashamed of that." You know, it's, it's... so that can definitely reduce the shame so it doesn't sort of solidify, but it, it... what often happens is we c- the shame is there and can be activated very easily i- under the right circumstances. What can often happen is, as we get older, understand ourselves, and have less things that make us feel shame because we're doing better at things-

    5. APAlex Partridge46:31

       Mm

    6. JPDr. Jo Perkins46:31

       ... if that's the case, of course. So actually, shame is just more of a small pool that can be, you know, stirred up, but isn't permanently-

    7. APAlex Partridge46:41

       Mm

    8. JPDr. Jo Perkins46:41

       ... flowing, if you like. So it's, it's there, but it softens or becomes less frequently activated, and when it's live, it can feel like it's never gone away. It's as real as ever. But I think we just get less situations.

    9. APAlex Partridge47:00

       Mm.

    10. JPDr. Jo Perkins47:00

        If we're managing ADHD and we're living a, a life where we're coping, um, then the shame just isn't being activated by new stuff, 'cause that's the really compounding-

    11. APAlex Partridge47:10

        Mm

    12. JPDr. Jo Perkins47:10

        ... one, is like, "Oh, my gosh, done that thing." You know, so that's where when someone isn't managing their ADHD or they've got other things going on, it can really be very present at any age because still here. "Oh, here we go again." But if you're managing it, it... so it can definitely shift. And you, and generally, as we get older, we do not care what people think. That's one of the huge benefits of aging.

    13. APAlex Partridge47:31

        Mm.

    14. JPDr. Jo Perkins47:31

        It's not that we... You know, some people will always care to an extent. Some people won't care much at all. That's liberating, 'cause actually, so what? So if I've embarrassed myself on that thi- n- you don't go home thinking everyone's gonna talk about you, or if they do, 'cause that's where your head goes and you've analyzed it, you know, come to that conclusion, you're not actually invested in what is said about you. You're like, "Yeah. So what? What's the worst that can happen?"

    15. APAlex Partridge47:54

        Mm.

    16. JPDr. Jo Perkins47:54

        You know, they said I, you know, made a fool of myself, or I got drunk, or I said the wrong thing, or I didn't do a good presentation. You're not as invested in it.

    17. APAlex Partridge48:04

        Mm.

    18. JPDr. Jo Perkins48:04

        So that is how the shame can be helped by that people pleasing. You're less likely to be triggered into it.

13. 48:12 – 52:52

    Does people pleasing decrease with age

    1. APAlex Partridge48:12

       Mm. What about people pleasing? Do you think people pleasing evaporates as you get older?

    2. JPDr. Jo Perkins48:18

       I think it d- I don't know if it evaporates. I mean, I think for some people it definitely does, and I think that, you know, again, evaporate can be quite quick. I think it's probably a longer process in, in reality, as we'll, we'll know. But I think that some people just go, "Yeah, just don't... I know what I need to do. I will do the right thing. I don't overcommit." And actually-By not people pleasing, they actually interestingly tend to please more people, 'cause they're not letting everyone down, 'cause they've overcommitted-

    3. APAlex Partridge48:44

       Mm-hmm

    4. JPDr. Jo Perkins48:44

       ... trying to people please. But once you understand yourself and your ADHD, and particularly as you get older, you just go, "Do you know what? That just doesn't work for me to go all the way over there to visit that person because I feel like I should, or to help someone else out, because actually my time is best spent here, or my energy needs to be directed here rather than squandered." And that is, is possible when we get to know ourselves better.

    5. APAlex Partridge49:07

       Mm-hmm.

    6. JPDr. Jo Perkins49:08

       That helps us stop people pleasing, but also not needing to people please because we've kind of got our tribe, got our life sorted in whatever way that looks.

    7. APAlex Partridge49:18

       Mm-hmm.

    8. JPDr. Jo Perkins49:18

       There's less people that we're trying to please. It can just feel a lot easier. And the less you do it, the less I think you're inclined to. It can get activated in s- it's always interesting, if someone starts people pleasing after a period of not-

    9. APAlex Partridge49:32

       Mm-hmm

    10. JPDr. Jo Perkins49:32

        ... is I'll always say, "What's going on in that dynamic?"

    11. APAlex Partridge49:35

        Right. Yes.

    12. JPDr. Jo Perkins49:35

        You trying to impress them? Are they making you feel bad? What's going on?

    13. APAlex Partridge49:38

        Mm-hmm.

    14. JPDr. Jo Perkins49:38

        Don't launch into the people pleasing. So once it starts to drop away, it can be really helpful when you notice it happening, going, "Oh, something's going on here. I'm noticing myself offering to do stuff that, why?"

    15. APAlex Partridge49:50

        Mm-hmm. For me, the, one of the biggest sources of shame is RSD. We did a fantastic episode-

    16. JPDr. Jo Perkins49:56

        Yeah

    17. APAlex Partridge49:56

        ... with yourself on that topic. And people pleasing, ironically, is the thing that I used to do in order to protect myself from the RSD.

    18. JPDr. Jo Perkins50:05

        Yeah.

    19. APAlex Partridge50:06

        I can't be triggered, I can't upset anyone if I just say yes and don't offend anyone. But actually, ironically, it's learning how to say no and just putting that pause between the ask, or, "Can I let you know tomorrow?" Limiting my people pleasing that has enabled me to be more confident-

    20. JPDr. Jo Perkins50:22

        Mm

    21. APAlex Partridge50:22

        ... which has, in turn, diluted the impact of RSD when it strikes. 'Cause it still does. I'm 36, and it still is as viscerally painful as it was from my first memory of it when I was about four, I remember. Um, but the awareness s- helps so much, because you can remind yourself in those moments that this is, this is going on. You know why this is going on, that you're not broken, you're just different-

    22. JPDr. Jo Perkins50:47

        Mm

    23. APAlex Partridge50:47

        ... and there's a reason why you're feeling these intense feelings.

    24. JPDr. Jo Perkins50:49

        Mm-hmm.

    25. APAlex Partridge50:49

        And I think as you get older, um, you get better at reminding yourself in those critical moments that what you're feeling isn't your fault, and that actually goes a long way to stripping away the shame.

    26. JPDr. Jo Perkins51:02

        Huge. Yeah. It, it's, I mean, you've articulated it beautifully, Alex. It's exactly that, and I think there's this thing where the irony is, as you're, you've said, you know, the, the more you try and people please to protect yourself and to not let people down and, and, and kind of ingratiate yourself, um, it's exhausting. You end up much more likely overpromising and under-delivering, so you get yourself in a right pickle-

    27. APAlex Partridge51:27

        Yes. [laughs]

    28. JPDr. Jo Perkins51:27

        ... where you say, "I'll do these 10 things," and you're either really resentful actually that it was your fault, but you still think, "Why am I doing this?" And you get angry, so you fall out with people. But also you get burnout, and actually you get, you're more likely, I mean, I, you know, I'll speak to clients and they go, "I knew I shouldn't have said yes. I knew I couldn't fit it in. Then I went along, and then I got absolutely roaring drunk, made, you know, a mistake, 'cause then I fell out with that person, then kicked the cat when I got home." You know, that sort of thing.

    29. APAlex Partridge51:51

        [laughs]

    30. JPDr. Jo Perkins51:52

        And it's like... And of course, feeling the very thing-
14. 52:52 – 56:08

    The truth about ADHD and menopause

    1. APAlex Partridge52:52

       How does ADHD and menopause intertwine?

    2. JPDr. Jo Perkins52:55

       Yeah, so this, um, as we said, uh, menopause, um, as we know, certainly for women who haven't been diagnosed prior to that point, as we know, many girls get, you know, lost in the system and, and are always the ones that will get the sort of late diagnosis as, as a woman, um, typically, and that's often around the peri, so stroke menopause time. Because that interaction of the hormonal changes really do affect our brain, and our brain is already wired in a particular way, and it struggles obviously with the executive functions-

    3. APAlex Partridge53:27

       Mm.

    4. JPDr. Jo Perkins53:27

       .. the emotional regulation. So when your hormones start changing, 'cause that's obviously what's happening, and it happens in young women as well. And again, it's not always clear. You know, it gets, certainly with ADHD girls, if, if they're not diagnosed, but even if they are, it's put down to PMT. But the brain is affected differently at different points in the cycle. They, and we know that, and, and it's, it's, um, can make it really the week, I think it's the week before your cycle. Again, you've had a great episode recently, I know, with Dr Louise Newson-

    5. APAlex Partridge53:59

       Yes

    6. JPDr. Jo Perkins53:59

       ... talking about hormones.

    7. APAlex Partridge54:00

       Mm.

    8. JPDr. Jo Perkins54:00

       So, you know, it's not my area of expertise, but I certainly work with it. And, um, as a woman, you'll see things just feel very chaotic, active, struggle to sleep in, in, in the le- week leading up-

    9. APAlex Partridge54:12

       Mm

    10. JPDr. Jo Perkins54:12

        ... to your cycle, and then after your period, things calm down again. So that can happen, and medication can be shifted and modified as a consequence for that. So the same is happening down the line at perimenopause-

    11. APAlex Partridge54:24

        Mm

    12. JPDr. Jo Perkins54:24

        ... and menopause. So it's, it's affecting your brain.

    13. APAlex Partridge54:27

        Mm-hmm.

    14. JPDr. Jo Perkins54:27

        So you will genuinely have, and different women will have different symptoms, but it will affect memory. A lot of the time, I will see a lot of women, um, going through this stage, and it's a long stage. It lasts years. Um, not the menopause bit, but you know, the perimenopause. You often don't know you're in it. And it will be that-Women are saying, "I've got extreme anxiety," and they'll get misdiagnosed

    15. APAlex Partridge54:49

        Mm

    16. JPDr. Jo Perkins54:49

        It's not that they don't have anxiety when they go to the doctors, but that will be the diagnosis and, yeah, here's, um, medication for anxiety, which is not going to the root of the problem because that might be HRT or other management techniques or ADHD medication

    17. APAlex Partridge55:04

        Mm

    18. JPDr. Jo Perkins55:04

        Or if they've already got ADHD medication, modifying that as they're going through their cycle, and that makes a big difference. So a lot of the time as well, more sleep issues will kick in around menopause because, again, that's affecting our brain, our body, and our system. So a lot of people who may not have had that many challenges with sleep will as they start to hit me- perimenopause, that's often the time when women will say to me, "Oh my gosh, I'm awake all night." You know, just

    19. APAlex Partridge55:32

        Mm

    20. JPDr. Jo Perkins55:32

        ... busy head, I'm struggling. And you can often just get fobbed off. Well, of course you've got a lot going on. You've got young children, if that's the case, or a big job, or you've got a lot on your plate. Whereas if you are aware that it is ADHD, you do things differently

    21. APAlex Partridge55:47

        Mm.

    22. JPDr. Jo Perkins55:48

        And it's not that you won't have some kind of challenges, but it doesn't have to be this hard

    23. APAlex Partridge55:52

        Mm.

    24. JPDr. Jo Perkins55:52

        So it's, it's having a very significant interaction with the ADHD symptoms

    25. APAlex Partridge55:58

        Mm

    26. JPDr. Jo Perkins55:58

        ... challenges, and traits. So it, it just exacerbates those for over years and it can feel very disorienting

    27. APAlex Partridge56:07

        Mm.

15. 56:08 – 59:51

    How to prepare for the menopause

    1. APAlex Partridge56:08

       Is there anything someone could do to prepare themselves for the menopause? And I, I appreciate it's a big question, but particularly emotional. Is there any emotional scaffolding someone could put around themselves as they're approaching the menopause?

    2. JPDr. Jo Perkins56:22

       Yeah. So I would say, I mean, it is, for me, there's a, a whole range of things that, that I would encourage anyone going through middle life, you know, as they approach, but particularly with menopause, because again, you go into it and it goes over years, the perimenopause. So I would say education. Find out, firstly, you track your own body

    3. APAlex Partridge56:43

       Mm

    4. JPDr. Jo Perkins56:44

       ... track your own symptoms, cycle, start keeping a diary, noting what's going on. Don't gaslight yourself and assume that you're just tired this morning. If you're struggling to sleep for three, four days, where are you at in your cycle? It might not make any sense for a number of months, but track it. Educate yourself by watching other episodes o- o- o- of this podcast, doing the reading. Thankfully, there's a lot more now that we can find out about the, the role of h- hormones and the interaction

    5. APAlex Partridge57:12

       Mm.

    6. JPDr. Jo Perkins57:12

       So you can start spotting, 'cause it isn't just hot flushes. It's not just you might get an irregular cycle. You may, you may not. There's so many other things. It's not just brain fog, you know, it... There, there's lots of things.

    7. APAlex Partridge57:22

       Mm.

    8. JPDr. Jo Perkins57:23

       So educate yourself about the interaction. I also think you can never start too early. If you're not someone that already has quite good scaffolding and a routine and a proactive approach to your health, I would say one of the most important things alongside the education piece is really understanding the importance of sleep, exercise, nutrition

    9. APAlex Partridge57:43

       Mm

    10. JPDr. Jo Perkins57:44

        ... balancing your energy, not people pleasing and overstretching

    11. APAlex Partridge57:48

        Yes

    12. JPDr. Jo Perkins57:48

        ... learning to say no

    13. APAlex Partridge57:49

        Mm

    14. JPDr. Jo Perkins57:50

        ... not just going, "Oh, I'm gonna feel rubbish 'cause I'm getting older," or, "I've got anxiety." Don't just think it's that. We can do so much more, but it gets harder-

    15. APAlex Partridge57:58

        Mm

    16. JPDr. Jo Perkins57:58

        ... as we get further into perimenopause and menopause. And if we're not thinking we can do anything about it, why... If we don't fancy going to the gym and there's no time, why would we start? So find something-

    17. APAlex Partridge58:09

        Mm

    18. JPDr. Jo Perkins58:09

        ... that works for you. And also, what I see a lot as well with women, you know, if they've always been training, let's say, and they might do particular kind of training, they might not be enjoying that. That might be becoming more painful. It might not be... Their body might be almost telling them, "Don't do it so hardcore."

    19. APAlex Partridge58:26

        Mm.

    20. JPDr. Jo Perkins58:26

        So listen to your body and what it's telling you, and it might be that during your cycle you do different things at different times. And if you're feeling like you need to stretch or do more strength or Pilates or whatever, walking, listen to it. Be flexible with your routine

    21. APAlex Partridge58:43

        Mm-hmm

    22. JPDr. Jo Perkins58:44

        And it can be really tough because obviously as you're getting older and going through perimenopause, your body's changing. So actually sometimes you wanna do more of the things that are gonna give you the quick fix, what you've always done

    23. APAlex Partridge58:52

        Mm.

    24. JPDr. Jo Perkins58:53

        And it can be a real challenge to do things that are different and new and not what you're used to. But I would say tune into your body

    25. APAlex Partridge59:01

        Mm

    26. JPDr. Jo Perkins59:01

        ... make adapting, adapt, you know, routines. But eat for vitality, prioritize health, really manage your alcohol intake, caffeine

    27. APAlex Partridge59:08

        Mm

    28. JPDr. Jo Perkins59:08

        All the stimulants that, you know, many of us will, will, will rely on, um, and use can creep up on us being a habit, and it can really play havoc with your anxiety

    29. APAlex Partridge59:18

        Mm.

    30. JPDr. Jo Perkins59:18

        Certainly alcohol really further impacts your sleep. And even a glass or two glasses of wine that might have before been quite pleasurable can really knock you out of whack
16. 59:51 – 1:03:33

    Can someone be too for an ADH diagnosis

    1. APAlex Partridge59:51

       Do you think somebody can be too old to be diagnosed with ADHD?

    2. JPDr. Jo Perkins59:56

       No, I don't think you're ever too old. I think the caveat being if you want to be. I think that, you know, if, if it's not occurred to you to have a diagnosis and you don't know anything about ADHD and someone starts telling you you should have one, that might not be the best thing.

    3. APAlex Partridge1:00:11

       Mm.

    4. JPDr. Jo Perkins1:00:11

       But for me as a psychologist, having self-awareness, information, knowledge, that's power

    5. APAlex Partridge1:00:20

       Mm.

    6. JPDr. Jo Perkins1:00:21

       That helps you make changes, understand yourself, use your agency to live a good life whatever age you are. And I think particularly as we get older and we are confronted maybe with different kind of caregivers, systems, whether that be the doctors, hospitals, if you know you have ADHD, it's really important that you can then, as more people in the professional world get educated about this, that you can sayI'm ADHD, so if they see you being more emotionally dysregulated, if you are having challenges, if you're in a setting where you might have to be waiting for quite a long time, you're getting impatient and angry-

    7. APAlex Partridge1:00:58

       Mm-hmm

    8. JPDr. Jo Perkins1:00:59

       ... it's really important you're not just seen as someone being really rude. You might be actually feeling quite anxious, agitated, needing to move around. If someone understands that you've got that, you know-

    9. APAlex Partridge1:01:07

       Mm-hmm

    10. JPDr. Jo Perkins1:01:08

        ... you- you've got a diagnosis and you can communicate that, you will be perceived differently. You are probably quite likely as well to avoid or minimize the chance of getting misdiagnosed or something.

    11. APAlex Partridge1:01:19

        Mm-hmm.

    12. JPDr. Jo Perkins1:01:19

        Um, and you might get information. You know, again, you know, as we get older, old, you know, you're thinking if you can ever be too old, you don't want someone thinking you've heard the information, especially if you're not showing any signs of cognitive decline, and you are fully with it. But of course, with ADHD, if you can't retain all the information, particularly medical information, being able to say to someone that, "Can you give me the leaflet? Can you write it down? Can I have someone, you know, else with me to take that information?" is really important.

    13. APAlex Partridge1:01:43

        Mm-hmm.

    14. JPDr. Jo Perkins1:01:43

        And if you don't know that that's a challenge, you may not do that. You may un- unlikely to advocate for yourself through that filter and understanding. So I'd say you're never too old, ever.

    15. APAlex Partridge1:01:54

        Mm-hmm.

    16. JPDr. Jo Perkins1:01:54

        But equally, it can come... It's a mixed experience initially. So I'd always put, put a bit of a health warning on, saying it's not this amazing thing instantly. It's very helpful, but there's also the chance that there will be some grief in there-

    17. APAlex Partridge1:02:11

        Mm-hmm

    18. JPDr. Jo Perkins1:02:11

        ... and some remorse and some if onlys, and that can be healthy. It, but it's, I don't want to suggest it's this, yeah, great. Get, get a diagnosis-

    19. APAlex Partridge1:02:19

        Mm-hmm

    20. JPDr. Jo Perkins1:02:19

        ... and, you know, someone will be shocked in later life, but definitely not too old, no. Providing you know what you're getting yourself into and how to use it.

    21. APAlex Partridge1:02:26

        Well, there's the image of a group of 100 year olds sat around a dinner table with, with a sherry.

    22. JPDr. Jo Perkins1:02:32

        Oh, I like the idea.

    23. APAlex Partridge1:02:33

        Sort of unpicking their life.

    24. JPDr. Jo Perkins1:02:34

        I mean, yeah.

    25. APAlex Partridge1:02:34

        Just all being diagnosed that week and having that in common. [laughs]

    26. JPDr. Jo Perkins1:02:37

        Imagine. I mean, you can find your tribe.

    27. APAlex Partridge1:02:39

        Mm-hmm.

    28. JPDr. Jo Perkins1:02:39

        You could... There's so, certainly now with the online world and so many things and, you know, that understanding and being able to make sense of so much.

    29. APAlex Partridge1:02:51

        Mm-hmm.

    30. JPDr. Jo Perkins1:02:51

        S- you, you could potentially, yes, there may be some grief inevitably, and what ifs and sadness, but also, uh, [sighs] stuff that we've, uh, you know, not been able to let go of or understand.
17. 1:03:33 – 1:10:41

    The ADHD agony aunt

    1. APAlex Partridge1:03:33

       Jo.

    2. JPDr. Jo Perkins1:03:33

       Pleasure.

    3. APAlex Partridge1:03:33

       I wanna do the ADHD agony aunt.

    4. JPDr. Jo Perkins1:03:35

       Yeah.

    5. APAlex Partridge1:03:35

       It's a very hot day. I'm hoping the, my sweat doesn't cause the machine to drop-

    6. JPDr. Jo Perkins1:03:39

       Blow up [laughs]

    7. APAlex Partridge1:03:39

       ... out of my hand like it did last summer. [laughs] Um, the ADHD agony aunt, you're very familiar with it.

    8. JPDr. Jo Perkins1:03:45

       Yeah.

    9. APAlex Partridge1:03:46

       It's called the Washing Machine of Woes because I always leave my laundry in the machine. I think I've asked you before and you said that you don't leave your laundry in the machine.

    10. JPDr. Jo Perkins1:03:54

        No, I don't tend to.

    11. APAlex Partridge1:03:56

        No.

    12. JPDr. Jo Perkins1:03:56

        On occasion.

    13. APAlex Partridge1:03:57

        [laughs]

    14. JPDr. Jo Perkins1:03:57

        No, I tried that and my brain doesn't like let go of it too much. No. Is that... Yeah.

    15. APAlex Partridge1:04:01

        Yeah. I am using the Tiimo app, which is a productivity app that reminds me, so I am getting-

    16. JPDr. Jo Perkins1:04:06

        Good

    17. APAlex Partridge1:04:06

        ... a lot better.

    18. JPDr. Jo Perkins1:04:06

        There's plenty other things I do forget, by the way. Don't, don't get me wrong.

    19. APAlex Partridge1:04:08

        Yeah. [laughs]

    20. JPDr. Jo Perkins1:04:08

        It's just not necessarily that one. It's definitely happened but...

    21. APAlex Partridge1:04:12

        This week, Jo, in the washing machine, someone has written in and asked, "I'm terrible at planning for my future because truthfully, I don't associate with the future me at all. I only think about the now. Is this normal, and what can I do to help out the future me, which will one day come?"

    22. JPDr. Jo Perkins1:04:32

        Well, yes, it's normal. Um, to the person asking the question, you can put your mind at, at rest there. Um, it's a very common one, and I think that it's, um, great that you're even asking the question because it means that you are aware the future's there, and there are things that would help you to do in the here and now. And what I'll say to people, it's really not uncommon, um, for people not to be able to visualize themselves-

    23. APAlex Partridge1:04:55

        Mm

    24. JPDr. Jo Perkins1:04:56

        ... in the future. Like, literally I'll say, "What can you see?" They're like, "I don't know. Nothing. I'm kind of here." So it is genuinely a real challenge, um, for people. So what I'll often say is, what you gotta do is externalize time. If you need to use a kind of, um, an image of someone else in the future, think of your parent, think of whatever else would help you externalize it, so it doesn't have to be you. You think, "Okay, what, what does that person need in the future?"

    25. APAlex Partridge1:05:19

        Mm.

    26. JPDr. Jo Perkins1:05:20

        So, I mean, in the basic sense, they're gonna need somewhere to live, some money to eat-

    27. APAlex Partridge1:05:24

        Mm

    28. JPDr. Jo Perkins1:05:24

        ... you know, some physical health, you know, mental health, and then you can start going, okay, well, what would be important to do now to get in the bank? So you start developing habits. Don't wait for the motivation. Don't wait for the time when you go, "I'm now gonna start planning." That day may well never come. So just start thinking about what are the basics that I think that future self, my future self, and if it helps to be- externalize them from yourself, do whatever needs to be done, and just go, right, health, relationships-

    29. APAlex Partridge1:05:54

        Mm

    30. JPDr. Jo Perkins1:05:54

        ... money, work, and start banking habits across those. And it's, don't worry, 'cause it can be really daunting in any of those areas if you've particularly neglected or struggle with one of them, let's say money, to go, "I'm never gonna have enough." Don't worry. Doing something is better than nothing. So again, it, if you start getting anxious, that's gonna keep you from planning.
18. 1:10:41 – 1:11:17

    A letter from the pervious guest

    1. JPDr. Jo Perkins1:10:41

       it.

    2. APAlex Partridge1:10:41

       Just finally, I want to deliver you a letter that was written-

    3. JPDr. Jo Perkins1:10:44

       Ooh

    4. APAlex Partridge1:10:44

       ... by the previous guest, where they wrote their three rules to live by. I'm gonna deliver the letter to you, Jo, and if, and if you could kindly read it out.

    5. JPDr. Jo Perkins1:10:50

       Three rules to live by. Focus on what's truly right. Empathize with those around you. Impute quality in everything you do. So apply quality in everything you do. I definitely subscribe to that.

    6. APAlex Partridge1:11:03

       Amazing.

    7. JPDr. Jo Perkins1:11:04

       Yeah.

    8. APAlex Partridge1:11:05

       Jo-

    9. JPDr. Jo Perkins1:11:05

       Thank you

    10. APAlex Partridge1:11:06

        ... as always, absolute pleasure. So much wisdom. Thank you so much.

    11. JPDr. Jo Perkins1:11:10

        Thank you for having me, Alex. It's always a joy having these rich conversations, so thank you. [upbeat music]

Episode duration: 1:11:17