Perimenopause, Estrogen, and Worsening ADHD

In this episode of SHE MD, Mary Alice Haney and Dr. Thaïs Aliabadi sit down with Dr. Steven Storage to unpack one of the most common mental health misdiagnoses affecting women today: ADHD being mistaken for anxiety or depression. Dr. Storage explains why ADHD is often overlooked in girls and women, and how many patients spend years being treated for anxiety before discovering the real cause of their symptoms.

The conversation explores how ADHD can present differently in women, including emotional overwhelm, chronic stress, brain fog, and difficulty focusing. Dr. Storage also discusses the role of brain imaging in ADHD diagnosis and how different brain patterns may require different treatment approaches, highlighting why traditional symptom checklists often miss the full picture.

They also discuss how hormonal changes, especially during perimenopause, can intensify ADHD symptoms, which is why many women first seek answers later in life. This episode sheds light on the importance of accurate diagnosis and brain-based approaches to better support women navigating ADHD.

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What You’ll Learn

• Why ADHD is so often misdiagnosed as anxiety or depression in women
• The key differences between ADHD and anxiety symptoms
• Why many women are diagnosed with ADHD later in life
• How hormonal shifts like perimenopause can worsen ADHD symptoms
• How brain imaging may help identify different types of ADHD

Key Timestamps

(0:00) Introduction to SHE MD

(03:09) What ADHD Actually Is (And Why the Name Is Misleading)

(07:05) ADHD in Women: Why It’s Often Missed or Misdiagnosed

(11:35) The ADHD Brain Explained: Dopamine & the Prefrontal Cortex

(18:08) ADHD Medications: Stimulants vs Non-Stimulants Explained

(21:28) ADHD vs Bipolar Disorder: Why Misdiagnosis Happens

(30:12) The 7 Different Types of ADHD

(39:12) Alcohol, Cannabis & the ADHD Brain

(45:46) How to Naturally Increase Dopamine

(47:45) Sleep, Exercise & Diet for ADHD Brain Health

(57:10) Perimenopause, Hormones & ADHD Symptoms in Women

(01:03:30) ADHD During Pregnancy & Natural Treatment Strategies

(01:12:30) Final Thoughts: Rethinking ADHD & Brain Health

Key Takeaways

• ADHD in women is frequently misdiagnosed as anxiety or depression.
• Symptoms can present differently in women, often showing up as overwhelm, brain fog, and emotional dysregulation rather than hyperactivity.
• Hormonal changes, particularly during perimenopause, can make ADHD symptoms significantly worse.
• Traditional diagnostic methods may overlook ADHD, especially in adults.
• Brain imaging may help identify different ADHD patterns and support more personalized treatment.

Guest Bio

Dr. Steven Storage is a board-certified psychiatrist specializing in brain health and ADHD in both adults and children. His work focuses on helping patients who are often overlooked or misdiagnosed better understand the root causes of their symptoms. Using a comprehensive, brain-based approach, he works with patients to identify patterns in attention, mood, and behavior and develop more personalized treatment strategies.

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