Ep. 499 ADHD Is Not What You Think – The Most Misunderstood Condition in Women with Shanna Pearson
- Team Cynthia
- Sep 9
- 39 min read
Updated: Sep 15
I am delighted to connect with Shanna Pearson today. She is the Founder and President of Expert ADHD Coaching, which is the most extensive ADHD coaching program of its kind in the world, providing one-on-one, action-based coaching for adults who are easily distracted and seeking personal, professional, and financial success. Shanna is also the author of Invisible ADHD.
In our discussion, we take a clear and practical look at what ADHD really is. We unpack the chemical changes that occur in the brain, highlighting the gender differences, and exploring why women have become the lost generation and why so many people get misdiagnosed. We also discuss common conditions that often accompany ADHD, the challenges of social conditioning, and share practical tools for addressing ADHD.
Whether you have ADHD or you struggle with overwhelm, this discussion offers helpful insights and strategies that are sure to make a real difference.
IN THIS EPISODE, YOU WILL LEARN:
What ADHD truly is
The brain biochemistry of those with ADHD
How ADHD differs in men and women
Why Shanna refers to women whose ADHD is undiagnosed until perimenopause or menopause as a lost generation
How ADHD in women often gets misdiagnosed
How hormonal changes during perimenopause and menopause impact ADHD symptoms
How societal expectations tend to exacerbate ADHD symptoms in women
Strategies for managing ADHD
Lifestyle factors that are essential for managing ADHD symptoms
How her book, Invisible ADHD, can help anyone struggling with ADHD or overwhelm
Bio: Shanna Pearson
Shanna Pearson is the Founder and President of Expert ADHD Coaching, the most extensive ADHD coaching program of its kind in the world, providing one-on-one action-based coaching for easily distracted adults seeking personal, professional, and financial success. With over 26 years of experience, she has designed and led focus and goal-achievement programs for executives and directors at Fortune 500 companies and world-class institutions, including Google, X, Tesla, PayPal, Pfizer, Intel, Ford Motor Company, Yale School of Medicine, Disney, Meta, Johnson & Johnson, Apple, and SpaceX—and has helped tens of thousands of adults transform their lives through her results-driven, brain-based approach. In addition to degrees in Psychology and Education, Shanna’s credentials include a lifetime spent mastering her own ADHD. She personally trains, certifies, and mentors all coaches in her proprietary Action-Based Coaching method and oversees more than 60,000 coaching sessions each year. She has been featured on NPR, FOX, NBC, Global TV, CTV, and more. Her new book is INVISIBLE ADHD: Proven Mood and Life Management for Smart Yet Scattered Women (Macmillan Flatiron; 9/9/25)
“Every woman going through the menopausal phase of life benefits from the tools that people with ADHD need to function.”
– Shanna Pearson
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Connect with Shanna Pearson
Transcript:
Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.
[00:00:29] Today, I had the honor of connecting with Shanna Pearson. She's the founder and president of Expert ADHD Coaching, the largest ADHD coaching program of its kind in the world, which provides one-on-one action-based coaching for easily distracted adults seeking personal, professional and financial success.
[00:00:49] She is also the author of the Invisible ADHD. Today, we spoke about what actually is ADHD, the changes that we see from a brain chemistry perspective, gender differences between men and women, why women are the lost generation? How so many people get misdiagnosed? And comorbidities that go along with ADHD diagnoses, the challenges of social conditioning, specific tools for addressing ADHD proactively including delayed gratification, mood scheduling, shrinking your to-do list.
[00:01:25] I found this to be a practical and insightful conversation and I would imagine irrespective of whether or not you have ADHD, anyone that is dealing with overwhelm, this will be a truly invaluable resource and book.
[00:01:40] Shanna, such a pleasure to connect with you. I've been really looking forward to interviewing you for the podcast. Welcome.
Shanna Pearson: [00:01:45] Thank you. It's really great to be here. I've been watching some of your podcasts and I think what you're doing is great and I'm excited to read your book.
Cynthia Thurlow: [00:01:53] Thank you. Yeah, 2026 it'll be out, but we're getting ready to roll out details in a couple of weeks.
Shanna Pearson: [00:01:58] Great.
Cynthia Thurlow: [00:02:00] I think ADHD is so misunderstood and in particular I think many women go their entire lifetime before they're actually diagnosed. So, I'm starting to see more and more patients in perimenopause and menopause who are like “You're not going to believe this. I just got diagnosed with ADHD.” So, let's unpack what ADHD actually is. Because I think many of us, maybe that are parents, our exposure to attention deficit hyperactivity disorder is really in the context of children's friends or children that we know and there's so much more to it. This is not something that just occurs in children. It is something that occurs throughout the trajectory of our lifetime.
Shanna Pearson: [00:02:46] If you're born with ADHD, you have ADHD. So, all of the adults that are being diagnosed now with ADHD have had it their entire life and we’re probably utilizing some pretty amazing skills and tools just to get by and things were likely-- If you're talking to these people now and you ask them about their childhood, things were likely a lot harder for them in terms of schoolwork and just being able to get something done and careers. And it just always seems like things were harder for them than they were for everyone else. So, they figure out ways to get by and to succeed, but it's stressful and it's difficult, and they've been living with this condition, and they had no idea.
Cynthia Thurlow: [00:03:31] I think for so many of us, whatever makes us unique, and whether it's that we're a little neurodivergent, whether we've got some degree of ADHD, I think we all compensate for our own peculiarities, our own uniqueness. And one of the things that I find really interesting is now we understand a whole lot more about the biochemistry of what's actually going on in the brain with ADHD. Can we talk a little bit about this? Because I do find it really interesting how neurotransmitters, how these chemical messengers might impact or might interact differently in an ADHD brain versus a non-ADHD brain.
Shanna Pearson: [00:04:10] So, all we know, and it's kind of interesting based on the fact that it seems like ADHD is everywhere lately, especially since the pandemic. All we actually know scientifically is that people who have ADHD have less dopamine available in their brain. And whether that's because we have less dopamine or whether we're producing less or whether it's because less is being absorbed, we don't know exactly, but we have less dopamine period. And lot of the actions and behaviors that we display as kids and as adults are ways to create more dopamine. And we don't know that that's why we're doing it, but that's what we're doing. I call it unconsciously creating stimulus.
Cynthia Thurlow: [00:04:57] And how does that show up? Like if someone's listening and they're curious, what are some of the habits or some of the symptoms that are more commonly seen with an ADHD brain?
Shanna Pearson: [00:05:08] Well, we're all different, [laughs] number one. But you'll see, I mean, if we want to talk about women specifically, it's quite different in general than for men specifically, because the ways that men tend to seek out-- unconsciously seek out dopamine is more physical, hyperactivity, just in actions, in movements, and honestly in eye contact. If you're sitting across the table from a man who has ADHD, it's much more likely that he won't be making eye contact with you. He'll be like looking around and you'll see his eye starting back and forth. And it's just hard for us to focus in general on one thing.
[00:05:49] For women, these behaviors tend to be much more internal and that's why they're not obvious. That's why a lot of women get missed, because our hyperactivity and the ways that we need to create dopamine, even though we don't know that's what we're doing, you can't see it. It's not outwardly disruptive, it's not obnoxious or disturbing or annoying for teachers, it's none of that. It’s just nonstop ruminating is a huge one, is one that a lot of us will relate to, catastrophizing.
[00:06:19] And when I say that, I don't mean, once in a while because we all do that every single day. Just in terms of how we think about one thing to the next thing, to the next thing to the next thing and it's really hard for us to follow through even on a thought. So, we tend to go in circles or just like you're here and then you're here and then you're here.
[00:06:45] And it's interesting because you were mentioning earlier that a lot of women in perimenopause and menopause are just finding out that they have ADHD. But if you think about what that actually is. When we enter into perimenopause, our estrogen is lower, it starts to decline, and that means that our dopamine is also declining. So now you have a person who already has lower dopamine and they're heading into-- And they've managed to get by in their life and they're doing okay, even though things have been harder and now they're hitting into a phase of life where their dopamine that they do have even, that's declining.
[00:07:27] So, it's like all of the symptoms and things that were, I guess, being managed in a way, you can't manage them anymore because it feels like everything now which is like x10. And a lot of us will refer to it as brain fog, that's the term, right? But for people with ADHD, it's been like that our entire life. And we just tried to cover it up or tried extra hard or just created systems. But now that, “brain fog,” has just like taking over our entire life and we cannot function.
Cynthia Thurlow: [00:08:04] Yeah. I would imagine as someone that doesn't have ADHD, it is hard navigating perimenopause for a non-ADHD brain.
Shanna Pearson: [00:08:14] Mm-hmm.
Cynthia Thurlow: [00:08:15] Take away whatever safety net you have created as a woman with ADHD, maybe not even diagnosed, and you pull out some of the hormones. We know that as we're navigating perimenopause, at some point during perimenopause, 20% to 30% higher levels of estrogen, and then that starts to decline in the latter stages prior to menopause.
Shanna Pearson: [00:08:37] Yep.
Cynthia Thurlow: [00:08:38] And so I can imagine, depending on the individual, that they may find that they're having a harder time supporting a healthy mood. They may be more distressed, there may be more depressive symptoms, more mood disorders. And this is just conjecture based on what we're talking about, because that safety net that we've created for ourselves is suddenly pulled away.
[00:09:00] And I tell everyone that we don't appreciate the neuro changes, the neurological changes, as women are navigating perimenopause into menopause, until all of a sudden, something just doesn't feel right. And it's not, “Oh, it's right before my cycle. It's a couple days each month. I have bad PMS or I just don't feel physically or emotionally great right before I get my menstrual cycle. Now all of a sudden, it is weeks and months of-
Shanna Pearson: [00:09:27] All the time off.
Cynthia Thurlow: [00:09:27] -feeling off. And so, I think for a lot of women, it's both validating and also distressing to know this is oftentimes a crux of when many women are getting diagnosed. And actually, you refer to this as the lost generation.
Shanna Pearson: [00:09:40] Yeah.
Cynthia Thurlow: [00:09:41] This is when--
Shanna Pearson: [00:09:42] That's the term these days.
Cynthia Thurlow: [00:09:44] Yeah, the lost generation. That there's a whole group of women who are feeling like they're kind of adrift at sea. Even if they get hormone replacement therapy or they've dialed in on lifestyle, they may still need more support to be able to navigate these significant changes in not just hormones, but also neurotransmitter production at this stage of life.
Shanna Pearson: [00:10:05] Mm-hmm. So that's exactly why so many women are seeking a diagnosis because it's like this is not-- And also, we tend to have friends who are in a similar age range as us. And so, you notice that you're-- It seems like you're like “perimenopause or menopause on steroids,” where it's just no, this is not what everyone else is experiencing. This is not typical brain fog. [crosstalk] And it turns out that this is ADHD, but I find it really interesting because I feel like every woman who's going through this phase of life benefits from tools that people who have ADHD need to function in their life because we're all dealing with this, “lower dopamine” related to lower estrogen, it’s like the same tools work whether you have ADHD or whether you just “feel like you have ADHD.” It's really just about managing your life. What we do isn't about medication or hormone replacement. It's just about tools and skills to go from point A to point B without losing your mind.
Cynthia Thurlow: [00:11:10] Yeah. And I think it was really helpful when you distinguished the gender differences. We think of ADHD in boys and young men is that it's much more physical, outward facing, and ADHD in women tends to be much more inward facing, which to me really speaks to how women kind of suffer in silence. This is a generational issue. This is certainly-- Our generation is maybe finding their voices, but I think subsequent generations, people who maybe had experienced ADHD, they just never got diagnosed because this is something that unless a woman is speaking about it more often than not, she might look completely, I'm going to say “normal from the exterior.” She may not have trouble focusing in on a conversation. She may not have trouble from an exterior perspective, being able to get tasks done but is really suffering in silence.
Shanna Pearson: [00:12:01] Yeah. No, it's 100%. And that's why a lot of us get missed. And that's why it's honestly heartbreaking. And we're still in this right now. In the year we're in and the time of life we're in with all of the medical breakthroughs and understanding and destigmatization of mental health, we're still getting missed and women are still being misdiagnosed and mis-medicated, which is-- it's heartbreaking because it just makes things a lot worse when you've been struggling your entire life and you're not feeling great about where your life is and how you're feeling and what you've been able or not able to accomplish, and you talk to your doctor about it. Practically all women are going to be misdiagnosed with depression or anxiety.
[00:12:56] And especially now, this year, they made the anxiety, self-assessments almost mandatory just before your yearly checkup. And we're going to answer-- I actually have the anxiety scales right here if you want to-- I know it’s mostly people are listening, but if you want to see all of the anxiety, the self-assessment. This is the GAD-7.
Cynthia Thurlow: [00:13:18] Okay.
Shanna Pearson: [00:13:18] And you've seen this, I'm sure, a thousand times. Every single one of these seven questions that they ask you on the self-assessment for anxiety would be answered as more than half the days or nearly every day for a woman who has ADHD. Trouble relaxing, being so restless that it's hard to sit still, feeling afraid as if something terrible might happen like what I was saying before about catastrophizing, not being able to control worrying, feeling nervous. These are all female ADHD symptoms.
[00:13:50] Now, men have them as well. But there's no woman that's not going to respond to every single one of these on a high level. So, they will be diagnosed with anxiety. And it's the same with depression, because the depression, the PHQ9, which I'm sure you're very familiar with, is nine questions. And eight of the nine questions would be answered more than half the days or nearly every day by a woman who has ADHD. Only the last one is 100% depression.
[00:14:21] Otherwise, feeling bad about yourself is one of these questions. Trouble concentrating on things. Tell me if there's a woman with ADHD that you know who doesn't do that. Trouble falling or staying asleep, this is any woman with ADHD would be one or the other. And it's just being [laughs] so fidgety or restless that you've been, you seem to be like moving around or speaking or you're just trying to like keep up with people, these are all 100%, except for the very last question, ADHD symptoms.
[00:14:54] So, everyone, unless you specifically seek out an ADHD diagnosis, you will be misdiagnosed with depression or anxiety. And I want to-- Because now that I'm talking about this and I've written this book and everybody wants to talk about this now it seems with me, it's wild because in the last-- I'd say in the last six months when I've been very aware of this and speaking about it all the time, I have yet to meet a woman born in the 1970s or 1980s, who has ADHD, who was not initially misdiagnosed. We all have the same story, every single one of us and most of us were put on antidepressants.
Cynthia Thurlow: [00:15:35] Really.
Shanna Pearson: [00:15:36] Yeah. And we're not depressed.
Cynthia Thurlow: [00:15:38] What I find interesting. So, for listeners, the GAD-7 and this other depression screen.
Shanna Pearson: [00:15:44] PHQ9.
Cynthia Thurlow: [00:15:45] Yeah. So, these screening tools, these are utilized by clinicians. Unless someone is actively looking for ADHD, I can appreciate why this gets missed. If someone's listening and they're like “I think I might have ADHD,” how do women go about getting properly diagnosed?
Shanna Pearson: [00:16:04] This is the key question, because even the ADHD self-assessment, the one that you'll tend to get at your physician's office, tends to be based on executive functioning. Following through on things, just like getting started on tasks and such. And really even the ADHD diagnosis misses a lot of the female symptoms and how we present. And so, my advice to anyone who might suspect that they have ADHD is to seek out a diagnosis with a physician who is very familiar with women and our symptoms. Otherwise, you will once again likely be misdiagnosed with depression or anxiety.
[00:16:46] And for people who are listening that are wondering, do I have ADHD or am I just anxious or maybe I do have depression. And by the way, a lot of us have both. So, it's like there's comorbid conditions, but the difference with women who have ADHD, and the one thing you can absolutely count on with a 100% of women is that we live in perpetual overwhelm. And it's so overwhelming where you often feel like you're a deer caught in headlights, you just don't know what to do, you don't know how to start, you don't know what to do first. And that's your experience all the time. You can't get out of it. And so that perpetual overwhelm, if you connect to that or if you're like, “Oh my gosh, that is totally me, and that's been me since I can remember,” then I would say you might want to look into this.
Cynthia Thurlow: [00:17:38] Well, and it's interesting because women are conditioned to believe that our brains are designed to multitask.
Shanna Pearson: [00:17:45] Right. [laughs]
Cynthia Thurlow: [00:17:46] So, imagine and I'm the mother of all boys and I'm the only female in my house. And with my kids, I could not give them five instructions. I can't even do that to my husband, one or two things at a time.
Shanna Pearson: [00:17:57] One at a time.
Cynthia Thurlow: [00:17:58] Right. And then they could process and file through. But women are conditioned to believe that we should be able to multitask 24/7. And I would imagine if you have an ADHD brain physiology, that would be not only overwhelming, it would be terrifying to try to think that you are expected to get 15 different directions and be able to synthesize it all beautifully in your brain. I would imagine with the social conditioning that we're told like “Oh, you're brilliant at multitasking, you're a female.”
Shanna Pearson: [00:18:28] Right. Here's the thing, because we need extra stimulus and we're constantly unconsciously seeking out dopamine, we love the idea of multitasking because it's a game and it's a game that our brain is playing. It's not necessarily a game that we're playing knowingly. And so, if I have to get six things done, I'm going to go for it, and that's at least a little bit more interesting than just doing one thing at a time. The problem is that we're not going to be able to do it well and it's not going to be done in the way that we would want it to be done, all of those six different things.
[00:19:06] But it's not something that we're necessarily afraid of because a lot of us love it and we're constantly doing it. It's a habitual way of living where we're doing six to ten things at the exact same time. And that's just who we are. And it's like nonstop, nonstop, nonstop, and that is beautiful for a dopamine-starved brain. Think about it, like that's exciting and fun and engaging. Except then at the end of the day, that's what-- I say, it's like running around at 90 miles an hour not getting what you want because you're not stopping and you're constantly doing and your results are not what you want, even though it's interesting.
Cynthia Thurlow: [00:19:42] So I would imagine that at some point you were inspired to focus in on ADHD and to help coach other women. How long did it take you to get a diagnosis?
Shanna Pearson: [00:19:56] It took way too long. My life would have been completely different if I had been diagnosed as a child. And that's just how it is for our generation. I'm sure all of us feel the same way who have been finally diagnosed. But it took a devastating experience and a life turned completely inside out just in the worst way possible. It took like hitting rock, rock bottom and then even deeper than that to be able to express how unbelievably horrible things were, so that-- And I was kind of lucky because when I was expressing things, I was at a friend's house, he was visiting his parents, and his dad was a psychiatrist, like what are the chances of that? So, the dad was overhearing me talking to my friend and he was like “Shanna, have you ever been diagnosed with ADHD?” And even then, I was like “That's something that kids have. I can't believe you're asking me that. That makes things even worse,” [laughs] but that started the process, but it took like a big explosion in life to even think in that direction.
Cynthia Thurlow: [00:21:08] Well, I think there's probably listeners that are listening to our conversation that are saying, “Yes, that's exactly how mine got diagnosed, or a loved one or a family friend.”
Shanna Pearson: [00:21:19] Right.
Cynthia Thurlow: [00:21:20] And I think sometimes when our lives are the most challenging and we have to dig a bit deeper and be more self-reflective, sometimes that's when-- when I use the term, the magic happens, that's when we are able to view ourselves differently at that point in our lives maybe than we ever have before.
Shanna Pearson: [00:21:40] I think it's absolutely amazing how many of us have hit the deepest, deepest depths of rock bottom and have-- It’s like rising like a phoenix and have like our entire lives have been transformed from that experience. And I just think it's beautiful and super bizarre how that tends to be. You know what happens. It's like well, why does it have to be so bad? But I think it does. I think if it were just muted or if it was just like a bad month or I got let go from a job, something like a typical terrible thing, then the transformation wouldn't happen because you would then again just be skirting along life on the outside and just trying to get by it. You have to hit certain levels in order to make very severe shifts. Because you probably know this, and I'm sure you talk about this like pain, pain is definitely a bigger motivator than pleasure, even though that's unfortunate that it is, but it is. If you're in pain, you're going to do something about it much more quickly than if you just decide that you want something.
Cynthia Thurlow: [00:22:49] Yeah. And it ties into one of my questions is how do feelings and emotions play into ADHD? Are they magnified? Are they intensified? How do feelings work with ADHD symptoms in women?
Shanna Pearson: [00:23:04] So for women, this is our thing. It's emotions and mood. And the biggest, longest chapter in my book is mood management because-- if it could have been-- honestly, every chapter in my book could have been a book, but mood management is everything. It's everything for women who have ADHD because-- Think about it like this, we have a brain and it's a beautiful brain and we're very smart, but our brain is unable to compartmentalize, unable, zero. [laughs]
[00:23:36] So, you've got a mood and you've got this emotion, and you cannot compartmentalize it. So, it goes into everything. It spreads into every aspect of your being, of your soul, of your body. Like it's just, you are, you become that mood. And that's great when it's a good mood because it's like “Wow, everything is amazing and it's so awesome and I love life and wow, this is fantastic.” And then if it's a bad mood, it's like “Everything is disastrous and terrible and my life sucks and I'm never going to amount to anything ever.” And so, because we cannot compartmentalize, moods and emotions are everything.
[00:24:17] And managing your moods and emotions is everything. Because think about it. You might think, “Oh, I'm always late and I'm so disorganized, and those are my biggest problems with my ADHD, those are my symptoms.” But you can have the best time management and organization systems in the world, and these are like a 100% of the time tried, tested, true, never fail. You will never be able to implement them if you don't feel like doing it, you just won't. You're going to have a whole bunch of systems and tools that are just brilliant and are going to completely change your life, but if you don't feel implementing them and you don't want to or you're having a bad day and you're just like don't want to get out of bed, none of that matters because our moods takeover everything.
[00:25:02] So, mood management is actually the number one thing. Even though none of our clients come to us saying, “I need to manage my mood,” they all come to us like, “I need to be on time for once. I need to remember my friends’ birthdays. I need to get organized because everything is such a mess.” That's what people see, but that's not what they really need because I think we all have a lot of those tools already. We all know what we're supposed to do.
Cynthia Thurlow: [00:25:26] Right. It's interesting, I had a wonderful roommate years ago who did have ADHD, was on medication, didn't love being on medication because she felt like it blunted her mood. She was a super happy, outgoing person and she said, “I know when I have to take this medication because I have to be able to focus. I have exams or whatever it was with school.” But she would admit to me and a lot of patients, she was not my patient, but a lot of patients would admit to me certain medications that I take to manage either mood disorders or ADHD, “I know I need it, but I don't feel good when I'm on it.”
Shanna Pearson: [00:26:00] Right.
Cynthia Thurlow: [00:26:01] So, maybe we can touch on the medication piece. I know this is not your area of expertise-
Shanna Pearson: [00:26:04] Definitely.
Cynthia Thurlow: [00:26:05] -but obviously, when we're talking about moods and motivation and structures and systems, an ADHD brain, there are drugs that can force them to fit into that, no. We say jokingly in medicine, sometimes you have a patient that needs to fit into a round hole, but they're square vice versa. It's like we're trying to force people into a system that their brains are not conditioned to be able to function within.
Shanna Pearson: [00:26:31] Correct, correct. That's the whole thing. It's like you're the square peg trying to fit into a round hole. And so for those of us who didn't know that we had ADHD, and you are in reality the square peg trying to fit into a round hole and that is your whole life, you feel you just never-- are never being understood, and you're just never going to belong. And everything is different for you, and you're on a different frequency as everyone around you and you don't know why.
[00:26:57] And then one day I hope somebody will tell you what's going on for you, actually, and it's the right diagnosis and it is ADHD, you will likely at least be asked if you want to try medication. And for some people, they're not even asked, they're just told, “Here's your prescription, go fill it and call me and let's check in again in about two months,” and that's like a very small piece is medication.
[00:27:27] And also, there are so many different types of medication. And not only that [laughs] are there different types of medication, there's an entire spectrum of the dosage, how much are you supposed to take? So, there's the typical dose, and that's what your doctor is going to prescribe for you is the typical dose, but you're not typical. And so, a lot of people, in my experience, because I would say 70% to 80% of our clients do take medication. So, they're in coaching and they take medication because obviously your medication does not come with a book of skills and tools.
[00:28:04] And so, the medication, my seeing and a lot of-- anybody who looks me up, we'll say like I always say, ADHD medication, it does help you focus, it does not help you focus on the right things. So, plenty of people who are taking an average dose of a typical ADHD med will be very-- They'll say, like “I was able to focus on organizing my kitchen cupboards for like seven hours yesterday, fantastic. But I didn't get anything done at work. Nothing, nothing.” Or what's more typical is like we see, hyper focus on our social media feeds. Literally, you turn it on and you're not even looking up for another three hours, that's not effective. [laughs] That's not good for your life.
[00:28:55] So how can you-- number one, if you're prescribed a medication, you really have to question the dosage. And if it's making you feel like your mood is blunted, you will want to question the actual medication that you've been prescribed because it shouldn't feel like that. It should just feel like just enough to keep you focused on what you want to be focused on.
Cynthia Thurlow: [00:29:15] Yeah, I think the bio individuality is certainly a role. Shared decision making with your provider is clearly important. To your point, a lot of these drugs are stimulants and they are not selective. Meaning you can organize your kitchen, but then you didn't work or-
Shanna Pearson: [00:29:32] Yeah.
Cynthia Thurlow: [00:29:33] -you start on scrolling on TikTok, but then you forget you burn the kitchen dinner or you forgot to pickup--
Shanna Pearson: [00:29:38] Yeah. Or you didn't pick up your kid. [laughs]
Cynthia Thurlow: [00:29:41] Forgot to pick up your child. And so those are definitely real concerns and issues. And the sad thing is, I'll be totally transparent, I do not have ADHD, but I can tell you like of all the social media platforms, the most and I don't want to use the term addictive, the particular platform that is the easiest to get sucked into is TikTok.
Shanna Pearson: [00:30:01] Oh, for sure. They call it ADHD talk. [Laughs]
Cynthia Thurlow: [00:30:06] So, to the point that like even someone who doesn't have a brain that's conditioned to be that way, these platforms are designed to keep you on them as long as possible-- As long as possible and distract yourself from the rest of your existence.
Shanna Pearson: [00:30:19] Yep.
Cynthia Thurlow: [00:30:18] Talk a little bit about treatments and you say pills don't treat skills.
Shanna Pearson: [00:30:23] Pills don't teach skills. [Laughs]
Cynthia Thurlow: [00:30:25] Yeah, don't teach skills. Let's talk a little bit about a lot of what you spend time discussing in the book is how to address ADHD proactively. What are the things that we can do in our personal lives? And for some of this, it can be a bit of strategy. And one thing that really stood out to me was shrinking your to-do list. What are we really good at as women? And there was a book that came out, gosh like 10 years ago, it's called Eat the Frog.
Shanna Pearson: [00:30:51] Oh, it's Brian Tracy.
Cynthia Thurlow: [00:30:52] Yeah. And so, this book is stupid, simple, short, but it is something that I remind myself every day, like don't put 20 things on your to-do list. Give yourself the two things you want to-do least and get them done first thing in the morning, that is eating the frog. But it goes along with your-- shrinking your to-do list in terms of prioritization because it is so easy to get lost in the overwhelm.
Shanna Pearson: [00:31:16] Oh my gosh, all of us do. All of us do. No matter who you are. Especially if you're a woman in perimenopause or menopause, you will get lost inside of the overwhelm. And so, I think it's so helpful, and I do this before even teaching people how to prioritize, because you need to prioritize, but first you have to get in the habit of doing less at a time. And that really is a habit that cannot be overstated because we tend to always want to do more and more and more and there's this never-ending list.
[00:31:49] So, I would say the typical client that comes to us has a to-do list that's minimum 30 items long. And remember, we have a brain that can't compartmentalize. So, you got this to-do list and it’s like this never-ending list and you can't compare compartmentalize. You're going to look at that list, your eyes are going to visually see it. What's your brain going to do? It's just like [onomatopoeia] and so it's just like this explosion of “Oh my gosh, what do I do first? I'm just going to go turn on the TV forget it.” and--
Cynthia Thurlow: [00:32:17] You're looking for a distraction.
Shanna Pearson: [00:32:19] I can't deal. I can't do any of this. I'm not doing this. I'm going for a walk. I'm going to text my friend. So, you have to get into a completely different habit, which at the beginning, before you start prioritizing is just pick two. We say keep it to three and you're free. But three is the maximum, the very, very maximum. Just pick two, just close your eyes and point to one and start putting those two things on a piece of paper. Not on your computer, not on your calendar because there's going to be thousands of other things there. Just write it down, just those two things. And that's all you're going to focus on right now. And that is a new way of dealing and that is a new way of managing.
[00:33:04] And then, once we can get into that habit, we can then start to prioritize obviously what two things you want to do now and what two things need to get done first. And then you need to really separate them. My to-do list, I always have-- I talk about a parking lot in my book, which I will-- I'm such a believer in this because if we have thoughts in our brain and we don't know what to do with them, we're going to start to take action on them right away, but if you have a parking lot and you just write down those thoughts now they have a place and you can kind of relax and not worry that you're going to lose the thought and you can keep doing whatever it was that you were doing initially. But if you have--
[00:33:41] Here's my two tasks. I'm showing you a notebook, it has task one with a very thick box around it. Task two with a very thick box around it. And you have to put the box around it because these have to be contained. They can't go out and you can't get anything else to go in. So, you focus on task one and then you focus on task two and that's it. And this is not overwhelming, especially when you break down your tasks into tiny little steps and then those become tasks in and of themselves. So, task one now has two mini tasks inside of it, and you just focus one of those at a time. That's how people with ADHD and that's how even a woman in perimenopause or menopause, that's how you're going to be able to get things done, is by training. It's a retraining just to focus one thing at a time.
Cynthia Thurlow: [00:34:33] I would actually argue that any woman in middle age needs that reminder. And I say this lovingly because my kids know, like I have sticky notes everywhere. [Shanna laughs] And so, if I'm recording a podcast and I'm like “Oh, I forgot to buy a birthday card,” I can write it down as I'm-- just I'm like [unintelligible] the thoughts out of my head.
Shanna Pearson: [00:34:56] Good.
Cynthia Thurlow: [00:34:57] How many of us have these massive to-do lists? You are never going to get all those things done. So, what I do every day is, I have, it's the eat the frog, but to your point, max, three things. These are the three things-
Shanna Pearson: [00:35:07] Good.
Cynthia Thurlow: [00:35:08] -I have to get done. And then I have another list that like I will pull things off of every day like to what on this list needs to be prioritized, if anything.
Shanna Pearson: [00:35:17] If anything.
Cynthia Thurlow: [00:35:17] But I think If-- I think for so many women, those long to-do lists are overwhelming. They are not productive. I would actually argue they probably make you feel bad because you're like “What I didn't get accomplished today?” I had a patient who told me that a couple weeks ago, “Look at all the things I didn't accomplish.” And I was like, “No, let's find a reframe.”
Shanna Pearson: [00:35:37] Mm-hmm. Good.
Cynthia Thurlow: [00:35:38] Because even if you Just got one thing done, one thing less on your list.
Shanna Pearson: [00:35:43] Yep. And you got it done and you actually did it rather than nothing.
Cynthia Thurlow: [00:35:46] Yeah, exactly.
Shanna Pearson: [00:35:47] No 100%.
Cynthia Thurlow: [00:35:50] Talk about lifestyle measures. On the podcast, we talk a lot about sleep and stress management and nutrition and exercise, these are all foundational to our lives. Probably even more so as we are in this middle age transition. Let's talk about these because it just reaffirms why our lifestyle choices can either enhance or exacerbate how we perceive ourselves and the world.
Shanna Pearson: [00:36:16] Right. You deal with people every single day. So, think about a neurotypical patient who has not gotten enough sleep for the last, let's say week, just one week, they haven't gotten enough sleep. Besides feeling tired, what are their symptoms going to be?
Cynthia Thurlow: [00:36:35] Oh, they're going to crave crappy food, they're not going to feel like exercising. They're probably not going to interact in a positive manner with their loved ones because they're short tempered and they're cranky. Oh, I mean, it just-- [crosstalk]
Shanna Pearson: [00:36:49] Are they going to be more patient or less patient than usual?
Cynthia Thurlow: [00:36:52] Much less.
Shanna Pearson: [00:36:54] Much less patient. Are they going to be more impulsive or less impulsive than usual?
Cynthia Thurlow: [00:36:58] More impulsive.
Shanna Pearson: [00:37:00] Much more impulsive. Are they going to be more overwhelmed or less overwhelmed than usual?
Cynthia Thurlow: [00:37:05] More overwhelmed.
Shanna Pearson: [00:37:05] For sure. Everything, every single symptom of sleep deprivation is an ADHD symptom, all of it.
Cynthia Thurlow: [00:37:13] Isn’t that insightful listening.
Shanna Pearson: [00:37:15] It's unbelievable. So, if you have ADHD and you are not getting enough sleep, forget about it. It's the number one thing that you need to be focusing on because-- And anyone who doesn't have enough sleep has all of the same symptoms you have. And now you who are born like this, now your symptoms have just multiplied by a hundred, a hundred. So again, that’s like, I would say that's so foundational and yet, and yet, because the typical ADHD medications tend to be stimulants.
[00:37:52] So now we're giving a person a beautiful, brilliant, all of the possibilities available to them in the world, [laughs] a stimulant medication and telling them that they need to get more sleep. So, it's very difficult if you're taking stimulants, which means-- It is doable and the only way to do it properly to make sure you're getting the right amount of sleep is to take your medication the second you wake up. Keep it next to your bedside table so that you take it as early as possible so that it wears off when you need to go back to sleep.
[00:38:27] If you don't take it till later. If you're somebody who takes your medication at 11:00 A.M. or noon, you're not going back to sleep until 02:00 A.M. or 03:00 A.M. and it's just a cycle. You cannot break free from that cycle because you're taking these medications.
Cynthia Thurlow: [00:38:42] Well, and it also, I would imagine disrupts your circadian biology.
Shanna Pearson: [00:38:45] Everything.
Cynthia Thurlow: [00:38:46] So, it’s going to impact when you fall asleep, when you get hungry, when you feel like you have a libido, if at all. It probably impacts-
Shanna Pearson: [00:38:54] Yeah, it does.
Cynthia Thurlow: [00:38:55] -everything. And sleep is so foundational to our health and we talk about that a lot here. When you said, imagine how you feel when you're sleep deprived, that is an ADHD brain. And I think about key times in my adult life like when I had newborns or sick kids or my husband wasn't home, and how I felt like I could barely tie my shoes and put one foot in front of the other. It is incredibly humbling. And so, I want listeners to really get a sense for what that distraction or that distracted brain really feels like.
Shanna Pearson: [00:39:28] That's a perfect example that you just shared. And that really is-- That seems to be our existence if we don't know how to manage it and we're just going with the flow and just trying to get by and we don't know what to do, that's how it feels. Just one foot in front of the other and it's so difficult. It's so difficult because everyone around you seems to be doing everything with no problem whatsoever, which makes it even feel worse.
Cynthia Thurlow: [00:39:54] Oh, of course. It starts that whole shame, blame, that whole-- Women do such a fantastic job with shaming.
Shanna Pearson: [00:40:02] Oh yeah.
Cynthia Thurlow: [00:40:02] We shame ourselves, backwards and forwards. Let's talk about some of the other strategies, because this is what I think for me as a clinician, really is what you do a really profoundly amazing job with, is really helping people think about the importance of having a system, creating goals. The value of delayed gratification in a society where our kids are growing up in a non-delayed gratification environment.
Shanna Pearson: [00:40:31] Isn't it? It's unbelievable when we watch our kids.
Cynthia Thurlow: [00:40:34] Well, I will give you this example because anyone from our generation will appreciate this. I was saying to my kids, “Unlike having a streaming service, when your dad and I were first married, we were subscribed to Netflix and we would get DVDs in the mail, so that's number one.” They were like, “What?”
Shanna Pearson: [00:40:51] Red box DVDs.
Cynthia Thurlow: [00:40:54] And I said, “Imagine when I was growing up in the 1980s, you would have a VHS store and you would sign up for the most popular movies. And when you got called, you could go and pick up the one copy they had of like Breakfast Club or whatever we’re wanting to watch, scary movie.” My kids were so stunned. And I said, “My generation knows what it's like for delayed gratification.” I said, “Your generation will never fully understand because whether it is-- you didn't have to go to the card catalog to find out where the book was in the library.” My kids were astonished. “What do you mean? You had to go to the card catalog to figure out where the book was and you had to go to the stacks to find the book and pull it out yourself.” There was no-- You instantly can download a PDF. There was none of that.
Shanna Pearson: [00:41:36] No.
Cynthia Thurlow: [00:41:37] This generation, I'm curious.
Shanna Pearson: [00:41:39] How it's going to turn out of.
Cynthia Thurlow: [00:41:40] How the lack of delayed gratification is going to play out for them and their brain physiology and whether or not we're going to see more people that are diagnosed with dopamine issues, brain dopamine issues. I would imagine we're going to see escalating rates-
Shanna Pearson: [00:41:57] Oh, yeah, there's no question.
Cynthia Thurlow: [00:41:58] -of these issues. Yeah.
Shanna Pearson: [00:41:59] There's no question. I have a son who's 13, and he obviously likes to play video games. And so, to his friends, he likes to do a million things, including music and sports and all of that, but I remember hearing his friends at our house like just talking about how they can't. It's impossible to wait for anything. So, they were having a hard time with one of the games and like trying to get-- I don't know what was going on, but it literally was less than two minutes and everyone was freaking out.
Cynthia Thurlow: [00:42:30] Mm-hmm.
Shanna Pearson: [00:42:32] And I was like “Okay, [laughs] let's see if we can go through this step by step, turn this off, turn that on, whatever,” but it was such a frustrating experience. And there's no question that this whole instant gratification at a moment like what you were talking about-- click on your converter and you can have any movie you want, anything at snap of the fingers. It's going to be interesting to see what happens, but there's no question that we're creating. We're making sure that everyone's brains are wired to just be like right now, right now, right now, that's exactly how these kids are growing up, and there's nothing-- Unless you're going to a school that has no technology, where everything is outdoors and your classroom is in a tree house, I don't know what is going to-- How we're going to be able to fix that part of what our kids are experiencing right now. I just don't because like fourth graders are going to school with a laptop.
Cynthia Thurlow: [00:43:34] Yeah. Oh, that was--
Shanna Pearson: [00:43:36] In my mind, that's going to school with a TV in your backpack, because you can-- Unless you turn off all of the Internet, you can have anything you want on that laptop.
Cynthia Thurlow: [00:43:45] Well, it's interesting, most schools that my boys, because I now have a high school senior and a college sophomore when they were in middle and high school, they had Chromebooks.
Shanna Pearson: [00:43:55] Right.
Cynthia Thurlow: [00:43:56] And the school system controlled the Chromebook. So, there was no Internet surfing from school. So, they had some control. But I agree with you that whether it's the power of an iPhone in a pocket, whether it's the accessibility. I was watching a show yesterday and this 23-year-old said, “If you can't get to the point—" She was saying to her sister who was trying to market something, “If you can't get to the point, in 10 seconds my generation will tune you out.”
Shanna Pearson: [00:44:21] Yeah, you’re [crosstalk]
Cynthia Thurlow: [00:44:22] And I thought, wow, that was so-- That kind of typifies this. We have a generation of kids that have a really short attention span and then magnify like if someone has the physiology of ADHD on top of that, I would think it would just magnify all of that.
Shanna Pearson: [00:44:36] Yeah, it does. It really does and it's distressing, because everyone in addition to the fact that they need everything instantly yesterday, [laughs] they still have to sit in a classroom for-- Our local high school, the classes are 90 minutes long.
Cynthia Thurlow: [00:44:53] That's long.
Shanna Pearson: [00:44:55] How is that allowed? [laughs] And that is just how it is. And so all of these kids are-- And of course they divide up the class with where you have to listen to the teacher and now you have to do your work and now we're going to talk about it, but still, this is 90 minutes on the same topic, and so a lot of kids are feeling much more frustrated with that than they would have when I was in high school. Our classes back in the day were 75 minutes, which honestly seems like a long time right now. But we were able to-- it was possible. Right now, I don't know how these kids are doing it and I don't think they're having an easy time with it.
Cynthia Thurlow: [00:45:31] No, I would imagine. I'm in the middle of a program that I'll thankfully, I'll be finished with it. And not thankfully, I'm grateful that I'm in a program, but I remember we were doing an in person cohort and they expected grown adults to sit all day long and passively-- We were getting lectures and we had our laptops open, so we're going through slides and I turned to the person next to me and I said, “I don't think I've had to sit still this long and concentrate in so many years.” And I said, “I have forgotten how challenging it is to do that, even with a brain that can focus.” I mean, I can do that, but--
Shanna Pearson: [00:46:06] You're not used to it.
Cynthia Thurlow: [00:46:08] No, but I said it gives you a profound appreciation for what we're expecting young-
Shanna Pearson: [00:46:12] Of our kids.
Cynthia Thurlow: [00:46:12] -kids doing.
Shanna Pearson: [00:46:13] 100%.
Cynthia Thurlow: [00:46:14] Exactly.
Shanna Pearson: [00:46:15] Yeah, a 100%
Cynthia Thurlow: If we were to think of three strategies that are in the book that you think are the most important. They're probably all important, but for listeners.
Shanna Pearson: [00:46:25] They're all important or they wouldn't be in the book. [laughs]
Cynthia Thurlow: [00:46:26] They’re all important, but maybe your favorite three that we can share with listeners. Obviously, if you think you have ADHD or you have a loved one, this would be an excellent resource. But let's focus the rest of our time just talking about three of your favorite strategies for women in middle age that are struggling with their symptoms.
Shanna Pearson: [00:46:44] I feel like one of the strategies that's like 100% success rate where everybody loves this, everybody wants to do it, and everyone does do it, and it works out brilliantly, is mood scheduling. Because we really aren't all morning people and some of us, great—
Cynthia Thurlow: [00:47:00] Surprise. [laughs]
Shanna Pearson: [00:47:01] A lot of us are, [laughs] but a lot of us are not. And we all have a unique circadian rhythm. And it turns out-- Like even, let's just say 80% of us are morning people or 70% of us, we tend to do the most menial tasks at the time of day when we're the most awake and wanting to be fed with information. And so, I think mood scheduling is very simple. Figure out the times of day that you have the most energy. Really figure this out, it might be like an hour between, 9 and 10, or it could be-- it actually could between 08:00 P.M and 09:00 P.M which shockingly, is a time that a lot of our clients tend to be like their most-- It’s like their calmest, most productive hour of the day. But, for a lot of people, it's early morning. It could be in the afternoon. And some people that are completely out of energy in the afternoon, zero. So, figure out the hours, the blocks that are your most productive times, and you're going to have more than one, hopefully, [laughs] this time and that time.
[00:48:09] And also figure out the times of day that you have the least amount of energy, because it's going to be similar. Every day, you're going to notice that you start-- like people talk about that 3 o'clock, whatever, the slowdown or they need a coffee, but for a lot of us, that's a great time of day. So just figure out what yours is. And when you have your high energy times of day, that's when you schedule your most difficult tasks. The difficult ones because your brain needs to be completely turned on. And so, use your natural circadian rhythm to help you. The times of day that you have the least amount of energy, that's when we schedule your easiest tasks. So, you really have to be very intentional. Okay. Don't just do things according to what you think you should be doing or what everyone else is doing.
[00:48:59] Easiest tasks at your lowest energy times, hardest tasks at your highest energy times. That will be a game changer for you. And so, I promise, [laughs] that's one thing that I would recommend everybody start doing immediately, is just like mood scheduling. We already talked about keep it to three and you're free. That is something where I think anyone listening or watching. It's so much easier said than done. So, you're going to hear it. You're going to be like “Oh, yeah, okay, keep it to three and you're free. Great, I'll do that,” but then you won't. [Laughter]
Cynthia Thurlow: [00:49:30] Human nature, right? We're like “Yes, I'll do that and then we don't.”
Shanna Pearson: [00:49:33] Yeah, “I'll do that. Oh, I know about that. I've heard that before.” I don't know if you noticed, but in my book, I cannot tell you how many times I tell people hearing about something does not mean you know it.
Cynthia Thurlow: [00:49:45] Yes.
Shanna Pearson: [00:49:45] It doesn't. I'm sorry. The only way you know something is by doing it. You doing it in your life period, end of story. Otherwise, you just know about something. So, you have to do these things. That's like the crux of our entire coaching program is not telling people what to do and hoping that they do it. It's making sure people do it by doing it with them and we are doing it together. And I'm literally holding your hand, but not physically, because usually it's over Zoom, and we’re-- It's like muscle memory. Now you're doing it. Like if I had you, Cynthia, let's figure out what are your highest energy times of day and write them down and actually put it in your calendar, what your most difficult tasks are, we're going to do that together. And then at the end of this podcast, you're going to actually have a different schedule, what you're doing like things at a different time of day. So don't just hear about these things, do it. Do the mood scheduling. Do the keep it to three and you're free. Actually, shrink your to-do list, that is like key for any woman who is overwhelmed, which I think is all of us. Oh, there's so many, and for--
Cynthia Thurlow: [00:50:57] I made a list of like everything in the book and I was like this is why I wanted to ask you, like three of your favorites-- [crosstalk]
Shanna Pearson: [00:51:03] So my personal. Like this is something that I started doing completely unknowingly, not knowing anything about my brain when I was much younger, in elementary school younger. But when I write things out with my dominant hand, so that's my left hand, it instantly slows me down and slows down my thinking process. Because now instead of thinking about the 50 billion things that I was thinking about just before, now I'm only thinking about drawing the letter A. And I’m like how do I make an A? And where do I put that little line across? And oh my God, it's not at the right place.
[00:51:40] And if I am upset, this is something that's really key for mood management. Anything that's upsetting, I try my very hardest to come up with a solution or an understanding of whatever it was that upset me. So, things that upset me personally would be when my-- Honestly, this sounds so silly because it's something that every parent has to deal with. But when my kids talk back to me, I take it personally. And it's like the dumbest thing ever and I completely know that. But I do, I take it personally and it really bothers me when they talk back to me, it upsets me. So, I know logically this is what kids do. And I try to come up with like, “Why did they do that? Were they feeling disrespected? Were they just wanting something so badly that they couldn't see another angle around it.” So, I think about any kind of solution or understanding and I try to simplify it into one sentence and then I'll write down that one sentence with my non-dominant hand.
[00:52:34] So, now I am completely focused. Instead of being hurt and upset and angry at my kids, I'm totally focused on every letter regarding the solution or the understanding I was trying to come to about why they talked back to me. And when I'm focusing on writing that out, I instantly go from a level 10 of upset to like a level 1. It's like an instant, it's like a switch. And that is my personal, one of my personal go-tos is writing things out, solutions with my non-dominant hand because my brain is way too fast and I can absolutely go into spins just like a lot of us. And so I stop that by doing the non-dominant handwriting.
Cynthia Thurlow: [00:53:18] I love that. I think a lot of the strategies in the book are even things that people that do not have ADHD that would benefit from.
Shanna Pearson: [00:53:25] 100%.
Cynthia Thurlow: [00:53:25] [crosstalk] It's practical, it's insightful, eat the frog, or keep it to three that has been a life changing thing for me as an entrepreneur, life changing. I so have enjoyed this conversation. I think this is really going to resonate with listeners, many of whom probably suspect they may have some degree of ADHD, maybe they haven't been formally diagnosed. Book is a great resource. Thank you.
Shanna Pearson: [00:53:50] This book is going to help everyone I already know that because so many people who have been reading advanced questions copies have been sharing it with friends and partners that do not have ADHD. And apparently there's-- This book will help everyone who has any amount of overwhelm stopping them in their life and so--
Cynthia Thurlow: [00:54:06] That’s everyone.
Shanna Pearson: [00:54:07] If you want, yeah, invisible ADHD, can go to invisibleadhd.com or just get it on Amazon. And if anybody does have ADHD and they want help going from point A to point B and they need extra support, we can be found at adhdcoaching.com and we also offer a free introductory session just to see if this is a good fit for you. So, there's no [unintelligible 00:54:30] whatsoever. You can just check it out if you want some help and support.
Cynthia Thurlow: [00:54:34] Well, thank you so much for this conversation and as I mentioned, and we'll mention in the intro, you've helped hundreds of thousands of women be able to take back their lives and help build strategies that are sustainable in addressing ADHD. And the other crux of that is if you're dealing with overwhelm, this book is going to be very helpful.
Shanna Pearson: [00:54:54] Oh yeah.
Cynthia Thurlow: [00:54:55] And I cannot think of any woman out there that at some capacity or another has had times in their lives where they have certainly felt that way. Thank you for this conversation.
Shanna Pearson: [00:55:03] Thank you, Cynthia. It was so great.
Cynthia Thurlow: [00:55:07] If you love this podcast episode, please leave a rating and review. Subscribe and tell a friend.
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