Migraines and ADHD in Women: Often Overlooked

As a woman who received an ADHD diagnosis at the age of 33, I can recall how my body often felt like an enigma. Along with the characteristic forgetfulness, distractive behaviours, internal restlessness, and emotional disruption, I also experienced crippling menstrual cycles and migraines that were severe enough to result in vomiting episodes during my time at a retail job when I was 20 years old.

Despite the unbearable migraine-related pain and nausea, I managed to maintain regular work and school hours. Juggling these commitments while simultaneously contending with undiagnosed ADHD, untreated migraines, extreme mood swings, and an erratic body, I was constantly presenting a facade of contentment, even though I felt like a walking corpse really. The act of trying to ignore or deny these issues possibly contributed to my depression diagnosis which preceded my ADHD diagnosis.

On getting my ADHD diagnosis, my journey of self-education and research commenced. I made an interesting discovery about how hormonal fluctuations particularly influence ADHD symptoms in women which adds another complex layer to the disorder. The main culprit behind all these challenges seemed to be low estrogen levels.

There appears to be a robust link between estrogen and dopamine, an essential neurotransmitter involved in ADHD. Low estrogen levels correspond to low dopamine levels and vice versa. Estrogen levels have predictable drops during a woman's life, such as before menstruation or during perimenopause, for instance, which results in a predictable worsening of ADHD symptoms. Low estrogen levels appear to particularly affect us, perhaps explaining why PMS's severe form, Premenstrual Mood Disorder (PMDD), is more prevalent in women with ADHD.

Besides, low estrogen levels can also initiate migraines. This connection might potentially explain why migraines, which are commoner in women, occur alongside ADHD about 35% of the time. As I began to connect the dots, it felt like I was solving the puzzle of my life. I finally managed to comprehend why I felt so disconnected from my body and mind during a migraine attack.

As I delved deeper into the relationship between migraines and ADHD in women, I discovered gender biasness in migraine research, similar to ADHD research. Migraines get little to zero attention in medical schools despite their common occurrence. According to Maria Konnikova's writing in Migraine: Inside a World of Invisible Pain (#CommissionsEarned), we owe the gender divide in migraine diagnosis to none other than Sigmund Freud.

In the 1968 essay "In Bed," Joan Didion notes that migraines are often seen as "imaginary" by the public, a perception that I argue is often associated with ADHD in women. But there's a valid reason behind this. As long as we continue concealing our symptoms and related pain — a habit that's tough to break — diagnosing ADHD in women will remain problematic.

In conclusion, women with ADHD and other conditions associated with hormonal and dopamine imbalances are like pressure cookers with poorly fitting lids. We and those around us strive to avoid the label of unruly shrews. I believe that we're all likely just as tired of this performance as I am. Irrespective of our condition, our symptoms deserve to be taken seriously.

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