If you’ve ever felt like your brain stopped working in neurodivergent midlife, this discussion may explain why.
Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression.
I am Sam Galloway (she/her), an autistic ADHDer (AuDHDer), and I have recently had a hysterectomy. As a neurodivergent perimenopause and PMDD survivor, I offer peer support and share knowledge on how to make it through the hard times.
Thanks for joining me on this wild midlife ride! 🎢
Thank you to Marie-Christine Oliver for this is fascinating and enriching chat!
So many brilliant people joined us live and we are so grateful for your contributions in the chat, as well as having you all there with us. It was intense so people dipped in and out.
For accessibility, the video has closed captions, the transcript is available within this post, and you can listen to an audio only version if preferred.
It was a long one (we went 40 minutes over our scheduled hour - ADHD much?), but we covered all the things. Well, we tried to!
We even completed the Meno-D rating scale to detect depression in menopause together which is one of my favourite supports in my menopausal transition, along with my cats, and my vaginal oestrogen cream. And yes, I mentioned clitoral atrophy because we should know about these things!
⚠️ Content warning for talk of suicidality, disordered eating, mental health hospital stays, early menopause, IVF, medical gaslighting, misdiagnosis, loss of career/function/sense of self, involuntary unmasking, and clitoral atrophy.
TL;DRead/Watch/Listen (AI generated)
Perimenopause can act as a burnout accelerant for neurodivergent women—especially those with ADHD and autism—because hormonal changes destabilise already overworked nervous systems.
This often leads to:
* Sudden loss of masking ability
* Cognitive decline and emotional dysregulation
* Misdiagnosis and medical gaslighting
* Identity collapse and increased suicidality risk
The conversation highlights a critical gap: research, language, and clinical understanding are lagging far behind lived experience.
⏱️⏱️ Full Timestamped Summary (AI generated)
00:00 – Intro (chaotic, human start) Live recording begins; Sam introduces the topic and guest Marie-Christine Oliver.
02:00 – Core concept Perimenopause as a burnout accelerant for neurodivergent nervous systems.
03:30 – Lived experience IVF, early perimenopause, nervous system collapse, career loss, suicidality, late diagnosis.
06:30 – The biology Estrogen supports dopamine + serotonin → drop creates a double neurological hit.
07:00 – Masking collapse Sudden loss of ability to cope → meltdowns, shutdowns, dysregulation.
08:00 – Cognitive decline Brain fog, memory loss, speech issues → often mistaken for dementia.
10:00 – HRT explained A buffer, not a cure; reduces extremes but doesn’t fully restore capacity.
13:00 – Mental health risks High rates of suicidality; symptoms often misunderstood or misdiagnosed.
15:00 – Research gaps Little to no research on ADHD + menopause or AuDHD.
20:00 – Key insight Menopause = point where masking becomes impossible.
22:00 – Quadruple empathy problem Breakdown between patient + doctor + neurotype + menopause context.
26:00 – Medical gaslighting Symptoms dismissed or mislabelled → confusion + self-doubt.
28:00 – Identity collapse Loss of career, function, and sense of self.
31:00 – Compounding pressures Parenting, aging parents, chronic illness, hormones—all at once.
33:00 – Diagnosis aftermath Labels accumulate; identity becomes deficit-based.
36:00 – Menod tool introduced A scale for identifying menopausal depression.
40:00 – Why the tool matters Captures real-life impact; useful for self-advocacy.
42:00 – Energy depletion Extreme fatigue; even basic tasks feel impossible.
43:00 – Paranoid thinking Workplace anxiety, social fear; blurred line between perception and reality.
45:00 – Irritability / rage Outbursts, meltdowns → nervous system overload, not personality.
47:00 – Self-esteem collapse Ranges from self-doubt to suicidality.
49:00 – Hospitalisation Can help or harm; highlights systemic inequalities.
50:00 – Social isolation Disconnection even when not alone.
52:00 – “What is normal?” Tools often based on neurotypical assumptions.
54:00 – Anxiety escalation Chronic nervous system dysregulation.
56:00 – Physical symptoms Pain, illness, unexplained issues tied to hormones + stress.
58:00 – Sleep disruption Creates worsening feedback loops.
60:00 – Body changes Weight, metabolism, physical identity shifts.
62:00 – Libido changes Under-discussed but significant impact.
64:00 – Memory + focus issues Deeply distressing; often misinterpreted as cognitive decline.
66:00 – Symptom accumulation Multiple high scores = severe functional impact.
68:00 – Whole-life impact Work, relationships, parenting all affected.
70:00 – Why systems fail Healthcare treats symptoms separately, not holistically.
72:00 – Forced self-advocacy Individuals must piece everything together themselves.
74:00 – Grief Loss of self, identity, and capacity.
76:00 – Burnout cycles Push → crash → partial recovery → repeat.
78:00 – Lifelong overcapacity Perimenopause exposes unsustainable patterns.
80:00 – Lack of prevention No warning, no preparation, no roadmap.
82:00 – What could have helped Earlier diagnosis, awareness, and reduced pressure.
84:00 – Systemic gaps Research, healthcare, and workplaces all lagging.
86:00 – Community importance Peer conversations filling the gap.
88:00 – Reframing Not failure → biological + neurological reality.
90:00 – What’s needed next Research, integrated care, recognition.
92:00 – Hope (with nuance) Improvement possible, but not full restoration.
94:00 – Ongoing vulnerability Need for pacing, boundaries, nervous system care.
96:00 – Final reflections This is widespread and under-recognised.
98:00 – Closing Validation, connection, and shared understanding.
100:00 – End
Resources:
Meno-D: A rating scale to detect depression in menopause
The conversations we’re having here are filling a gap that research and healthcare still haven’t caught up with. If this work matters to you, consider becoming a paid subscriber to support it.
Thank you to everyone who tuned into my live video! Join me for my next live video in the Substack app.
