In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Sasha Hamdani, a board certified psychiatrist and ADHD clinical expert who wrote Self-Care for People with ADHD and the forthcoming Too Sensitive, moving from diagnosis into what to actually do once ADHD and perimenopause or menopause start colliding.

Dr. Hamdani explains how ADHD symptoms and medication effectiveness shift across the menstrual cycle, tracing the pattern back to the drop in estrogen and rise in progesterone that hits right before a period, and walks through where nonstimulant medication options fit for women who want an alternative to stimulants. She lays out her version of a menopause toolkit, prioritizing sleep, exercise, and nutrition ahead of any prescription, and explains why psychiatrists have reprioritized sleep given new data on how stimulant medication works in the brain.

The conversation moves through nutrition and appetite regulation, the role GLP1 medications can play in quieting food noise, and a candid look at which supplements, including omega 3, ferritin, and magnesium, actually have data behind them versus which are marketed with none. Dr. Hamdani connects circadian rhythm and delayed melatonin onset to the sleep struggles common in ADHD, and explains why morning light exposure functions almost like a switch for the brain.

From there the discussion turns to emotional dysregulation, rejection sensitive dysphoria, and the outsized role both play in rage, overreaction, and the panic so many women describe feeling around perimenopause and menopause. Dr. Hamdani walks through what a real ADHD assessment looks like, how a practitioner decides between hormone therapy, stimulant medication, and nonstimulant medication, and how partners can move from frustration to genuinely useful support. The episode closes with three actionable recommendations and a look at where ADHD research and treatment for women need to go next.

Guest links:

• Sasha Hamdani, MD
  
• Sasha Hamdani, MD (Facebook)
  
• Sasha Hamdani, MD (YouTube)
  
• Sasha Hamdani, MD (Instagram)
  
• Sasha Hamdani, MD (TikTok)
  
• Sasha Hamdani (LinkedIn)

Books:

• “Too Sensitive: Rejection, Resilience, and the Science of Feeling Deeply,” by Dr. Sasha Hamdani
  
• “Self Care For People With ADHD,” by Dr. Sasha Hamdani
  
• “The New Perimenopause,” by Dr. Mary Claire Haver
  
• “The New Menopause,"⁠ by Dr. Mary Claire Haver

Articles

• Genetics of attention deficit hyperactivity disorder (Molecular Psychology)
  
• The heritability of clinically diagnosed Attention-Deficit/Hyperactivity Disorder across the life span (Psychological Medicine)
  
• Attention-Deficit Hyperactivity Disorder: A Category or a Continuum? Genetic Analysis of a Large-Scale Twin Study (Journal of the American Academy of Child & Adolescent Psychiatry)
  
• Menopause depression: Under recognised and poorly treated (Australian & New Zealand Journal of Psychiatry)
  
• Stimulant medications affect arousal and reward, not attention networks (Cell)
  
• New Insights into the Mechanism of Action of Viloxazine: Serotonin and Norepinephrine Modulating Properties (Journal of Experimental Pharmacology)
  
• The role of the Mediterranean diet in reducing the risk of cognitive impairement, dementia, and Alzheimer's disease: a meta-analysis (Geroscience)
  
• Omega-3 Polyunsaturated Fatty Acids for Core Symptoms of Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis of Randomized Controlled Trials (The Journal of Clinical Psychiatry)
  
• Dietary Interventions and Supplements for Managing Attention-Deficit/Hyperactivity Disorder (ADHD): A Systematic Review of Efficacy and Recommendations (Cureus)
  
• The effect of vitamin D and magnesium supplementation on the mental health status of attention-deficit hyperactive children: a randomized controlled trial (BMC Pediatrics)
  

Other Resources:

• Stimulant ADHD medications work differently than thought (Washington University)
  
• QELBREE Drug Data Fact Sheet (FDA)