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About Us
RMC specialises in adult (17+) ADHD
RMC is a Psychiatrist, Medical Practitioner, Psychiatric Nurse & Social Work Practitioner.
RMC has never and will never close our books.
We are transparent with our waiting list, and will eventually see every client.
RMC does not request payment to secure an appointment.
Payment is 5 working days before.
Our 4 practitioners each have over 17 years clinical mental health experience
Waiting Lists : updated 6 March
Undiagnosed ADHD : mid Sept 2025
Diagnosed ADHD : end of May 2025
Mood/Anxiety/Trauma : end of May 2025
Our Specialisation
Deep understanding of AuDHD & how stimulant medication may present
Undiagnosed or misdiagnosed ADHD in Women
Clinical Assessments with Clients who identify as Non-Binary or Transgender
Undiagnosed & diagnosed ADHD in late adolescent
Impact of the menstrual cycle on ADHD symptoms, and how PMDD, PMS or PME can exacerbate ADHD
Impact of peri-menopause & menopause on ADHD symptoms
Embracing a Queer & Neurodiverse affirming clinical assessment.
Undiagnosed ADHD in late adolescent boys & associations with Oppositional Defiant Disorder (ODD)
& anger & cannabis
Undiagnosed ADHD in men and associations with alcohol use, self-esteem & relationship issues
Undiagnosed ADHD in Defence & Emergency Services personnel & associations
with PTSD & C-PTSD
Commensing ADHD medication with clients who have been diagnosed with ADHD by a psychologist.
Transitioning late adolescents, who are diagnosed with ADHD , from their paediatrician to a psychiatrist, and working with the family and the paediatrician/child psychiatrist.
RMC has professional relationships with paediatricians and child psychiatrists across the ACT region.
ADHD Service & Price
GP Referral
A GP referral is required for all undiagnosed & diagnosed ADHD assessments.
Please see your GP prior to contacting our clinic.
Your GP will send your referral directly to us.
Booking Approach
Text message confirmation within 48 hours of the clinic receiving your GP referral.
Phone call and text contact to book your appointment within 7 days of receiving your GP referral.
Blood Test, ECG & Urine Drug Test
A pathology visit is required where a brief ECG test on your heart and Urine Drug test and Blood Test will take place. Click here for more detail
Blood Pressure reading
Obtained from any pharmacy
Appointment Location
Video appointments and at our clinic in Belconnen, 2617.
New ADHD Diagnosis and Medication Treatment
$1500 with a Medicare rebate of $247.25
Cost $1252.75
The price includes covers 3 aspects
1. Clinical Assessment
2 to 3 hours with Mental Health Clinician
2. Psychiatric Consultation & Diagnosis
30 mins with Psychiatrist
3. Medication Support
check-in call from Dr Lewis
email helpdesk
phone review
clinical support to help with finding the correct dose
Already Diagnosed ADHD :
Diagnosed ADHD by a neurologist or paediatrian or psychiatrist:
Reviews, changes or optimisation of current ADHD medication
Diagnosed ADHD by a Clinical Psychologist :
Commencement on ADHD medication
Price :
60 minute appointment $700 with a Medicare rebate of $192= $508
90 minute appointment $900 with a Medicare rebate of $192= $708
1. Clinical Assessment
60 mins or 90 mins with Medical Practitioner & Mental Health Specalist
2. Prescribing of ADHD Medication by Dr Lewis
Dr Lewis to prescribe or amend stimulant medication. Detail
Dr Res to prescribe all classes of psychiatric & physical health medication
3. Medication Support
email helpdesk
phone review
clinical support to help with finding the correct dose
phone call from Dr Lewis or Dr Res if required
ADHD Assessment & Diagnosis
Part 1 : ADHD Clinical Assessment
Part 2: ADHD Psychiatric Consultation
Duration
RMC practices a Neurodiverse Affirming assessment.
We allow 3 hours for this aspect, typically the average duration is about 2.5 hours.
This aspect is a relaxed and yet structured approach which allows clients the freedom to
engage in a conversation style assessment.
We encourage a partner or adult family members to be present in the clinical assessment, if the client wishes this to be so. Clients can also find it helpful when completing the self report electronic questionnaires to share the questions, for a perspective from another trusted adult.
Clients are encouraging to take a comfort break at any stage.
Our team are very aware that individuals with neurodiverse presentations may benefit from
movement and a comfort break from the assessment for a brief period.
For video consultations we encourage our Clients to be in a physical space where they feel safe and at peace.
This may be, for example, a certain chair, sofa, blanket and tea that allows an individual to be relaxed and talk freely.
The ADHD clinical assessment explores :
1. Executive Functioning
This investigation explores symptoms across Self Organisation, Self Restraint,
Self Motivation, Self Regulation of Emotions, & Self Management to Time.
Executive Functioning challenges encompasses:
Difficulty with focused and sustained attention
Hype-focusing , Distractability, Procrastination,
Verbal & cognitive impulsivity, Behavioural Impulsivity,
Difficulties with emotional regulation & Rejection sensitivity,
Planning & prioritisation, Time Blindness
Working Memory, Inner Restlessness, Insomnia & Sleep hygiene
The clinical assessment uses :
Barkley Deficits in Executive Functioning Scale (BDEFS)
Difficulties in Emotional Regulation Scale (DERS)
Rejection Sensitivity Questionnaire (RSQ)
2. Clinical Interview
This activity is conducted using the :
DIVA-5, The Diagnostic Interview for ADHD in adults
The Adult ADHD self-report Scale (ASRS)
Insomnia Severity Scale
3. Functional Impairment
Functional impairment is central to ADHD and consequences and difficulty functioning in certain areas of daily life are for the most part what triggers the request for an ADHD assessment.
This activity is explored using :
The WEISS Functional Impairment Rating Scale .
Impairment typically occurs across Family, Work, Education, Life Skills, Self Esteem ,Relationships
4. Mental Health Disorders
The symptoms of ADHD are common in other mental health disorders.
An evaluation will consider whether the symptoms belong to ADHD, another mental health condition,
another physical health condition, or if they represent more than one disorder.
ADHD can be present with other mental health disorders.
The clinical assessment uses the:
SCID-5, The Structured Clinical Interview for DSM-5.
Screening for Trauma, Autism, Bipolar Mood Disorder,
Borderline Personality Disorder, Anxiety & Depression.
A referral to a Clinical Psychologist may be required if the
Clinical team identify a possible Intellectual Disability.
Our diagnostic approach does not include the use of neuropsychological tests.
Further information
Part 2: ADHD Psychiatric Consultation
Part 2: ADHD Psychiatric Consultation
Psychiatrists are specialists in diagnosing, and treating the range of adult mental health and psychiatric disorders. See ADHD diagnostic frameworks.
The Psychiatrist confirms the diagnosis of ADHD.
Psychiatrists are trained in understanding how medication works on the brain and body and any interactions or potential complications between different medications.
Dr Lewis will collaboratively discuss ADHD medication:
- How it works.
- Long & short acting.
- Benefits & effectiveness.
- Explore the results of your ECG, urine drug screen and blood pressure test results.
- Review your Blood Test results to exclude any possible medical conditions that may be leading to difficulty with attention and short term memory.
- Review all medications you are prescribed with the aim of assessing if there are potential side-effects.
Part 3: Medication Clinical Support & Guidance
Explanation of ADHD medication
Clinical trials highlighting effectiveness and safety
Studies on Safety of Vyvanse medication:
How ADHD medication works: click here for more details
Finding the correct dose
With stimulant medication is fundamental to gaining benefits of longer attention, less distractibility, greater focused attention, less difficulty with starting and finishing activities that are boring, long, tedious, repetitive, difficult, needing a lot of thought or preparation or do not offer an immediate reward.
The optimal dose
For ADHD medication is not determined by height or weight, but is determined by how efficiently the medication is metabolised in the GI tract, how efficiently the medication is metabolised and how efficiently the medication passes across the blood brain barrier.
The correct dose is specific to each person and one person may require a much higher dose to obtain the same benefits as another individual. Some people may experience mild physical side- effects, and so an approach of gradually testing out a gradually increased dose, incrementally, is required.
Dr Lewis has created a comprehensive Improvements & Side Effects Diary to help monitor your progress and decide on the most suitable dose of ADHD medication.
The easy to read diary includes explanations and answers to any common occurring side effects which sometimes present while a person in adapting to the medication at different doses.
Our approach follows an established approach of diluting medication in water, and by using a plastic syringe, gradually increasing the amount of the solution every three days.
Blood Test, ECG & Urine Drug Test
Blood Test
At the pathology clinic the nurse will undertake a full blood test which explores a number of different medical conditions and presentations.
This is important to rule out any possible medical causes of long-term challenges with attention, concentration, energy, and motivation.
Your GP may have undertaken this blood test at the time of your appointment with them when you first discussed the possibility of ADHD.
If the blood test has not been undertaken by your GP then our clinic will send you a script which will include the ECG and urine drug test.
Detail on a Full Blood Test can be found here at Health Direct Gov AU
ECG and Urine Drug Test
Emailed to you
Please print this form out & take to either:
Laverty Pathology
Capital Capital
Both have multiple clinics
Results sent directly to our clinic
ECG
This is a brief test that which monitors your heart.
This is required as ADHD can cause an increase in heart rate.
Further details found here
Urine drug test
This is to ensure that any prescribed ADHD medication does not
interact with any possible substances an individual is using.
Blood Pressure Reading
Any pharmacy offers a reading. It takes a few minutes and does not require an appointment.
Please take a picture on your smart device and email this directly to the clinic
Approach to the assessment
Approach to the assessment
Adults with attention-deficit/hyperactivity disorder (ADHD) have difficulty in self-management,
including organisation, planning, initiating and completing tasks on a timely basis, tracking
and shifting tasks, self-monitoring, and self-inhibition.
These are termed “executive functions” (EFs) which, can be viewed
as “those self-directed actions needed to choose goals and to create, enact,
and sustain actions toward those goals (Barkley, 2012).
This difficulty in self-regulation typically results in reduced productivity, inefficiency, missed deadlines,
poor planning, “careless” errors, and losing and forgetting things as a result of disorganistation.
In some (particularly those with the combined form of ADHD), reduced inhibitory control
may also lead to emotional dysregulation and inappropriate verbal and/or physical behavior in interpersonal interelationships. Over the lifetime of the individual, these difficulties contribute to failure to achieve goals—personally, academically, and occupationally. These failures in turn likely contribute to the high rates of anxiety and depression in adults with ADHD
The diagnostic clinical assessment is conducted using a semi-structured clinical interview, which explores the presentation as an Executive Functioning Deficits Disorder.
ADHD is a neurodevelopmental disorder that manifests in something called executive dysfunction.
Executive dysfunction causes your brain to have difficulty selecting and monitoring your
behavior to reach your goals.
It affects task management, scheduling, awareness of time, goal setting, and concentration.
A better way to think about and detect these symptoms are as problems with executive functioning (EF).
Executive Functioning encompasses working memory, self-inhibition, resistance to distraction,
attentional shifting, organising, planning, self-monitoring and time blindness.
The term “Attention Deficit“ is unhelpful and leads to confusion and misunderstanding of
exactly what this presentation is.
Hyperactivity is one of the many aspects of ADHD, however adults with ADHD are not hyperactive in the same way an 8 year boy is. This misunderstanding is what has lead to so many adults remaining undiagnosed for so long.
The term “hyperactivity ” current evidence shows, has no diagnostic validity in adults, and should be replaced with Impulsivity. Impulsivity has the potential to lead to significant negative consequences for adults in multiple areas of their life.
The most significant issue is that the current diagnostic criteria and terms used are wholly inadequate and discriminatory when considering how this disorder presents in Women and Adolescent girls.
Our diagnostic approach embraces ADHD as a broader Executive Functioning Self Regulation Deficit Disorder in Women which encompasses difficulty in emotional regulation and rejection sensitivity and cognitive and verbal and behavioural impulsivity.
Co-occurring Disorders
Approach to the assessment
More than two-thirds of individuals with ADHD have at least one other coexisting condition. The symptoms of ADHD—constant motion and fidgetiness, interrupting and blurting out, difficulty sitting still and need for constant reminders, etc.—may overshadow these other disorders.
But just as untreated ADHD can present challenges in everyday life, other disorders can also cause unnecessary suffering in individuals with ADHD and their families if left untreated. Any disorder can coexist with ADHD, but certain disorders tend to occur more commonly with ADHD. ADHD may coexist with one or more
Disruptive behaviour disorders
40 percent of individuals with ADHD have
oppositional defiant disorder (ODD). ODD involves a pattern of arguing; losing one’s temper; refusing to follow rules; blaming others; deliberately annoying others; and being
angry, resentful, spiteful and vindictive.
Among individuals with ADHD, conduct disorder (CD) may also be present, occurring in 27 percent of children, 45–50 percent of adolescents and 20–25 percent of adults with ADHD. Children with conduct disorder may be aggressive to people or animals, destroy property, lie or steal things from others, run away, skip school or break curfews. Adults with CD often exhibit behaviors that get them into trouble with the law.
Learning disorders
Up to 50 percent of children with ADHD have a coexisting learning disorder, whereas 5 percent of children without ADHD have learning disorders. Learning disorders can cause problems with how individuals acquire or use new information such as reading or calculating. The most common learning disorders are dyslexia and dyscalculia. In addition, 12 percent of children with ADHD have speech problems, compared with 3 percent without ADHD.
Sleep disorders
One-quarter to one-half of parents of children with ADHD report that their children suffer from a sleep problem, especially difficulties with falling asleep and staying asleep. Sleep problems can be a symptom of ADHD, may be made worse by ADHD or may make the symptoms of ADHD worse.
Anxiety
Up to 30 percent of children and up to 53 percent of adults with ADHD may also have an anxiety disorder. Patients with anxiety disorders often worry excessively about a number of things (school, work, etc.) and may feel edgy, stressed out, tired and tense and have trouble getting restful sleep.
Mood disorders
In adults, approximately 38 percent of ADHD patients have a co-occurring mood disorder. Mood disorders are characterized by extreme changes in mood. Children with mood disorders may seem to be in a bad mood often. They may cry daily or be frequently irritable with others for no apparent reason. Mood disorders include depression, mania and bipolar disorder.
Approximately 14 percent of children with ADHD also have depression, whereas only 1 percent of children without ADHD have depression. In adults with ADHD, approximately 47 percent also have depression. Typically, ADHD occurs first and depression occurs later. Both environmental and genetic factors may contribute.
Up to 20 percent of individuals with ADHD may show symptoms of bipolar disorder, a severe condition involving periods of mania, abnormally elevated mood and energy, contrasted by episodes of clinical depression. If left untreated, bipolar disorder can damage relationships and lead to job loss, school problems and even suicide.
Functional Impairment in ADHD
Functional Impairment in ADHD
Our diagnostic approach uses the Weiss Functional Impairment Rating Scale.
The WFIRS-S items collect the reporter’s perspective of their own functioning across seven domains:
Family (8 items), Work (11 items), School (10 items), Life Skills (12 items),
Self-Concept (5 items), Social (9 items) and Risk (14 items).
A functional impairment indicates that the available resources, comprised of internal resources eg, ability to concentrate, remember, and not be impulsive) and external resources (eg, support from parents and teachers), are inadequate to meet the environmental demands (eg, academic, occupational, financial, and social functions) that tend to increase in number, scope, and complexity with increasing age and level of independence.
As the numbers and levels of internal and external resources differ between individuals, functional impairments will emerge at different timepoints; some patients will demonstrate impairments early in childhood, whereas impairments may not emerge in others until later in life.
At RMC we explore your lived experience of your impairments and when they emerged for you and that may well be into your adult life.
Resources on ADHD
Functional Impairment in ADHD
Click here for resources on Women and ADHD
Introduction to ADHD
By Dr Tracy Marks
ADHD & Caffeine
By Dr Russell Barkley
Men with ADHD
Resources for managing disregulation, shame & anger
Executive Functioning
ADHD & Executive Functioning
By Dr Russell Barkley
Causes of ADHD
By Dr Russell Barkley
Why ADHD is so impairing
By Dr Russell Barkley
Rejection Sensitivity Dysphoria
Rejection Sensitivity & Borderline Personality Disorder & ADHD
Video By Dr Sanil Rege
ADHD & Rejection Sensitivity Dysphoria
By Dr Russell Barkley
An ADHD guide to Emotional Dysregulation &
Rejection Sensitivity Dysphoria
By Dr William Dodson
Rejection Sensitivity & Social Anxiety
By Dr Sharon Saline
Hyperfocusing
by Dr Russell Barkley
Perfectionism
By Dr Sharon Saline
Sleep
Sleep & ADHD
By Dr Russell Barkley
Women & ADHD
Background to Women & ADHD
Background to Women & ADHD
Background to Women & ADHD
Profile of ADHD in Women
For a long time, it was thought that ADHD was primarily a condition in boys and some men. Research and lived experience have shown this is inaccurate, however. While women still receive fewer diagnoses for ADHD, the gap between women and men in overall prevalence has narrowed in recent years.
This means prevalence of ADHD in women is almost the same as the prevalence in men.
As boys dominate clinical samples of ADHD in childhood, female manifestations and gender differences have been relatively neglected in research as well as clinical practice [159–162].
In childhood ADHD is identified far more frequently in boys than girls with around a one in five ratio in most studies. However, the differences in prevalence and diagnostic rates according to gender become far less skewed with age, as more females are identified and become diagnosed in adulthood [17, 161, 163, 164];
and in some adult clinical series female cases may predominate.
Several factors may explain these observations. In childhood, girls may have less externalizing problems than boys: they suffer more from internalizing problems, chronic fatigue and inattention while boys may be more hyperactive and more aggressive [165, 166].
Girls show lower rates of hyperactivity and comorbid conduct disorder than males, and more frequently have the inattentive subtype of ADHD, with a later onset of impairment [162, 167].
For these reasons, general practitioners and health care professionals are less aware of ADHD in girls and they are thus less likely to be referred for treatment [168].
In adulthood, the higher prevalence of anxiety and depressive disorders in women may conceal underlying ADHD and influence diagnosis and treatment. As more women seek help from psychiatrists than men, the change in referral pattern may also contribute to the change in gender ratio within clinical populations [169].
Girls are diagnosed with ADHD at just under half the rate at which boys are diagnosed. This difference in diagnosis rate is made up for in adulthood, where women and men are diagnosed with ADHD at roughly the same rate.
The current ADHD prevalence for all adults is 4.4 percent.
Diagnosis of ADHD in girls and women:
ADHD symptoms continue to be overlooked in young girls and teens, even when they are struggling. Most experts conclude this is because girls more often exhibit the predominantly inattentive presentation of ADHD, while parents and professionals expect to see the predominantly hyperactive-impulsive presentation more often seen in boys.
Previously, it was assumed by some medical professionals that ADHD was a condition mainly found in boys, and they did not evaluate girls without the hyperactive-impulsive presentation for the disorder
Women experiencing ADHD symptoms may seek a mental health evaluation when they find themselves struggling with daily life. Since other mental health conditions, such as depression and anxiety, frequently co-occur with ADHD, a woman may be diagnosed with one of these conditions before the underlying ADHD is identified.
Women & ADHD
Background to Women & ADHD
Background to Women & ADHD
At Rainbow we have an in-depth understanding of how ADHD symptoms in adult females, both undiagnosed and diagnosed, really present and how and why these symptoms look different at different stages of life, menstrual cycle and peri-menopause, menopause and post-menopause.
Please see : Female-specific pharmacotherapy in ADHD: premenstrual adjustment
of psychostimulant dosage (Front. Psychiatry 14:1306194.)
Rejection sensitivity is not a formal diagnosis or disorder, but many women report that the inability to control their reactions to rejection is one of the most undermining aspects of their ADHD.
Impaired executive functions and emotional dysregulation increase the tendency to personalise ambiguous social interactions, interpret them negatively, and be unable to regulate an emotional reaction to the interaction that prompted it.
For too many years, women with ADHD have been routinely dismissed, disregarded, and misdiagnosed when they pursue evaluations and diagnoses for impairments like distractibility, executive dysfunction, and emotional dysregulation. Despite a growing canon of research on attention deficit hyperactivity disorder (ADHD or ADD) in girls and women, many clinicians continue to get it wrong — misattributing symptoms of ADHD in females to anxiety, mood disorder, or even hormones.
Many studies highlight the problem of rater/informant bias in parent and teacher reports. Some show that teachers are more likely to refer boys for ADHD treatment, even when such boys show equal or lower levels of impairment compared to female students.
Women and girls with ADHD have a distinct symptom presentation, with internalizing symptoms (eg, inattentiveness) being more prominent than externalizing symptoms (eg, impulsiveness and hyperactivity).
Their symptoms are more likely to be overlooked and they are less likely to be
referred for diagnosis and treatment.
Females with ADHD may develop better coping strategies than males with ADHD and, as a result, can better mask or mitigate the impact of their ADHD symptoms.
ADHD Missed diagnosis of ADHD in women and girls may occur when anxiety or depression presents in association with ADHD because symptoms of ADHD may mistakenly be attributed to the coexisting condition.
The clinical assessment our Clinical Director, Phil, undertakes embraces all aspects covered in this discussion, and this is conducted in an informal, relaxed manner, while blending his extensive experience and knowledge of under diagnosis, misdiagnosis, emotional disregulation, rejection sensitivity, impulsivity and executive functioning and self regulation deficits that present with the disorder that is still named ADHD.
Missed Diagnosis
Background to Women & ADHD
Co-occurring Disorders
ADHD Missed diagnosis of ADHD in women and girls may occur when anxiety or depression presents in association with ADHD because symptoms of ADHD may mistakenly be attributed to the coexisting condition.
Emotional dysregulation is a core symptom of ADHD. The result: overblown reactions to small setbacks or challenges. In this short video, learn the brain chemistry
Significantly there are situations where Women have been misdiagnosed with Borderline Personality Disorder or Borderline Personality Disorder.
Impulsivity and emotional disregulation are present in both disorders, however careful clinical assessment questions and a true understanding of both disorders
Co-occurring Disorders
Co-occurring Disorders
Co-occurring Disorders
While there are many types of co-occurring conditions, researchers and clinicians tend to focus on several that more frequently affect women and girls.
Disordered eating and diagnosed eating disorders, alcohol and substance abuse, sleep difficulties, self-harm, mood disorders, and tic disorders can all co-occur with ADHD in girls and women.
Additionally, fibromyalgia, chronic fatigue syndrome, and body dysmorphic disorder (an incorrect self-view of one’s body) have been noted as co-occurring conditions.
Most women who have ADHD report having a poorer self-image or lower self-esteem than their peers.
Depression and anxiety are often the most visible coexisting conditions experienced by women who have ADHD. Both conditions can be present as separate disorders or as the result of struggling with undiagnosed or poorly treated ADHD for a very long time.
The two conditions frequently prompt women to seek medical and mental health care and can lead to a diagnosis of ADHD.
When treating a woman or girl who has ADHD and a co-occurring condition, the clinician or treatment specialist needs to address the condition causing the most difficulty at that moment, especially conditions that can be life-threatening if untreated.
However, many ADHD experts recommend treating both ADHD and the co-occurring condition together, because better management of ADHD symptoms can improve the treatment effectiveness for the co-occurring condition. Learn more about co-occurring conditions
Rejection Sensitivity
Co-occurring Disorders
Rejection Sensitivity
Rejection sensitive dysphoria (RSD) is extreme emotional sensitivity
and pain triggered by the perception that a person has been rejected
or criticized by important people in their life. It may also be triggered
by a sense of falling short, failing to meet their own high standards
or others’ expectations.
Dysphoria is Greek for “difficult to bear.”
This is because that the emotional response hurts them much more than it does
people without the condition. No one likes to be rejected, criticized or fail. For people with RSD, these universal life experiences are much more severe than for neurotypical individuals.
They are unbearable, restricting, and highly impairing.
When this emotional response is internalised (and it often is for people with RSD), it can imitate a full, major mood disorder complete with suicidal ideation.
The sudden change from feeling perfectly fine to feeling intensely sad that results from RSD is often misdiagnosed as rapid cycling mood disorder.
It can take a long time for physicians to recognize that these
symptoms are caused by the sudden emotional changes associated
with ADHD and rejection sensitivity, while all other aspects of
relating to others seem typical. RSD is, in fact, a common ADHD trait,
particularly in adults.
When this emotional response is externalised, it looks like an
impressive, instantaneous rage at the person or situation responsible.
RSD can make adults with ADHD anticipate rejection — even when it
is anything but certain. This can make them vigilant about avoiding
it, which can be misdiagnosed as social phobia.
Social phobia is an intense anticipatory fear that you will embarrass or humiliate
yourself in public, or that you will be scrutinized harshly by the
outside world.
Rejection sensitivity is hard to tease apart. Often, people can’t find
the words to describe its pain. They say it’s intense, awful, terrible,
overwhelming. It is always triggered by the perceived or real loss of
approval, love, or respect.
People with ADHD cope in two main ways, which are not mutually exclusive.
They become people pleasers. They scan every person they meet to
figure out what that person admires and praises. Then they present
that false self to others. Often this becomes such a dominating goal
that they forget what they actually wanted from their own lives. They
are too busy making sure other people aren’t displeased with.
They stop trying. If there is the slightest possibility that a person
might try something new and fail or fall short in front of anyone else,
it becomes too painful or too risky to make the effort. These bright,
capable people avoid any activities that are anxiety-provoking and
end up giving up things like dating, applying for jobs, or speaking up
in public (both socially and professionally).
Some people use the pain of RSD to find adaptation and
overachieve. They constantly work to be the best at what they do and
strive for idealized perfection. Sometimes they are driven to be above
reproach.
Rejection sensitivity is part of ADHD. It’s neurologic and genetic.
Early childhood trauma makes anything worse, but it does not cause
RSD. Often, patients are comforted just to know there is a name for
this feeling. It makes a difference knowing what it is, that they are
not alone, and that almost 100% of people with ADHD experience
rejection sensitivity. After hearing this diagnosis, they’re relieved to
know it’s not their fault and that they are not damaged
Rejection Sensitivity & Borderline Personality Disorder & ADHD
Video By Dr Sanil Rege
ADHD & Rejection Sensitivity Dysphoria
By Dr Russell Barkley
An ADHD guide to Emotional Dysregulation &
Rejection Sensitivity Dysphoria
By Dr William Dodson
Rejection Sensitivity & Social Anxiety
By Dr Sharon Saline
PMS & PMDD
Co-occurring Disorders
Rejection Sensitivity
Hormonal Effects on ADHD
The average menstrual cycle is about 28 days, counting from the first day of your period. During the first two weeks, known as the follicular phase, levels of estrogen rise steadily, while progesterone levels are low.
Estrogen promotes the release of the feel-good neurotransmitters, serotonin, and dopamine, in the brain.
Studies suggest that the first two weeks of the cycle go more smoothly for women with ADHD than the second two weeks when progesterone levels rise. 1 During the third and fourth weeks, called the luteal phase, progesterone diminishes the beneficial effects of estrogen on the brain, possibly reducing the effectiveness of stimulant medications.2
PMDD and PME are diagnosed through daily symptom tracking, along with tracking your menstrual cycles. Daily symptom tracking will show you and your doctor if your symptoms arise in your premenstrual/luteal phase (PMDD), worsen in your premenstrual/luteal phase (PME), or occur throughout your cycle without a noticeable worsening in the premenstrual/luteal phase (not PMDD or PME).
Symptom Tracking for PMDD & PME
PMDD and PME have a biological basis, there is not yet a blood, hormone, or saliva test to make the diagnosis. However, these tests can be helpful to rule out or show a co-occurring hormone imbalance or vitamin deficiency which could cause similar symptoms to PMDD and PME.
Tracking your symptoms daily for two menstrual cycles is the official way to diagnose PMDD or PME, according to the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders, fifth edition) and ICD-11 (International Classification of Diseases, 11th Revision).
Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are chronic, hormone-based conditions, which can be life-changing for sufferers.
Clinical implications of increased premenstrual stimulant dosage may help control premenstrual worsening of ADHD and mood which may lead to improvements in focus, energy, productivity and mood.
Cycle awareness is essential: PMDD calendars or applications may help.
Dosing and timing of increase should be individually determine
Monitoring and adjustments should be personalised
Appears to be valid for several types of psychostimulants
Additional side effects are minimal or absent.
Research has not yet explained the disproportionate links between ADHD and both PMDD and postpartum mood disorders, and currently science does not know why women with ADHD appear more sensitive to the hormonal fluctuations of the menstrual cycle and the hormonal changes following childbirth
Perimenopause & Menopause
Resources : Podcasts & YouTube Channels
Perimenopause & Menopause
Changing Estrogen Levels Affect Women’s ADHD Symptoms—Part Three [Internet] CHADD. [cited 2021 Feb 23]. Available from: https://chadd.org/adhd-weekly/changing-estrogen-levels-affect-womens-adhd-symptoms-part-three
ADHD and Menopause: What You Need to Know and What You Can Do [Internet] Psych Central. 2016. [cited 2021 Feb 23]. Available from: https://psychcentral.com/lib/adhd-and-menopause-what-you-need-to-know-and-what-you-can-do
During perimenopause and menopause, estrogen and progesterone levels decline (35)
and ADHD becomes more severe.
Perimenopause occurs in the years leading up to menopause. It may take a few months or 10 years, though the average amount of time is 4 years.
During this period, estrogen levels decline, and ovaries stop releasing eggs. Menopause occurs immediately after this phase (36). The decline of estrogens that until then affected the release of neurotransmitters serotonin and dopamine induces various changes in the biochemistry of the brain.
Dopamine deficiency is responsible for the presentation of ADHD symptoms whereas serotonin deficiency leads to depressive mood.
Given thus that dopamine is the trademark of ADHD, this additional change can lead to even greater difficulties with focusing and concentration (37, 38). As postmenopausal women run a higher risk of osteoporosis and cardiovascular conditions, they also have to face the potentially changing psychiatric disorders that can make the solution of the problem more difficult (39); whereas it is considered more possible for postmenopausal women also suffering from ADHD to be more vulnerable to the mood disorders of menopause (27)
Resources
Resources : Podcasts & YouTube Channels
Perimenopause & Menopause
Perfectionism
By Dr Sharon Saline
Rejection Sensitivity & Borderline Personality Disorder & ADHD
Video By Dr Sanil Rege
ADHD & Rejection Sensitivity Dysphoria
By Dr Russell Barkley
An ADHD guide to Emotional Dysregulation &
Rejection Sensitivity Dysphoria
By Dr William Dodson
Rejection Sensitivity & Social Anxiety
By Dr Sharon Saline
Regret & Resolve: How Women can transform the challenges of a late diagnosis of ADHD
By Dr Kathleen Nadeau
Video
Stigma & Unique Risks for Girls & Women with ADHD
By Dr Stephen Hinshaw
Hormones Women & ADHD
By Professor Sandra Kooij
Impact of Hormones on Lives of Girls & Women with ADHD
By Professor Sandra Kooij
Video
35 mins
70 mins
PMDD Explanation by Royal College of Nursing
Female Hormones & ADHD By Dr Russell Barkley
Hormones & midlife & interaction with ADHD
By Dr Carol Robbins Video
The Emotional lives of Girls with ADHD.
By Dr Lotta Skoglund
Resources : Podcasts & YouTube Channels
Resources : Podcasts & YouTube Channels
Resources : Podcasts & YouTube Channels
Causes of ADHD
By Dr Russell Barkley
Why ADHD is so impairing
By Dr Russell Barkley
Dr Louise Newson : GP specialist on ADHD and Women’s health YouTube channel
Podcasts I have ADHD
Kristen Carder
ADHD MUMS Podcasts :
A lifeline for Australian mums navigating ADHD and motherhood. Perfect for struggling, burnt out mums who want to drop perfectionism.
