The Perimenopausal Therapist's Guide to Not Losing Your Keys (Or Your Mind) in the Executive Dysfunction Jungle

Oh, hello there. Are you, like me, currently staring at a perfectly organized to-do list that feels less like a helpful guide and more like a long list of future misses and mistakes? Do you find yourself walking into a room with a purpose, only for that purpose to immediately evaporate into a shimmering, non-committal mist? Does your brain randomly decide to erase bits of memory linked to keeping appointments and putting wet laundry in the dryer?

Welcome, then, to the glorious, bewildering, and often infuriating intersection of late-diagnosed ADHD/autism and perimenopause. For years, I just thought I was quirky, a bit scatterbrained, perhaps a connoisseur of organized chaos. My therapy practice? A well-oiled machine, fueled by hyperfocus and sheer, unadulterated willpower. I was a master of compensating, a black belt in "fake it 'til you make it."

Then came the Hot Flashes of Doom. And with them, an uninvited guest: a turbocharged version of my existing executive dysfunction. It’s like my frontal lobe and my ovaries decided to ride off into the sunset leaving me sweating in the dust.

Suddenly, tasks that were once challenging became Mount Everest. Forgetfulness became a daily sport. My ability to initiate anything that wasn't immediately life-threatening dwindled faster than my estrogen levels. It's truly a marvel I'm even writing this blog post. I probably started it three weeks ago and just found the tab again under 17 other tabs dedicated to “professional clothes that feel like sweatpants” and “why does my shoulder hurt randomly?”. (Frozen shoulder, BTW. It’s a perimenopause thing. Look it up).

A Day in the Life (or, "The Quest for the Elusive Spoon")

Just yesterday, I embarked on a heroic journey to make myself a Chai latte. Before you get too excited, it comes in a packet.

1. Retrieve cup: Found one in the cupboard amongst the 30,000 others. As if playing a game of Jenga, I pulled one out with the agility of a ten year old.

2. Locate packet of Chai Latte: Straightforward. Box acquired.

3. Heat up water in boiling pot: Pot empty of water. Stared. walked away. Turned back around. What was I doing? Oh, right, filling up the pot. Take it over to the sink and fill it up.

4. The Spoon Debacle: This is where the plot thickens. I knew I needed a spoon to mix the mix. My hand reached for the drawer. My brain, however, was already planning my next client session, pondering the existential dread of laundry, and wondering if I’d started the laundry. I opened the drawer, gazed at the cutlery, and… closed it. Without a spoon.

5. The Revelation: I stood there, dry Chai Latte powder sitting at the bottom of the mug, staring at it blankly. Something was missing. A crucial element. My eyes darted around the kitchen. The spoon. THE SPOON! I slammed my hand to my forehead (gracefully, of course).

6. Spoon Acquired: Finally, after what felt like a mini-quest, I had my spoon. Filled my mug with boiling water and went to my office to start my day.

This is my brain on perimenopause + late-diagnosed neurodivergence. It's a comedy of errors, a daily treasure hunt, and a testament to the fact that sometimes, the simplest tasks require the most complex mental gymnastics.

So, How Does a Therapist Specializing in Helping ADHD/Autistic Clients Help Herself?

If you, too, are navigating this joyous double-whammy, here are some tips I've reluctantly, painstakingly, and sometimes accidentally stumbled upon:

Plan For the Inevitable:

Externalize ALL THE THINGS: Your brain is leaking information at a rapid pace. Accept it.

• Visual Cues: Put things where you need them. Keys go on a hook right by the door. Mail has a designated tray that screams "OPEN ME NOW!"

• Whiteboards are Your Bestfriend: Write down tasks, ideas, random brilliant thoughts that will otherwise vanish into the ether. Use different colored markers! It's like a mini-art project that helps you remember to buy milk.

• Voice Notes Are Your Backup Brain: Just got an idea in the shower? Holler it into your phone. Don't trust your brain to hold onto it until you're dressed.

1. The "One-Touch" Rule (Aspirational, But Worth Trying): If you can do a task in less than 2 minutes, do it now. This applies to putting away that one sock, responding to a quick email, or putting the cap back on the toothpaste. It saves you from accumulating a mountain of tiny tasks that eventually become an unscalable psychological Everest.

2. Befriend Alarms & Timers (Your New Robot Overlords): Seriously, set alarms for everything.

   • "Time to switch laundry."

   • "Remember that thing you have to do at 3 PM."

   • "Did you drink water today?" (Because hydration helps prevent the brain fog from reaching Bermuda Triangle levels).

   • The "Body Doubling" App: If you struggle with initiation, find an app or online community for body doubling. Sometimes just knowing someone else is "virtually" working can trick your brain into starting.

Practice Self Compassion:

1. Prioritize Radical Self-Compassion: You are not lazy, you are not stupid. Your brain is navigating significant hormonal shifts while simultaneously dealing with its inherent neurodivergent wiring. That's like trying to juggle flaming chainsaws while riding a unicycle on a tightrope, blindfolded. Give yourself grace. A lot of it.

2. Simplify and Automate: Can you automate bill payments? Can you order groceries online? Can you delegate tasks? If it reduces cognitive load, do it. Your future self will thank you by not having to forage for food because you forgot to go to the store.

3. Embrace the Mess (Sometimes): The house might not be pristine. Your desk might have a small ecosystem thriving on it. It's okay. Focus on what truly matters. If your clients are getting excellent care and you're mostly remembering to eat, you're winning.

4. Lean on Your Support System: Talk to your partner, friends, or trusted colleagues. Let them know what's going on. Sometimes just vocalizing "my brain is on vacation without me" can lighten the load. And who knows, they might even find your keys for you.

Dealing with executive dysfunction in perimenopause when you're late-diagnosed is a wild ride. It's frustrating, it's hilarious, and it's a profound lesson in self-acceptance. So, take a deep breath, laugh at the absurdity, and remember: if you can find your way back to this blog post after getting distracted by a squirrel outside your window, you're already doing great.

Now, if you'll excuse me, I think I left my coffee in the microwave. Or was it the fridge? The quest continues!