Welcome to IVF This, episode 160, what? IVF and ADHD. 

Hello, hello, hello, my beautiful friends. I hope you are all doing so, so well today. Today's topic is a little bit more niche. It doesn't mean that you, I don't want you to turn off the podcast episode just because you either don't believe you have ADHD or don't have a diagnosis of ADHD because I do think that.

Everyone has ADHD traits or people experience moments of like ADHD traits. So I think you will find this episode valuable. But this really is kind of a love letter to my fellow ADHDers. I've talked a lot about how I have ADHD. I was diagnosed when I was in my early 20s, but I didn't actually start getting treatment or on medication until the last about 18 months -ish, the last year and a half, it just got to a point where my symptoms, although I've always been a chaos goblin, my ADHD symptoms have been much more progressive, which can actually happen postpartum. You can actually experience an exacerbation, as we call it, or a worsening of the symptoms of ADHD postpartum because of the way that dopamine, which is the big thing that ADHD brains lack, we don't produce enough dopamine, and estrogen, which estrogen is a naturally occurring hormone and they bind together. So dopamine is the thing that helps you do the things that you need to do. It's called executive function. And, because ADHD brains have a lack of it. That's why you see a lot of the hyperactivity, the disorganization, the executive dysfunction. So when estrogen is low, dopamine is not pushed through. This is a very, very rudimentary way of describing it, but estrogen protects dopamine. And so when you have a low level of estrogen, which occurs during the luteal phase of your cycle, as well as postpartum, that makes your ADHD symptoms worse. Now, you probably don't need all of that background information, especially if you do have a diagnosis of ADHD, you probably know a lot about that, but I wanted to give a little bit of a crash course in what that looks like. So for people who maybe don't have as much familiarity with ADHD, ADHD is a neurodevelopmental disorder that affects both children and adults. It's characterized by symptoms like inattention, hyperactivity, impulsivity. When you're dealing with IVF, which is a highly structured, highly regimented process, that can be very challenging for someone with ADHD. So we're gonna talk about some of the ways that that can be really challenging, how it's really challenging, I should say, and then how we can kind of work with our brains. And all of this is a love letter to my ADHDers because friends, I've had to live this many, many times for now 20 plus years. I think at this point in my life, I have now spent longer diagnosed with ADHD than I have when I was undiagnosed with ADHD. So a lot of the core things that we think about with ADHD in particular is that,hyperactivity component and it does look very different in women and men, boys and girls. The hyperactivity with boys tends to be much more external. That is traditionally how we view ADHD is that hyperactivity component. For women and girls, that hyperactivity tends to look more like restlessness. It looks more internal, right? So it's the racing of thoughts, it's restlessness, it's unease.

Untreated ADHD in women tends to look a lot like depression and anxiety. So there is a lot of challenges when you're talking about IVF, particularly with how physically, mentally, emotionally, financially taxing the experience can be. So let's talk a little bit about inattention in an organization. One of the biggest challenges, my particular brand of ADHD is the inattentive type. So keeping track of medications, appointments, various stages of the IVF process, it can be very overwhelming. I remember just before the start, I think it was my very first transfer cycle, I had gone on a work trip to a conference with my boss, who was also a very good friend of mine, and I literally left my loop wrong. I was in the start of the transfer protocol. And so I was kind of, I think I was stopping birth control and I was on the Lupron before I started adding the estrogen and then the progesterone. But I left my Lupron at home. And I was about, I was four or five hours away from it. And so all of the fear just welled up that night that I got into town and I realized that I didn't have my medication. You know flurries of messages and phone calls to my doctor's office and they were like, you know, it's okay to miss one dose. But if you can't get your medication or don't have access to medication, then we're going to have to call the transfer cycle off if you miss two doses. So that very next day, because of my inattention, and it does happen, I don't fault myself for it, but I spent an entire day literally in the Dallas Fort Worth area trying to track down a compounding pharmacy to spend the, I think it was like $300 for a five day supply of Lupron. It was an obnoxious thing that I had to go through, in no small part, I should say, to the inattentive nature of my ADHD. You could have put a gun to my head and I would have said that I had packed it, but I didn't. And the consequence of that was that I had to spend an entire day and a few more hundred dollars on tracking down that Lupron.

So there are so many details that we have to keep track that I think that that adds to the mental labor of IVF. So I can remember multiple times checking the same calendar, the same calendar day. Am I taking this medication? Am I taking that medication? What's the dosage for this? I would listen to or watch a YouTube video, especially mixing the Menopur.

If you know you know you have to become like a minor and chemist to mix one of the medications that are oftenly used for sim cycles, it's called Menopur. And I would watch a YouTube video at least once or twice before each injection for the first week that I ever gave myself. Once you get used to it, you can become a little bit more confident in it, but I would double, triple, quadruple check what I was doing just in that heightened state of stress and frustration, right? There is that underlying anxiety that we experience that I experience. It was near constant that I was going to miss something crucial, okay? That is a massive aspect of IVF and ADHD. Hyperactivity, which I said mostly can look like restlessness or difficulty staying calm during long waiting periods inherent in IVF, there's a massive component of hurry up and wait, hurry up and wait for IVF. The two week wait for embryo transfers to get to beta, particularly torturous. Someone with ADHD, myself, might struggle to constantly feel the urge to do something to distract themselves, which actually, In a lot of cases, for myself and my clients that I know have ADHD would lead to a lack of rest or an increased state of stress, right? I can't tell you, I can't even begin to tell you how difficult it is for me to sit still, right? And not just like I have to be fidgeting with something. I mean, I move around, I talk with my hands a lot, I do those things. But just to sit on the couch and like watch a television show with my family It can be excruciating for me because I have this like low hum restlessness that's just constantly, like I feel like I'm constantly, I'm making this hand motion that I know you can't see if you're listening to the podcast, but it just always feels like I have to be doing something, right? That is a massive, that can be very challenging during those periods where you do have to wait, right? You're either waiting for your period to start, you're waiting for your period to come, you're waiting for beta results, test results, you're waiting to start your protocol, all of that, there's a lot of waiting, and that is particularly challenging. Another aspect is impulsivity. Hasty decisions, difficulty sticking to dietary restrictions, Even spending money. I know a lot of ADHDers, we can sometimes have spending issues, spending problems. I will not ask my husband to weigh in on this, but we will use things like impulsively trying to change our diet or add supplements, sometimes without even consulting our doctors, in hoping to speed up the process, right? Improving our chances, but that is from a place of impulsivity, not necessarily measured decision -making, right? They can sometimes go hand in hand. I think more often that's luck than anything, but that is an aspect, right? One of my clients, I know she went impulsively. I didn't use that word with her because it can feel judgmental but it's the act of impulsiveness, not a judgment on her character or anything like that, went and bought a whole bunch of herbal supplements. She went to Whole Foods or something, spent like $300 on herbal supplements, and then never talked about it with her doctor, and it wasn't until she, I think she went to either see an acupuncturist or some sort of complimentary nutrition or something like that.

And they went through some of her supplements and they were like, you cannot, you actually can't be taking this during pregnancy, right? So some of the medications I think would interfere with her, the medications and her protocol, things like that. But because it's such a stressful experience, our impulse, that impulsivity leads to making rash decisions. Not because we are intentionally trying to do it, but because we feel that sense of restlessness we're trying to.

We're trying to outsmart the restlessness. Basically, we're just trying to do something so that we don't have to feel that restlessness and it can come back and bite us in the ass. One of the two of the biggest psychological challenges of IVF, the first one, which is my still to this day, my biggest challenge is emotional dysregulation. I know emotional dysregulation isn't necessarily thought of a lot with, ADHD. And actually if you go back into the literature, 30, 40 years when ADHD was, I think it would have been in the DSM, the Diagnostic and Statistical Manual of Mental Health, mental disorders I should say, one of the first iterations, first or second maybe, had emotional regulation as one of the primary diagnostic criteria. And it doesn't have that anymore. It's starting to come back with the DSM -5, what is it revision, the DSM -5 revision, but emotional dysregulation is one of the primary diagnostic criteria for ADHD. Just meaning we have a much harder time with hiding how we feel, but also regulating, meaning that if I get really angry, it takes me a lot longer and a lot more mental effort to calm myself down.

If I get really depressed, it takes me a lot longer and a lot more mental effort to get back up to kind of a more neutral place, right? It can lead to very intense emotional reactions. And it's not just about feeling sad or anxious. It can mean swinging from hope to despair in rapid succession, which is exhausting. And that's another aspect that I'll talk about. But,

I know people talk about the emotional roller coaster during IVF and being constantly on edge. That is for a lot of people with ADHD, particularly untreated ADHD, that's kind of our overall experience in life is just feeling like that constant sense of edge. So you can imagine if that's our baseline, how it would feel during IVF, right? If we already feel on edge and just kind of something always, a restlessness always under the surface, you can imagine how much more intensified that is during IVF. I remember thinking, and my best friend also has ADHD. I mean, we've done a lot of things together. I feel like we probably didn't need to do IVF and ADHD together. We probably could have done some other things like traveling, but this is what we decided to do with our lives. But like, I remember talking to her while she was going through IVF and while I was going through IVF. We never did it at the exact same time, but just kind of coming together and talking about that process and how it was almost like every test result, every doctor's appointment, even just seeing like my doctor's name pop up on my phone when I would answer it, when they would call, I literally felt like it could push me over the edge. It never did, but there was this constant sense of dread that would come over me.

The emotional responses can be so intense that even small setbacks can feel enormous, leading to us feeling very drained and disheartened.

Another thing that I don't think is talked about enough in the world of ADHD is rejection sensitivity at dysmorphia. Rejection sensitivity, ooh, it sounds strange if you've never experienced it or if you can't relate, but bear with me. The fear of IVF failing feels like a personal rejection. And as I talk about this particular section, I want you to remember that I said that everyone, Everyone in the world has traits or can have experiences of ADHD without actually having ADHD. And I think this is probably one of those universal experiences that the fear of IVF failing feels like a personal rejection, right? That we are personally being rejected, either our body is rejecting us, the universe is rejecting us, God is rejecting us, our partners, society is rejecting us, right? It can be very debilitating.

and exacerbate or worsen symptoms of anxiety and depression. Every failed cycle, every failed transfer, every month that you get that negative pregnancy test can feel like a personal failing. And I feel like, again, I think this is a pretty universal experience, even outside of ADHD, when you're going through IVF or when you've experienced infertility. I think this is a really shared experience for us. It, and I think the putting words to it is so important because you're not crazy. There's nothing wrong with you. It's not in fact a personal failing, but it feels so, so incredibly personal. So deeply, viscerally, gutterly, gutterly? Gutterly personally, okay? It truly does feel like there is something fundamentally wrong with you even in light of all the logic in the world, it still feels like there is something fundamentally wrong with you. And there's not, it feels that way though, okay? So this sense of rejection was not just from the process, right? It's not just from the process, it's not just from the failures or anything like that, it's from our own bodies. Again, when I say rejected, when I found out that I would need to have my ovary more than likely removed it did end up getting removed. I almost felt like my, even my ovary was rejecting me. Even my ovary, I'd gotten by that point of having to have it surgically removed, we had probably been trying almost a year and a half. And I was in the deepest depression that I can remember outside of like I was medicated on Prozac when I was about 16, 15, 16, something like that.

Outside of that experience, this was the deepest depression I had ever experienced in my life. And in that moment, when I found out that I had something called an ovarian, nope, hang on. Doesn't matter. When I found out that I needed to have my ovary removed, I genuinely was like, wow, even my left ovary is abandoning ship because I am that useless, right? Looking back, I can absolutely see the fault in my logic, but I can also see how I got there, right? I can also see and have so much compassion for that. gosh, I was late 20s, I was 28 maybe when that happened 29, something like that. I have so much compassion for Emily 10 years ago because I wanted something so bad that felt so incredibly elusive, so far away, and so foreign to me that I was literally feeling like my body was rejecting me, right? And I know that that's a common experience for us. I talked about anxiety and depression. Untreated ADHD can look a lot like anxiety and depression. In fact, untreated ADHD can lead to severe anxiety and severe depression. I think that that's something that really contributed to the severe postpartum depression and anxiety I had after I had my first one. There's so many, so many moments where we feel like we're gonna have a misstep, where we're gonna have a thing that it's gonna be our fault, right? For people who have, were not undiagnosed ADHD and not diagnosed until later in life. There is a core fundamental belief that we just screw everything up because we've been told that I can remember my fifth grade teacher telling me that I was destined to be a screw up. Now we can have another conversation about that individual and the way he was talking to a fifth grader, but it's still like that. That's still, I can still, there is still a wound there for me.

And so this idea of like, I'm gonna screw this up, something I'm gonna do something that's gonna mess this up and either it's not gonna work, I'm not gonna get pregnant or I'm gonna lose the pregnancy because of my own foul up. And just having that constant fear, that constant state of anxiety, it leads to worsening or a persistent state of anxiety that really just further complicates the experience.

All of this leading to emotional exhaustion and burnout. The constant, this is again, one of those universal experiences, right? Not just ADHD specific, but the constant emotional roller coaster will and can, can and will lead to burnout. Burnout isn't just about feeling tired. It is a state of emotional, physical and mental exhaustion caused by prolonged stress, okay? Now, ADHD is a little bit more prone to burnout and there is actually, Phrases like neurodivergent burnout, ADHD burnout, autism burnout, those because we're already in that heightened state almost constantly of prolonged stress. But just the experience of IVF, I think it can be a very universal experience because of that prolonged stress, no matter how long the process takes, how many cycles you have to do, best case scenario, it's still gonna take you about three to six months, depending on the protocol, your experience, follow -up testing, things like that. That's a very long time to be that emotionally invested in something and that hyper -focused. And then when you add on, right, burnout is often accompanied by a sense of hopelessness and it can severely impact your overall wellbeing. This leaves you feeling completely depleted, detached and literally unable to muster energy or interest in continuing the process. We do, a lot of us are just accustomed to white -knuckling our way through, but that doesn't make it a great experience. I did an episode, I think it was episode like 48 or 50 on infertility burnout that I want you to listen to if you haven't or haven't listened to it in a while. But Homarex signs of burnout include depleted energy, increased mental distance from the fertility process, reduced personal productivity, a lot of social isolation, that's what we typically, no, sorry, many of us can recognize it in like social isolation, despair, an overwhelming sense of fatigue that never seems to end. I remember a client of mine talked about burnout and how it was like she was walking through molasses all day, every day. She was emotionally numb. She like found it hard to engage in any activity, not just activities that she really enjoyed, but anything, just getting out of bed. The emotional exhaustion makes it so difficult to stay motivated and hopeful, which is a big part of the IVF process. Another aspect of burnout is the internal critic becomes louder in times of stress. That drunk a -hole at the ball game that I've talked about before, just spouting drunken nonsense, comes a lot, much louder. The volume gets turned way up during times of stress. So your inner critic is probably also, on top of all of the normal BS it's telling you, it's probably also telling you things like you're not handling this well, you're not doing enough, you're gonna fail, you're gonna fail as an IVF patient, you're gonna fail as a mom, all of those things, right?

The constant negative self -talk is also draining and leads to that perpetual feeling of burnout. So what can we do? I spent a lot of time talking about what it is. I just want you to know all of the things that I just talked about, deeply personal, deeply personal experience that I've had going through the last 20 years of just being diagnosed, as well as the last 10 years of going through infertility and IVF. There are people, there are ADHDers that find organizational tools can be very helpful. Calendars, alarms, apps designed specifically for medication reminders. There is one app that I actually use that's called Routinary, R -O -U -T -I -N -E -R -Y. I've set it up, I use it for just a few things. I don't dedicate my entire world to it, but a few things that I really wanna make sure that I keep into a routine and like that discipline. So there are a lot of ways that it can be managed through organizational tools. Really the biggest thing is breaking down the process into manageable steps, right? So it's not, my God, I have to look at my entire day and go through the process. We're gonna go hour by hour, okay? That's a lot of how I have to live my life so that I don't get so overwhelmed that I just go into ADHD paralysis and spend the entire day on the couch surfing TikTok. Mindfulness and relaxation. I find most of my mindfulness is through deep breathing and progressive muscle relaxation. But if yoga, journaling, if those are your jams, wonderful. Those are known to help with things like hyperactivity and impulsivity.

They also give you a sense of control in an otherwise chaotic situation. Seeking professional support. If you're suspicious that you have ADHD, I would have you reach out to either your primary care doctor or your OB -GYN. They have resources to help you get diagnosed. It is a rather, it can be, I should say, a rather lengthy process. So, If you suspect that you might have it, go ahead and just make the call. Just do it. There's not gonna be any harm in just making a phone call. Just make one phone call and then go from there. If you can always come to me for coaching, it's a special brand that I bring for IVF and ADHD. Cognitive behavioral therapy, if you have a counselor or a therapist, can be very beneficial.

For me, one of the best things is kind of personal stories, sharing my personal stories and experiences. I think the more that we can relate these things to things that people actually experience, the less likely we are going to use them against ourselves and think that there is something wrong with us and pathologize things. Community support. I think Reddit has a relatively good, it's been a while since I was on Reddit on this particular subreddit around ADHD and IVF, but it's got a pretty good online forum. And all in all, I just want you to be able to find the resources that you need, the resources that you feel like would support you. Even if, I know I do the take back your life call, even if you have no interest in working with me, but you don't know where to start, I'm a social worker by training. We'll find resources. You can book a call either on my website, www.ivfthiscoaching .com or on my social media handles at ivfthiscoaching. Even if you just want to talk through your particular challenges without any interest in coaching with me, that's not a problem, you're not gonna hurt my feelings. I just want you to have the resources and support that are gonna help you through this process, whatever that looks like. So kind of as we wrap up, I just want to extend the biggest hug and love and support for all of my fellow ADHDers.

All of my fellow IVFers, ADHD or not, this is a really, really challenging situation scenario that nobody has a how -to manual. None of us know exactly how to navigate it. If you listened to my last podcast episode, I talk a lot about you learn by doing, by finding your purpose by learning by doing. That's a lot of what it is. So if you're going into this process and you're like, I need to know how to handle, myself, I need to know how to handle my ADHD, I need to know what I'm, a lot of it is just gonna be doing it and learning and learning from. One of the things that I tell my prospective clients is if you're willing to be wrong about yourself, that probably makes you one of the most coachable people in the world. So be willing to be wrong about yourself. That includes whether things are working for you and not working for you, but that also includes that maybe there's nothing is wrong with you.

You've been just trying to make your brain work the way people tell you it should work rather than working with the brain you actually have. That was one of my biggest struggles when I was first diagnosed. So if you have any questions about ADHD, you can always reach out even just by email, hello at ivfthiscoaching .com. All of this to say, I just adore you all. Don't worry if you feel like a chaos goblin. I am routinely a chaos goblin every single day of the week. And I just want you to know that there are real challenges with going through IVF when you have ADHD. There are real challenges of going through IVF when you don't, and that you don't have to do it alone. So I hope this was helpful. Have a beautiful week, and I'll talk to you soon. Bye bye.