Perimenopause, brain fog, and noise sensitivity: Lizzie O’Leary’s late ADHD diagnosis

Journalist Lizzie O’Leary spent decades asking sharp questions for a living. Then the words started disappearing. Brain fog. Surprising rage. A head full of buzzing bees.

Lizzie, who hosts Slate’s What Next: TBD podcast, was diagnosed with ADHD at 50 after perimenopause made her ADHD symptoms too powerful to push aside. Lizzie talks about emotional regulation challenges that hurt her career, sensory sensitivity she’d written off as quirks, and what she wishes she’d known when she was younger.

• Listen: How menopause and hormones impact ADHD symptoms in women

• Read: ADHD and emotions: What you need to know

• Watch: Psychotherapist explains ADHD mood swings and emotional regulation

Lizzie O’Leary: The people I worked for ended up putting a different reporter on my story, like with the news that I had broken and the sources that I had worked, and I was furious. Stomp across the newsroom yelling furious.

Now knowing that I have ADHD, I still have that feeling, but I’m like, oh, I know what this is. And I feel sad for the 35-year-old version of me who got in her own way so much.

Laura Key: Hi everyone, and welcome back to "ADHD Aha!", the show where people share the moment when it finally clicked that they have ADHD. What happens when someone who’s spent a career asking sharp questions suddenly has to turn that lens on herself?

My guest today is Lizzie O’Leary. Lizzie is a reporter, a mom, and host of Slate’s "What Next TBD". Lizzie was diagnosed pretty recently, after brain fog, surprising rage, and the strain of everyday life pushed her to look for answers. Lizzie, so glad you could be here with me today. Welcome. How are you?

Lizzie: I’m okay. I’m actually really excited to have this conversation.

Laura: Yeah, me too. Well, let’s start at the beginning of the ADHD story. Tell me about getting diagnosed. What prompted you to seek out a diagnosis?

Lizzie: So, I was diagnosed in December, which is not that long ago. I’m 50, and over the past few years, my body has gone insane, partially because of perimenopause. And now, of course, I’ve learned undiagnosed ADHD where I was just holding things together with chewing gum.

And I would say sometime around the middle of last year, I was on BlueSky, believe it or not. I typed in like kind of a throwaway post, which was like, what’s it called when clutter makes your brain short circuit and you become totally overwhelmed?

And like five people replied to me, it’s ADHD. I was kind of like, ha-ha-ha, whatever, but I’ve always had that experience where there’s too much and I just can’t deal and either go into a cleaning rage or just shut down completely.

And that stayed with me. And then as I started to struggle more and more with brain fog and being randomly furious, I not only talked to my gynecologist about, you know, going on hormones, but I asked my therapist like, hey, you know, starting to read more about ADHD and what it looks like in women and what it looks like in perimenopause, and I think I’d like to get tested.

And I went through, you know, that process and she was like, "Yep, you — you’ve got it."

Laura: Was she surprised when you when you brought it up? Or was she like, "Yeah, that that might track"?

Lizzie: She was surprised. She said like, "I wouldn’t have thought you." She’s like, "You’re so together, you are very decisive, and you have a, you know, very functional career. I’m surprised." And I was like, "Yeah, but you didn’t know me as a teenager. You didn’t know me as a kid and like I have coping mechanisms that I like muscled to."

Laura: She said you’re so decisive. That’s interesting.

Lizzie: I think she was implying that like I don’t get torn up in the sort of process of like I can’t quite start, I can’t quite commit, I can’t do this, but actually I do. I just don’t think she saw that.

Laura: And then so like you’ve got the perimenopause, menopause, everything going on and the classic perimenopause ADHD story is 100%. You mentioned brain fog. Tell me, like, describe a describe a half hour in the life of brain fog.

Lizzie: I remember coming into the living room, I think this was sometime last year, and trying to tell my husband that something was on the coffee table. But I couldn’t say it. I like came into the room, I left the room, I came into the room like, why am I in here? What am I looking for?

And then I said there’s the thing, and it’s on the square thing with the books on it in between the couches. And he looked at me like I was completely insane. The words "coffee table" had just left my brain.

You know, I’m a journalist and I do interviews, and I also found that happening in my interviews. I would have a thought or a question for a guest and it would just leave. Oh, wow. And so I’d have to prep myself in a much more aggressive manner and be like, there’s this. And if they say this, here’s your follow-up. And if they say this, here’s your follow-up, just so I wouldn’t completely lose it.

Laura: Oh wow. Yeah. I mean we’re laughing about it, but that sounds extremely stressful especially in your line of work.

Lizzie: It was very — yeah, it was stressful.

Laura: With the brain fog and the emotional regulation ever clash or like feed off of each other?

(04:42) Emotional regulation and ADHD patterns.

Lizzie: Yes. I don’t think my husband would mind me saying this, but like we would have fights where I would be furious, but also unable to articulate why I was so furious.

I have since learned a lot about ADHD and emotional regulation and, you know, have begun to sort of reexamine my own patterns in the past and learn like, oh, I do have rejection sensitive dysphoria.

I did get myself in big trouble both in relationships and professional settings because of these like huge feelings. But they were so magnified in perimenopause that I just like felt like I couldn’t control them and sometimes couldn’t articulate them.

Laura: Tell me about the difference, the contrast, what it maybe was like before and then what it was like around that time that you’re like I need to do something.

Lizzie: Best way I could describe it is my brain has always felt like a busy place. And I sort of didn’t understand how busy compared to most people’s brains because I assumed that I think like many people assume that everyone kind of moves through the world in the same way.

But I was often doing like three or four things in my head while I was existing in the world, which is just how I’ve always done it. Like I didn’t really need to keep a physical calendar because I just knew. Like I could — I could really do stuff in the background.

I always felt like I was like a computer with like another program running in the background. And then I stopped being able to do that. And I began to notice it where I would just miss things. I missed a doctor’s appointment, which is very unlike me.

And I noticed that I just had to keep writing things down more so that I wouldn’t forget everything. I think I became even more rigid actually and maybe unpleasant to be around because I was just like so focused on knuckling through these different things we had to do.

Like school drop-off is here, and I take this medication in the morning, and I take this medication at night. I also went through cancer kind of around this period of time, so it was just like a lot of stuff.

But then, I would say end of last year, last fall, I told my husband "My brain feels like it’s full of bees." Now that background computer has reached this crescendo of activity and distraction and just like noise I couldn’t turn off. And it was really getting in the way of my ability to do anything else.

Laura: It’s interesting that you mentioned the rigidity as kind of a reaction to all of that. I totally relate to that. I find myself before I need to go anywhere with one of my kids or if I have an appointment, like a half hour before I’m ready and I’m just sitting there irritated that it hasn’t started yet because I’m worried that if I go off in another direction that I will forget that I need to do the thing. So I’m like yelling at everybody to get ready and be ready on time and they’re like, "We don’t have to leave yet. What are you talking about, Mom?"

Lizzie: I felt like I sort of lost my ability to be in the moment. Yes, yes. And I have a six-year-old and like the most important thing to him is that I am in the moment with him. That like when we’re playing, we’re playing. When we’re reading, we’re reading. That I’m not making a shopping list in my head during that moment.

That was I think another big signal for me. Like, you need to actually be present for your child. And I would imagine this would not surprise you, I have a very hard time resting at the end of the day and just like letting things go undone. I’m like, "But I could clean the refrigerator shelves. Maybe I should. It’s 10:00. Why don’t I do that right now before bed? That makes sense."

Laura: It kind of goes against the image that a lot of people have of ADHD. I think that there are some people who have this image of ADHD and it’s you’re free and you’re flowing and you’re impulsive and you’re just doing whatever and you’re constantly in the moment because you’re hyperfocused, which may be true some of the time. But the hypervigilance and the extreme organization, it goes against what many probably view to be ADHD.

Lizzie: Yeah, I think that’s true. And I’m also like, I’m the oldest of — I have confusing half-siblings — but I’m the oldest, I’m the only daughter, so I think I also just sort of have that. That turns it up to 11 somehow.

(09:28) How ADHD has affected Lizzie's relationships.

Laura: You mentioned in our pre-interview that you’d be open to talking about how ADHD has maybe affected your relationships. Are you comfortable talking about that?

Lizzie: Yeah, yeah. When I look back on my relationships, especially when I was younger, I would get — I mean I think probably hyperfocused on the beginning of a relationship. And it was so exciting and I would just be like thinking about the person all the time and probably in a kind of, you know, normal rubric coming on strong, but to me I was just fascinated.

Like, oh let me learn about this, let me learn this thing about you. Let me experience that, let me do this. And I would say there was a period of this time, probably my 20s to mid-30s, where I would have really exciting big deal four-month relationships. Four-month itch, you know.

Either I would bounce because I was like, "Oh you’re just a person. You’re just like a normal person with flaws and interests and weird habits like the same as anybody else. You’re not some exciting kind of object of hyperfixation." Or I would so over-hyperfixate that the relationship would end at the four-month mark because they were like, "Hey, you’re a little intense."

Because I just sort of didn’t have the ability to moderate and slow down. It did develop somewhat more naturally as I got older and just became a more experienced person. But, you know, I didn’t meet my husband until I was 41 and I had just learned a lot more from trial and error.

Laura: I often think about my husband, who I feel like really understands me and I’m really fortunate to be with him. I’m like, wow, I feel like I got really lucky on this one, you know.

Lizzie: Same. And I think by the time I met my husband, he’s a little bit older than I am, he also was a middle-aged person who had done a lot of work and knew who he was. And by the time I met him, that was my number one criteria. It’s like a person who has examined themselves. This is how they move in the world. It doesn’t mean that they don’t have any flexibility, but that they’re pretty sure of who they are.

Laura: Similar on my side. I know I’m not interviewing me right now, but I’m really relating hard to what you’re saying.

Lizzie: I mean it’s so helpful to me to actually hear you say that because I’m like, "Wow, these are not just like problems I have, these are not things that are wrong with me. Some of these are just behaviors and ways of existing that are more common in ADHD."

Laura: Have ADHD symptoms ever gotten in the way for you professionally?

Lizzie: If I think back to when I was a reporter at Bloomberg News, so that was my kind of early 30s. I was, you know, very energetic. I mean side note, side quest, I think having ADHD makes me a good reporter. Like I will go crazy learning all the details about something.

I mean I covered the BP oil spill. I could tell you so much about how oil rigs work. That was like a really good marriage of skill and neurotype. But I also noticed that I got in trouble mostly because I had emotional reactions at work. They were too big, that were not well-regulated, and they got me in trouble.

Laura: Are you open to giving an example?

Lizzie: Yeah, yeah. So gosh, this must have been 2009 during the auto bankruptcies. So I had gotten a tip that Chrysler was going to go bankrupt, that Chrysler was going to declare bankruptcy. It was a huge story.

And at the time I was a television reporter and I was sort of sharing a beat with a couple of other reporters. And the people I worked for ended up putting a different reporter on my story, like with the news that I had broken and the sources that I had worked, and put them at the White House to like do the live shots and debriefs and all of that stuff.

And I was furious. Yeah. I was like stomping across the newsroom yelling furious. Because to me it just didn’t seem right or fair. Justice sensitivity, right? Yeah. Yeah.

I did the work, I broke the story, I should get the credit for it and I should be the one who is doing this. And, you know, my bosses were kind of like, "Well, we appreciate that and you did, but like that’s not how it’s going to work today. We have a reporter so we got to rotate this person’s got to do this, this person’s got to do this."

And like I just didn’t have the capacity to shut up and say, "Yeah, okay," and go home and be mad in private. I think that that inability to go home and be mad in private really hurt my career for I don’t know, maybe a decade.

I would work really hard, I would just kill a story, I’d be good at it, I’d get on a plane and, you know, stay up for 15 hours doing live shots. But I remember someone saying to me when they were actually going to hire me for a job, "I did a little research about you. And everyone says you’re like an amazing reporter, you have an incredible capacity for work, but that you can be volatile. And that you have these moods that are hard to manage and can make you tough to work with."

(15:52) Professional consequences of undiagnosed ADHD.

Laura: Ooh. How did that feel as — yeah.

Lizzie: It was — it was crushing. It was crushing. Talk about RSD. I remember my whole body feeling like it was on fire.

Laura: Oh god. Lizzie, what did you do? Like how did you cope?

Lizzie: I said that’s not an inaccurate way to describe me, and it’s something I’m working on. And, you know, if I push back on that, I’m just going to sound like I’m not hearing the criticism. And so I will have to work for you and you can decide whether you think my work makes up for it.

Laura: Did you get the job?

Lizzie: I did. And I don’t think I ever got out from under that perception, whether it was accurate or not. Yeah. I’m not someone who is generally full of regret, but I do wish I had been diagnosed sooner because it would have given me the ability to say, "Someone is giving you a piece of criticism, it doesn’t mean you’re terrible, it’s not like a big red stamp on you. It is a piece of feedback that you can just listen to and let the reaction pass."

And now knowing that I have ADHD, I still have that feeling. Of course. But I’m like, oh I know what this is. And I know that if I ride it out for 20 minutes, I’m going to feel different. It doesn’t always work, but like just knowing that is such a powerful tool. And I feel sad for the 35-year-old version of me who got in her own way so much and felt like there was something galactically wrong with her.

Laura: I mean you weren’t diagnosed that long ago. That’s pretty impressive that you’re already able to have that thought in a decade.

Lizzie: I mean I just embarrassed myself in a meeting like a few months ago. This is not a skill I’ve perfected. Yeah. My face is very transparent. Like I’ve learned to be like, "Hmm, camera off."

Laura: When I introduced you I talked about how, you know, you’ve spent a career asking hard questions and you’ve kind of, you know, turned this lens now on yourself. When you started to think maybe I have ADHD or maybe right after you got diagnosed or even still now, like what are the big questions about ADHD that you had or have as it pertains to to you as a person?

Lizzie: Well, so I think one of the things that I struggle with a lot and I feel like maybe the sort of ADHD internet is not always helpful in this way is picking out like what behaviors are neurodiversity, what behaviors are just my personality.

And like I don’t actually want to lose anything that feels core to who I am by saying, "Oh you do X, Y, Z because you have ADHD."

Laura: Do you have an example?

Lizzie: My hyperfixation research skills are really good. It is a thing I am proud of. Like I can learn a lot really quickly. And it’s I think probably one of my biggest professional strengths. I don’t want the ADHD diagnosis to like take away from that as a skill.

Laura: Yeah, yeah. And it doesn’t have to.

Lizzie: It doesn’t have to. But it’s a little bit of like, "Oh was I only good at that because I have ADHD?"

Laura: What other questions have you had about your ADHD and who you are?

Lizzie: I do think that learning more about ADHD and relationships is really helpful. I have a lot of sensory issues and I think some of my — my sensory overwhelm has fed into, you know, certain romantic behaviors that are not helpful.

Learning how to pace myself in an argument, learning how to — I mean I think every couple goes through this — to how to have like good fights where we’re having conflict but it’s in a constructive way. That is a place where I’m — I mean I’m just like such a research-driven person. Like I want to read a book and learn all these things to then understand myself.

I just want to learn more. Like more about how I interact in the world. I’m very close with one of my brothers. And I remember sending him a question a couple of months ago and the text was "Wait, do neurotypical people’s clothes not hurt?"

Laura: "What are you talking about?"

Lizzie: He was like "What are you talking about?" He’s like, "No, neurotypical people’s clothes don’t hurt."

Laura: My sound sensitivity is actually what led to my ADHD evaluation and diagnosis. I was talking with my therapist or psychiatrist, somebody, and he asked me this very specific question. He was like, "When you’re in the coffee shop and you hear someone a few tables away clink their spoon or something, how does it make you feel?"

And I was like, "It drives me crazy. I’m completely off my game." And it also kind of affects my relationships too because I’m so sensitive to like mouth sounds. It’s hard to be close to somebody.

Lizzie: I’m laughing but this was I feel like during the kind of most intense parts of COVID when my husband and I were in a New York City apartment together. I was also pregnant. And I was just like, "I can’t sit across a table from you and eat. Your chewing, I can hear it, there are smells, I’m get like I’m going to have a mental breakdown. Like I just need to go in the other room."

Laura: Yeah, the sound sensitivity is a lot and with the ADHD it’s hard to know what where one starts, where one ends, where they, you know, that they just collide and it’s this vicious cycle because you get then hyperfocused on that thing.

Lizzie: Right. No, this was my husband being like "Can I just eat in my own home?" And I’m like "No, you have a piece of corn here. So the answer’s no, you can’t."

Laura: Last time we chatted you mentioned something about not feeling like you deserved to have ADHD. Now how are you feeling about that now? Does it feel small? Do you feel undeserved?

(20:53) Navigating the complexities of the ADHD diagnosis.

Lizzie: I feel a little undeserved. Okay. I feel it’s a little bit like this sort of — I know that there are big societal conversations around this — like if everyone’s neurodivergent, is anyone? You know, certainly this is a big conversation in ASD where people with low support needs, you know, are saying "I’m autistic" and then, you know, maybe the parents of children with high support needs have a hard time with that. Like understandably like these two things are not the same.

And so sometimes I feel that way. Like there are ADHD things that I don’t relate to. I remember when I did do the diagnostic testing, like I did some also computer-based testing and it was like, you know, "Some of these things you sort perfectly, others not at all."

But then there things where I’m like I know my pattern recognition is amazing. I also know that my working memory is shit. I still feel a little uncomfortable kind of claiming the diagnosis. But like I probably feel more comfortable now than I did when we first talked.

Some of that is like listening to the "Climbing the Walls" podcast that Anders did, that was very helpful for me learning about how ADHD presents in women specifically. Because again I think so much of like the perception question is just based on this very particular model and when I grew up and what that meant.

And then also I think this question of like I grew up quite privileged. Were privileged parents just getting an ADHD diagnosis for their child to have extra time on tests? Like that was I remember that being like a magazine cover kind of query. Just asking questions. And so I think that’s all a mix that’s still sorting itself around in my brain.

Laura: I definitely felt that way post-diagnosis and I still sometimes feel that way now. I’m like I got straight A’s in school, I did so well and then I look back to how I kind of killed myself to do that. I also think like what you talk about with the kids and, you know, that’s a very real issue of the scale of need, right? But then as an adult we can call this self-care too. I know it’s a hokey word but.

Lizzie: Right. The more I have learned about ADHD and the more I have like started working with it, if that makes any sense, then I can know, oh I’ll give myself like an hour of power in the morning to do all of my administrative tasks.

And then if it gets to be 5:00 p.m., I can just tell myself you’re not going to call the dentist today. And that’s okay. And you don’t have to like agonize about the fact that you didn’t call the dentist and how are you such a lazy person that you cannot just make one phone call to call the dentist even though you need to schedule this appointment and your teeth really need to be cleaned. I’m like give yourself — like you’ll do it tomorrow. You’ll do it in the hour of administrative power the next day.

Like that is a profound change for me. Trying to learn to give myself permission to switch off. And one thing I will say is that I think — so not unlike a lot of people my age — I am dealing with a lot of sandwich generation stuff. Caregiving for older parents, raising a child, just a lot of family stuff.

And realizing that there are several people in my family who probably have undiagnosed ADHD and learning to give them grace when they have a big emotional reaction was like amazing. And to say I’m going to say this thing to my mom, she’s going to freak out, and then I’m going to give her three days and check back in and she’s going to be okay.

Laura: Yeah. Huge. That is amazing.

Lizzie: It’s like suddenly understanding a language.

Laura: And it’s not just giving them grace. That also allows you to be more relaxed, right, in a family setting.

Lizzie: Right. So my younger half-brother also has ADHD. Also very recently diagnosed. And that has been like a real — the two of us have been able to share a lot of these experiences and feelings and talk through this process together.

He asked me about my experience going on meds and I said it was just incredible that I suddenly didn’t have the brain full of bees anymore. Like bees were quiet. And right before I came to do this interview, he sent me two pictures of like massive cleaning projects that he’s doing, which is with the caption "Five ants." And I was like, "I see you. I know what’s up."

He also said I could tell you guys that like yes, he has a writing deadline coming up and he has chosen to do this instead.

Laura: That’s funny. I love that it’s a family affair. Okay. I love that.

Lizzie: It’s — but it’s such a family — I’m like, "Oh man, we all understand each other a little better." And we don’t feel like we’re lazy.

Laura: That’s a huge win in and of itself right there.

Lizzie: I mean I still feel like I’m lazy. It does come from profound unworthiness, it comes from like very identifiable things that other people who have ADHD also share with you.

Laura: Lizzie, it’s been so great chatting with you. Thank you so much for being here today.

Lizzie: Thank you for having me.

Laura: Thanks for listening today. As always, if you want to share your own aha moment, email us at ADHDaha@Understood.org or send a message to our voicemail inbox. You’ll find a link in the show notes along with resources and links to anything we mentioned in the episode.

This show is brought to you by Understood.org. Understood.org is a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. If you want to help us continue this work, donate at understood.org/give.

"ADHD Aha!" is produced and edited by Jessamine Molli. Say hi, Jessamine.

Jessamine Molli: Hi everyone.

Laura: And edited by Alyssa Shea. Video is produced by Calvin Knie. Our theme music was written by Justin D. Wright. Production support provided by Andrew Rector. Briana Berry is our production director. Neil Drumming is our editorial director. From Understood.org, our executive producers are Scott Cocchiere and Jordan Davidson. And I’m your host, Laura Key. Thanks so much for listening.