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ADHD and hormones (Catie’s story)

Catie Osborn’s ADHD flew under the radar until she had to get an ovary removed in her late 20s. Left with one ovary (“Han Solo-vary”), she experienced a hormone shift that made her ADHD symptoms much more noticeable.

Catie is a former “gifted kid” who excelled in school. Growing up, she didn’t fit ADHD stereotypes, aside from being a bit messy. Once she was diagnosed, she started seeing ADHD flags everywhere. Hear what she’s learned from her experience and her work, like how hormones — especially in people who get periods — can impact ADHD symptoms.

Catie, aka catieosaurus on TikTok, is a certified sex educator, neurodivergency specialist, and co-host of the podcast Catie and Erik’s Infinite Quest: An ADHD Adventure.

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Episode transcript

Catie: After my ovary was removed, the shift in my hormones was so profound that my ADHD that had sort of been like under the surface really started showing up in a lot more places in my life in a way that was very, very scary. I couldn't remember things. I couldn't focus. I couldn't sit down to do my work. And so I got diagnosed with ADHD and I learned that ADHD and PCOS — polycystic ovary syndrome — are very connected. And so I guess my "aha" moment came like three days after my diagnosis because I went, "Oh. OK. Those hormones the whole time. All right."

Laura: From the Understood Podcast Network, this is "ADHD Aha!," a podcast where people share the moment when it finally clicked that they or someone they know has ADHD. My name is Laura Key. I'm the editorial director here at Understood. And as someone who's had my own ADHD "aha" moment, I'll be your host.

I am really happy to be here with you today, Catie Osborn.

Catie: Hello.

Laura: Catie Osborn, also known Catieosaurus on TikTok. Catie is a certified sex educator and a neurodivergency specialist. And also she is the co-host of "Catie and Erik's Infinite Quest and ADHD Adventure." I've been listening to so much of your show lately, Catie. I really, really enjoy it. So candid, so real, so relatable.

Catie: Oh, thank you.

Laura: Erik Gude is your co-host. I'm excited to dive into some of the topics that the two of you talk about. But first, this is a show called "ADHD Aha!" And your "aha!" moment is so interesting and so educational for a lot of people, especially women. So let's just start there. Tell me about your ADHD "aha" moment. When did you start to think you might have ADHD?

Catie: Our tale begins when I was 29. So it feels important to contextualize before I tell the "aha" moment that I was extremely good at school growing up. And I grew up in the '90s when sort of like the conversation around ADHD was that it was very much like a school thing. It was very much like a "little kids who like mess around in the back of the classroom" type of thing. And so I will fully confess that I was very undereducated on ADHD and what ADHD could look like in different people, and just like the range and sort of spectrum of, you know, symptoms associated with ADHD.

And so growing up, I was great at school. I was amazing at school. I loved school. It was my thing. But I was terrible at like keeping my room clean. I was terrible at organizing. I was really bad at like, you know, managing my emotions. I had all of these like little underlying, sort of like tiny red flags. But because I was very academically successful, I sort of just flew under that radar.

And so I went to college, I went to grad school, I got several master's degrees. And all along the way, I'm just burning myself out a little bit more and burning myself out a little bit more and burning myself out, you know, a little bit more. Struggling to cope, struggling to keep up and all this stuff.

And then I had an ovarian torsion, which I do not recommend. So basically I had a cyst on my right ovary and the cyst got so large that the weight of it basically pulled my ovary like around itself inside my body, and the circulation to that ovary got cut off. And it's a very serious medical emergency. People who have testicles, we often talk about like testicular torsion, but people who have ovaries can also have ovarian torsion. It's very similar in terms of what happens in the body. And so I had an ovarian torsion and it was an extreme medical emergency. I almost died and I had to go in for emergency surgery, and they removed my right ovary. So now all that remains is "Han Solo-vary." I'll pause for the uproarious laughter that I'm sure is coming from your audience.

So I had an ovarian torsion, and things started to happen in my brain that were just very confusing. I'm an actor and a performer, and so at the time I was working at a Shakespeare company and we were doing three shows in rep and I'm — hair flip — very good at my job. So I had some like big deal parts in the, in the company, you know. So it's kind of a big deal. I'm pretty fancy.

And so I would sit down to try and memorize my lines and I just — I couldn't do it. And I love Shakespeare. Shakespeare is my, like, hyper fixation. I've been like obsessed with Shakespeare for years and years. Just like one of the things that I love most, I'm most passionate about in the whole world. And I couldn't memorize my dang lines.

And then like slowly, like other stuff started to happen as well. Like, I noticed that I would just forget more things. I would lose my phone, I would lose my keys. My house was a mess. Like I had to hire professional organizers to come in and dig me out of the hole that I had to put myself in. And it was really scary. It was really scary. And at the time I thought very honestly that I had early onset dementia.

And it kind of came to a head one night. It was like two weeks before the show. But our first show was supposed to open and I didn't have my lines. I didn't. I just didn't have my lines. And I was like, my personal and my professional reputation are on the line. Like, I've never been the actor who is like a week out from performance and doesn't know their lines. And that's so unprofessional and it's so embarrassing. And so I was like having my husband quiz me on my lines. And he — I remember very specifically, he looked at me and he was like, "Are you OK? You are never this bad. You are never this bad on your lines." Because, like, I couldn't retain information when I did find like the focus to like sit down and learn my lines, I would just immediately get distracted. I wasn't holding information and I was like, "No, I'm not, I'm not OK."

Now, thankfully, this is where the story takes a happy turn, because I have a friend who has pretty profound ADHD. And he looked at me and he was like, "You have ADHD." And I was like, "No, I don't. What are you talking about? ADHD is like a kid thing," you know? And he was like, "No, you have ADHD." And I was like, "OK, well, I at least need to get some help." And so the part of the story that I don't get to tell very often is that that friend actually made the phone call for me to go to the psychologist and get an evaluation, because I was just so not functioning at the time and I will always be forever grateful for that. Like, he was the person who made that call for me.

And so I got an appointment. And then once again, extreme stroke of luck is I found my way to a psychologist who is also a former burnt-out, gifted kid who has ADHD, who has anxiety, who has depression. And so I walked into her office and she was like, "Oh, yeah, yep. I recognize myself in you. I understand this experience. I know what it's like to be really good at school and have that like female experience of ADHD." And so the evaluation process was extremely simple. That was like the easy part of the whole thing.

And then I always say it was the day before my 30th birthday when I went into that appointment, which was like a trip because it was like, "Welcome to your 30s. Here's an entirely new way of understanding yourself and understanding how you navigate through the world." And so I started doing research. I started doing research on ADHD. I started doing research on especially like just the different ways that ADHD can affect us. And one of the things that I was shocked to learn is that your hormones affect ADHD, especially in people who get periods. And so I was like, Oh my gosh. And so I start connecting the dots. And then I just got mad because I'd flown under the radar for so long. Nobody had ever talked to me about this facet of ADHD. And now I'm here. That was so long. I'm so sorry.

Laura: It was great. We're done now with the questions — no I'm just kidding.

Catie: Yeah, good talk, everybody, thanks for being here. Good.

Laura: Well, that's a lot to unpack right there. So you're talking about hormone changes. You had a very extreme example of a hormonal shift.

Catie: Yeah. So when I had my ovary removed, it was really interesting because basically it all happened in less than a day. Like, I went from being like, "Oh, it's just cramps" to like literally almost dying. So they removed my ovary and then basically, like, the doctor was like, "Yeah, you know, you might have some, like, hormone troubles, but, you know, girl stuff. Am I right?" You know what I mean? Where I was just like, cool, thanks for that, you know, useful information.

But then it was like as I started learning more about like ADHD and how it's like related to your hormones, it's honestly fascinating. Yeah, there's this really cool study that was done and it was a very small study. So this research is still in its infancy. But basically in people who get periods, ADHD tends to be worse the week or so before your period. And that is because the levels of dopamine and serotonin in your body are also very low, along with the levels of estrogen in your body. And estrogen is one of the things that helps promote dopamine and serotonin. So it's like your attention is regulated by those chemicals, your emotional processing is regulated by it.

So it's like no wonder that people with ADHD tend to have more like issues with like PMDD and that kind of stuff. But it's up to the point where there is that, like I was talking about, there was a study done recently where they had people who get periods come in and take an ADHD evaluation. Now all of them had ADHD. Like they it was known. They had already all been diagnosed. But depending on where they were in their monthly cycle, their ADHD changed so much that some of them would not get diagnosed depending on where they were.

So when they came in, like the week before their period, their ADHD was pronounced enough that they would like, you know, quote unquote, fail the test and be like, OK, you have ADHD. But during the other couple weeks of the month, they were totally fine. And so there's like this really interesting conversation that's starting to happen about now that we're really understanding like ADHD's connection to hormones, are we missing a lot of people based purely on how much, you know, quote unquote, they're struggling depending on where they are in the month. And similarly, one thing that I hear a lot as well is from people who say like, "Yeah, my ADHD meds were great until the week before my period." And it's well, that's because your hormones are affecting everything in your body. It's so interesting.

Laura: It is so interesting. And I just want to be really clear...

Catie: People yelling about hormones.

Laura: Yeah, let's get really loud all of a sudden. I want to make it clear for folks who are listening: So you had an ovary removed. Han Solo-vary is left. Right? I've got that, right? And so that led to some extreme hormonal shifts than normally, like for like a period, right? But like it's not that having an ovary removed is the reason that you have ADHD. It's — the hormonal shift is what made you more aware of your symptoms, right?

Catie: That's, yeah. No, you're exactly right. Like, basically what happened was my ADHD had already been kind of latent. I had grown up building systems and structures that supported the amount to which I was struggling. But then like overnight, my hormones completely shifted and so that like really exacerbated my ADHD symptoms to the point where it was like, OK, this is a problem.

But that actually beautifully leads in to the next point that I was going to make, which is we see this happen a lot in women as they go into menopause, where a lot of older women start getting diagnosed with ADHD in their 40s and their 50s as menopause starts like approaching. And it's for the exact same reason. It's that your hormones are lessening. You're having less of that estrogen in your body just as like a baseline. And because of that, then they're starting to realize, hey, wait a minute, there's some stuff going on here that I'm now struggling with. And so, yeah, it's been really interesting. Like in the past decade or so, there's been this like massive uptick in women in their 40s, 50s, and 60s who are getting ADHD diagnoses. And it's exactly because of that. It's because your hormones are so like profoundly linked to a lot of ADHD stuff that that just winds up happening.

Laura: So you're talking about being afraid that you have early onset dementia. You're not the first person who's actually raised this with me this week. We work with a lot of experts at our organization, at Understood.org. And speaking with one of them today and talking about, you know, when does someone who is in a workplace start to realize that they may be struggling with a learning or thinking difference or struggling with ADHD at work? They're like, it's the forgetfulness. It's often the forgetfulness. And they think that they actually are struggling with dementia. And a lot of people, that's their entry point. That's their "aha" moment. And then they go see a doctor. So, OK, now I digress. But tell me more about like that conflation or overlap.

Catie: I mean, I think it's just really interesting because I think what it — in my experience at least, what it came down to for me was honestly again, just like an absolute undereducation on ADHD. I didn't understand what ADHD could look like or might look like. And so the only sort of like direct thing that I knew that could be a thing that affected forgetfulness was like, oh, it must clearly be dementia. Now, obviously I was very wrong. But I think that that's a really common thing because we see that narrative. We see the stories on TV of like the Lifetime movies or whatever. Like we see that experience, that commonality represented. And so I think it honestly, like it makes a lot of sense to me that people would make that leap from like, well, I've never been forgetful, or I've never struggled with this thing, to now I am. So it must be this specific thing.

And again, I think a lot of that just has to do with undereducation and honestly, like not having the information to recognize just the latent symptoms of ADHD that are with you earlier in life. Like I certainly didn't, you know. I certainly didn't think about things like how I would get involved in like every single activity there was and like really struggled to finish projects until the last minute or struggled to like start my homework until like, "No, it's really due" the night before. All of these again like really tiny red flags that now that I know, like, oh, it's been ADHD all along. I was like, OK, that makes so much sense. But when you don't know, when you're not educated, you don't have that background to go "Oh." So it's just clearly it's dementia.

Laura: I was listening to one of your more recent podcast episodes, but I wrote down something that you said that really — it gave me chills. I'm going to misquote you probably, but: "The forgetfulness that you experience in everyday life, it can make you feel small and afraid and powerless to how your brain works." And then I love because you flipped too: "And it's a superpower" and laughed because... No, but that really struck a nerve with me and I don't think that people realize just how tricky ADHD symptoms can be.

Catie: Yeah, I mean, I think the thing, especially as I got more into my work and into my research and the more that I learned, I think the thing that I was most frustrated about, and I think also — both frustrated and fascinated I think is a good way to say it — because I just didn't realize how much ADHD affects the every moment of every day. It's not just a school thing, it's not just a work thing. It's not just preferring to send the text message or struggling to keep your room clean. It is a overarching, all-encompassing, neurodevelopmental disorder that affects every moment of every day. And when you start contextualizing it in that way, I think it's a lot easier to approach because the conversation is still so much about school. It's just still so much about the office. It's not about how it affects our entire life from the moment we wake up to the moment we have trouble going to sleep.

Laura: On the forgetfulness front, now that you have this awareness of your diagnosis, can you give more examples of recontextualizing these ADHD symptoms that at the time you didn't know were ADHD?

Catie: Oh God. Just my entire childhood. I joke about it on TikTok, but it's true. I have like profound desk dumping trauma because I was the kid in class whose grown-ass adult teacher would dump their desk and make me crawl around on the ground to find my crayons because my desk was too dirty. Like that kind of stuff.

Laura: Overly punitive.

Catie: Yeah, it really was. I don't get mad about a lot of stuff having to do with ADHD, but I do get mad about the adults who are like, "I'm going to punish you for this thing." Like, "You're messy, so I'm going to dump your desk," but then provide you no supports and not teach you how to organize and not give you any skills or structures that you can build upon. They're just like "You're bad and messy."

Laura: Right.

Catie: Another big one is that I was bulimic from the time I was 15 until I got into therapy when I was in my 30s for it. So about half of my life I've spent with an eating disorder and there's a profound link between eating disorders and ADHD. And that's really the one that I think I look back on and I go, "If only." You know, if only somebody had told me, if only that information had been available, which is again, a big part of why I do what I do now, because I want to be the person talking about it.

Laura: Can you talk a little bit about that link between eating disorders and ADHD?

Catie: Yeah. So there is a big link between people who struggle with eating disorders and ADHD. In particular, people with ADHD struggle with binge eating. Some people struggle with food restriction, but for a lot of people, it's binge eating. And then in like my case, that can then lead to bulimia. And there's fascinating research being done on it. But primarily what it is, is the binge eating part of it is absolutely grounded in executive dysfunction. You're dopamine seeking, you know, the food tastes good. But then you combine things like time blindness where, you know, you start eating the ice cream and then you look down and the ice cream is just gone. And then there's also just emotional processing and how we process emotion. Well, the food makes me feel good, so I'm going to keep eating it because I'm having trouble regulating my emotions.

And so it's like when you sort of like lay it out point by point, you're like, oh my God, of course it makes sense that people with ADHD struggle with binge eating. Like that makes so much absolute sense. And then even more like a lot of medications for ADHD will suppress the appetite. And then you're like, "Oh my gosh, I haven't eaten all day, so I'm going to eat this entire pizza." And that can really lead to disordered eating.

Laura: Which ADHD symptom would you say still impacts you the most or still is like the old chestnut that you just can't seem to crack.

Catie: The old chestnut. It's weird how often I get this question, and it's weird how I still have not decided on my answer, honestly. I think for me, and this is going to be weird, but I will explain, is time perception. I think for me that is — that's a huge thing because for me, I'm pretty good at task initiation and I'm terrible at finishing projects. But for me, time perception is a big one because I also feel like it's one where like it's like, oh is like wacky. It's like whimsical. People with ADHD are always five minutes late. It's so cute and wacky. But it's like, no, it's been six months since I called my mom because I didn't realize it's been that long. You know, it's been three weeks since I sent that email back about the brand deal that I was going to get or whatever. That kind of thing, where I feel like time perception and struggles therein can be so damaging to not only just like basic life stuff, like upkeep. It's like I consistently forget to take the garbage out because I forget that it's Tuesday. It's the oh, it's been literally a year since I dusted my house. Like that kind of thing where time is so nebulous for me that I just constantly feel like I'm sort of standing in like this, like hurricane of things happening around me. And I'll reach out and grab something. But by the time I get ahold of that, 20 other things have blown past me. And it's very defeating. It's very frustrating. And it's very — it's, I mean, it's embarrassing. It's embarrassing as like a grown adult to be like, I forget to call my mom or, you know, I forget that I have friends, like that kind of stuff.

But it's because the difference of two weeks and two days to me absolutely depends on what I'm doing. Sometimes two days feels like an eternity, and sometimes two months will go by before I even realize that they have. And that's scary. It's scary to constantly be worrying about, well, what did I double-book myself or what did I forget? Or what am I going to be late for? Or whose wedding am I going to not show up for because I didn't realize it was this week and not next month? That's the one that I think gets me the most because it affects everything that I do.

Laura: That's what I wanted to know, though, because I don't want to ever paint a picture that it's like, OK, you got diagnosed with ADHD and now you don't struggle with symptoms anymore.

Catie: Yeah, I'm fixed.

Laura: Yeah, yeah. Diagnosis can lead to treatment can lead to all these things that can help, but it's not — that's not a curable disorder. How did getting a diagnosis, having a name for what you were struggling with, how was that helpful?

Catie: At first it wasn't, I think is my real answer. At first I kind of went, OK, great. But it doesn't solve any of my issues, you know what I mean? And for a really long time, like, I really lived in that place of like, great. It doesn't solve the fact that I can't remember my lines. It doesn't solve the fact that every month my house goes to heck before my period starts, you know, like that kind of stuff. The more that I started researching and the longer I started working in this way that I'm now working, the more I started realizing that it was less about having a name and it was more about having a fundamental understanding that so many of the things that I have struggled with, so many of the things that I always thought I was just wrong or bad or broken or fundamentally flawed, it had nothing to do with me. It had nothing to do with how hard I tried. It had nothing to do with, like, how motivated I was. It wasn't that I wasn't just trying hard enough. It wasn't that I just needed a plan or I just needed to keep my room clean. It's that I have a disorder that makes those things extremely difficult and extremely challenging. And realizing that all of these places where I felt like a screw-up and a failure and I've carried shame and guilt and embarrassment were not my fault. And beginning to sort of like reframe my understanding of my struggles and the things that I find difficult with that understanding, that was incredibly, incredibly powerful. Especially when it came to things like, oh, I am predisposed to an eating disorder. Like I am predisposed to emotional dysregulation. I am predisposed to like all of these things that I've always really felt like, well, why can't I just be like everybody else? And it's like, well, because my brain is not like everybody else's.

And so having that opportunity, I think, really brought me forward in terms of self-acceptance and patience with myself and grace with myself and kindness with myself and understanding with myself. And that has been really important. I think that's been the big takeaway for this.

Laura: I'm just pausing to bask in that for a second. That was really lovely what you just said. I really relate to what you've been talking about in terms of being burnt out. Just working myself so, so hard and making very unhealthy decisions for my body and for my brain. And I agree with you. Like talking with you about also even the hormonal changes that happen before you get your period, like these little nuggets that you learn along the way, I'm like, oh my God, this makes so much more sense now too. Because I can't be kind to myself during that week before my period starts. Wondering if I should up my medication dosage for them.

Catie: Yeah. And that's the thing, you know, is like that, that understanding of like, oh, OK, well, now — and then it's like, OK, well, now I know, you know, like, and then it's like that next.... If you know that you're going to struggle more the week before your period, then OK, let's start building a system and structures in which you can treat yourself more gently. You know, like for me, I'm incredibly chore-averse that week. And so it's like, OK, let's put a little money in the budget so I can order takeout so I don't have to worry about dishes. You know, just like small, little, gentle things that you can do to support yourself. Like, it doesn't have to be an overhaul. It doesn't have to be this, like, massive, life-changing thing. It can just be like, no, I'm going to get, you know, takeout twice this week instead of once because, you know, it's easier for me to, like, not have to worry about the dishes. Like, just, you know, stuff like that.

Laura: I love that. I want to start doing that. I'm going to add a little reminder to my calendar.

Catie: Get a lot of ramen the week before your period.

Laura: Oh, nice.

Catie: I love ramen so much.

Laura: For me it would be Indian food for sure. Catie, it has been so nice to talk with you, and I would love to have you back on the show at some point. If I ever need a sub, if I'm out, can you come in?

Catie: Yeah, let's do it. Yeah, of course.

Laura: You just can't upstage me. You're so good at this, but yeah. OK. Thanks so much for being here. This really means a lot to me.

Catie: Yeah, thank you for having me. I appreciate it.

Laura: You've been listening to "ADHD Aha!" from the Understood Podcast Network. If you want to share your own "aha" moment, email us at ADHDaha@Understood.org. I'd love to hear from you.

If you want to learn more about the topics we covered today, check out the show notes for this episode. We include more resources as well as links to anything we mentioned in the episode. Understood is a nonprofit organization dedicated to helping people who learn and think differently discover their potential and thrive. We have no affiliation with pharmaceutical companies. Learn more at Understood.org/mission.

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

Jessamine: Hi, everyone.

Laura: Briana Berry is our production director. Our theme music was written by Justin D. Wright, who also mixes the show. For the Understood Podcast Network, Scott Cocchiere is our creative director, Seth Melnick is our executive producer, and I'm your host, Laura Key. Thanks so much for listening.

 

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