ADHD in Women Over 40: Why Everything Suddenly Feels Harder

In this episode of The Connected Community Podcast: Exploring Possibility, I sit down with Britt Ritchie, a doctorate-prepared psychiatric nurse practitioner and founder of Mind Alchemy Mental Health in Denver, to explore ADHD in women and why it is so often missed until later in life.

We talk about the ways ADHD can look different in women, particularly those with inattentive or combined presentations who may never have fit the stereotypical picture of hyperactivity. For many women, years of developing strategies, masking symptoms, overachieving, and simply working harder can keep ADHD hidden. Then perimenopause and menopause arrive. As hormones shift, strategies that once worked may become less effective, and struggles with focus, organization, motivation, emotional regulation, memory, and overwhelm can suddenly feel much more noticeable.

Britt also shares her own experience of appearing successful and high-achieving while privately struggling with anxiety, perfectionism, and undiagnosed ADHD. We explore the relationship between ADHD, anxiety, depression, and burnout; what a thorough ADHD evaluation can look like; medication and treatment options; genetic and functional testing; and how lifestyle, physical health, and the nervous system can all be considered as part of a more individualized approach to mental health care.

We also talk about the stigma that still surrounds psychiatric medication, why it can seem like “everyone has ADHD” today, how our increasingly stimulating environment affects attention, and the strengths that can come with an ADHD brain.

Britt brings more than 18 years of healthcare experience spanning ICU and perioperative nursing, community mental health, hospital psychiatry, and academia. She earned both her MSN and Doctor of Nursing Practice from the University of Colorado and later served as an assistant professor. Through Mind Alchemy Mental Health, she now specializes in women’s mental health, including ADHD, anxiety, depression, burnout, and emotional exhaustion, combining psychiatric care with a holistic, mind-body approach.

ADHD in women and how it differs from men

Impact of hormonal changes and perimenopause on ADHD symptoms

The importance of proper diagnosis and testing methods

Medication and supplement options for ADHD

The role of genetic testing in personalized treatment

Holistic health strategies including labs and lifestyle adjustments

Stigma and misconceptions around psych medications