The Unseen Storm
- Amelia Loveland
- Sep 22, 2025
- 5 min read
Updated: Dec 16, 2025
Why Perimenopause and Late-Diagnosed AuDHD Lead to Burnout in Women
(The Abridged Version)
Perimenopause poses significant challenges for many women. For those who receive late diagnoses of both autism and ADHD (AuDHD), the transition can provoke a distinct form of burnout. This occurs as hormonal changes disrupt lifelong coping strategies, resulting in not only physical symptoms but also profound exhaustion and identity loss.
The convergence of perimenopause and unrecognised neurodivergence creates a perfect storm for burnout that is often overlooked.
The Hidden Neurotype
AuDHD women are often undiagnosed because the diagnostic criteria for autism and ADHD were historically based on male presentations (Bargiela, 2015; Craddock, 2024; Fusar-Poli et al., 2022). Consequently, many of these women develop a coping mechanism called "masking" (Bach & Vestergaard, 2023). Masking involves suppressing their authentic behaviour, often subconsciously, to blend in. This constant suppression depletes emotional and physical resources, frequently leading to burnout (Alaghband-Rad et al., 2023; Arnold et al., 2023).
Detecting these conditions is especially difficult because signs of AuDHD in women are often internalised: rather than disruptive behaviour, women tend to struggle with organisation, time management, and social exhaustion (Pyszkowska, 2025; Seers & Hogg, 2023). Misdiagnosis is common; women are frequently mislabelled as anxious, depressed, or lazy (Ross et al., 2023). This mislabelling leads to years of self-doubt and fatigue as they try to cope like their neurotypical peers.
Burnout: More Than Stress
Neurodivergent burnout presents differently from typical work-related burnout. Rather than arising solely from overwork, it results from the chronic emotional toll of masking and unmet needs, both intensified in perimenopause (Higgins et al., 2021; Raymaker et al., 2020).
As oestrogen declines and neurotransmitter function further deteriorates, especially for women with ADHD, symptoms such as mental fog and emotional swings worsen (Grummisch et al., 2023; Kooij et al., 2025; Shanmugan & Epperson, 2014).
This convergence makes it nearly impossible to sustain old coping mechanisms.
Common signs of neurodivergent burnout include lower sensory tolerance, social withdrawal, increased anxiety, and disconnection from self and surroundings (Arnold et al., 2023; Raymaker et al., 2020). Some women even lose skills they had previously acquired, turning everyday tasks into major hurdles.
A Crisis—But Also an Opportunity
For many women, perimenopause marks the breaking point where accumulated pressures become overwhelming. Yet this crisis also crystallises why late-diagnosed AuDHD and hormonal changes so often result in burnout. Identifying the core issue transforms collapse into an opportunity for self-understanding and targeted recovery.
Strategies for Recovery
Recovery from neurodivergent burnout benefits from a holistic approach. Hormone Replacement Therapy (HRT) can stabilise symptoms, and ADHD medicines may help—even for those undiagnosed (Hampson, 2018; Kooij et al., 2025).
Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT) support emotional regulation and lessen the burden of masking (Quinn, 2014).
In addition to medical and therapeutic interventions, lifestyle changes are essential. Sleep hygiene, a balanced diet, hydration, and regular exercise support brain health and emotional well-being (Brinton, 2009; Maki & Henderson, 2012).
Building a supportive community—through peers who understand AuDHD and perimenopause or neuro-affirming professionals—can reduce isolation and foster belonging (Millenet et al., 2018).
Crucially, recovery requires acceptance: letting go of masking, setting boundaries, and building environments that support neurodivergent needs.
The goal is to live authentically—not just survive, but thrive.
Linked Posts
References
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