Hormonal transitions and perinatal presentations

Dr. Gogne discusses how hormonal changes across the perinatal period, menopause, and cancer care unmask or worsen executive dysfunction in women.

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Episode 203 with Dr. Anupriya Gonge.

“For mothers, the executive functioning demands keep shifting. Just as you find your rhythm, everything changes again.”

Dr. Anupriya Gogne is a board-certified addiction psychiatrist who specializes in women’s mental health, She is also the Division Director of Outpatient Psychiatry at Brown University Health in Rhode Island. Over the past eight years, she has worked closely with adult and perinatal women navigating a wide range of psychiatric challenges. After her own late-in-life ADHD diagnosis, Dr. Gogne began to reframe much of what she was seeing in her clinical work — particularly in high-achieving women who had spent years feeling overwhelmed, misunderstood, or misdiagnosed. This personal and professional insight led her to write the book “Neurodevelopmental Disorders in Adult Women: Special Considerations in the Perinatal Period,” which offers a clinical guide for trainees and practitioners and sheds light on the often-overlooked experiences of neurodivergent women and mothers.

We discuss how ADHD often presents differently in women, especially during the perinatal period, and how executive dysfunction can be mistaken for laziness, depression, or character flaws. Dr. Gogne shares her own experience of being a high-functioning but chronically exhausted student and professional, and how the diagnosis helped her understand her lifelong struggles with attention, restlessness, and self-criticism. We talk about the gendered ways society responds to executive dysfunction in mothers vs. fathers, the importance of strengths-based and trauma-informed care, and the intersection of ADHD with culture, trauma, and hormonal transitions. Dr. Gogne also shares how cultural norms in India shaped her ability to mask and compensate for her symptoms, and why she believes ADHD is not a disorder, but rather a state of nervous system dysregulation that deserves more compassionate and individualized treatment.

In this episode, we discuss: