Misdiagnosis: Anxiety and Bipolar vs ADHD

Hey Team!

This week I’m talking with Kara Cruz, a licensed marriage and family therapist and Certified Perinatal Mental Health Professional with over 15 years of experience supporting women through life transitions. Kara’s work focuses on the intersection of ADHD and reproductive mental health—helping women navigate the complex terrain of hormones, identity, and self-trust.

In our conversation, Kara and I dig into how ADHD symptoms can change and intensify across different hormonal stages - puberty, pregnancy, postpartum, and perimenopause - and what that means for real-life functioning. We also get into how ADHD in women often goes undiagnosed or misdiagnosed as anxiety or bipolar disorder, and how learning to track your cycle, protect your energy, and build realistic routines can make a world of difference in your adhd management.

And I want to emphasize that even if you don’t have a cycle there is still a lot to get out of this episode, when I was working on the top tips for this episode I had to cut a few because there was just so much good stuff. I had a great time talking with Kara and learned a ton, I think you’ll love this episode too.

If you'd life to follow along on the show notes page you can find that at HackingYourADHD.com/249

YouTube: https://tinyurl.com/y835cnrk

Patreon: https://www.patreon.com/HackingYourADHD

This Episode's Top Tips

1. 1. ADHD symptoms don’t exist in a vacuum and hormones can crank them up or turn them down. And this can be greatly impacted depending on your stage of life or if you have a cycle, and then where you are in that cycle.
   2. Burnout is often a side effect of saying “yes” too many times when your brain and body are already maxed out. Protecting your energy starts with noticing when your capacity dips and giving yourself permission to scale back. It’s important to create these boundaries so that you are protecting the version of you that you that you still want to be at the end of the week.
   3. A big takeaway from Kara’s work is that your body will tell you what’s up, tight shoulders, clenched jaw, fatigue, restlessness are all early warnings that your system’s running on fumes. Building quick body check-ins into your day can help you catch burnout at a “three” instead of waiting for it to hit “ten.”
   4. Managing ADHD isn’t only about planners and meds; it’s also about repairing your relationship with yourself and the shame that has built up from ADHD struggles. That means recognizing how years of undiagnosed or misunderstood ADHD may have shaped your self-esteem through shame and self-blame and learning to separate your symptoms from your worth.
   5. And with that last tip, I just want to remind everyone, yes, you are enough.