Part 4: Nervous System Regulation in Neurodivergent Menopause
Hello and welcome to Divergent Menopause, previously known as The Autistic Perimenopause: A Temporary Regression. I am Sam Galloway (she/her) and I am an AuDHD woman four weeks into surgical menopause (hysterectomy). If you are interested, there is more on why I needed the surgery here. Thanks for joining me on this wild midlife ride! 🎢Hi All, Welcome to the final video of the mini series with Amanda Hanna from SomaPsych. I hope you have enjoyed it! Please let me know in the comments whether you like this format, and what topics you would to see covered in future mini series. This episode requires a content warning for suicidal ideation and actions, panic attacks, mental health crises and feelings of hopelessness. So many helpful techniques offered, and I would love to know which, if any, you find most effective. Please let us know in the poll, and feel free to expand in the comments. In case you missed the previous videos, the first offers techniques to use in the margins of our day to regulate our nervous systems and feel rested. In the second video Amanda suggests how to stop anxiety spiralling at night and (hopefully!) get back to sleep. The third video covers how to manage chronic pain flares and reduce recovery times.Why do we need S.O.S. techniques for de-escalating sudden panic, suicidal ideation and feelings of hopelessness?In my experience of pre-menstrual dysphoric disorder (PMDD), pregnancies, postpartum, puberty and perimenopause (not listed here in chronological order), states of hormonal flux trigger extremes of mood and personal safety concerns.Now that I am in a state of surgical post-menopause by hysterectomy, and in the fresh absence of my ovaries, my hormone production has now flatlined. That was the intention of my highly medicalised menopausal treatment plan, in order to eliminate all risk to myself from my own hormonal fluctuations.Some people may have lovely menstrual cycles and manage their perimenopause with minimal medical interventions. I am genuinely happy for those people, and wish we could all be like that. But we can’t. Some of us experience sudden moods that are so inextricably linked to our extreme hormonal highs and lows, that we cannot understand why we think we would be better off dead before we have had time to challenge that thought. For autistic women, our suicide risk is 13 times higher than that of neurotypicals during midlife. 1 in 4 ADHD women have attempted suicide. Perhaps, like me, you are an AuDHDer. I don’t have the stats on us, but I expect they are bleak. I don't tell you those statistics to shock or frighten you. My intention is to make you aware that you may be at increased risk, but that you have the ability to mitigate that risk by being aware of your emotional states throughout times of hormonal flux. We can be extremely impulsive, which may have been great when we were younger, but we have so much more at stake in midlife. If your highly sensitive brain tricks you into thinking your rage is shameful and your family would be better off without you, please know that that is a common thought. We just don't live in a society where it is acceptable to share these thoughts with someone else. I get DMs from people frequently who are feeling this way.Our thoughts are not facts, they can’t objectively dictate to us. Thoughts come, and then they go, and new ones take their place. Please share with others if you are experiencing thoughts of suicide, self-harm or causing harm to others. Ruminating on these thoughts isn’t unusual, and just because certain thoughts persist and/or recur doesn’t make them any more substantial or credible. You matter to me, to this community and to all the people who love you. Sometimes it doesn't feel like this, I know. During perimenopause I too experienced intrusive thoughts that put my family and I at risk. Thoughts that I should stop my car on the train tracks and wait for a freight train to stop my pain and functioning regressions. My kids were in the back of the car! And it was a recurrent thought.Often I wasn’t even experiencing suicidal ideation until I reached a railway crossing, and that would trigger the thought. I would hum, stim, flap all whilst driving; trying to hush and force away the thought, consciously accelerating across the tracks and willing myself to stay in motion on the road. It took all of my limited energy to just get my kids and I home safely, at which point I would need to crash (excuse the pun) out on the sofa. Often autistic inertia followed. It would take me 24 hours to process the thoughts, which had come and gone in the fraction of a second, and to tell my husband and/or my doctor what had happened. I don't wish that pain on you. It can be common in neurodivergent menopause, but please, let’s not normalise it. It is a signal that you need more support, more rest, more mental health interventions - and those aren’t bad things. As late diagnosed neurodivergent, we have stuffed down our feelings for decades. This is the time to unmask, to reach out, to prioritise yourself. For me, this looked like surgical intervention to stop the problem at its root cause - by cutting out my ovaries the surgeons have stopped my hormonal flux. Yes, it is drastic, but not as drastic as the potential headline “Local woman, 44, and two sons killed on impact by freight train”. Please, take your thoughts to someone else if and when they are bothering you. I am not saying a hysterectomy is the answer for you, but I know for sure that suicide definitely isn’t. Please don't underestimate the power of a safety plan! Contrary to popular belief, talking about suicide does not lead to suicide. If you are experiencing suicidal ideation, self-injurious thoughts or behaviours, and/or fear for your own or someone else’s safety, please tell someone you trust. Although overwhelmingly intense, these feelings do pass. Get help now to protect your future self. Zoom AI has provided the following summary of the conversation:SummaryManaging Panic and Suicidal IdeationSam and Amanda discussed techniques for managing panic, anxiety, and suicidal ideation, particularly in the context of neurodivergence and hormonal fluctuations. Amanda emphasized the importance of recognising patterns and creating a "rescue kit" with soothing objects and practical items like water and medication to help manage overwhelming moments. They also highlighted the need to remember that these experiences are temporary and to practice self-compassion during difficult times.Safety Planning for Panic ManagementAmanda and Sam discussed strategies for managing panic attacks and creating safety plans. Amanda shared her methods of using post-it notes and voice recordings as reminders during overwhelming moments. Sam mentioned a video she created on writing autism-adapted suicide safety plans, emphasising the importance of considering professionals' availability and boundaries. They both stressed the value of evolving safety plans and having prearranged signals with supportive contacts for distraction or reassurance.Mindfulness Tools for OverwhelmAmanda discussed the challenges of managing overwhelming situations without proper safety resources, explaining how the brain can become hyper vigilant or fixated on past or future concerns. She described various personal tools people use to ground themselves in the present moment, such as physical sensations or specific activities, and emphasised that finding an effective tool requires personal discovery. Amanda concluded that these tools serve as circuit breakers to help individuals regain focus and presence.Neurodivergent Emotional Management StrategiesAmanda and Sam discussed strategies for managing intense emotional states, particularly focusing on post-panic attacks and suicidal ideation. Sam shared her experience of having suicidal thoughts while driving, particularly during hormonal fluctuations, and emphasised the importance of having a plan for dealing with such moments. They agreed that it's crucial to recognise these feelings as part of their neurodivergent experiences and to consider the impact on loved ones, rather than acting impulsively. Amanda highlighted the need for more open conversations about these experiences, especially in neurodivergent and hormonal contexts.Emotional Regulation Techniques DiscussionAmanda and Sam discussed tools for managing discomfort and panic attacks, with Amanda introducing "riding the wave" as a technique for observing and navigating emotional states without immediate action. Sam shared personal experiences with ADHD and autism, highlighting how pattern recognition can both help and hinder understanding of emotional responses. They agreed that building nervous system regulation capacity through regular practice, even when feeling well, is crucial for better managing challenging moments.* Toolkit: Warning Signs of Suicide for Autistic People: An autism-specific resource based on research findings and expert consensusPlease take good care of yourself. Cheers, If you find my work valuable, why not become a paid subscriber to The Autistic Perimenopause: A Temporary Regression? (This is not a rhetorical question.) Get full access to Divergent Menopause at samgallowayaudhd.substack.com/subscribe
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