In short

Feeling overwhelmed all the time in perimenopause isn’t a personal failing. As progesterone and oestrogen change, your brain temporarily loses some of its natural calming and focus support, so the same mental load feels heavier. Working on what’s blocking your body from adapting to these hormone changes can restore your capacity, says Sarah McLachlan, The Perimenopause Naturopath (BHSc Naturopathy), Australia.

In this post:

• Why your mental load feels heavier, even though you’re just as capable as ever
• The physical drivers behind wired-but-tired overwhelm
• What your hormones and neurotransmitters have to do with it (progesterone, GABA, serotonin and dopamine)
• Perimenopause, ADHD or both? An honest look from an AuDHD naturopath
• What actually helps, starting today

Have you noticed that overwhelmed is your default setting these days? While we can’t escape stress completely, being overwhelmed all the time is a sign that something needs attention.

And I want to say this upfront: it’s not because you’ve gone soft, lost your edge or aren’t as good as other women. There are real, physical reasons behind it. Let’s look at what they are and how you can turn it around.

Why do I feel overwhelmed all the time?

First up, let’s get honest about how much you actually handle on a daily basis. Hands up if you’re dealing with:

• One or more kids (and all that brings, from homework and hobbies to school dramas)
• Paid work (I bet you have more responsibility than ever, sound about right?)
• Ageing parents
• Running the household (unpaid work!)
• Keeping up a social life
• Worrying about the environment, the news cycle, the state of the world (need I go on?)

You might not tick every box, but you have a lot of mental tabs open at any one time, especially since we’ve been raised in an era when hyperindependence is valued. It’s no wonder we have an epidemic of wired but tired women in their 40s.

And believe it or not, that’s only the tip of the iceberg.

What’s physically driving the overwhelm?

No, that stress and inability to cope with life are not all in your head. There are legitimate physical reasons why you get so overwhelmed, and they come back to us having primal bodies and brains in a modern world that runs 24/7.

You know how you kind of feel fine, you’re active, doing things, chugging along, but at the same time you’re physically and mentally exhausted? Every day you wake up weary to the bones and it feels like you’re wading through knee-high mud.

This is what’s known as wired-but-tired, or if you prefer the science-y term, hyper-arousal. In this state you’ll experience:

• Changes to your brain waves that make it harder for your mind to shut down and rest
• A rapid heart rate
• Disrupted circadian rhythms
• Sleep issues, including waking overnight, being unable to fall asleep, sleeping lightly and waking ridiculously early

You might find you need coffee to kickstart you in the morning and a glass of wine at night to switch your brain down a notch. I hate to be the bearer of bad news, but the wine effect is only temporary, and it actually adds to the disrupted sleep.

The added factors stacking the deck

• Being undernourished (not eating enough, particularly if you’ve been dieting or having coffee as your breakfast of choice)
• Low nutrient levels (most packaged foods offer energy but little nutritional value, and the nutrients your stress response burns through, like magnesium, B vitamins and zinc, run down fastest)
• Falling progesterone due to perimenopause (there goes your built-in stress resilience)

Combined, these mean you don’t get enough restful sleep, you’re more likely to make food choices that further deplete you, and you’re stuck on a merry-go-round of symptoms that feed each other.

What do your hormones have to do with it?

Here’s what’s actually happening, because this is the piece most women have never been told.

Progesterone is your calm hormone. Your body converts it into allopregnanolone, which works on the same calming brain (GABA) receptors as anti-anxiety medications. Research in reproductive psychiatry links changes in this system to the anxiety and mood shifts of the menopause transition. So when progesterone production becomes patchy in perimenopause, which it does before anything shows up as “abnormal” on a blood test, your built-in calming system is quieter than it used to be. Same life, less resilience and capacity. If that pattern sounds familiar, I go deeper on low progesterone and anxiety in its own post.

Oestrogen, meanwhile, supports dopamine and serotonin, the brain chemicals behind focus, motivation, working memory and mood. In perimenopause oestrogen doesn’t just decline, it roller coasters on its way out. Which is why your concentration, your recall and your ability to juggle can feel brilliant one day and gone the next.

Now, the old advice here was to “balance your hormones.” I’ve stopped using that framing, because it sets you up to chase a fix that doesn’t exist. It’s like searching for the pot of gold at the end of the rainbow. Perimenopause hormones are meant to be changing. You can’t hold them still, and you don’t need to.

What you can do is work on what’s blocking your body from adapting to the change: the under-eating, the blood sugar rollercoaster, the nutrient gaps, the sleep debt and the relentless stress load that leave your body and brain without the resources they need to adjust. When you clear those blockers, your experience of this phase changes. That’s the work I do with clients, and it’s why two women with identical hormone results can feel completely different.

Is it perimenopause, ADHD or both?

Something I’m seeing more and more, in clinic and in the research: women in their 40s who feel like they can no longer hold it together the way they used to, and start wondering whether they’re neurodivergent.

I want to tread carefully and honestly here, because I sit on both sides of this one. I’m an AuDHD woman myself, diagnosed before perimenopause arrived.

For some women, the wondering is right. Many neurodivergent women spend decades masking, running elaborate systems of lists, effort and sheer will to appear on top of things. That masking is energetically expensive, and it runs on the very brain chemistry perimenopause disrupts. When oestrogen and progesterone shift, the scaffolding wobbles, and what was always underneath becomes visible. Research backs this up: a 2025 population study of more than 5,000 women found severe perimenopausal symptoms in 54.2% of women with ADHD, compared with 30.1% of women without (Jakobsdóttir Smári et al., European Psychiatry, 2025).

Women with ADHD also report symptoms earlier. And here in Australia, adult ADHD medicine use has risen more than six-fold since 2016-17, with women now more likely than men to be prescribed (UNSW Medicines Intelligence, 2026). Midlife women aren’t imagining this. Late recognition is real, and if that’s your story, it deserves proper assessment and support, not eye-rolling and dismissal.

But I’ll be equally honest about the other side, because I see it just as often. Perimenopause itself produces ADHD-like changes: scattered focus, word-finding failures, walking into rooms with no idea why, zero tolerance for noise and demands. For many women this is the hormone transition talking, not a lifelong neurotype. The clue is often in your history. If your brain worked in a neurotypical way for 40 years and only started misfiring alongside other perimenopause signs, there’s a good chance this is your body struggling to adapt to the hormone changes, and with the right support it settles as you move through the transition.

Worth exploring as possible ADHD or autism	More likely the perimenopause transition
The struggles are lifelong, you’ve just hidden them well (school reports, decades of coping systems, always feeling “different”)	Your brain and capacity worked in a fairly typical way until your 40s
Exhaustion after socialising, sensory overwhelm and masking have been lifelong patterns	Overwhelm arrived alongside cycle changes, night waking, heavier or irregular periods
A formal assessment has been on your mind for years	Symptoms swing week to week with your cycle rather than being constant
Family members are diagnosed	Symptoms improve when sleep, blood sugar and stress load improve

Either way, and this matters to me: the struggle is real. Whether you’re AuDHD, ADHD, autistic, or a woman whose brain is being rattled by perimenopause, you’re not lazy and you’re not losing it. You don’t have to prove a diagnosis to deserve support. And these paths aren’t mutually exclusive, plenty of women are both. If a formal assessment would bring you clarity, pursue it. Supporting your body through perimenopause and understanding your neurotype aren’t competing projects, they help each other.

“I’m AuDHD myself, diagnosed before perimenopause arrived. So when a woman tells me she can’t hold the threads together any more, I believe and understand her. Whether it’s ADHD, autism, perimenopause or all three at once, the struggle is real, and it deserves support, not a lecture about time management.”

Sarah McLachlan, The Perimenopause Naturopath (BHSc Naturopathy), Australia

How to feel calm and in control again

So you want to stop feeling overwhelmed all the time and get some capacity back. Here are the tips I give my clients:

Add more restfulness to your day

For some women this means getting more sleep. But it can also be a few moments of calm wherever they fit, like 5-10 minutes in the morning to sip your coffee in the fresh air before the day starts. Give your nervous system a chance to come off high alert.

Say no

We can’t say no to everything. But I bet you’re saying yes to plenty of things you don’t need to, and all it’s doing is draining you. The world will not fall apart if you’re not the one who helps with every issue and event that pops up.

Outsource, or reset your standards

This depends on your support system and finances, but in most cases we either need someone else to do some tasks, or we need to get more realistic about them. The obvious example is the housework. You can outsource to your partner, your kids or a paid cleaner, or you can accept the house won’t get vacuumed every single week and dusty skirting boards are not a sign of failure. It doesn’t have to cost money either: alternating school-run carpooling with another local mum buys you two mornings a week.

Reduce caffeine, sugar and alcohol

Sorry, not sorry: when you’re already overwhelmed, these add to the load on your nervous system and liver. I’m not saying give up coffee or wine completely. I’m saying notice when they’re propping up a system that actually needs rest and refuelling.

Correct any nutrient deficiencies

Running low on nutrients puts extra stress on your body. And when the nutrients in question power your stress response and nervous system (iron, magnesium, B vitamins, zinc and friends), it’s a double whammy. This is worth testing rather than guessing. Real data beats another random supplement.

Work on what’s blocking your body from adapting

This is the step that replaces hormone-balancing wishful thinking. Your body is designed to adapt to the hormone changes of perimenopause, but it can’t do it while it’s undernourished, under-slept, riding blood sugar swings and marinating in stress hormones. Steady meals with enough protein, stable blood sugar, genuine rest and a lighter stress load give your body and brain the resources to adjust. That’s when the overwhelm starts to lift, not because your hormones went back to “normal”, but because your body stopped fighting the transition with an empty tank.

But what if you don’t even know where to start?

I get it. If you’re feeling overwhelmed all the time, the last thing you need is more to-dos on your list.

That’s exactly what a free Clarity Call is for. It’s a relaxed conversation, where we look at what’s really behind your symptoms, where to look for answers, and whether I’m the right person to guide you through that. You’ll leave clearer and more confident about your next step, even if that step isn’t working with me.