Navigating ADHD During Pregnancy
By Brooke Whitfield-Fattovich, MS, LMHC, NCC
ADHD & Pregnancy
As someone who was diagnosed with ADHD later in life, I did not receive the early interventions or learn the skills that others do who are diagnosed and treated earlier. Therefore, I struggled with memory, focus, task completion, impulsivity, and fleeting thoughts. As an adult, I began to learn about ADHD and how to manage my symptoms without the use of medication. I thought I had it all under control… until I became pregnant.
Pregnancy presented a new layer of complexity, and the hormones threw me for a loop. My usual routines seemed to fall apart, and I was beginning to forget doctor’s appointments. Sleep became an issue, and waking up in the morning was challenging. My brain was already struggling with ADHD, and combined with pregnancy, I was navigating a whole new territory. I had to take extra time with my planning and make a conscious effort every day to follow my plan. As a mother, PhD student, and full-time clinical supervisor in the mental health field, all while undergoing IVF, I could not afford to fall into disorganization and chaos. Due to my own journey, I chose to specialize in women’s infertility, pregnancy, and postpartum. ADHD is a unique layer to add to my personal pregnancy experience, and therefore, I thought it would be helpful to write an article specifically addressing ADHD and pregnancy — and the challenges it brings.
Pregnancy and ADHD Medication
Attention Deficit Hyperactivity Disorder (ADHD) is categorized as a neurodevelopmental disorder, with symptoms including inattention, forgetfulness, distractibility, disorganization, impulsivity, and hyperactivity (Freeman, 2014). Experiencing these challenges can interfere with daily life, functioning, and responsibilities. While ADHD medication helps with managing these symptoms, this poses a concern for pregnant women. Although there is no significant research indicating that ADHD medication is harmful, there is also no data to state that it is not (Silver, 2024). There is no ethical way to conduct such research on pregnant women and babies, and therefore, doctors advise pregnant women to forego their ADHD medication during pregnancy and breastfeeding (Silver, 2024). Navigating pregnancy with ADHD can create unique challenges; however, with the proper support and strategies, there are effective ways to manage it.
Mental, Emotional, and Physical Changes
Pregnancy alone brings a slew of mental, emotional, and physical changes. For example, it is common for neurotypical pregnant women to report impaired memory in comparison to their pre-pregnancy functioning (Freeman, 2014). Individuals with ADHD already contend with poor memory and rely heavily on their medication for daily functioning. Pregnant individuals then may find it particularly challenging to manage increased memory impairment while simultaneously adjusting to the absence of their regular medication. Additionally, fluctuating hormones have been shown to influence the variability of ADHD symptoms (Healthline, 2023). Therefore, preparing pregnant women with ADHD for their prenatal and mental health journey is crucial for ensuring a healthy pregnancy and maternal well-being.
Preparation
ADHD and pregnancy place a heavy demand on women physically, mentally, and emotionally. To reduce the load, women must have the information and opportunity to prepare effectively for this experience. According to the American Journal of Obstetrics and Gynecology, the most critical areas to address for managing and minimizing ADHD symptoms, alongside pregnancy symptoms, are daily planning, routine, self-care, emotional regulation practices, medication management, and securing a support system (Scoten, Katarina, Paquette, Carrion, Deirdre, 2024).
Pregnancy introduces additional responsibilities, including doctor appointments, preparing the baby’s room and necessities, planning for maternity leave, and arranging postpartum support. Allocating time to plan for the upcoming week can alleviate the anxiety associated with new and existing tasks. Establishing a routine, creating lists, and setting phone reminders are effective strategies to ease the burden on individuals with ADHD.
Emotional Regulation
Next is emotional regulation and recognizing how this skill is more critical now than ever. The influx of hormones that accompanies pregnancy also causes fluctuations in ADHD symptoms (Healthline, 2023). Understanding how to soothe and prevent dysregulation during this time will support the ADHD brain in directing energy toward effective functioning while under a new version of stress (Scoten, Katarina, Paquette, Carrion, Deirdre, 2024). The ability to emotionally regulate also increases overall well-being and decreases symptoms of anxiety and depression (Scoten, Katarina, Paquette, Carrion, Deirdre, 2024). Evidence-based techniques such as mindfulness, meditation, and deep breathing can be performed anywhere and anytime. These techniques have proven effective in managing dysregulation and regulating emotions overall.
Self-Care
Self-care is essential for everyone, whether neurotypical, neurodiverse, pregnant, or not pregnant. However, when facing challenges and demanding more of ourselves, self-care becomes even more critical. Engaging in activities that provide a sense of nurturing is imperative to best support our mental, physical, and emotional health. Incorporating self-care into your weekly plan relieves us of the new task burden and becomes more of a routine activity than an additional chore. Activities can range from picking up your favorite smoothie or dessert, chatting with a friend, going for a walk, or treating yourself to a facial, just to name a few. Take some time to think about the different things you enjoy and how you can work them into your schedule and routines. This may become more challenging once your baby arrives, but then it will be time to think of new ways to engage in self-care activities.
Support Systems
Lastly, surround yourself with support during this exciting time. Support could mean friends and family, support groups, or a therapist. Having a space to share your experience, voice concerns, and connect with others on the same journey will help alleviate the sense of aloneness, lower stress and anxiety, and increase overall well-being. Although navigating pregnancy with ADHD presents unique challenges, support and strategies can help women feel better prepared.
Different Brains will be presenting a FREE live virtual webinar about ADHD & Pregnancy on Wednesday, July 10th at 7:00pm ET. To learn more and register, click here.
References
Freeman, M. P. (2014). ADHD and pregnancy. American Journal of Psychiatry, 171(7), 723-728. doi:10.1176/appi.ajp.2013.13050680. Accessed 18, June 2024.
Healthline. (2023, July). What to Know About ADHD During or After Pregnancy. https://www.healthline.com/health/pregnancy/adhd-after-pregnancy
Scoten, O., Katarina, T. A. B. I., Paquette, V., Carrion, P., Deirdre, R. Y. A. N., Radonjic, N. V., … & Hippman, C. (2024). Attention-Deficit/Hyperactivity Disorder in pregnancy
and the postpartum period. American Journal of Obstetrics and Gynecology.
Doi:10.1016/j.ajog.2024.02.297. Accessed 19, June 2024.
Silver, L. (2024, April 22). Are ADHD Medications Safe to Take While Pregnant or Nursing? ADDitude. additudemag.com/how-safe-are-adhd-medications-while-pregant-or-nursing.
Brooke Whitfield-Fattovich, MS, LMHC, NCC was born in Newcastle Upon Tyne, England, and moved to Florida at age 8. She graduated from Florida Atlantic University with a bachelor’s degree in Psychology and began her career in the addiction and recovery field in 2013. Brooke later earned a master’s degree in Mental Health Counseling and is currently pursuing a PhD in Counselor Education, focusing on marriage, couples, and family therapy. Working in private practice, Brooke specializes in women’s infertility, pregnancy, and postpartum issues, drawing from her personal experience with secondary infertility. Her dedication to helping others is reflected in her compassionate and holistic approach to therapy.
