When Hormones Hijack Your Brain
Suicidal Thoughts, Panic Attacks, and the Midlife Storm
I wish someone had told me years ago that suicidal thoughts in perimenopause are not a moral failing—they’re a neurological and hormonal crisis. That distinction could have saved me decades of shame.
The data are sobering: suicide rates for women peak in midlife, and the risk can be even greater for neurodivergent women because ADHD, autism, and OCD already carry higher baseline rates of self-harm and suicidal ideation (Chapman et al., 2025; Kooij et al., 2025). Add plunging estrogen, chaotic cortisol, and misfiring dopamine to an already sensitive nervous system, and the perfect storm is born.
For most of my 30s and 40s, I was prescribed antidepressants, antipsychotics, and sedatives for what doctors labeled “treatment-resistant depression.” No one asked about hormones. No one screened for ADHD or OCD. And yet, there were intervals where I thought about ending my life—not because I wanted to die, but because the idea of relief from the chaos in my brain felt like the only way out.
The scariest part was how foreign those thoughts felt. They weren’t mine. They showed up like uninvited guests, whispering about rest and relief in a way that terrified me. My ND brain—already wired for rumination and intrusive loops—couldn’t easily eject them. They stuck, replaying like a bad song you can’t turn off.
And then there were the panic attacks.
I’d never had one until my 30s, and when they came, they floored me. Shooting numbness down my left arm, skyrocketing blood pressure, hyperventilation that felt like suffocating—I was convinced I was having a heart attack. During my worst panic attack, I genuinely thought I was dying. And here’s the tragic twist: in that moment, part of me almost wanted to. The sheer exhaustion of living in a perpetual state of cortisol-driven fight-or-flight made death feel, for a flash, like relief.
That’s how panic attacks trick you: they’re not just physical, they’re existential. They can plant thoughts that don’t feel like yours, and they can make you question whether you’re safe inside your own mind.
Eventually, I learned the difference between panic attacks and meltdowns triggered by overstimulation. I learned grounding strategies, how to slow my breathing, how to remind myself that my heart wasn’t failing—it was my brain chemistry sending out false alarms. But I only learned that after years of dismissal and misdiagnosis.
Almost two years into proper ADHD and OCD treatment, combined with hormone replacement therapy for estrogen decline, I feel like myself again. The dark thoughts lost their grip once my brain chemistry found balance. That doesn’t mean the journey was easy. It was a gauntlet of trial-and-error, endless tweaking of medications, doses, and strategies. But it was worth it.
If you’re in that dark place, please know this: you are not crazy, not broken, and not beyond help. It’s not you—it’s your brain chemistry. And it can change.
What to Do If You’re in That Place
When suicidal thoughts or panic attacks crash into you, it can feel impossible to reach for help. Here’s a simple roadmap to start from:
Name it out loud. Tell yourself: This is a panic attack. This is my hormones. This is my brain chemistry misfiring—not a death sentence. Naming breaks the spell.
Ground your body. Try the 4-4-6 breath: inhale for 4, hold for 4, exhale for 6. Put your hands on something solid. Wiggle your toes. Remind your nervous system that you’re still here.
Call someone you trust. A friend, partner, or peer from your ND community. Say the words: “I’m not okay right now. Can you sit with me, even on the phone?”
Reach out for professional help.
In the U.S., dial 988 (Suicide & Crisis Lifeline).
In the U.K. & Ireland, call Samaritans at 116 123.
In Australia, call Lifeline on 13 11 14.
For other countries, check
https://findahelpline.com
Keep asking until someone listens. If one doctor dismisses you, get a second (or third) opinion. Self-advocacy can feel exhausting, but your life is worth the persistence.
Why We Need More Education
Emergency rooms are flooded with people who think they’re having heart attacks when they’re really having panic attacks. That’s not their fault—it’s a failure of education and awareness. Women, especially neurodivergent women, deserve better tools to distinguish between the two, and better access to providers who understand the overlap between ADHD, autism, OCD, and hormonal changes.
Because here’s the truth: antidepressants won’t help if the problem isn’t depression. No amount of “just think positive” will soothe an estrogen-starved, dopamine-craving, panic-prone nervous system. But with the right combination of medical care, community support, and self-advocacy, relief is possible.
Don’t let anyone dismiss your exhaustion. Fight for your sleep, fight for your peace, fight for your life—because it truly depends on it.
References
Chapman, S., Abrahams, R., Jackson, M., & Sumner, R. L. (2025). Examining the link between ADHD symptoms and menopausal experiences. Journal of Attention Disorders. Advance online publication. https://doi.org/10.1177/10870547251355006
Kooij, J. J. S., de Jong, M., Agnew-Blais, J., et al. (2025). Research advances and future directions in female ADHD: the lifelong interplay of hormonal fluctuations with mood, cognition, and disease. Frontiers in Global Women's Health, 6, 1613628. https://doi.org/10.3389/fgwh.2025.1613628
PS: Season 2 of the ADHD Peri Punks Podcast launched today. Episode 1 is out! “Grief, Rage & Radical Rest: ADHD, RSD & Burnout with ADHD AF Podcast Host and Activist, Laura Mears-Reynolds (Part 1)”