How my period is supercharging my ADHD

Phone alarms are what get teaching assistant Layla through her day. She has four alarms to wake up, one to get dressed, another to pack her work bag, and so on.

"There's a million different ones. Different times of the day," says the 30-year-old as she scrolls through the alerts on her phone.

"It feels like overkill to a lot of people, but I have these markers that I need to hit," says Layla, adding that the process helps keep her ADHD brain focused and establish a routine.

But that sense of control evaporates as soon as Layla's period nears - the peak of her menstrual cycle.

"It's like you're clinging on, for dear life, onto the ball that is continuing to roll, and sort of cursing yourself and the world the entire time."

ADHD is a condition where the brain works differently to a lot of people including difficulties with things like concentrating, regulating emotions and sitting still, according to the NHS.

Conversations are rife on social media and chat forums about women's menstrual cycles exacerbating their ADHD symptoms.

A first of its kind study by Kings College and Queen Mary University in London is putting that link to the test, by asking 50 women who have ADHD and are taking medication for it, to track their menstrual cycle and the impact it has on their ADHD symptoms, and daily life more broadly.

Roughly 2.5m people in the UK are thought to have ADHD. Hundreds of thousands of those are waiting for an NHS diagnosis.

Social media as well as greater awareness of ADHD - in particular how women live with it - have led to an unprecedented surge in demand for ADHD assessments.

NHS figures from December last year show a 23% increase in stimulants and drugs prescribed for ADHD, compared to the previous year.

But a government taskforce report in November last year found ADHD was still being under-diagnosed and under-treated. The BBC revealed some areas of England are now shutting their NHS waiting lists because they cannot cope with demand.

Nineteen-year-old Héloïse is studying for three university degrees.

She calls ritalin - the medication she takes for her ADHD - a lifeline which gives her a three-hour window of focus to study. Héloïse takes the pill, sits in the library and waits for it to kick in.

But during her period, she just "waits and waits" for a reaction that never comes. "It feels like losing a walking stick or something you use to support yourself. All of a sudden it's broken," she says.

It was not until she mapped her symptoms for the Kings College study that she saw the pattern between hormonal changes and her ADHD symptoms.

Other women taking part in the research used similar language, with some saying they felt "disabled" by their symptoms at certain times of the month.

The women participating in the project have kept an electronic diary of their hormones and the severity of their ADHD symptoms, including anxiety, depression and impulsive behaviour.

The researchers, plotting their cycle alongside how they feel, are investigating whether there's a pattern both in their symptoms and in how effective their medication is at helping manage them.

Psychiatrist Sally Cubbin, a neurodiversity specialist who worked on the Kings College study, believes hormones and ADHD are inextricably linked - and hopes this trial will reflect that.

She describes how, at times in a woman's cycle, like just before a period when the hormone oestrogen is low, it affects the dopamine, our body's 'feel-good' hormone, making ADHD symptoms much stronger.

Those monthly dips in oestrogen do not just negatively affect the ability to focus and manage tasks, Dr Cubbin says.

"Women are also more likely to make dodgy decisions and take risks" which can include binge eating, spending money, "even not taking contraception".

For Layla, those impulsive decisions are all too familiar. She says she struggles with overeating and cravings during her period.

For example, "I love pickles. I know that if I eat too many pickles I'm gonna feel ill." She says it is not because she's hungry; but "it's this impulse to do it and then once it's in your head it's really difficult to shut it down or turn it off."

'Validating and freeing'

Lead academic on the Kings College project Dr Jessica Agnew-Blais says ADHD in women - especially adults - is an important new area of research. Until the late 90s it was seen as a condition that only affected children, and then mainly boys.

"We're seeing increasing numbers of women," says Dr Catherine Durkin of the Royal College of Psychiatrists. "Thanks to increasing awareness of how ADHD symptoms can present in women, more are recognising where they have struggled throughout their lives and are now asking for help."