Can a 34-year-old woman’s ADHD get worse after pregnancy?

Question

Hello doctor,

My 34-year-old wife was recently diagnosed with ADHD (attention deficit hyperactivity disorder) after our eight-year-old son was diagnosed, and she recognized that she has the same symptoms. The psychiatrist explained that women are often missed because they tend to internalize symptoms more than boys. She struggled with organization and focus, but assumed it was just part of her personality. Since having children, her ADHD symptoms have become much worse, and she is unable to keep up with household tasks or remember appointments.

She tried Adderall (Amphetamine and Dextroamphetamine) 20 mg daily, which improves her focus but makes her anxious and suppresses her appetite. She lost 15 pounds in two months, and her periods have become irregular.

The most challenging part for her is the constant guilt of not feeling like a good enough mother, when in reality, the ADHD is making everything more complicated. She also has postpartum depression, which may be linked to previously undiagnosed ADHD. She has tried therapy, but also needs medication that will not affect breastfeeding, as we have a 14-month-old baby.

Can ADHD symptoms worsen during pregnancy and the postpartum period?

We are also worried about the risk of passing ADHD to our children since it tends to run in families.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

First of all, your wife may consider taking Venlafaxine (Amphetamine and Dextroamphetamine) instead of Adderall, as Venlafaxine is an antidepressant that can also help with ADHD (attention deficit hyperactivity disorder) symptoms.

Second, hormonal changes during pregnancy can make ADHD symptoms more severe, so it is essential that she continues her medications under the guidance of a psychiatrist and follows up regularly with an obstetrician.

Third, medications like Venlafaxine can be found in breast milk. Therefore, she should consult a pediatrician to decide whether to continue breastfeeding, depending on any symptoms that may appear in the baby.

Fourth, many diseases, including ADHD, have genetic components, but the interaction between genes and the environment also plays a significant role in whether symptoms develop. To help reduce risks, children should avoid exposure to screens such as laptops and phones until age of four. At that age, they may be allowed a maximum of 30 minutes daily. Afterward, screen time can increase gradually by half an hour each year, so, for example, a five-year-old can spend up to one hour per day on screens. This helps in healthy brain development and may lower ADHD risk factors.

Finally, cognitive behavioral therapy (CBT) can benefit your wife by teaching her strategies to manage stress, improve focus, and regulate emotions.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.