The Overlooked Diagnosis: ADHD in Women, Perimenopause, and Mental Health

Description

ADHD doesn’t fade with age—it evolves. For many women, midlife brings a sudden storm of forgetfulness, emotional swings, and overwhelm that doesn’t quite fit the familiar categories of depression, anxiety, or burnout. What’s often really happening is a hidden convergence of ADHD and perimenopause—an overlooked diagnostic intersection where hormonal shifts amplify executive dysfunction and emotional dysregulation. This course invites clinicians to re-examine their diagnostic lens and learn to identify what’s been missed for decades: how ADHD manifests, masks, and morphs in women navigating midlife transitions.

As estrogen and progesterone fluctuate, the brain’s regulatory systems change. Clients who once coped through structure and sheer determination find their old strategies collapsing—stimulant medications suddenly feel less effective, the late-luteal week becomes a predictable crisis point, and emotional reactivity intensifies. Meanwhile, cultural scripts around competence and caregiving pressure women to mask harder, leading to shame, self-blame, and a painful sense of “I should be managing this.” This training names those patterns and translates emerging neurobiological and clinical insights into clear, compassionate frameworks for assessment and care.

Melanie Smith, PhD, LMHC, CEDS-S, brings extensive experience as a psychotherapist, national trainer, and co-author of The Renfrew Unified Treatment for Eating Disorders and Comorbidity. As Director of Training at The Renfrew Center, she merges scientific precision with deep empathy—offering clinicians language, structure, and tools that honor both biology and lived experience.

Dr. Smith delivers this as a clinic-first seminar: brief myth-busting to surface why women’s ADHD is missed; a cycle-aware model you can map with clients; and short lecture segments interwoven with case vignettes, guided reflection prompts, and “language labs” that reshape scripts for assessment and psychoeducation. You’ll see decision trees for differential diagnosis, documentation cues, and collaboration frameworks for prescribers. The tone is neurodiversity-affirming, precise, and practical—aimed at tools you can use in session the same day.

You’ll learn how estrogen and progesterone fluctuations alter attention, working memory, emotion regulation, and medication response—why stimulants may seem to “stop working,” why late-luteal weeks reliably worsen symptoms, and how cycle-aware history-taking prevents misdiagnosis with mood and anxiety disorders. Dr. Smith surfaces lived realities—masking, overcompensation, rejection-sensitive dysphoria (RSD), and the cost of being “high-performing yet misunderstood”—and translates them into concrete steps for differential diagnosis in perimenopause, targeted psychoeducation, psychotherapy strategies, and effective prescriber collaboration.

Key Takeaways:

• Identify ADHD in women during perimenopause with clarity and cultural sensitivity.

• Distinguish hormonal effects from mood and anxiety disorders for accurate diagnosis.

• Apply cycle-aware, evidence-based interventions to improve functioning and self-understanding.

Why this course?

• Brings visibility to one of the most underrecognized presentations in adult mental health.

• Prevents costly misdiagnosis by integrating hormonal, neurological, and psychosocial data.

• Equips clinicians with language, tools, and case strategies ready for immediate clinical use.

Learning Objectives:

By the end of this training, participants will be able to:

• Identify at least three ways ADHD symptoms present differently in women compared to men, particularly during perimenopause.

• Differentiate between ADHD, mood disorders, and anxiety disorders in midlife women, accounting for hormonal influences across the lifespan and cycle.

• Apply evidence-based strategies for assessment, psychoeducation, and treatment planning that address the intersection of ADHD, perimenopause, and mental health.

When midlife symptoms overlap and old explanations stop fitting, clinical clarity becomes an act of care. This course gives you the insight and structure to reframe clients’ experiences, document them accurately, and plan treatment that restores confidence and self-trust.

Enroll today to strengthen your diagnostic accuracy, deepen your empathy, and help midlife women finally see their symptoms—and themselves—clearly.

Format and Access

This is a non-interactive, self-study course; over three hours of video instruction and a post-test.

Course Details

Availability: 

From the time of registration, you have six months to access the coursework.

Who Should Attend: 

This course is intended for clinicians who provide behavioral health services.

Teaching Methods: 

This is a non-interactive, self-study course. Teaching methods for this course include recorded lectures, videos, a post-test, and a course evaluation.

How to Attend: 

Course access and completion instructions.

Instructor and Disclosures

Instructor

About Melanie Smith, PhD, LMHC, CEDS-C

Melanie Smith (she/her) is a therapist in private practice at CBT of Central & South Florida (https://cbtcentralflorida.com) and a Consulting Clinical Training Specialist for the Renfrew Center. She is a Licensed Mental Health Counselor and Qualified Supervisor in the State of Florida. Additionally, she is a Certified Eating Disorders Specialist and Approved Consultant (CEDS-C) and is a Certified Therapist & Trainer of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP). Special treatment interests include Avoidant Restrictive Food Intake Disorder (ARFID), Disorders of Gut-Brain Interaction such as Rumination Syndrome, OCD, phobias including emetophobia, health-related anxiety, and coping with chronic pain & chronic illness.

Dr. Smith is passionate about the dissemination and implementation of evidence-based treatments, clinical supervision, and clinical training and has presented numerous lectures, workshops, and Keynote presentations at academic and professional conferences nationally and internationally. She has co-authored publications in peer-reviewed journals and is co-author of the peer-reviewed treatment manual and patient workbook, The Renfrew Unified Treatment Model for Eating Disorders and Comorbidity, published by Oxford University Press.

Disclosure Statement: 

The instructor(s) for this course receive compensation for their services. There are no reported conflicts of interest to disclose.

CE Hours

Credit Hours:

This course consists of 3 continuing education hours of credit.

Counselors:

Telehealth Certification Institute, LLC has been approved by NBCC as an Approved Continuing Education Provider, ACEP No, 6693.  Programs that do not qualify for NBCC credit are clearly identified.  Telehealth Certification Institute, LLC is solely responsible for all aspects of the programs.

Telehealth Certification Institute, LLC is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for Licensed Mental Health Counselors. #MHC-0048.

Marriage and Family Therapists:

Many MFT licensing boards accept our courses or one of the approvals which we have from professional associations.  You can check with your board to determine if your licensing board would accept this course.

Telehealth Certification Institute, LLC is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for licensed marriage and family therapists #MFT-0135, effective May 8, 2025.

Social Workers:

Telehealth Certification Institute LLC, #1609, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 05/02/2024 – 05/02/2027. Social workers completing this course receive 3 clinical continuing education credits.

Telehealth Certification Institute, LLC is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for Licensed Social Workers #SW-0435.

Addiction Professionals:

This course has been approved by Telehealth Certification Institute LLC, as a NAADAC Approved Education Provider, for educational credits, effective 10/15/2025. NAADAC Provider #193104, Telehealth Certification Institute LLC is responsible for all aspects of the programming.

Psychologists:

Telehealth Certification Institute LLC is approved by the American Psychological Association to sponsor continuing education for psychologists. Telehealth Certification Institute LLC maintains responsibility for this program and its content.

Telehealth Certification Institute, LLC is recognized by the New York State Education Department’s State Board for Psychology as an approved provider of continuing education for Licensed Psychologists #PSY-0128.

Art Therapists:

Telehealth Certification Institute, LLC is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for Licensed Creative Arts Therapists #CAT-0093.

Other Professionals:

This course qualifies for 180 minutes of instructional content as required by many national, state and local licensing boards and professional organizations.  Retain your certificate of completion and contact your board or organization for specific filing requirements.

This course is a non-interactive, online self-study.

Participants may request a printed version of their certificate of completion to be delivered by mail. A shipping/handling fee of $6.95 will be charged per request. Shipping internationally may require an additional charge.

Accommodations and Policies

Close Captioning is available for live webinars and recorded video presentations.

You can click on the following links to view our policies:

• Accommodations for Individuals with Disabilities.
• Cancellation Policy
• Grievance Policy
• Support Options
• Disclosure Statement