ADHD and Pregnancy: Managing Your Symptoms and Navigating a Complicated Time
By Dr. Jillian Neill, PsyD | Licensed Psychologist, Washington, DC | Neurodivergent & Perinatal Mental Health Specialist
Dr. Neill is a clinician at Dr. Emma Basch & Associates, a Washington, DC practice specializing in women's mental health, neurodivergence, and perinatal care. She holds the Authority to Practice Interjurisdictional Telepsychology (APIT) through PsyPact.
One thing no one warns you about before you get pregnant? Pregnancy Brain. Although many of us are familiar with morning sickness, aches and pains, and emotional changes that come with pregnancy, research has also shown that pregnancy can affect cognitive tasks, including executive functioning, focus, and memory. Research suggests this phenomenon is experienced by somewhere around 70-80% of pregnant people and can be disruptive at home, at work, and in relationships.
Why ADHD Makes Pregnancy Cognitively Harder
Although it has not been extensively researched, there is evidence that people with ADHD may be particularly affected by cognitive symptoms and impairments during pregnancy. Because ADHD is characterised by deficits in executive functioning, people with ADHD may feel especially affected by the cognitive changes that can come with pregnancy.
Additionally, there are more demands on executive functioning during pregnancy, such as medical appointments and navigating new logistics, potentially causing more strain on an already taxed system. Add that to the physical and emotional symptoms that come with pregnancy, and you have a perfect storm for feeling huge strain.. Women who have managed their ADHD symptoms well through masking and perfectionism may really struggle here as these strategies may not meet the demand of the increased strain.
The Medication Question: Navigating an ADHD Pregnancy without Medication
It is also important to note that over 50% of adults diagnosed with ADHD are prescribed stimulant medication to treat their ADHD, as this is considered a first-line treatment for ADHD. However, many pregnant people go off their medication when they are pregnant, often at the urging of their medication provider. As a result, they are dealing with their ADHD untreated at a time when they may be particularly vulnerable to their symptoms.
Navigating ADHD during pregnancy is complicated and messy, but there are effective strategies that can help you cope.
Our Top Four Tips for Managing ADHD During Pregnancy
1. If you are on medication, consult with a prescriber who has expertise in working with pregnant people.
Many people with ADHD are advised to stop stimulant medications while pregnant because of concerns about the impact of stimulants on the developing fetus. However, while the evidence for the harms of stimulant use during pregnancy is mixed, there is evidence that ceasing stimulants during pregnancy can also have negative impacts, particularly for people with moderate to severe ADHD symptoms. For example, a 2024 study found that pregnant people with ADHD who discontinued their stimulant medication were found to have higher levels of depression than those who did not, even when they were on antidepressants. A well-informed and conscientious provider can help you determine what the best course of action is for your pregnancy.
2. Be aware of what your body and brain need
Even outside of pregnancy, sleep deficits are associated with an increase in ADHD symptoms. Therefore, being sure to get enough sleep may be particularly important when you are pregnant. Listening to your body’s cues related to sleep and rest may help with symptom management. Physical exercise has also routinely been shown to help improve executive functioning and focus in people with ADHD, so trying to give your body the rest and movement it needs can also help.
3. Seek out additional support
If you are struggling with the impact of your ADHD on your pregnancy, seek out therapy or coaching to help you manage your symptoms. A well-trained provider can help support you as you navigate the challenges of pregnancy and ADHD. This may include working to develop systems or routines to help with executive functioning tasks or deeper emotional support.
4. Approach yourself and your pregnancy with self-compassion
Pregnancy can come with many challenges- physical, mental, and emotional- regardless of whether or not you have ADHD. It is important to remember to be kind to yourself during your pregnancy. Having a compassionate view of the challenges you are experiencing can help you have more realistic expectations for yourself during this transitional time.
You don't have to navigate this alone
Pregnancy is a vulnerable time for our physical, mental, and emotional health. Having ADHD and being pregnant poses its own unique set of challenges. Thankfully, there is help available for pregnant people with ADHD who may need additional support. The experts here at Dr. Emma Basch and Associates are here to help. We offer psychotherapy, short-term consultation, strategy building, and care coordination. Ready to take the next step? Reach out, and will take it from here.
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There are more demands on executive functioning during pregnancy, such as medical appointments and navigating new logistics, potentially causing more strain on an already taxed system.
It is also important to note that over 50% of adults diagnosed with ADHD are prescribed stimulant medication to treat their ADHD, as this is considered a first-line treatment for ADHD. However, many pregnant people go off their medication when they are pregnant, often at the urging of their medication provider. As a result, they are dealing with their ADHD untreated at a time when they may be particularly vulnerable to their symptoms.
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Many people with ADHD are advised to stop stimulant medications while pregnant because of concerns about the impact of stimulants on the developing fetus.
This is not a one-size-fits-all decision and should be made in close collaboration with a prescribing provider who is familiar with both ADHD and perinatal care.
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Physical exercise has routinely been shown to be a valuable complementary intervention for ADHD through a hybrid approach that may improve cognitive and emotional functioning while addressing comorbidities. here