Progress Report: Metabolic Coaching for Neurodivergent Perimenopausal Women
The Unmasked Woman: AuDHD, Perimenopause & Metabolic HealthShow Notes
Hannah's 6-month progress report from The Unmasked Woman: what's actually working, and what's missing, when coaching neurodivergent women through perimenopause and burnout. In this episode: ✹ Why doing everything "right" for your health doesn't work if you're neurodivergent ✹ The Cell Danger Response ✹ Two types of clients: quick turnarounds vs. deeply established burnout ✹ Why exercise and movement advice often backfires for a depleted ND nervous system ✹The two biggest levers for recovery: blood sugar stabilisation and sensory rest ✹Where to find support if this sounds like you
Dear reader I didn’t publish last week. I took an impromptu holiday. I’d already written this piece, and was looking forward to sharing it but I gifted myself some free time instead. I’m telling you this to remind us all that it’s perfectly okay not to do what we said we’d do if our intuition is telling us otherwise and that we need a break. Six months ago I reached out to let you know I’d retrained as a metabolic health coach, specifically for our overlooked community: neurodivergent, perimenopausal women. I told you to get in touch if you wanted to know more. This came after my own healing from CFS and burnout, and my new understanding of how I’d healed — the Cell Danger Response. I wasn’t keen to retrain. I already have so many unused qualifications sitting on a shelf. And I knew exactly how much hassle going in a new direction is. It takes time and it takes metabolic energy, and I wasn’t sure I had either to spare. But I couldn’t deny the call. Years of research led me here. Back when I was sick, the Cell Danger Response, before I had a name for it, felt like heavy unmoveable concrete stuck inside my body. What I know now is that it is moveable, with the right tools. I’ve been a coach for nearly a decade, so I was confident I could build something with good structure and strong ethical boundaries that could genuinely help although I wasn’t sure exactly what it would look like. I opened up applications to spend one month with me figuring out symptoms and trying small lifestyle changes, something I now call The Forensic Energy Detective Assessment. I didn’t expect the volume of applications I received. That says something about how needed this type of intervention is, and how underserved our community is. Since then, I now also have a three month container running for the 30% of women who needed and wanted more than one month’s support (more on that soon) after their assessment. Separate from the one-to-one work, I’ve opened applications for the world’s first metabolic health retreat for perimenopausal neurodivergent women, here in Cambodia to take place in Jan and Feb 2027. It was extremely challenging to build, and I’m immensely proud of it. You can read more about that here. Additionally, a client came to stay near me here in Cambodia so I could support her through deep burnout in person. She’s a longstanding client and we already knew each other well. She was too exhausted to move much at the beginning and it was a good reminder of how physically disabling burnout can be. But her stay here worked. I’d do it again and you can read the case study here. Let’s dig into what actually happened with clients so we can see the useful, bigger picture. Firstly, every woman who came to me with problematic symptoms had what I’d call a ‘sterling’ approach to her health. Healthy lifestyle, rarely drank alcohol, and valued nature and exercise. Women who were in or have been in talking therapy, eat organic, do Pilates when they can. Some have spent thousands, tens of thousands even, trying to heal, with some working with the world’s leading doctors. What was missing for these women? The neurodivergent piece. They were doing all the right things, yes. For a healthy neurotypical person. And look, everything is ‘so f*****g confusing’. This is what a client said to me verbatim last week when discussing mainstream health content. And yes, yes it is. We have big phar
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Dear reader As promised, a low-demand coaching video to help you understand what your energetic capacity actually is (something we're never taught and is difficult to work out). Knowing this helps us avoid ending up bed recovering, puzzled and wondering what went wrong. Make a tea, get comfy and grab a journal ✍🏾. Let's do this together. This is me showing up for you unmasked. I'm softly spoken (I hope you can hear me okay) and I'm not following a script. I could offer you something more polished but it's metabolically costly and I don't see the value. By showing up exactly as I am, quirks n all, I hope to model what unmasking in the public domain can look like. Please leave a comment if you have any questions or thoughts you'd like to share.
Dear reader, Last Wednesday I rode home from my writers’ group on my Honda, the heat pressing down on my neck. It was just after noon. The strange, unsettled heat of Cambodia, when the rains have arrived but left again before they were supposed to. Everybody’s waiting. Wishing for rain again. The writers’ group meets fortnightly at a vegetarian café on a quiet road. We sit outside. I love it. The conversations, the pleasure of being with people who care as much about words as I do. There had been a few more of us than usual, which meant more conversation, more ideas flying, more energies entwined. I rode home smiling. Then I had to lay down in the dark and my brain felt like concrete. I could still feel the conversations moving around inside my body. A residual vibration. The voices, the coffee orders, the creative ideas, the chuckles, all still swirling somewhere between my chest and my skull. I wasn’t upset or anxious. I was simply paying the bill. I rest after lunch every day anyway. I call it Medicinal Cellular Repair, horizontal time in the dark that I treat as non-negotiable. But this was different. This time I had absolutely no choice in the matter. My body decided I must. This is the experience nobody names properly for neurodivergent women: the crash that arrives after something good. Not after a hard day or a confrontational meeting or a sensory nightmare. After something you loved, chose, and would choose again tomorrow. The same week I had a thirty-minute swimming lesson at a hotel pool across town. Outdoors, in the shade, the water is just slightly cooler than body temperature. Lovely. And I LOVE swimming. The pool itself I’m less sure about. No plants. Concrete surroundings that feel a little lonely, a little gloomy. And my swim coach, going strong on the chat as always. I came home and went into my dark room again. There was a flicker of resentment on the way home. Not at the lesson, but at the situation. How do I get this man to stop talking so much and so close to my face? Here’s what’s actually happening: our mitochondria — the tiny engines inside every cell that produce our energy — don’t distinguish between good stimulation and bad. They just see load. For a neurodivergent nervous system, any social interaction, however joyful, however chosen, requires enormous processing. The eye contact, the vocal tones, another person’s energy, the sensory landscape of a concrete pool with no plants and continual talking. Every input is being processed at a higher intensity than a neurotypical brain would require. Our mitochondria are running hot the whole time. And when we get home, the debt needs to be paid. What makes this so hard to explain, to ourselves as much as anyone, is the dissonance. We expect to feel bad after hard things. We do not expect to feel wrecked after a writers’ group we’ve been looking forward to all week. And because we can’t explain it, we might reach for shame. I’m too sensitive. I’m weak. Why can’t I just be normal? But there’s no version of this that is weakness. It is cellular. It is biological. Understanding this changes the question. Not: what is wrong with me? But: what do I actually need? What we need is to take the crash seriously rather than pushing through it or marinating in guilt about it. The dark room and horizontal time isn’t indulgence, it’s repair. Medicinal Cellular Repair We also need to plan for it. Not to avoid the things we love but to hold the recovery time afterwards as part of the same decision. The writers’ group is a yes. The dark room after is also a yes. The swimming lesson is a yes. The relieved, necessary collapse afterwards is also a yes. We’re running a more complex operating system than most people around us, on hardware that requires more careful maintenance. The bill will always need paying. But once we know that, we can stop being surprised by it and start budgeting properly instead. What's the last genuinely good thing that took you out for the rest of
If you're an AuDHD woman somewhere in the perimenopause fog, tired of feeling like sh*t and tired of not knowing what's going on with your own body and mind — you're in the right place. The Unmasked Woman is personal essays on daily life as an AuDHD woman in perimenopause — energy, identity, health, all of it — read aloud so you don't have to look at a screen. This first episode introduces the show: why I started it, and the mitochondria connection behind so much of what gets written off as 'just' ADHD or 'just' perimenopause. New episodes weekly. Read, listen and subscribe: hannahanstee.substack.com