Dr. Carole Goguen, PsyD
Licensed Psychologist (CA PSY 17685)
ADHD-Certified Clinical Services Provider
25+ years clinical experience
ADHD Therapist for Women
Serving All of California
Late-Night Therapy
As Late As 10 pm
Searching for
the Calm Within?
You've been told you worry too much. That you're overthinking it. That you just need to relax. And maybe you've tried — the breathing exercises, the journaling, the meditation apps — and still, the noise won't quit.
For many women, anxiety isn't just anxiety. It's the constant mental chatter that won't let you finish a thought. It's lying awake running through everything you said, everything you forgot, everything you should have done differently. It's the knot in your stomach before a meeting you've already over-prepared for. It's snapping at someone you love and not quite knowing why.
Carole Goguen, PsyD
When Anxiety and ADHD Live Together
Most of the women I work with don’t come to me saying “I have anxiety.” They come saying they’re exhausted. That they can’t stop the racing thoughts. That they lie awake replaying conversations, dreading tomorrow’s to-do list, convinced they’re one dropped ball away from everything falling apart.
What they’re describing is anxiety — but it’s a specific kind. It’s anxiety that grew in the soil of undiagnosed ADHD.
When your brain has spent years struggling to keep up, forgetting things that matter, missing deadlines despite trying harder than anyone around you knows — your nervous system learns to brace for impact. Constantly. The worry isn’t irrational. It’s a response that made sense given everything you’ve been through. But it stops being useful when it becomes the background noise of your entire life.
This is why so many women with ADHD have already tried anxiety treatment — and found it helped, but not completely. Treating anxiety without addressing the ADHD underneath is like treating smoke without finding the fire.
What ADHD-Driven Anxiety Actually Looks Like
It’s not always what people picture when they think of anxiety. For women with ADHD, it often looks like this:
The dread that arrives before you’ve even gotten out of bed.
Before you’ve looked at your phone or your calendar, your body is already tense — already scanning for what you might have forgotten, what you might have missed, what’s coming that you’re not ready for.
Rejection sensitivity that feels like an alarm system with no off switch.
A slightly short text from a friend. A neutral look from your boss. A comment that probably meant nothing. For women with ADHD, the fear of criticism or rejection can feel physically overwhelming — disproportionate to the situation, impossible to talk yourself out of, and deeply exhausting to manage day after day.
Anxiety that masquerades as perfectionism.
You go over things three times. You rewrite the email for forty minutes. You overprepare for meetings because you’re terrified of being exposed as someone who can’t keep up. What looks like high standards from the outside is often a woman with ADHD doing everything she can to stay ahead of the shame.
The spiral after something goes wrong.
Missing a deadline or forgetting an appointment doesn’t just feel like a mistake — it feels like evidence. Proof that you are who you’ve always been afraid you are. The shame comes fast and it goes deep, and it’s almost impossible to climb out of without understanding where it actually comes from.
Anxiety that gets dramatically worse at certain times of the month.
Hormonal fluctuations — especially in the week before your period, during perimenopause, or after childbirth — directly affect dopamine regulation. For women with ADHD, this can turn manageable anxiety into something that feels completely unmanageable, for reasons that have nothing to do with your circumstances and everything to do with your neurology.
Why Standard Anxiety Treatment Sometimes Isn’t Enough
You may have already tried therapy for anxiety. Maybe it helped — you learned to identify your triggers, practice breathing, challenge your thoughts. And maybe it still felt like something was missing.
That’s not a failure of the therapy or of you. It’s what happens when anxiety is treated in isolation from the ADHD driving it.
Standard cognitive-behavioral approaches for anxiety were designed for neurotypical brains. They assume you can consistently apply skills between sessions, that insight will translate into behavior change, that the same technique will work the same way week after week. For a brain with ADHD, that’s rarely how it goes — and feeling like you can’t even do therapy right can become its own source of anxiety.
Effective anxiety treatment for women with ADHD needs to be adapted. The pacing needs to account for how ADHD brains process and retain information. The strategies need to be realistic for a brain that experiences time blindness, working memory challenges, and emotional dysregulation — not designed for someone else’s brain and handed to you to figure out.
That’s what I offer. Not generic anxiety therapy with your name on it. Anxiety treatment that understands why your nervous system works the way it does — and builds from there.
Here’s What We Actually Work On Together
Anxiety can be a daunting and overwhelming experience, but understanding its roots can pave the way toward effective management and relief. We start by understanding your specific anxiety — not anxiety in general, but yours. Where it shows up, what triggers it, how much of it is connected to ADHD, and how much has taken on a life of its own.
From there, we work on three things simultaneously:
Calming the nervous system that has been on high alert for years — through approaches that work with your brain’s actual wiring, not against it.
Addressing the ADHD underneath — because for most of the women I work with, treating the root cause is what finally makes the anxiety manageable in a lasting way.
Rebuilding your relationship with yourself — undoing the shame, the self-doubt, and the deeply ingrained belief that you are broken. Because so much of what feels like anxiety is actually grief. Grief for the years you spent blaming yourself for something that was never your fault.
This isn’t a linear process. Some weeks we work on practical strategies. Some weeks we sit with something harder. The pace is yours. But the direction is always forward.
You've Spent Long Enough
Living on High Alert
Anxiety this persistent doesn't just go away on its own — and pushing through it alone isn't a long-term strategy. What changes things is having a space where you can finally slow down, figure out what's actually driving it, and build the tools to manage it in a way that works for your specific brain and your specific life.
That's what I'm here to do.
When you're ready to stop white-knuckling it and start actually feeling better,
I'd love to talk.