Thoughts on neurodivergence in Ireland

 As more people become educated about neurodivergence, it is only logical that the number of people diagnosed with neurodivergencies will increase, which includes those with ADHD. Some people think that conditions such as ADHD and autism are some kind of diagnostic fad whose numbers are overblown and overmedicated. I disagree, and so does the research, so I encourage you to seek reliable information rather than wasting my own time making the argument.

But that's neither here nor there. Being an American who worked for years in the healthcare industry and was raised by a licensed social worker who now has an outpatient practice, I have had more exposure to the medical world than a lot of people. And in my experience, between an Irish person and an American person with the same symptoms, the American is more likely to make a doctor's appointment while the Irish person might take a paracetamol and hope for the best. I get it. I see things a little differently in my new country than a lot of my peers, but I'm ok with that. 

I also seem to be drawn to neurodivergent people, for whatever reason, and have encouraged multiple people in my life to get assessed and all but one of them obtained diagnoses. I'm like the neurodivergent whisperer. However, despite what you may read below, I encourage anyone who thinks they may have a neurodivergence to seek an evaluation and don't give up until you get one.

Shortly after my partner and I moved to Ireland, I noticed that he was really struggling with his Master's work, particularly his independent thesis. Regular classes, which came with the accountability of classroom discussions and essay deadlines, seemed to be easier to manage. However, once he was left to his own devices for the thesis, he struggled to keep up. We were on social welfare at the time, so we asked our then-GP for a referral to get him evaluated for ADHD. She seemed confused, but made the referral, possibly because she had been the GP for his entire family for decades and let's just say certain traits run in the family.

However, when it came time for the psychiatrist in the HSE Health Centre to meet with us, things went very pear-shaped. By then, we'd done some research and some reflecting. We knew he met the diagnostic criteria for ADHD. But the doctor that we met with? According to her, ADHD in adults doesn't exist. It certainly doesn't exist in people who passed the Leaving Cert (even if it took two tries), apparently. And for someone with multiple diplomas? Preposterous! 

No no - according to this person, ADHD is an invention of American drug companies who want to get everyone hooked on addictive stimulant medication. And we only thought my partner had ADHD because we'd spent so much time in America and clearly had been duped by the US pharma industry. So it's no surprise that when he mentioned he'd experimented with drugs in order to self-medicate, she gave us a long lecture on the evils of drugs and from that moment treated us as drug seekers.

It will be no surprise to learn that we did not get him an ADHD diagnosis that day. The doctor said she'd happily refer him for CBT and he was welcome to anti-depressants if he wanted them, despite the fact that he had no symptoms of depression at that time. We left feeling very, very angry and helpless.

We managed to scrape enough money together for a private evaluation. The cost was more than 300 euro. He administered several tests and questionnaires, and interviewed my partner extensively. After he reviewed all of the material, he confirmed that my partner did indeed meet the diagnostic criteria for ADHD. 

But he couldn't prescribe medication, as he was a psychologist and not a medical doctor. So he referred us to a psychiatrist who would have to confirm the diagnosis and write a prescription. We cycled up to the appointment, not knowing what to expect. The psychiatrist reviewed the material from the psychologist and asked a few questions to my partner. Then, very casually, after what couldn't have been more than 20 minutes, he informed us that my partner was autistic. 'Just a touch!' he said, so as not to alarm us. We were both so stunned that we didn't say much. He wrote out a prescription and asked for another 300 quid. The appointment hadn't lasted a half hour. At the time, we were so broke, that I'm sure I physically jumped. We didn't know it at the time, but this was one of Ireland's top autism experts and highly sought after. Still, he hadn't earned our 300 quid. So my pushy American kicked in and I friggin' haggled with him. And you know what? It worked. We paid 150 and it was money well spent.

Yet as we cycled home, we looked at each other, absolutely perplexed. Autism? (Or, as it was called at the time, Asperger's Syndrome.) How was that possible? In fact, he had done a whole research project on Asperger's in university and never considered that he might be on the spectrum. So we did what anyone would do: we googled it.

And let me tell you, if researching ADHD was an epiphany, seeing my partner through the lens of autism was a revelation. ADHD explained a lot, but autism explained much, much more. All these 'quirks' and oddities that I thought were unique? Nope - classic signs of autism. In retrospect, I don't know how our relationship managed to survive five+ years of neurotypical expectations. 

If you think getting evaluated for neurodivergencies in Ireland is hard, well, you're not going to like what I'm about to tell you about finding supports for them, especially supports through the HSE. Generally speaking, if you can make it to adulthood and pass as neurotypical well enough to go to college, get a job, and generally appear "normal" (with the biggest scare quotes imaginable), then you will struggle to find accommodations from universities and employers, even with said institutions claim to provide them. You may technically have a disability and be eligible for disability supports from the HSE, but good luck navigating the system to access them. 

The first big barrier was academia's attitudes toward supports. After completing his Master's programme, my partner was accepted to do a PhD. It's common knowledge that getting through a PhD is challenging for everyone; for someone with both ADHD and autism, it takes a Herculean effort. Add to that the stress of being evicted from our home during a housing crisis, losing our beloved cat, and then the pressures of having elderly parents. He had registered with the disability office of the university, but they didn't know what to do with him. They had nothing to offer, no accommodations and not even a counselling service. And he didn't want to talk about being a person with ADHD and autism for fear of losing respect or being seen as using them as some sort of an excuse invented for poor performance. Except that...he was struggling. And he needed some slack, not to mention editorial guidance. By the time his mother passed away, he was so far into burnout that there was no coming back. Three-quarters of the way through, he quit. 

Now, we know that autistic academic burnout is a real thing and it's intense. But are things any better at that university for people with ADHD and autism? Probably not. 

We managed to get a meeting with an HSE disability officer. She was very understanding. We got a referral to an organisation who helps adults with autism. However, they help people who struggle with day-to-day tasks, who need training and practice with everyday conversations and socialising, and generally from a younger age group. For someone that didn't even get diagnosed until 40-something years of age, this organisation just didn't know what to do to help. 

Meanwhile, my partner became a full-time carer for his father, who was slowly dying from an unfortunate combination of physical and mental ailments, including dementia. His physical ailments may have been surmountable, but the dementia had taken away his appetite, and we essentially watched him starve while his body became too weak to ward off recurring infections. Family carers get a massively raw deal. If the person in need is elderly, you are trying to keep someone alive 24/7/365 knowing you will definitely fail. Any disability that you yourself may have gets pushed to the side. No matter how difficult it gets, you have to keep doing it because there's no other option. Respite care exists in theory, but I can say from experience that in reality, it's often not possible. 

Feeling frustrated with public health options, I tried to find someone who specialised in ADHD and autism in adults who could at least offer advice or guidance on managing a caring role while having these neurodivergencies. The fees these people charged were astronomical. Thousands of euro. We simply didn't have it. So we just had to persevere. 

And this has been the most frustrating thing: finding support for ADULTS with neurodivergencies in Ireland. Nearly everything is geared toward kids, and even then, neurodivergent children in Ireland don't get enough support. So you can imagine how difficult it is to live in a world that expects you to act, appear, and BE neurotypical once you reach adulthood. 

It's a fallacy that autistic people don't have empathy. I fucking HATE when people use 'autistic' as shorthand to describe a sociopathic asshole or someone just generally awkward. But many people with autism will struggle with how to live in a world where they are forced to do things that simply don't come naturally to them, particularly when it comes to care roles, whether that's parenting or ministering to an elderly parent. And we, as a society, are letting them down. The lack of supports for adults leads to a lot of pain, and it also means that the people they care for needlessly suffer as well. And I'm not saying that my partner didn't do an amazing job caring for the three elderly people in his life; I'm saying that it came at a huge price and didn't always go as planned.

For me, in the middle of all this, I could no longer ignore that the books I was reading about ADHD also described me. My partner would often read about an ADHD trait and proclaim, 'That's YOU! You do that!' and I'd try to shush him and ignore the fact that he was right. And there is ADHD in my family, so really I should have put it together sooner. By the time I managed to get a private evaluation, I was 38 years of age. Upon being diagnosed, I decided to put off medication, as I was hoping to get pregnant. The psychiatrist said to get in touch when I was ready and he'd write it up.

Five years later, when that was no longer an issue, I decided to see if medication would improve my ADHD. The guy who diagnosed me had retired. That's when I discovered that no psychiatrist will prescribe ADHD medication based on another practitioner's diagnosis, which is why that doctor so many years ago had wanted to charge 300 euro. He considered that an evaluation, not just a consultation. 

After waiting for six months to see a new psychiatrist and paying another 350 euro, I got my medication. And then I had to pay another 150 for a check-up... three more times before she agreed to let my GP manage my meds going forward. And let me tell you what this entails.

Ireland recently passed a law that means doctors can't prescribe more than one month of a stimulant medication. So for example, I take allergy meds. When I request a refill from the GP via email, they will typically send three to five months worth of scripts. Of course, I can only fill one at a time, but they remain on file in the chemist so all I have to do is pop into them when I need more. But with my Medikinet (slow-release Ritalin), I have to email a refill request every single month. (And if that month has more than 30 days, you need to rob Peter to pay Paul, i.e. skip a day). For someone who struggles with executive functioning, this can be a very large barrier, if you even manage to get through the barriers involved in getting a prescription at all. This paradox is beautifully explained by Jessica McCabe from the Youtube Channel 'How to ADHD': 

Between me and my partner, we've had four evaluations and spent nearly 1,500 euro. He would like to try a different medication than the one he's on, but to do that, as his original prescriber has retired, he would need to get a third evaluation and start from scratch all over again. Based on what I paid, that's another 600 euro.

There is apparently a new Adult ADHD programme initiated by the HSE. But when you read the fine print, this programme has massive barriers built in from the very start. First of all, you need to get a referral from your GP. If you have one of the many, MANY, in fact majority, of GPs who have outdated ideas about ADHD in adults, that's problem number one. They'll often offer to give you anti-depressants and send you on your way. So you basically need to walk into the appointment with the diagnostic criteria in hand and be able to explain exactly which symptoms you have had, that you've had them basically forever, and give examples of times that these things impacted your life. You essentially need to perform your own evaluation and present it to your GP.

But if you manage to get a referral, through the new programme, 'Adults with symptoms of ADHD are referred to their local General Adult Psychiatry Service for mental health assessment and each person referred is also asked to complete two ADHD screening questionnaires. This includes adults who have previously been treated for ADHD as children and/or adolescents and who have current symptoms suggestive of ADHD.' In other words, you don't see a specialist at first. So that's three major hoops to jump through just to be assessed by an ADHD specialist.

And even if you go private, self-referring is nearly impossible. Like so many things in Ireland, the GP is the gatekeeper.

I have no ending for this. I guess it's all just to say that we are being failed. You need to be so organised, self-aware, and on top of things to get diagnosed and treated for neurodivergence when these are the exact things we struggle with in the first place! It's kind of a wonder anyone gets any help at all.

 

Reflections on Ignoring Pain

 

Many years ago, I was talking with my brother about a health issue that one of my sisters was having at the time. He said, 'Well, I told her that if you ignore it, it will go away', to which I responded, 'YEAH! That's what I always say!'

'No,' he said, 'I was being sarcastic. You shouldn't ignore health problems', and he gave me a look, like, 'What's wrong with you?' But for me, over the years, honestly that has been the best approach. 

In the months leading up to my first marriage, when I was working and in graduate school, juggling a long commute from my home in southern Maine to my university in Boston, a strained relationship with my fiancé and his family, and wedding planning, I was suffering from crippling abdominal pain. It hurt just to breathe, as if all my organs were swollen. I went to the university health centre, and had all kinds of tests done, but they couldn't find anything wrong with me. 'It's probably stress', they finally concluded. And sure enough, after the wedding when I had slightly less on my plate, the pain went away.

In the months after my second marriage, when I was working three jobs, unloading 90% of everything I owned, moving into a temporary room in preparation for emigrating to a new country that I knew practically nothing about, leaving behind my family, friends, career, and everything I considered 'home', I started feeling this strange, painful sensation in my throat and chest, like I swallowed a hard candy. It felt like something was stuck, and no matter what I did, it wouldn't go away. The doctor examined me and ordered an MRI, which came out normal. 'It's probably stress', she finally concluded. And sure enough, the moment I stepped off the plane in Dublin, that feeling in my throat was gone.

Other pains, such as abdominal pain that I asked doctors about for decades, was put down to normal female reproductive pain, probably from ovarian cysts coming and going. Only through trying to get pregnant did anyone decide to investigate it. I had endometriosis, as it turned out.

I struggled with shoulder pain for years before a doctor finally ordered an MRI and whoops! By then, I had a partially torn rotator cuff from a bone spur that had been growing and the only course was surgery. When I tore the other side, a different doctor, incredulous that I'd had a tear ten years previously, told me I was too young to have torn it at my current age, let alone younger. The MRI, which I pushed for, showed (quelle suprise!) a partial tear. Since it's from an injury rather than a bone spur, and it's not as painful as the other one, I just deal with it.

I've learned that I have a high threshold for pain based purely on the number of ailments I have ignored over the years. When I recently discovered that I am peri-menopausal, I realised that I had had many symptoms leading up to it, but had ignored the majority of them.

Women are taught to ignore pain of all kinds.

In my previous post, I talked about all the symptoms that I have been unable to ignore these past few months, and my journey to figuring out their cause. Happily, all of the exams, tests, and scans have come back normal. The picture of health! And that old chestnut,  'It's probably stress' looms large. However, this time, there's no stress. Home life is great. My job is great. Friends are great. Family is great. Fitness levels are great. Money stuff is...good, which honestly I'm happy with. ('Great' would be a stretch!) I've never been less stressed in my entire life. 

My head isn't haunted, like. Something is causing me to hear and feel the blood pumping in my left ear. It's not a magic spell or a ghost. There is an explanation and I won't give up until I find it. 

However, I have had to go back to the drawing board. And that has led me to realise a sort of elephant in the room: I have been ignoring pain in my neck, back, ribs and hips to such an extent that I didn't even really acknowledge its existence until now. After ruling out everything else, suddenly there it was: I'm in pain! Pain that could be impacting the rest of my body. Pain that probably could be relieved. So I made an appointment with an osteopath.

The laundry list of ailments that I gave this poor guy - how was I walking around with all of that going on? From head to toe, I described no less than ten points of chronic pain that have been going on for months to decades. When he examined my neck, he described the left side as 'totally jammed'. As he turned my head, the rest of my body followed. I felt embarrassed for myself - I don't even remember the last time I turned my head without a cacophony of crunching and strain.

Is my 'jammed' neck causing all my problems? Probably not. But will I feel immense relief once it's unjammed? Once I start rehabbing my displaced ribs? Once I fix the pinched nerve in my leg? Once I stretch out the achilles tendon pain? Once I attend to this tennis elbow, and so on? I surely will. 

This is all a long-winded way of saying that despite all my work trying to be healthy and get a diagnosis for health problems, I still managed to shove down and neglect my body. So I recommend doing a scan of yourself and trying to be honest, like really honest, about how you feel? Do you have pain that you're ignoring?  

A picture

Previously, I posted about how I've been doing things to improve my health since lockdown. Once I recovered from an infection last March, I re-started the couch to 5k and slowly built up to 5k and beyond. I can now run a 10k easily and plan on increasing my run times once the weather warms up a bit with the goal of regular 15 to 20k runs. 

I also have been incorporating other types of workouts depending on my mood, which may include weight or strength training, yoga, ballet, dance workouts, aerobics. And I walk pretty much every day in addition to all of the above. 

Expanding my cooking horizons has become a real highlight of lockdown life, and my diet is healthier than it's ever been before, filled with tonnes of vegetables and fruits, healthy vegetarian proteins, and very little fried foods. 

My alcohol and caffeine intake is moderate. I have one cup of coffee each morning (occasionally two on Fridays and Saturdays) and I like to have a drink, sometimes two, of an evening (but not every evening).

Recently, I bumped into a friend of mine while on a run and he described me as 'the picture of health' and I had to agree. I feel really good - strong, energetic most days, and all of the exercise has improved my mental health considerably. But a picture can hide as much as it conveys. It reminds me of when my dad used to respond to compliments on his youthful appearance with, 'I'm rotting from the inside out'.

I've been battling a frustrating medical condition that is not only rare, but invisible. And it's not the first time. 

Back in late 2017, after a trip to Venice, I came down with a bizarre vestibular issue that made me feel like I was on a boat. All. of. the. time. For several months, I walked around with sea legs and felt myself floating on a non-existent ocean as I tried to fall asleep. I even suffered with sea sickness from it. Finally, I was able to gradually rid myself of the affliction through vestibular physical therapy. Then, a year after my remission, it came back and lasted nearly another year. While I still have balance issues caused by damage to my right inner ear, I'm off my boat and can mostly ignore it in day-to-day life.

So, when I started having pain and fullness in my ears last year after a bad cold, I figured it would go away. When it didn't, I went to the GP who gave me antibiotics for a middle ear infection. The pain eased, but I was left hearing the sound and sensation of my heart beating in the left side of my head. It's called Pulsatile Tinnitus and it's constant. The only time I don't hear it is when other noises drown it out. But I began to notice other things, like tingling on my head, mostly on the left side. Fullness, neck pain, eye spasms, headaches are others, and for the past month I've been trying to ignore other worrisome symptoms such as dysphagia (trouble swallowing) and an ache in my left leg.

Since last summer, I've had two ENT consultations, an MRI, and MRA, a dental checkup, several craniosacral therapy sessions, a full blood workup, and I've tried taking a month off my ADHD medication. None of those things produced answers or a cure. I joined a Facebook group for people with Pulsatile Tinnitus and began educating myself on the most common causes. 

Pulsatile Tinnitus (PT) isn't a diagnosis; it's a symptom of something else, and it's usually nothing to do with the ear, though many make that assumption. As I started reading people's PT stories, I saw how difficult it is to get a diagnosis. Most of the people in the group have spent years getting to the bottom of it. But an alarming number, when they finally discover their diagnosis, have life-threatening or serious conditions, usually vascular in nature. There was even an episode of House about it!

My symptoms are most noticeable first thing in the morning (from the quiet and the pressure of my head on the pillow) and late at night (also from the quiet). This can make sleeping difficult, not just because of the whooshing noise in my ear, but also because I often find myself unable to sleep, stuck in an ADHD hyperfocus, looking online for answers to what's wrong with me. The panic caused by googling symptoms is something we've all experienced. After months of dealing with a mystery condition, you can go a little mad. And then, add to that the condition itself, a constant whooshing in my head of the blood flowing through my body, and it's a wonder I can function normally.

I made it my mission to find someone in Ireland who wouldn't fob me off as my GP and ENT had. I started to research the types of specialists who diagnose the most common causes of PT. Finally, I found a news article about a consultant in Dublin who I thought may be able to help me, and I emailed him to see if he had dealt with PT. My heart leapt when he responded that he had. He told me the main conditions that he would want to rule out, and when I saw that they were all vascular, I made an appointment to see him in person. We discussed my symptoms and previous scans. He looked in my ears with a special microscope just to be sure I didn't have a specific ear issue that can cause PT. He said that he wanted to send me for a CT angiogram to check my arteries and to rule out fibromuscular dysplasia (FMD). I had come across FMD in the Facebook group but I didn't remember what it was. He wrote it down and told me to look it up when I got home. I left feeling comfort in the knowledge that I'd found someone who may be able to help me. I felt hope for the first time in a long time. 

I didn't bother to google FMD for more than a week. When I did, I have to say, I wasn't thrilled, especially when I reviewed the list symptoms, most of which I have. I keep telling myself that just because I have most of the symptoms, doesn't mean I have it! But then I think, if it's not this, then what is it? All I know is, I've accepted that this isn't going away, it cannot be ignored, and I will not stop until I know what's going on. 

Tomorrow, I'll be going for the CT angiogram. I didn't google that either until I was discussing it with my manager at work and he googled it. That's when we both realised how naive I'd been only taking the morning off work. It's definitely a full day off from work procedure. 

Why am I writing all of this? A couple of reasons. First, because I want to say to anyone searching for a diagnosis to any sort of medical issue, DO NOT GIVE UP. And secondly, because while I'm doing really, really great in so many ways -- better than I've ever been in my entire life, in fact -- I'm still having a hard time with this one aspect of my life and I'm suffering physically and mentally. I'm afraid of what lurks behind this picture of health. I'm afraid that I'm not actually healthy. I'm afraid that I'll drop dead before I figure out what's wrong with me. I'm afraid that I will have to give up this new active lifestyle that is part of who I am now. I'm afraid that I deserve this. I'm afraid that I'll never know, like so many people with PT and other conditions. 

But at the same time, I feel incredibly OPTIMISTIC. I swear, I do have a balanced view. I'm taking it in stride as well as anyone could. I'm confident in my new doctor. I'm confident that I can do whatever needs to be done to cure myself once I find it out. I'm grateful that I have amazingly supportive friends and family to help me in all kinds of ways. And now, we'll just have to wait and see. Wish me luck!

xoxo

Skincare tips from a lady in her late 40s who has tried everything

 I need to acknowledge how incredibly lucky I am in the skin department, for the most part. However, age makes everyone its bitch and despite being a stone's throw from menopause, I still get spots. And to make matters worse, my skin has always been dry as a biscuit and allergic to practically everything, including citrus oils (bergamot, limonene, linalool, etc., which are in the majority of skincare products).

Thanks to my mother's extreme paranoia of looking her age (which, it must be said, served her well), I have tried to care for my skin from a young age. When I was 7 or 8, I remember spending my allowance on clay masks and moisturisers! (I should have been buying sunblock, but it was the 1970s so that wouldn't happen until, oh, twenty years later.)

When it comes to beauty and skincare in particular, a lot of people I know take one of two approaches: natural products only and 'throw every chemical known to man on there'. I fall somewhere in the middle. It's also very easy to spend a LOT of money on skincare, but these days there are loads of affordable products that easily compete with the pricey stuff.

Recently, I have been using the 'curly girl method' on my hair, which entails cutting out silicone in my hair products along with drying alcohols and detergents. And that got me thinking, if silicone and that other nasty stuff dries out my hair, what are they doing to my face? I  read the labels of my skin products, and discovered that most of them used silicone, even the dermatologist-recommended brands, such as Cetaphil, Cerave, and Elave. It turns out that silicone is actually not bad for your skin -- it can help retain moisture -- but I also don't want it in every single product, so I started searching for silicone-free skincare products. It was especially difficult to find moisturisers with SPF that didn't use silicone. But I found some, and I'm going to tell you how!

There are two websites that I use to figure out if a hair product is 'curly girl approved: IsitCG and CurlsBot. You simply copy and paste the ingredients into the tool and it tells you which ingredients are not 'approved' and which ones you should use with caution, such as ingredients that can leave build-up residue over time. Having realised that all of the precautions I take with my hair are the same ones I wanted to take with my skin, I decided to use the tool on skin products. 

One of my favourite brands at the moment is an American brand called Acure Organics, which is very affordable and can be ordered online, but it's not always handy to do that from overseas. If you're in America, though, do give it a try.

Cleansing

Ironically, I have found that the best routine for my skin has been a 'less is more' approach. For example, if I don't have makeup on my face, I don't wash it at the end of the day. And if I'm showering first thing in the morning with a bare face, I usually won't cleanse it in the morning either. I only cleanse my face after exercise and to remove makeup. Otherwise, I leave it be.

You may have heard of people who use oil cleansers, either formulas made by a company or an oil you can buy in a food shop. Coconut oil is one you see online a lot. While coconut oil is great for removing eye makeup, I do NOT recommend coconut oil to cleanse because it is highly comedogenic, which is a fancy way of saying it will clog your pores. If you like the idea of cleansing your face with oil, I recommend hemp oil, which available in any health food shop. Simply spread it over your face, and then wipe it off with a hot, damp cloth. Personally, I no longer cleanse with oil because the hot water in my house (and most houses in Ireland) is unreliable and you really do need hot water to rinse the oil from the cloth after you've removed in from your face. And even then, the oil tends to discolour the cloths over time. 

I recommend gentle, silicone-free creme cleansers. Here are a few that pass the test: Acure Seriously Soothing Cleansing Cream (UK link here), Earth Science, A-D-E Creamy Fruit Oil Cleanser, Dry & Sensitive Skin, Dr. Organic Argan Oil Face Wash, Dr. Organic Manuka Honey Face Wash, and Sukin Cream Cleanser. 

Moisturising

My skin has been dry since I was a baby, so I am always battling cracks, flakes, and rough patches. Here are the night-time moisturisers in my rotation currently: Sukin Calming Night Cream, Sensitive, Acure Radically Rejuvenating Whipped Night Cream, Acure Ultra Hydrating 12 Hour Facial Moisturizer.

And for day time, I try to use moisturisers with a fairly high spf, though it's difficult to find ones that I'm not allergic to, even the supposedly sensitive ones. But these three have worked well:

Radically Rejuvenating SPF Day Cream, Soltan Face Sensitive Protect 50+ SPF, and Avene Very High Protection Cream for Sensitive Skin 50+ SPF (there's a tinted BB cream version that's nice too).

Serums and other anti-aging measures

Once a week, I try to exfoliate with this glycolic acid cleanser from Image. Don't use
those abrasive exfoliants on your face! Back in the day, we used that apricot scrub,
which felt amazing, but as you get older, your skin is much more delicate and it can
wreak havoc. So you're better off using a chemical exfoliant. I massage it into my
face dry for exactly one minute, then rinse off with a cloth. 

In addition to my moisturiser, I alternate a few serums, which I use depending on what my skin is doing, the weather, and my plans for the day.

Because I have dry skin, I often use hyaluronic acid serum right after I wash my face. You want to always use hyaluronic acid when your skin is freshly hydrated (in other words, after it's just been wet). If you want to use it but haven't just come out of the shower, you can splash or spray your face with water, dab it dry, and slap some on. I use The Ordinary Hyaluronic Acid + B5 because it's cheap and cheerful. 

I'm prone to hormone-related breakouts along my jawline and hairline, so I like to use a couple of products that keep these at bay and clear things up if I happen to get a couple of spots. They're both from The Ordinary: Niacinamide & Zinc Serum and Azaleic Acid Suspension. (The latter does contain silicone and has been harder to find in Dublin.)

Lately, I've been trying to give my under-eyes some love and attention, so I've been using these two products: The Ordinary Caffeine Solution and CeraVe Reparative Eye Cream. 

And finally, a few nights a week, I like to use a couple of oils. To combat wrinkles, I use The Ordinary Retinol Serum and then I like to use a roll-on rose hip oil around my mouth and eyes just to keep things soft and supple.

Before I close, I want to add one last product, which is somewhere between skincare and makeup. Glossier's Futuredew is an oil serum hybrid that gives my skin an amazing glow on days when I just want to look more polished. It's very subtle and I love the way it looks.

What are your favourite skincare products? Is there something you think I should try? Tell me about it!