Midlife Mary was not the same Mary. Her boss encouraged her to go for a promotion. She felt sick with worry. About pretty much everything. She cared too much and not at all, at the same time.  

She cancelled social commitments and didn't go for the promotion.  

One night she abruptly woke from her night-sweat disrupted sleep unable to breathe properly. She wanted to throw up. She was sweating, shaking and parts of her body felt numb.  

That was her first panic attack.

After her hospital visit, she booked in with her GP to discuss her health concerns. Lack of sleep, sweating, anxiety, a sense of dread and a total loss of confidence.  

"Could this be hormones or menopause?" she asked?  

“No, you are not there yet” said the doctor to 49-year-old Mary. He prescribed anti-depressant medication. By the time we connected she wanted off the medication and she wanted to know what was going on with her.  

56% of women experience psychological symptoms of menopause including anxiety, memory challenges, brain fog, insomnia and depression.

As hormones drop so does confidence. Throw midlife in the mix and it’s completely overwhelming.  

Menopause is mental health. 

A taboo within a taboo, that we need to understand and talk about. Otherwise, women struggle on in silence. They put pressure on themselves at work and subject themselves to performance ridicule when they inevitably drop a ball.

It's like pouring gas on an open flame worsening menopause symptoms.  

The number one treatment offered to menopausal women in Australia is anti-depressants.   

Midlife women are taking anti-depressants in droves 

It’s no wonder 67% of women aged 40 – 55 are afraid of menopause’s impact on their mental health. 

What can we do?  

Professor John Eden is a researcher, gynaecologist and reproductive endocrinologist (a specialist in women’s hormones). He estimates 1 in 8 women in Australia are getting treatment for menopause symptoms.  

What happens as hormones change? 

Let’s explore mood and anxiety.  

How do hormones impact mood?  

Your mood is chemically controlled in the brain. Our levels of serotonin, dopamine, cortisol, and other hormones affect how happy, sad, or anxious we may feel. 

In perimenopause, the hormonal pathways and the performance of neurotransmitters are at the root of menopausal mood changes.   

Serotonin 

Serotonin is a neurotransmitter known as the happy chemical. The more serotonin that we have in our brains, the happier we feel. 

Estrogen 

Estrogen makes our brain cells more receptive to serotonin. When estrogen levels decline during menopause, serotonin take-up decreases. This can cause mood to become lower and exacerbate negative thoughts and perceptions.  

Progestogen 

Progestogen makes brain cells more receptive to take up a neurotransmitter called GABA, which calms brain activity and helps with sleep.  

When progestogen levels go down, GABA is less potent. Our brains are exposed to chemicals that can agitate them and make us feel stressed and anxious. 

Dopamine 

Sex hormones inhibit the concentration of another neurotransmitter, dopamine, in the brain. 

Dopamine influences brain pleasure and reward centres and affects our emotional responses to stimuli. Decreased dopamine makes us feel less joy and satisfaction. It can cause sadness towards things that wouldn't otherwise concern us. 

During perimenopause, declining and erratic sex hormones make our cortisol levels spike higher than usual. This wreaks emotional havoc.

These days stress is more likely to be a person, an e-mail or being busy. It's less likely to be a threat we need to fight off or run away from. But by not fighting or running—and completing the stress process our body expects—we do not physically discharge these chemicals as we should. 

They linger in the body, making us feel jittery, tingly, breathless, and lightheaded. Our thoughts race, and we feel a sense of watchful anticipation or trepidation. 

We experience mild panic. 

The result is emotional turbulence.  

The psychological effects of such symptoms are wide-ranging. Our ability to perform tasks may be affected, and our capacity to do our jobs effectively may diminish. As a result, our confidence suffers as our stress increases.  

Our relationships may also suffer, compounded by a possible loss of libido and the psychological confusion of, "Who am I? Why can't I do or feel like I used to? What is happening to me?!"  

Peeling back the layers.... 

Anxiety

Anxiety is a common and normal emotion that everyone experiences from time to time. 

It can be triggered by stress, uncertainty, or situations that we perceive as threatening or overwhelming. When we experience anxiety, it is often accompanied by physical symptoms such as racing thoughts, rapid heartbeat, and difficulty concentrating. While it is natural to feel anxious in certain situations, chronic anxiety can interfere with our daily lives and well-being. 

Managing anxiety can be challenging, but with practice and persistence, you can learn to better cope with your anxiety and improve your overall well-being. Remember, during menopause, anxiety can show quite severe increases, but this is all part of the body trying to adjust to its new hormonal status.  

What can we do? 

If you are struggling with anxiety, here are 10 tips to improve well-being: 

1. Complete the emotional stress cycle: find a way to let your body know you are not in danger and can stop being stressed. This helps avoid burnout and emotional exhaustion. Feeling emotionally exhausted? 6 things you can do to release your stress  
2. Find a relaxation technique you like: Techniques like deep breathing, progressive muscle relaxation, and mindfulness meditation.  
3. Exercise regularly: Regular physical activity has been shown to reduce anxiety and improve mood.  
4. Prioritise sleep:  Lack of sleep can increase anxiety and make it more difficult to cope with stress.  
5. Talk to someone: Sharing your feelings and thoughts with someone you trust can be a great way to cope with anxiety.  
6. Seek professional help: If your anxiety is severe or is interfering with your daily life, it may be helpful to seek professional help.  
7. Access experts: Listen in to my podcast chat with Dr Jodi Richardson about managing anxiety is full of tips   Follow Dr Jodi Richardson here on IG for more tips
8. Dance: Take Yo Praise (& boogie) 
9. Laugh: Could it possibly be perimenopause???? 
10. Build community: sign up to Meno Collective to connect with like-hearted women experiencing similar midlife challenges and growth opportunities.