How Menopause Impacts Anxiety, Depression and Panic Attacks 

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In this post, you’ll learn how menopause impacts anxiety, depression and panic attacks. 

Menopause can have a huge impact on women’s mental health. Let me give you a couple of examples. I had a friend who was always a little anxious, but one summer in her mid-40’s her anxiety just exploded. She went from being a bit of a worrier, to barely functioning. She couldn’t sit still in church anymore, her whole body shook with anxiety, she would pace the halls in anxious, shaky circles.  Why did her anxiety get so extreme? Before I take a stab at that, let me share another example.  

Mel Robbins is a bestselling author, life coach and YouTuber. Mel posted a video about anxiety where a middle aged woman approaches Mel at a book signing. In tears, this woman asks Mel what to do about panic attacks, now Mel, who I respect, has had panic attacks her whole life and quickly jumps in with a good psychological solution- but she missed something- this woman said “This is new to me”. When you get a new symptom, something that you haven’t had previously in your life, we’ve got to ask the question- what has changed biologically? Because I bet you my friend and this woman on the video, both of whom are middle aged, were not connecting their new anxiety to the whole body changes that come with menopause. We’ve got to check that because in addition to good psychological advice, women can also benefit from some menopause-informed medical care. Don’t get me wrong, both are important, but the menopause treatment is the one that gets missed so often, and so that’s what we’re talking about today. 

Menopause can really impact mental health, but there are effective treatments, you don’t just have to grit your way through it, so let’s talk about it, and I’m excited to have menopause expert Dr. Mary-Claire Haver here to share the medical aspect of it. 

And we are going to go into treatment options, including Hormone Replacement Therapy, in just a minute, but first…

Menopause Is Not Just Hot Flashes

Menopause is not just hot flashes, it’s not just the end of your period. It is a process that leads to changes throughout your entire body. Perimenopause begins 7-10 years before your period stops so you can start to see changes in your entire body, your sleep and your mental health as early as your mid-30’s. We start having a decline in estrogen and progesterone. Estrogen has been shown to have a modulating effect on mood-regulating neurotransmitters such as serotonin and dopamine. And that’s going to make us more vulnerable to stress. 

So it’s common to see, especially in perimenopause, symptoms like: 

  • Depression 
    • Anxiety– a lot of women experience more worry, restlessness, and physical symptoms like heart palpitations. Which can also lead to more symptoms of 
  • Panic Disorder and 
  • Irritability: Hormonal changes can make women more prone to mood swings and frustration, affecting their interactions with others.
  • It’s also very common for women to experience difficulty sleeping, insomnia, night sweats or early morning wakening- which can contribute to more irritability and 
  • that takes us to …Brain fog. Some women experience memory lapses and difficulty concentrating during menopause, which can be really frustrating.

And this is all in addition to the common things people think about when it comes to menopause, hot flashes, night sweats, and metabolism changes which can make your body change quickly, in energy levels or weight gain. 

And all of this, from lack of sleep to physical symptoms can impact your self-esteem and relationships, and clearly your mental health. 

Fortunately, you don’t have to just suffer, there are effective treatments, which we are going to get into. First though, let’s address one other issue associated with women’s mental health around menopause

Gaslighting. When it comes to women’s health generally–and especially understanding the shift into menopause– awareness, education and even medical support are lacking. Women frequently get gaslit, even by their doctors, told to just deal with it, or their symptoms are dismissed as “Just anxiety”, or “just menopause”, but without giving them any effective strategies to deal with it.  Going through menopause is confusing enough, but when doctors don’t listen to you, downplay your symptoms, or you’re the one who has to take your research to them and they’re not willing to listen, trying to get the support you need can be so hard.  I’m not going to rant here, but women’s health issues have often been downplayed, so spend time learning about menopause on your own, find a provider who is skilled at treating menopause, and be prepared that you are going to have to advocate for the treatment you deserve.  Because there are effective treatments. 

Let’s talk about 4 main things you can do to help with symptoms of menopause and stay healthy through these transition years:

  1. Hormone Replacement Therapy (HRT)
  2. Nutrition
  3. Sleep
  4. Exercise

Dr. Haver helped me understand her first recommendation, which is Hormone Replacement Therapy. Here’s what she says about how HRT can lead to benefits in many areas, including mental health. 

And I know that a lot of people have concerns about HRT, especially since a study 20 years ago made headlines saying that it causes breast cancer. Now I asked Dr. Haver about these concerns and we ended up having a much longer conversation on this topic- you can check out the entire conversation on my podcast, but the summary is: All medications come with some risks, the added risk of breast cancer is actually very very low. For most people HRT is a safe option and its pros outweigh the cons, but of course, work with your individual provider, a skilled doctor who can help you make the right decision for you. Here’s a bit more of what Dr. Haversaid:

So, consider HRT as a good treatment option. Talk to your doctor about it. But it isn’t our only option. When we consider that mental health stems from physical health, it includes how we take care of our body in other ways.

Dr. Haver and I also talked about nutrition being a big factor for both physical and mental health during middle age. There are three aspects of how we feed and fuel our bodies that help to manage the effects of perimenopause and menopause. Let’s first look at… anti inflammatory nutrition. 

The second thing is intermittent fasting– what Dr. Haver recommends, is eating during an 8 hour window during the day and then fasting for 16 hours. So for example, you could eat from 10am to 6pm, and then fast from 6pm to 10am the next day. This can help with metabolism, weight gain, inflammation, it can improve our cell’s resilience and for some people improve their blood sugar. But as always work with your doctor before making these changes. 

And then 3rd, exploring your micronutrients and considering supplements. 

She also recommends some other supplements including Turmeric, Collagen, Omega fatty acids, vitamin D and K combined. Figuring out the right supplements for you will require careful work with an understanding doctor, probably some blood tests, and most likely a little experimentation. But there is evidence that deficits in some of these nutrients affects brain health and overall health, and that supplementing can improve mental health and physical health. 

OK, so as we look at mental health as women move into perimenopause and menopause, it’s important to remember a few things. 

  1. This is probably impacting you sooner than you realize, 7-10 years before your period ends. 
  2. Perimenopause is actually when we see most of the mental health impacts
  3. HRT, in addition to SSRI’s (antidepressants) can be an effective way to decrease symptoms and also protect other organs
  4. Along with Sleep and Exercise,  Nutrition is vital in maintaining mental and physical health through the lifespan. I have many videos about these topics on my channel and in my courses. 

We are so used to hearing women and men complain about the effects of menopause. But – it’s a developmental change that comes with benefits too,  It’s. 

    • For one, No more periods! No more birth control!
    • Menopause often marks a transition in life where women may have more time and energy to focus on their own interests, careers, hobbies, or personal growth, as they are no longer dealing with the demands of raising young children. 
    • As my brilliant friend and editor says “Menopause doesn’t give us more time. Being an empty nester does that. What perimenopause and menopause do (which has been powerful for me) is to call loudly for women to think about their own health and care again. It turns out to be a little gift in between the years of sacrificing so much for their children and sacrificing a lot as they care for elderly parents. It’s kind of beautiful how our bodies say for a few years, “Pay attention to what is going on here. Take a season to recuperate and regenerate.”
    • It’s also a chance to explore your own identity.
    • The emotional stability that often comes after menopause can lead to more harmonious relationships, as mood swings and hormonal fluctuations decrease.
    • And many women become more confident, more direct, more assertive. 
  • Dr., Haver- “My ability to tolerate other people’s BS and alcohol have completely Disintegrated.”

OK, I hope this is helpful. Menopause . comes with challenges to mental and physical health, but also some cool changes. It is a life transition that you can’t avoid, but it is something that you can “Grow through”  You can develop the ability to get more real with people, to explore your true self and values. It gives you a chance to evaluate your life path and make sure you’re passionately pursuing the course you want to be on, and for a lot of women, they stop caring as much about what everyone else thinks and can really focus on being their best authentic self. 

Check out the course below, Break the Anxiety Cycle in 30 Days.

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