“Forgetfulness and fogginess were torture. Sometimes my kids would look at me as if to say…who are you? And what have you done with our mother?”
DAVINA McCALL, NEWS PRESENTER
My Story
While I did suffer physical symptoms of menopause, it was the change to my mental health that hit like a tsunami and knocked me off my feet.
I was almost 50 but acting like a hormonal teenager, watching TV in my bedroom all day and night, hiding away from the world. As mentioned in my introduction, at one point I did not leave the house for three months. I was overwhelmed by everything and excited by nothing. Vacations used to be so enjoyable but the thought of packing, getting to the airport, and remembering my passport just felt like too much. I did go on vacation to LA once, which should have been amazing, but I spent the whole trip in my hotel bedroom. I was a real fun holiday companion! Christmas was another challenge; I couldn’t even be bothered putting a tree up. Diagnosing myself with depression, I took myself to the doctor, who agreed and gave me antidepressants. Neither of us considered menopause.
I took the antidepressants and felt a little better, but not much. Driving became impossible; I was too anxious and afraid. It was the worst anxiety: the kind with no real root cause. Exhaustion hit me like a truck! Social anxiety then came along to join the party of fatigue and depression, and I got to the point where I couldn’t even look people in the eye. I used to be out all the time—with a real case of FOMO (Fear of Missing Out) when I wasn’t—and I loved the company of others, but that stopped overnight as my confidence hit an all-time low. I’d scroll through other people’s Facebook posts and feel that everyone else was living their best life—and then there was me. I started to go to a very dark place.
My brain would race, and because I suffer from ADHD, I started to worry that it might be getting worse. I was over-emotional and not at all rational. I would sit in sweatsuits and order clothes from the internet that I knew I would never wear. I just could not take a joke; I would go ballistic when my partner made a comment about my (lack of) cooking ability. I would explode when my daughter’s room was a mess. When I would go to a store and there was a line, I would throw the basket on the floor and march out. I’m an animal rights activist, and if I saw a picture or film with an animal being mistreated it would trigger floods of tears. I started to really miss the person I used to be and wondered if she would ever come back.
When I started having the symptoms in my early forties,I was still drinking. Self-medicating to try to alleviate them, I would drink more and more, then blame my exhaustion and anxiety on a hangover. I think the perimenopausal symptoms were a factor in my frequent relapses as I started on the path to sobriety.
Things are very different now. I look back at that time as awful but necessary to get me to where I am now. Free and refreshed is how I would describe myself; others call it “post-menopausal zest.” A stronger sense of who I am and what I want in life are just two of the benefits of making it to the other side. My FOMO has been replaced with JOMO (Joy of Missing Out). Self-reflection made me realize that I just wanted to be seen in the right places with the right people to feel worthy, so I would hang out with anyone and everyone. But I know now that spending time with quality people is what really makes my heart light up.
So, how did I get there? Well, HRT helped me balance out those pesky hormones, and I also use CBD oil to alleviate anxiety. A friend introduced me to it, and from the first time I tried it I found a sense of calm I hadn’t felt in a long time. I eased myself off antidepressants as I found myself starting to feel better. I was so impressed with the effects of CBD oil that I added it to my product line; it is important to get the good-quality stuff, though.
What else helped? Cognitive Behavioral Therapy (CBT). This was part of my rehab, and it is all about changing the way you think and behave. I found the exercises useful for getting out of my own head and the “poor me” mentality I had developed. Online support groups also made me feel a lot less alone. We really are the first generation to start talking about menopause; I dread to think what it must have been like to suffer in silence.
Tattoos with messages that resonated with me also helped. “Love yourself first” is tattooed down my arm. “This too will pass” is inked on my chest. Because it does pass. There isn’t an overnight fix, and I still have down days, but they are not so severe or so frequent. You might not want to get tattooed (or maybe you do?), but you could save your positive messages as pop-up reminders on your phone.
“CBT helped me notice my triggers then find ways of working through them—it saved me!”
As with PMS, some women are lucky and won’t suffer any symptoms as they go through menopause, but if you do (and I’m guessing you probably do if you are reading this book), know that you are not alone and there is help out there. And to talk about it, let’s hand it over to two experts in this area. First, Dr. Meg Arroll, psychologist, who can talk about what the medical profession can offer to fight the mental symptoms of menopause—and then coach Dawn Breslin, who has the most brilliant technique for helping you put yourself first, right now.
expert view
Let’s Talk
About…
Menopause &
Mental Health
With Dr. Meg Arroll, Psychologist
Psychological and emotional symptoms can be some of the most confusing and frightening aspects of menopause. Many women ask, “Am I losing my mind or is it my hormones—and how do I know the difference?” The answer can be complex, as physiological processes affect our emotional well-being and vice versa.
Depression and anxiety are the two primary mental health issues faced during menopause. First though, I need to explain that the “depressed mood” that affects about a third of post-menopausal women is different from “clinical depression.” To differentiate, symptoms of clinical depression also include prolonged tiredness, loss of interest in normal activities, weight loss, and sadness and irritability alongside that low mood. If you are also experiencing these then you should talk to your doctor.
Depression and anxiety often occur together, and the symptoms of the latter are characterized by tension, nervousness, panic, worry, and feeling on edge. In severe cases, anxiety can lead to panic attacks, causing shortness of breath, chest pain, sweating, dizziness, and heart palpitations—but although panic attacks can be scary and intense, they aren’t usually dangerous. They can, however, have a significant impact on your daily life and functioning.
Why does menopause lead to anxiety and depression?
Estrogen has many functions, one of which is to calm, so when levels drop, psychological symptoms can be the result. But this isn’t the only reason why you might experience emotional symptoms during menopause. As Dr. Jarvis mentioned before, menopause often happens at exactly the point in your life when you have the most on your plate, and the combination of stress and fluctuating hormones can be difficult.
Talking really can help
As Meg discovered, one method that can help some of these symptoms is Cognitive Behavioral Therapy (CBT). The theory behind CBT is that we can change our thoughts and beliefs (cognitions) to break behavioral patterns that might be affecting our health. CBT is carried out by a professionally trained therapist over, usually, six to twelve sessions, during which unhelpful thought patterns and behaviors are identified and challenged—for instance, you may think, “My symptoms are completely ruining my life, and I can’t do anything properly anymore,” but the aim of CBT would be to alter this belief so that more supportive thoughts can emerge, such as, “My symptoms are troublesome at the moment, but I know talking about them with other women will make me feel better.”
Research studies have shown that CBT is a safe treatment, particularly for women who cannot or do not want to use HRT, and it reduces psychological symptoms, improves sleep quality, and supports your daily life.
Other talking therapies to consider include hypnotherapy, Mindfulness-Based Stress Reduction (MBSR), and relaxation training, all of which have been studied scientifically and shown to help the psychological symptoms of menopause.
Hypnotherapy
In this treatment, a practitioner will help an individual reach a “hypnotic state” of deep relaxation, in which health-promoting suggestions are made. You’re always in total control over your thoughts and actions; the hypnotherapist merely enables you to focus your attention on inner sensations and experiences. Like CBT, hypnotherapy is safe and doesn’t cause the side effects associated with some medications, and research has shown it to be as effective as some drugs for treating menopausal symptoms. Hypnotherapy can also help to improve sleep, concentration, and the ability to engage in life once again.
MBSR (Mindfulness-based stress reduction)
This is the formal method of mindfulness, which again is taught by a trained practitioner in a course of six to eight weekly sessions. Mindfulness has become very popular, but it is only these more structured methods that have been studied properly by researchers. MBSR has been found to consistently reduce stress and psychological symptoms in menopausal women.
Relaxation training
Relaxation training for menopausal symptoms includes progressive muscle relaxation, slowing down and pacing breathing patterns, and guided imagery. Overall, these techniques appear to reduce general menopausal symptoms, vasomotor symptoms (like hot flashes), and psychological symptoms such as low mood, but they should usually be part of a more comprehensive treatment plan. The breath exercise on this page is one example of this.
A final word…
Your doctor should take any mental health symptoms you experience seriously. Although it would be an overstatement to say that menopause leads to suicide, figures from the Office of National Statistics do show that midlife is the time period with the highest rate of suicide in the UK for females between 50 to 54 years. You should feel not only listened to but heard.*
The Quick Calming Exercise to Learn
Counselor Diane Danzebrink has a simple tip to help calm you if you are feeling anxious or overwhelmed:
“One of the first things that I teach my clients with anxiety is to take back control of just one thing in their lives—and, as we all need to breathe, that’s often where I like to start. When we breathe out the body can’t help but relax, so simply breathing out for longer than we breathe in, with counting in your head, can bring us back to control. Try it. Try breathing in through your nose for a count of one and out from your mouth for a count of three and see how it makes you feel. Use it whenever you start to feel overwhelmed.”
HOW
REFRAMING
YOUR THINKING
CAN HELP
While the best results of CBT come from working with a therapist one-on-one, here are a few common thought patterns that you might experience during menopause, along with some simple ways to reframe those thoughts to reduce their power over you. If any of them sound a bit familiar, try and use the ideas that follow to change your narrative:
Mind-reading
You think: This hot flash is awful; everyone must be staring at me.
Try thinking: Everyone is far more concerned with themselves, so they won’t have noticed.
“Should” statements
You think: This is a natural process; I should be able to cope better with it.
Try thinking: Menopause can be a difficult process, and, as such, I am coping.
Catastrophizing
You think: There must be something deeply wrong for me to be so forgetful.
Try thinking: Forgetfulness is a common symptom of menopause, and it doesn’t mean there’s a higher chance of dementia or other neurocognitive conditions.
Discounting the positives
You think: There’s nothing good about midlife; it’s all downhill from here.
Try thinking: There are many positive things about this half of my life, and I will make a concerted effort to focus on them.
Overgeneralization and perfectionist thinking
You think: I made a mistake at work when I was having a bad day, and I just don’t think I’m good at it anymore.
Try thinking: There were countless days that I was good at my job, which means I am good at it—no one’s perfect, after all.
The Alignment Process
With Dawn Breslin, Author and founder of The Harmonizing Academy
When my menopause hit, a choice faced me: Refuse to accept menopause and continue to struggle upstream to try and get back to pre-menopausal me. Or start a new stage in my life, where I would cast off that which no longer suited me and use that space to focus on what I really wanted. I chose the latter and used a technique I and many women who have come to me for support have found useful. It is called The Harmonizing Alignment Process, and it works via four key pillars:
Pillar 1: Find what makes you happy
For most of us, our passion has always been there, bubbling somewhere beneath the surface of our responsibilities. MenoPAUSE is the ideal opportunity to start refocusing your lens.
Childhood photos and photos from times in our lives when we felt really happy can help here: If you have some, you may want to get them out and spend time looking at them.
Try and reconnect with the happy and spontaneous you. What did you like? Running through the woods? Art? Live music? Dancing? If you take the time, you can begin to hear those desires and joys whispering, telling you they are still there, begging you to reclaim your sparkle.
Forget the opinions of others and take time to list the things that energize and exhilarate you. The things that make you feel alive.
Pillar 2: Create boundaries
This is probably the toughest part. Strong boundaries are needed to ensure you free the time and have the energy to do what you identified in Pillar 1. Most women of menopausal age simply have too much going on to fit anything more in until they drop something. Maybe you have become an unpaid babysitter to your grandchildren five days a week and are starting to feel a bit resentful, or you are the one at work everyone depends on to put in the long hours. Maybe you have some friends who drain you, but guilt makes you continue to spend time with them. You need to set boundaries to stop this and put yourself first.
Establishing strong boundaries can be hard if you are not used to doing it. One positive thing about that short fuse that often bubbles to the surface during menopause is that it can often give you the energy to get those boundaries in place. Difficult decisions abound in this pillar—what exactly do you need to drop to allow yourself space to flourish? Then how are you going to accomplish that? The next pillar can help with this.
Pillar 3: Self-care
When I talk about self-care, I am not talking about a bubble bath and a magazine. I am talking about FIERCE self-care. It’s giving yourself permission to really take care of yourself. To refuel your tank. And that doesn’t need to be an expensive day at a spa. It might be taking a vacation alone, whether somewhere local, booking into a cheap B&B, or somewhere amazing you have always wanted to go. Or spending a day in bed with your favorite books or TV series when you are tired rather than plowing ahead.
Often, when I talk to women and ask what they really want, they say, “I just want to spend a few days in bed sleeping, but I can’t.” And sometimes they really can’t, but often, with some boundary setting, it is possible. One woman got her husband to take the children to his mother’s for the weekend. She then climbed into bed and stayed there for forty-eight hours. A pitstop, if you like, recalibrating her life. And most important—don’t feel guilty about it. This kind of self-care is essential to give you the energy to make the changes you need.
Pillar 4: Courage
Rewriting the script of your life takes guts. Redesigning your life based on your deep desires may mean rebelling against what others expect from you. Don’t expect everyone to like it!
So, it’s your choice. You can fade away or have a long, hard look at your life and ruthlessly prune what no longer serves you and start planting the garden your heart desires. Accept that it might be tough—but it can also be worth it as you march to the next phase of your life with pride, strength, and determination.
CBD oil explained
CBD (short for cannabidiol) oil acts on receptors in the brain that control functions like sleep and pain. It also seems to alter blood flow in the brain. This combination of effects has been shown to help many problems that you can experience in menopause, including anxiety.
As you might have guessed by the first part of that word, CBD is extracted from plants in the cannabis sativa family; these include hemp and marijuana. Don’t panic, though! CBD is not going to get you high. The substance in cannabis that does that is called THC (or tetrahydrocannabinol, if you like long words). It’s found in large quantities in marijuana only, and most products sold without a prescription come from hemp, which naturally has very low THC levels.
How much to take?
This is very, very hard to answer, as it varies from person to person, but a starting dose of 20mg is often suggested. Try that for a few days, and if you don’t get relief, increase by 20mg. Keep going until you find the dose that works for you (obviously never exceeding the maximum intake per day listed on your product). Reduce your dosage if symptoms seem to get worse again.
CBD oil labeling can be very confusing, so it’s best to start with a product that clearly states how many mg of CBD it contains per drop, rather than just saying what percentage of CBD is in the bottle.
Is CBD safe?
Research is still ongoing about all of the effects of CBD, but generally it seems that, yes, it is safe—however, you must speak to your doctor before using it if you are on any kind of medication, as it can interfere with the metabolism of some drugs.