Lots of factors can contribute to menopause anxiety, from your fluctuating hormones to the physical ways in which they manifest. Add in big changes that coincide with midlife, and you’ve got a recipe for worry and tension. While some degree of anxiety during this major transition is absolutely normal, we can’t be on edge all the time. And we won’t!
Ahead, your guide to anxiety during perimenopause — and how to catch a break from your worries.
What causes anxiety during perimenopause and menopause?
According to the North American Menopause Society (NAMS), women in any phase of the menopause transition may experience generalized anxiety or intense mood disturbances out of proportion to inciting events.
Chalk your fluctuating mood up to fluctuating hormones. On top of regulating your menstrual cycle, your sex hormones can impact mood-regulating chemicals in your brain. Those declining estrogen levels can take a major toll on your mood, causing irritability, mood swings, and anxiety. You might find yourself struggling with negative thoughts or feeling so physically tense it’s hard to rest — or both.
The physical symptoms you face during menopause can also make you feel anxious. Lack of sleep, whether due to night sweats or stress, can directly impact your mood, and anxiety can make it tough to sleep, resulting in a vicious cycle. If you’re experiencing debilitating symptoms for the first time, you might worry about how they’ll impact your life and want to know how long they’ll last.
How can I curb my anxiety during perimenopause and menopause?Anxiety during menopause (and really anytime) can make it difficult to go about a normal routine. Maybe you’re so exhausted from worrying that you skip your workout class, or you’re feeling anxious about your hot flashes so you opt out of getting together with your friends. Over time, this loss of function can start to take a big toll on your mental health and general well-being. Here are a few ways to curb your anxiety, if it’s starting to get in the way.
Keep track of your moods: Whether you use an actual journal or an app on your phone, make an effort to keep track of your emotional state each day. Are you reacting out of proportion to everyday events, and what is triggering you? Keeping tabs on those triggers can help you identify and manage your mood as your hormones shift.
Seek out support: Anxiety can feel overwhelming. Naming the experience — and talking to a trustworthy, empathetic loved one about it — can take some overwhelm out of what you’re going through. You might be surprised to learn, when you open up, that others are going through the same thing, and that the people who care about you want to be there for you.
Check your self-talk: Your thoughts play a huge role in how you feel both emotionally and physically. If you’re caught in a spiral of negative thinking or worries, try to pay attention to and reframe your thoughts. For example, maybe you’re anxious that you’ll always have hot flashes. Remind yourself of the facts: Physical symptoms of menopause, while difficult, won’t last forever — and there are lots of support and treatment options if you feel worse.
Move your body: Exercise doesn’t just improve your physical health. Moving your body can release pent-up stress and ameliorate anxious feelings. Plus, exercise releases chemicals that contribute to a positive mood (hello, endorphins). Whenever you feel on edge, make an effort to move your body, whether it’s a walk around the block or a quick yoga video. Physical activity can also help you sleep better, which might alleviate your anxiety.
Watch what you eat and drink: Certain foods and drinks can make your anxiety worse, so if you’re struggling, try to be more mindful about what you put in your body. For example, along with disrupting sleep, caffeine can be a major contributor to anxiety. Alcohol, while relaxing at first, can actually make anxiety worse. High-sugar foods can spike your blood sugar and cause you to crash. If you have a treat (you deserve it), pair it with a protein to avoid feeling shaky and nervous afterward.
Aim for quality shut-eye: Getting enough sleep is a huge part of mental health and can also improve menopause symptoms including anxiety. Aim for eight hours of sleep each night. If that’s unlikely, rethink your sleep hygiene routine — end your screen time at least an hour before bed, make your bedroom feel extra cozy (which may very well involve a fan and cooling sheets), and avoid caffeine and alcohol at night. If you still can’t sleep, check in with your doctor for more shut-eye strategies.
When should I talk to my doctor about anxiety?
A bit of anxiety is par for the course, especially when you’re facing huge physical changes. But if anxious thoughts are making it hard to function several days a week, you’re having panic attacks, or your symptoms are getting worse even when you’re doing your best to cope, reach out to a healthcare provider.
Along with hearing you out and validating your experience, a therapist can help you understand what you’re feeling and give you strategies to manage your anxiety day-to-day.
A medical provider, whether your gynecologist, primary care provider, or psychiatrist, may want to rule out other causes for anxiety (for example, a thyroid disorder). They may also want to discuss other treatment options, such as anti-anxiety medication, hormonal replacement therapy (HRT), or a combination of both. (A specialist may be more likely to connect the dots between your mood changes and your hormonal changes.)
It can feel vulnerable to admit to this struggle, but speaking up about your anxiety can provide a much-needed reminder that you’re not alone during a super isolating time — and empower you to cope with all the changes.