Did you know anxiety is a really common symptom of the menopause? Previously I wouldn’t have described myself as an anxious person but I have found my anxiety levels during menopause seem to spring up unexpected all the time. I thought I’d been managing this but talking with my husband he said I seem to worry about everything. Small things that I used to just take in my stride seem huge issues and it’s just not like me.
Before studying and learning all about the menopause and working with 100s of women going through the menopause, I really didn’t understand or expect the psychological impact these changes would have. I think most of us know about some of the most common physical symptoms such as hot flushes and night sweats but the psychological impact wasn’t so obvious.
For me, my anxiety is a frustration and I’ve found ways to manage this, which I’ll come onto shortly. I know for many of my clients and members of the Menopause Club anxiety can be incredibly debilitating.
“My problem was anxiety – and my goodness, was it overwhelming. So overwhelming I had to stop work, I didn’t want to see any friends, and on many occasions I felt as if was stuck at home by panic” Janet, 49
“I ended up in A&E twice thinking I was having a heart attack. After weeks of tests coming back normal I’ve been told these attacks are a symptom of the menopause! WTF!” Allison 50
Why does this happen in peri-menopause/menopause?
Research shows anxiety and depression is more common around menopause. Stacey B. Gramann, Psychiatry Resident at the University of Massachusetts, reports in a survey of nearly 3,500 women aged 50-79 years, panic attacks were most common among women in the menopause.
Several so-called psychological symptoms of the menopause can be attributed to the known reduction of blood flow to the brain as oestrogen deprivation causes blood vessels to constrict. The result is clumsiness, a reduced reaction time and a lack of ability to judge distance, along with a woolly ‘out of body’ feeling.
Progesterone acts as a natural sedative, softening and balancing the effects of oestrogen and promoting sleep. Because progesterone is a woman’s ‘calming’ hormone, with less of it around it makes complete sense that we may feel more overwhelmed and easily stressed, anxious, edgy and short tempered. In many women, this leads to symptoms such as tension headaches, palpitations, digestive issues and more – and, in some cases, full-blown panic disorder.
To make this hormonal roller coaster even more potent, alongside your body changes, you may well be experiencing other life events around the time of perimenopause which can exacerbate anxiety. Dealing with teenagers, kids leaving home, ageing parents, relationships, finances, work, getting older – I’m sure you can add in many things here!
Everyone experiences anxiety at some point, but when it becomes out of proportion, persistent or appears for no apparent reason, it can become a problem. You may well already know this but when we are anxious the stress hormone adrenaline is triggered as part of the ‘fight or flight’ response. This response is designed to protect us from danger and is totally natural biologically, so really, anxiety only becomes a problem when we don’t actually need to run away or fight for survival. To experience rising anxiety in a situation where we tell ourselves we ‘should’ feel perfectly fine only makes us confused and angry with ourselves. Sometimes, if we experience waves of panic in an unexpected environment such as in a supermarket or business meeting, it can be truly terrifying.
Physical Symptoms of Adrenal Dysfunction (Adapted from ‘Are You Tired and Wired’ by Marcel Pick)
- You’re tired on waking even after a ‘good’ nights sleep
- You find it difficult to stay awake in the evening once sat down
- You need to/want to sleep in the afternoon
- You feel both alert and exhausted
- If you stop….you drop – fall asleep or doze off
- You have heart palpitations
- You have gained weight around your middle
- You’re losing muscle mass
- You can’t tolerate exercise, especially high volumes like you used to
- You generally don’t feel ‘well’ most of the time
- You retain water
- You struggle with low blood sugar
- You can’t make it through the day without coffee
- You struggle with PMS, perimenopausal/menopausal symptoms
- You’re easily irritated and prone to outburst
- You sometime feel listless, depressed and emotionally numb
- You have a low sex drive
- You’re tearful more than usual
- You’re easily startled
- Your stress and feelings of being stressed are chronic
- Everything seems like a huge effort
How to tackle anxiety:
Here are some suggestions for you to consider:
- Talk to friends. Sharing your feelings and emotions is often the best way to discover that many of us are actually feeling the same way. It’s easy to think we are slowly going mad and are afraid to share our feelings. Talking it out can also help us to get to the root of our anxieties.
- Develop an exercise plan. Pick a form of exercise you really enjoy and do it on a regular basis.. This could be walking, running, swimming, yoga, or dance – whatever appeals to you. Many members have shared how much walking and getting outside makes a huge difference to their anxiety levels. Consistency is the key in helping you burn off some of that nervous energy. Studies have shown that anxiety can be significantly reduced by regular, gentle exercise, so it is well worth making it a part of your daily routine.
- Focus on your breathing. When you feel overwhelmed take a few minutes to calm your breathing. Breathe in for the count of 7, and breathe out counting to 11. After a few, deep relaxing breaths, your body and mind can slow down and your thoughts can become much clearer.
- Develop Me-Time. So much of our energy is devoted to what’s going on around us be that work, family or caring for others. It is very necessary to take time-out for yourself. Take even 10 minutes each day when you escape to your bedroom, or the garden and hide from the world: relax, reflect or keep a journal.
- Take time to meditate or practice mindfulness. Use meditation to focus, to quieten the mind, and to become present in the moment. Mindfulness can create feelings of wellbeing and relaxation, lower our blood pressure and heart rate and can reduce menopausal anxiety and stress.
- Practice Yoga. Certain combinations of poses can help reduce anxiety and leave us feeling stronger and more relaxed.
- Try to resolve past emotional issues. Menopause can be a time for forgiveness, healing, and compassion. Whether you need to seek out professional help or can come to terms with these issues yourself, try your best to let go, forgive, and move on. Start by being compassionate with yourself. Life is too short to hold grudges or put up with being unfairly treated by others.
- Talk to your GP/Health professional. By keeping an open dialogue and developing a good relationship with your doctor, you may be better able to manage the physical causes of your menopause anxiety. Consider asking about hormone replacement therapy (HRT). While some women are not comfortable with the pills or creams, HRT has made a big difference to many. If you are not comfortable discussing your options with your doctor this may be a time to find a new GP. Seek out a GP who has expertise or experience of the menopause.
- Track your triggers. How many cups of coffee or caffeinated drinks are you drinking every day? Try cutting back to see if caffeine triggers your anxiety and nervousness.
- Equally, look at your alcohol intake. Alcohol is a depressant and we can often use it as a crutch to lessen our feelings of anxiety, thereby exacerbating the problem.
- Consider supplements that will support your mental well-being – vitamin D3, magnesium and vitamin B complex. Certain products contain natural ingredients that might provide relief for your symptoms. Herbal tea, such as camomile, is known for its calming properties.
- Educate yourself. As the saying goes – ‘knowledge is power’. Learn more about your symptoms so that you can make decisions about what’s best for your mind and body. Use our booklet “What’s My Body Trying to Tell Me?” to track your symptoms.
Dealing with a panic attack
Many women experience panic attacks during the menopause. When someone has a panic attack, they experience intense feelings of anxiety or “doom.” These feelings may be accompanied by physical symptoms, such as:
- heart palpitations
- shortness of breath
- tingling sensations
Panic attacks most commonly last for 10-30 minutes, but they can also recur in a series of episodes that can last for hours.
Many people experiencing a panic attack for the first time worry that they are having a heart attack or a nervous breakdown. Panic attacks can be among the most terrifying experiences of a person’s life. This article explains more about the difference between chest pains of a panic attack and a heart attack:
If someone has panic attacks, they should speak to their doctor. They may either prescribe some medication or refer the person for a mental therapy that may be able to help.
Some people find that practicing mindfulness techniques can help prevent panic attacks. In mindfulness, practitioners focus on the thoughts and physical symptoms that accompany a panic attack and learn how to manage them.
Irregular breathing can cause panic attacks. For example, trying to breathe in more than your body can let you, or breathing too quickly. Learning to control breathing when experiencing high levels of anxiety can help people to control panic attacks.
Having someone with you during a panic attack is helpful. This person can reassure you, gently encourage you to slow your breathing down, and stay with you until the attack has passed.
Here are some great tips from a great website Mindful: Find Balance During a Moment of Panic
As with anxiety more generally, some lifestyle changes are known to help reduce panic attacks. These include:
- eating a healthful, balanced diet with lots of fresh fruit and vegetables
- avoiding alcohol
- reducing consumption of caffeine
- learning self-relaxation techniques
- getting plenty of fresh air
The most important takeaways from this are:
- Anxiety is a normal symptom of the menopause – you’re not going crazy!
- There are practical things you can do to help improve your anxiety
- It will pass
- You are not on your own – join our Facebook community for more support
- If it feels like it’s too much – seek help – from friends, family, your GP – don’t struggle on your own.