A little over a year ago on LinkedIn, I broke my silence on how it felt to work through an often debilitatingly symptomatic menopausal transition while pretending everything was fine.
I was frustrated and exhausted. Within hours, 173,000 people viewed that post, and it changed the trajectory of my career from being just a workplace well-being strategist to include women’s health advocacy.
Now, when women learn that I battled my own perimenopause demons and run a menopause resource site and community, the floodgates open and they share stories of suicidal ideation, careers destroyed and longstanding partnerships severed. While It makes sense to leave toxic jobs and dysfunctional partnerships, we cannot ignore the shockingly high statistics around divorce and quitting jobs in midlife women.
For many, the word ‘menopause’ conjures up a gray haired crone, wearing red, sweating through her dress and looking like she’s about to tear someone’s head off. These harmful stereotypes keep women dangerously silent, and very few people speak about one of the first and most debilitating symptoms of perimenopause, which is new onset or worsening anxiety or depression.
Mental health challenges and the menopausal transition are nuanced, but recent literature suggests 15 to 30% of women will experience their first case of depression during menopause, and 50 to 70% of women who previously experienced anxiety or depression will encounter exacerbation of their symptoms or a new diagnosis.
Sadly, I was in the second camp.
My Story
Prior to my menopausal transition, If you looked in the encyclopedia for the term “lifelong anxiety sufferer,” you would see some diagnostic terminology and a picture of my nervously smiling face. Despite being painfully shy and having catastrophic thoughts from a very young age, I was able to channel my people-pleasing tendencies into chronic overachieving.
Anxiety seemed to be a winning strategy for me, unless it was a week before my cycle. That was when the wheels came off.
From the age of 14, I experienced horrible period pain and intense Premenstrual Syndrome (PMS), which have since been diagnosed as endometriosis and Premenstrual Dysphoric Disorder (PMDD). To “solve” these issues, I was prescribed a combined oral contraceptive and told to take ibuprofen every four hours for the pain. Birth control worked temporarily, relieving both the horrific cramps and sudden mood swings.
At that time, no healthcare professionals, including mental health professionals, reconciled the connection between my hormones and emotions as something severe enough to warrant monitoring or medication. When I went off the pill at 39 to try to conceive, I had no idea that I was entering perimenopause—or about to experience depression beyond my imagination.
At 44, I went from the daily anxiety of trying to protect my life to wanting to end it in an instant. The best way to describe how I felt, is that my brain was short circuiting.
During these periods of odd catatonia, I couldn’t talk and could barely cry. I felt totally numb and dead on the inside. There were days that I couldn’t stand the sight of myself or my husband. At times, I hated myself for my inability to self-regulate. I wanted to climb out of my body, frequently fantasized about blowing up my life, and on the worst days, began to consider a rooftop departure. These feelings were new and terrifying.
Overnight, I had morphed from a vibrant, outgoing, holiday and family loving woman, into a version of myself that resembled none of those things and had no idea why. I had never been depressed, other than the couple brief early-age incidents of PMDD.
I thought I was losing my mind and needed to be institutionalized. It wasn’t until I spoke to my incredible physician that I realized these feelings were symptoms of perimenopause. I thought 44 was too young for “the change,” and quickly learned how wrong I was. Thankfully, I was started on Lexapro, and within three days I began feeling more like myself.
Emotions in midlife are often a mix of so many things like work, partnership, children and caregiving for parents, making it hard to reconcile the source of depression and anxiety.
With the medication disrupting my depression and constant catastrophizing, I was suddenly able to articulate my body and personality dysmorphia to my partner. Together, we started tracking patterns of where in my cycle I felt better or worse. I learned to take space in my relationship when I needed it, and meet myself with a heavy dose of self-compassion.
Three years later, with the addition of menopausal hormone therapy, I feel fantastic, and while I still have days where I can get a little low, they are nothing like how I felt at 44.
While medications have been life saving for me, awareness, self-compassion and community have also been game changers. Had I known my hormone fluctuations were the reason behind my drastic personality change, I wouldn’t have been so terrified, and I am not alone.
A recent study by Bonafide Health shows that 50% of women between the ages of 40-49 feel hopeless about menopause, and four out five women feel like we should be talking more about the symptoms.
So much research and work needs to be done to educate women, allies, even doctors about the menopausal transition.
I am a white, educated woman who worked for 20 years in healthcare, has a loving supportive family, great doctors and language around mental health challenges, and perimenopausal depression still rocked my world. I cannot imagine how troubling symptoms like mine would be for someone with a different lived experience, which is why I now work daily to ensure that women know what is happening to them and have the tools and resources to not only survive but thrive through the menopausal transition.