Dealing with the emotional side of the menopause

Going through the perimenopause and menopause can sometimes feel like an emotional rollercoaster – a ride that none of us signed up for! A natural decline in oestrogen and progesterone – the hormones responsible for maintaining the female reproductive system – can trigger mood swings and cause conditions such as menopause depression and perimenopause anxiety.

In fact, emotional problems are one of the most common side effect of the menopause. If you are going through perimenopause, you may notice you experience heightened emotional volatility in the run-up to your period. This is when your hormones are naturally at their lowest. Premenstrual syndrome (PMS) and negative emotions may reach a peak just before your period begins, and you may start to feel better after the first few days of your menstrual cycle.

As you progress further into perimenopause and menopause, your emotional instability may increase to several days a month to more, primarily due to fluctuating hormone levels. At the peak of menopause, some women report feeling in a near-constant state of PMS as the body prepares for the menstrual cycle to stop permanently.

It goes without saying that mood disturbances and mental health problems can be one of the toughest side effects of the menopause. Almost half of menopausal women report feelings of depression or anxiety, which can have a negative impact on self-confidence, relationships and overall quality of life.

Read on for menopause support and to discover everything you need to know about dealing with the emotional side effects of the menopause.

One moment I was happy, one moment I wanted to smash my husband's face in.

Menopause and mental wellbeing

The perimenopause and menopause stages cause hormonal changes that can have a serious impact on your mental wellbeing. Some of the emotional challenges you may experience are:

Feelings of sadness

Mood swings

Increased irritability

Anxiety

Depression

Rage and aggressiveness

Difficulty concentrating (brain fog)

Fatigue

Tension

If you experience any of the feelings above in your 40s and 50s on a frequent or prolonged basis, or symptoms come on suddenly, there’s a good chance it could be related to the menopause. Below, you’ll find some tips that will help you recognise and manage menopausal mood swings, perimenopause and menopause anxiety, menopause depression and more.

Tip 1: Speak to your doctor about menopause depression

Depression can cause feelings of sadness and a loss of interest in activities you once enjoyed. For a diagnosis of depression, symptoms must last at least two weeks and must represent a change in your previous level of functioning. If you suspect you are experiencing menopause depression and it is having a negative impact on your quality of life, it is important to speak to your doctor before embarking on any self-management techniques. This is so they can rule out other medical or psychiatric conditions, and direct you to the help you need.

While lots of women have symptoms of depression during the menopause, you are more likely to experience them if you have had similar at other points in your life. A doctor may recommend various treatments depending on your situation – whether a course of HRT (hormone replacement therapy), another medicine such as antidepressants, cognitive behavioural therapy, or a combination.

I used to feel sad and not know why I feel sad.

Tip 2: Prepare for the side effects of menopause in practical ways

Preparing for and managing the physical symptoms of menopause in practical ways can help support your mental health and wellbeing. Women going through the menopause often experience physical side effects such as hot flushes and bladder problems. These can be debilitating, and contribute to or exacerbate menopause depression, anxiety and mood swings.

Managing physical symptoms can help you feel in control, and lessen the likelihood of any detrimental emotional effects. For example, if you suffer from menopause migraines or headaches, ensure you stay hydrated, avoid too much screen time and keep paracetamol in your handbag. If you are experiencing menopause-related incontinence, make sure you stay dry and protected by wearing a TENA Lights for Sensitive Skin throughout the day and night. If you know you are prone to getting hot flushes just before your period, try to schedule work meetings outside of this time, and speak to your manager or human resources department if you need support when dealing with menopause symptoms in the workplace.

Tip 3: Eat well for optimum mental health

Eating a balanced diet rich in nutrients, vitamins and minerals is important at all stages of life, but is especially important during the menopause, when your body experiences many emotional and physical changes.

To help keep your mood stable, ensure you eat enough protein rich foods that contain the amino acid tryptophan. Tryptophan helps manufacture serotonin, which can help balance menopause mood swings. Turkey, cottage cheese, oats and legumes are all tasty sources of this amino acid. To help combat menopause depression and anxiety, you might like to adopt new strategies, such as eating breakfast, or eating regular small meals throughout the day to keep blood sugar – and therefore mood – stable.

Tip 4: Engage in calming practices to help menopause anxiety

Some women find learning to relax can be a really useful source of menopause support. Lowering expectations on yourself is important. For example, rhythmic breathing can help calm menopause anxiety. Unstable emotions often disrupt your regular breathing pattern, so if you feel angry, worried or stressed, try to find a quiet place free of distractions and noise. Take some long, slow, deep breaths, or check out one of the many rhythmic breathing apps available. You’ve got this!

Similarly, integrating calming practices such as meditation, mindfulness or journaling into your day can be helpful for preparing for the menopause and managing menopausal symptoms. When it comes to exercise, you might like to choose low-impact workouts such as yoga or swimming, which are good for both the mind and body.

As well as engaging in calming practices, you might find that getting good quality sleep and going for relaxing walks in nature help relieve any negative emotional side effects of the menopause.

Tip 5: Seek menopause support from your closest relationships

When women go through the menopause, they sometimes feel that their unstable emotions threaten not only their personal sense of mental balance, but their relationships too. Trying to keep a lid on unstable emotions can be exhausting – it’s okay to reach out for help during the menopause. Laughing and having fun with your family and friends can be a nourishing to relieve difficult emotions.

If you are feeling confused by irrational emotions and mood swings around the menopause, make sure to nurture relationships with your partner, children, family and friends. Family members, especially, may feel like the target of an onslaught of menopausal emotions. Rather than biting your tongue or exploding, try to talk to the people you love about how you are feeling, and tell them if you need extra understanding, patience sympathy and support. Let people know when you need space and time alone to process your emotions, and conversely, ensure to schedule in quality time with your loved ones when you are feeling up to it.

“I have more hair on my face than I do on my head”.

Ingi’s appearance altered when she started her menopause, but the biggest change was in her personality. In this video she and her girls discuss mood swings, sleepless nights, and the power of asking ‘are you alright?’.

Watch Ingi’s story now.

Tip 6: Channel negative emotions of menopause depression and anxiety into something creative

As the body changes and adapts to a new phase of life, women going through the menopause often report feeling a loss of identity, purpose and sense of self. Whether you have children or not, some women find it difficult to accept the end of fertile years – a change that brings about feelings of sadness and low self-worth. The loss of fertility can even bring an increased awareness of ageing and mortality.

Some women therefore find channelling negative emotions into something creative is a good way to deal with or combat these feelings. Painting, dancing, becoming a more proficient cook, learning a new language or engaging in an exciting new form of exercise are all ideas that can help you build a new sense of identity and increase self-confidence during the menopause.

With lots to consider throughout all stages of the menopause, the emotional side can get overlooked. If you feel like you need further support, don’t hesitate to contact a professional, such as your nearest GP.