Mental Health Awareness Month Series – Part 3
Many women come into the office during their 40s and 50s saying some version of this:
“I just don’t feel like myself anymore.”
Or:
“I feel more anxious than I’ve ever felt in my life.”
Or even:
“I don’t know what happened to me.”
If this sounds familiar, you are not alone.
For many women, perimenopause and menopause can significantly affect mental health, yet many are surprised by it because no one warned them this could happen.
Mood changes during this stage of life are real, common, and worthy of attention.
It’s Not “Just Hormones”—But Hormones Matter
Hormones influence much more than periods and hot flashes.
Changes in estrogen and progesterone can affect:
- Mood
- Anxiety levels
- Sleep quality
- Brain fog and focus
- Emotional resilience
- Stress response
Estrogen interacts with brain chemicals like serotonin and dopamine, which play a role in mood and emotional wellbeing.
Progesterone can have calming effects for some women.
As these hormones fluctuate—especially during perimenopause—many women experience emotional changes that feel sudden or unfamiliar.
It’s Not Just Hormones: Why This Stage of Life Can Feel So Heavy
While hormones can absolutely play a role, they are often only one piece of the puzzle.
For many women, this season of life comes with an extraordinary amount of invisible stress.
You may be:
- Raising children or teenagers
- Parenting young adults who still need support
- Caring for aging parents
- Managing a demanding career or leadership role
- Navigating relationship changes or divorce
- Experiencing grief, loss, or changing family dynamics
- Carrying the mental load of everyone else’s needs
At the same time, your body may suddenly stop responding the way it once did.
Sleep becomes harder.
Stress feels harder to tolerate.
Weight shifts.
Energy changes.
Recovery feels slower.
And many women start wondering:
“Why can’t I handle things the way I used to?”
The truth is:
You are likely carrying more than ever before—while your body is becoming less resilient to stress at the exact same time.
Then add in:
- Hormonal fluctuations
- Poor sleep
- Increased inflammation
- Blood sugar changes or insulin resistance
- Alcohol affecting sleep or anxiety more than it used to
- Less time for movement, joy, friendships, or self-care
…and it becomes easier to understand why mental health symptoms may show up during this stage of life.
Sometimes women assume:
“I’m just bad at coping.”
But often, what they are experiencing is a very real combination of biology, stress, and life transition colliding all at once.
Anxiety Can Show Up for the First Time
One thing that surprises many women?
Anxiety may show up for the first time during perimenopause.
Women often say:
“I was never an anxious person before.”
Symptoms can include:
- Racing thoughts
- Feeling overwhelmed easily
- Heart palpitations
- Panic-like symptoms
- Increased irritability
- Trouble relaxing
- Feeling emotionally “on edge”
Sometimes women think something is seriously wrong medically—or feel like they are “losing themselves.”
What they are experiencing may actually be part of a hormonal transition.
Depression During Menopause Can Look Different
Depression does not always look like sadness.
Sometimes it looks like:
- Fatigue
- Low motivation
- Emotional numbness
- Brain fog
- Increased irritability
- Pulling away socially
- Loss of confidence
- Feeling unlike yourself
Many women continue functioning—working, parenting, caring for everyone else—while quietly struggling.
Sleep Changes Can Make Everything Worse
One of the biggest contributors to mood changes during menopause?
Poor sleep.
Night sweats, frequent awakenings, racing thoughts, or waking up around 2–4 a.m. can leave women emotionally depleted.
Poor sleep affects:
- Anxiety
- Mood
- Focus
- Stress tolerance
- Blood sugar and cravings
Sometimes sleep disruption is the hidden driver underneath worsening mental health symptoms.
When to Seek Help
You do not have to “just push through.”
Talk to your doctor if:
- Anxiety or sadness is affecting daily life
- Sleep has significantly worsened
- You feel emotionally unlike yourself
- You are losing joy in things you used to enjoy
- Mood changes are affecting relationships or work
You deserve to be taken seriously.
Treatment Is Not One-Size-Fits-All
Support may include:
- Improving sleep
- Regular movement and exercise
- Nutrition and reducing alcohol intake
- Stress management strategies
- Therapy or counseling
- Medication for anxiety or depression
- Hormone therapy when appropriate
There is no one “right” answer.
The goal is helping you feel like yourself again.
Helpful Resources
The Menopause Society (formerly NAMS)
Evidence-based information on menopause symptoms and treatment options.
988 Suicide & Crisis Lifeline
Call or text 988 if you are struggling emotionally or need immediate support.
Final Thoughts
If you’ve been wondering:
“Why don’t I feel like myself?”
Please know this:
You are not weak. You are not “crazy.” And you are not alone.
Mental health symptoms during perimenopause and menopause are common—and treatable.
You deserve support, answers, and a plan that helps you feel like yourself again.
Mental Health Awareness Month Series
Part 1: I Don’t Feel Like Myself: Could Alcohol Be Affecting Your Mental Health?
Part 2: I Don’t Feel Like Myself: Understanding Postpartum Depression
Part 3:I Don’t Feel Like Myself: Anxiety & Depression During Menopause
