Acknowledging the tough, vulnerable parts of perimenopause – anxiety, self-doubt, and self-criticism

When you think of menopause or perimenopause, what do you think of? It’s pretty common that your first thoughts might be hot flashes, or irregular periods, or maybe sleep issues and irritability. But there’s a lot more to it.

As a woman in my late 30’s, and a clinical psychologist, I’m a bit embarrassed to say that that was about all I knew about menopause too until the last couple of years. I don’t remember menopause being discussed at all in my psychology training, and when I look back now I can see a big gap in the way I worked with midlife women. It wasn’t until I got interested in hormones and women’s wellbeing that I began to appreciate the psychological symptoms of menopause, and with this knowledge, I’m shocked at what I didn’t know before.

Many women describe losing their sense of themselves and their zest for life during their menopause transition. Brain fog can undermine confidence at work and socially, with frequent experiences like completely losing your train of thought or forgetting things that used to come easily like words or people’s names. Emotional ups and downs of anxiety, low mood, and irritability are common, and add to what can already be a demanding phase of life when we throw in job and family demands. No wonder then, so many women feel overwhelmed.

While the conversation about menopause has come a long way toward being more open, I wonder if we are truly open about this more vulnerable side of it. How many people feel brave enough to share feeling lost, overwhelmed, and uncertain of themselves? We’re often not good at sitting with that vulnerability, instead being quick to minimise it or hurry ourselves along with comments like ‘it could be worse’ or ‘I’m just being silly’.

Almost all my clients are quick to this pattern of minimising what they go through and criticising themselves, and I know this pattern well myself. I’ll say things to myself in my own head that I would never say to anyone else – ‘you’re being ridiculous’, ‘you idiot’, ‘just get over it’ – often with much more colourful language!

Instead of this criticism and self-judgement, there’s huge value in instead meeting yourself where you’re at, acknowledging that it’s tough, and allowing yourself to be having a hard time. To me, this is the value of more open conversations about menopause – normalising that it’s tough and so common to struggle. This acknowledgement to ourselves is always useful, but it’s especially valuable during perimenopause.

The often messy and uncertain nature of perimenopause, as well as its unavoidable link to ageing, lend themselves to women comparing themselves negatively to others, beating themselves up for not achieving their high standards for themselves, and dismissing their own feelings and needs. Unfortunately, this just makes life harder. Now, not only might you be feeling overwhelmed, but you’re also angry at yourself for feeling overwhelmed and not coping better. In this way, we add to our own mental and emotional load.

Top tips for dealing with perimenopause anxiety

If this self-criticism is sounding all too familiar, here are my top tips –

• Pay attention to how you talk to yourself – what do you say to yourself and, even more importantly, what tone do you use?
• Find a gentle way to connect to yourself when you notice patterns of self-criticism and dismissiveness, for example ‘hey, that was really harsh with myself’, or ‘my inner critic is mean today!’. Remember, tone is important here, so aim for the kind tone you would use with someone you care about.
• Ask yourself, what would I say to a friend struggling in this way? Try to offer yourself a bit more of that care.
• Do something kind for yourself – this can be as simple as taking a couple of minutes to enjoy a cup of tea, or using a scented hand lotion you love the smell of. These are small, manageable actions, and done with an intention of kindness to yourself when you need it, they can grow into an attitude of self-care rather than self-criticism.

From my own experience, crafting a kinder relationship with myself is an ongoing journey. Some days I am better at it than others, but certainly it makes a difference. When I connect to a genuine place of kindness for myself, it brings a feeling of relief, a feeling of being understood, and being ok even in the midst of feeling a mess. What a powerful thing to be able to give ourselves.