symptoms

Anxiety and Perimenopause

Anxiety and Perimenopause

Anxious: adjective

  1. experiencing worry, unease, or nervousness, typically about an imminent event or something with an uncertain outcome.
  2. wanting something very much, typically with a feeling of unease.

Sexy: adjective

  1. Sexually attractive or exciting.
  2. Sexually aroused.

Definitions are from Google, courtesy of Oxford Languages.

Can You Be Anxious and Sexy?

Until recently I would have said that a person cannot be both anxious and sexy. Perhaps one or the other, but not both at the same time. Someone who is uneasy and nervous can’t usually also pull off sexually attractive or exciting. In my opinion, it’s also highly unlikely that someone experiencing anxiety can also be sexually aroused.

Then I got a pair of socks for Christmas.  Yes. Socks.  Here is a picture:

There was a time when I may have been offended or upset that my partner thought of me as an anxious person. (He put the socks in my Christmas stocking.) But not now. I love that he still openly finds me sexy, and I really appreciate his nod to my anxiety; not as a joke, but as a fact.

Challenging Hormonal Changes

Since university, I have had bouts of anxiety, which I always managed to suppress with a combination of grit and for several years a selective serotonin reuptake inhibitor (SSRI).  But after my first child was born, my body’s postpartum hormonal cocktail combined with cruel and unusual sleep deprivation required me to get professional help.

Talk therapy allowed me to understand why I was anxious and how to manage those feelings so that I wasn’t under a daily cloud of fear and ‘what if’. I didn’t seem to need the meds at this point, I just needed to let out all of my pent up angst, feelings, and traumatic experiences.

 

Perimenopause, Anxiety And Depression

In the last couple of years, I have been blindsided by an unprecedented level of anxiety. It’s unlike anything I have experienced before. I was able to finally realize that this new, more intense, anxiety was cyclical.  And that it usually came with a few days of depression. Scary.

Turns out I have premenstrual dysphoric disorder. Undiagnosed for my entire menstrual life, until it came back with a vengeance this past year. It is a severe medical condition that can have many symptoms, including anxiety and depression.

I am using medication again, but not an SSRI this time. After some trial and error, including a bad experience with the birth control pill, I am now on a daily dose of pharmaceutical oral micronized progesterone and that seems to be smoothing things out. Fingers crossed. I am still anxious, but It’s not nearly as intense or frequent. And the depression seems to be gone.

Can You Be Perimenopausal, Anxious, and Sexy?

Before the socks, I would have said that as someone in perimenopause, I can be anxious (definitely anxious) and I can be sexy (I usually have to work at it), but I can’t be both at the same time. Then I put the socks on for the first time and I had a moment. My thinking shifted, and here is where I landed.

I used to think anxiety was something to be ashamed of; something I had to hide, and something I was trying to cure. But I realized when I slid on those socks that my thinking about my anxiety has evolved and changed.

Glennon Doyle, who wrote Untamed, talks about her anxiety as proof that she is paying attention; that she understands what is happening in the world and is doing her best to help make it a better one.

I have long admired that view, but until I put on these socks, I didn’t feel that truth.  Despite my admiration for Ms. Doyle and my long-term relationship with my anxiety, I had continued to try to eradicate it from by being; I was trying to cure my humanity.

Yes, my anxiety needs to be managed. For me it has been therapy and meds, and now hormone replacement in the form of progesterone. And this is very important; as Glennon Doyle says “take the damn meds!”.

I Realize Now That Anxiety Is Something To Acknowledge And Understand.

But now when I have what I will call an anxiety flare, I don’t beat myself up. I no longer have feelings of disappointment, shame, or frustration that my anxiety couldn’t be ‘controlled’. I no longer think I am a failure because I got really worried that something bad might happen.

I recognize now that anxiety is not something to be cured, it is something to acknowledge and understand. It is a part of me. And the more I try to fight it, the closer I slide toward it becoming all consuming.

My partner and children know that I am in perimenopause and that my moods can be unpredictable. They know that I suffer from anxiety, and that sometimes it will get the best of me. I am at a place now where I can, sometimes even in the moment, realize ‘oh yes, things aren’t that bad: I am about to ovulate, or bleed, or I am just in crazy perimenopause’.

I don’t try to control it. I no longer see it as something ‘other’. My anxiety is a part of me. There are supposed to be bad days. Coming to this realization has required a lot of work, and I know that this work will never be finished.

We were told we could have it all; we just weren’t told the cost.

We have been socialized to be perfect; to look young, be happy, skinny, and effortlessly put together. We were told we could have it all; we just weren’t told the cost.

Of course I’m anxious. I am human, and I am perimenopausal. The key for me has been to:

  • Get help, both therapy and medication;
  • Allow myself to feel instead of suppress;
  • Ask for help; I no longer try to pretend with my family and friends that I am okay when I am not (Big shout out to Michelle);
  • Understand that we are constantly changing, especially in perimenopause. So what worked before may need to be tweaked or changed;
  • Stop trying to cure my humanity and embrace my beautiful, imperfect self;
  • Define my priorities, and where I want to focus my energy;
  • Learn to be present; and most recently,
  • Understand the concept of multiplicity.

Shame, Blame, And A Defeatist Attitude Are No Longer Necessary.

I am reading a parenting book called Good Inside by Dr. Becky Kennedy. In chapter 2 it talks about multiplicity, which is the ability to accept multiple realities at once and how this is critical to healthy relationships. The notion of “two things are true’ allows people in a relationship to feel seen and heard, even if they are in conflict.

So helpful for my relationships; but perhaps most importantly, so helpful in my relationship with myself. I don’t need to go to shame, a defeatist attitude, or blame (we are our worst critics.) when the big scary feelings hit.

The truth is that I can be a great mom, who struggles with perimenopause. I can be a great partner, who loses their temper. I can be a great friend, who forgets to call. And I can be both anxious and sexy.

Anxiety can become debilitating and seeking help is important. It is also important to say that there is no shame in any of the methods someone chooses to support their mental health. Maybe you need antidepressants and/or a therapist and/or hormone replacement therapy and/or breath work and/or yoga and/or meditation and/or time with friends and/or a support group and/or…

There is no one answer. What is right for you should be based on what you need, not what works for someone else or their definition of what is appropriate. What is working for me today is acceptance, the concept of multiplicity, medication, and the right pair of socks:

Anxious and sexy today. Funny and a hot mess tomorrow.

You get the idea.

Perspective Is Important.

Call To Action

Perimenopause can bring on new or increased feelings of anxiety, irritability, and/or depression.  Perspective is important as fluctuating hormones in this stage of life often coincide with stress from other life stage events like demanding careers, parenting, eldercare, managing a household and/or community work. This can lead to the assumption that life in general is causing the mood changes, when often fluctuating and/or decreasing hormones are the culprit.

Is It Menopause Related Anxiety or Is It Life?

Why is this distinction important? When I realized that my anxiety was a symptom of perimenopause, I felt empowered. I was able to stop negative thoughts like ‘I can’t handle my job’ or ‘why can’t I be a better mom?’. It was comforting to realize that my changing hormones were causing my anxiety, and that my anxiety was in fact cyclical.

Also, many doctors may be quick to prescribe antidepressants or antianxiety medications without looking at the full picture. Yes, antidepressants and antianxiety medications can be very effective treatment for perimenopausal mood changes, but so can hormone replacement therapy. And hormone replacement therapy can offer other benefits, like relief for other symptoms, such as vaginal dryness, and prevent osteoporosis.

The more you understand, the better you can advocate for the best solutions for your unique menopausal transition.

Track your cycles and your symptoms.

Write down your questions for your medical provider.

Ask them if what you are experiencing could be due to perimenopause and how that impacts your treatment options.

And remember, you can be both anxious and confident.

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