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When we think of menopause symptoms, issues such as hot flashes, dry skin, decreased libido and poor sleep come to mind. However, it's crucial to understand that the hormonal changes that occur during menopause (and perimenopause) can also significantly impact mood and mental health, leading to anxiety.
“In the last 10 years, we have begun to consider how hormonal changes can correlate with mood disorders,” explains Christina Maxwell, MA, LCPC, with the Anxiety Treatment Center of Greater Chicago. “It is not uncommon for women in midlife to have acute anxiety or an anxiety disorder that happens for the first time during this stage of their life. For others, anxiety and depression may have been under control for some time. Then the hormonal changes cause these issues to flare up.”
Why the Increase in Anxiety?
“I often see midlife anxiety stemming from a combination of hormonal changes and life pressures that collide during this period,” explains Dr. Himali Maniar Patel, an OB/GYN. “As levels of estrogen and progesterone start to shift with menopause, they directly impact neurotransmitters like serotonin, which plays a huge role in regulating mood. When estrogen drops, serotonin levels also tend to fall, which can lead to feelings of anxiety or even trigger panic attacks.”
Beyond the hormonal shifts, midlife often brings new or intensified stresses for women including career demands, family responsibilities, aging parents and facing their own mortality.
“Together, these changes create a ‘perfect storm’ for heightened anxiety, which is why so many women find themselves struggling with it during this stage,” says Dr. Maniar Patel.
This Anxiety Feels Different
“I'll often hear from women in my practice that they are waking up in the middle of the night in a panic,” says Maxwell. “Or, they feel overwhelmed or more emotional during their daily life, but the reaction is disproportionate to what is happening.”
The increased signs of anxiety can include:
• Irritability, feeling tense or restless
• Trouble sleeping
• Stomach issues like nausea or diarrhea
• Heart racing, trembling
• Having a sense of danger, panic or dread
Normalize Anxiety
“If you have never had a panic attack before, it can be frightening,” says Maxwell. “It's not uncommon for patients to call me concerned that this sudden onset of anxiety is stemming from a trauma resurfacing from their childhood.”
One of the most comforting realizations for many women is that anxiety is a common symptom of menopause. When Maxwell shares this with patients, there's often a palpable sense of relief. Understanding that what they're going through is a normal part of this life stage can significantly reduce the intensity and frequency of anxiety and panic attacks.
5 Ways to Lower Anxiety
While eating well, engaging in physical activity and getting enough sleep are critical, it can be challenging when you are experiencing acute anxiety.
In the moment, these might help:
1. Change Temperature
One of the simplest ways to deal with anxiety is to splash cold water on your face or hold an ice pack. “It’s a quick way to interrupt panic symptoms,” says Dr. Maniar Patel. “This works by activating the body’s ‘dive reflex,’ which naturally slows the heart rate and induces calm.”
2. Breathing Exercises
Diaphragmatic breathing can be extremely helpful in relieving anxiety. “The exhale needs to be slower than the inhale,” explains Maxwell. “Breathe in for four and out for five. The chest remains still while the belly rises and falls. It can take as little as two minutes and is very effective.”
This technique can also be used throughout the day as a reset. “If you are experiencing anxiety regularly and aren’t sleeping well, your sympathetic nervous system is already elevated,” she adds. “Practice this diaphragmatic breathing twice a day, when you are in the car or in bed, to lower your anxiety and activate your parasympathetic nervous system, helping your body relax.”
3. Engage Your Senses
“Mentally focus on five things one can see, four things to touch, three to hear, two to smell and one to taste,” says Dr. Maniar Patel. “This technique, known as grounding, pulls the mind away from anxious thoughts and back into the present.”
4. Invest in Friendships
One of the most significant predictors of contentment is social connection. “Between work, kids, parents, partners and self-care, it is easy to let friendships slip,” says Maxwell. “But investing in good relationships is very important for mental health. Meet for a walk or a cup of coffee or schedule time for a 10-minute phone call.”
5. Re-Prioritize
Decrease anxiety by setting healthy boundaries. “It is easy to get overwhelmed by all you have to do, especially when you aren't sleeping well,” says Maxwell. “But maybe there is a way to lighten your load? Maybe you don't 'have to' do everything.”
Priorities shift as we age. It may be time to adapt. “Ask yourself, 'Does the way I spend my time match my values?’”
See if there is a way to simplify your life and be more intentional with your time.
Some anxiety is a part of life. “We aren’t always happy,” adds Maxwell. “It is okay to have some anxiety, especially when you are experiencing stressful situations.” If anxiety is interfering in your life for more than 4-6 weeks, professional help may be necessary. “Accepting that anxiety is normal doesn't mean there is nothing you can do.”
Even if you are functioning (getting out of bed, going to work and taking care of your house), anxiety may still be an issue. “If you aren't enjoying your life or your relationships like you used to, seek help,” advises Maxwell. “Professional help for midlife anxiety may include seeking [someone like] me.”
For some people, medication (hormone therapy, SSRIs, SNRIs or a combination) may be necessary to alleviate anxiety. Others may benefit from therapy such as CBT, DBT or talk therapy.
“Be wary of self-medicating and supplements,” says Maxwell. “Make sure you are getting your information from reputable sources.”
“Midlife anxiety is highly manageable with these small but meaningful lifestyle changes,” says Dr. Maniar Patel. “Managing hormones, taking care of physical and mental health and using quick calming techniques can help women feel more in control and resilient during this stage of life.”
Do you often get anxious? What do you do about it? Let us know in the comments below.
Marta Monteiro
Follow Article Topics: Health
