Understanding more about our mental health during menopause.
As part of our Lunch & Learn series, we were joined by Linda Gillham, Healthy Minds Lead at Peppy Health, to discuss menopause, mental health and techniques we can all use.
Henpicked: Let’s start with one of the questions we’re very often asked by women experiencing psychological symptoms of menopause. Am I losing my mind?
Linda Gillham: No you’re not. But I do hear a lot that people feel like they are. Many of the psychological effects of perimenopause and menopause aren’t well known. While some people may have suffered anxiety through their lives, others haven’t. Perimenopause might be the first time you experience a panic attack, for example. And the symptoms can feel very similar to a heart attack. It can be terrifying as you think there’s surely something physically wrong, sending your thought processes into a negative circle, which can have a detrimental effect on self esteem, mental health and everyday functioning.
Henpicked: How can we approach this type of anxiety?
Linda Gillham: In a cognitive behavioural approach to anxiety, we look at how thoughts are linked to feelings which are linked to behaviour. Very often we start to have thoughts about something that’s going to happen, or that may have already happened and we’re still worried about it. Our bodies go into the stress response of fight, flight and freeze, which we need to survive and can be useful in some situations. But not if you’re in a queue at the supermarket and you feel this rise or flush, feel like you’re going to pass out. That loss of control is so frightening.
What can happen then is we start to avoid situations because we fear we’re going to feel anxious or panicky. This has been exacerbated by the year we’ve all had, where there is a real threat outside the front door.
A few techniques I’d recommend if you do feel panic attacks becoming a problem. The butterfly hug was taught to survivors of Hurricane Pauline in Mexico. Simply put your hands on your collarbones and tap at the top while breathing deeply and slowly. This is like a physical hug, offering reassurance. If you find yourself out and about and feel rising panic, placing your hand on your heart can have huge impact. It sends a message to your body, slow down, it’s okay. We often start to hyperventilate and can’t catch our breath, which sends the opposite message to our body. Speed up and run away. If we can learn to slow down we can have less of reaction or reduce a panic attack a bit quicker.
Henpicked: Is driving anxiety common?
Linda Gillham: Yes, we’re hearing this more and more. We’ve been doing less driving of late, and for many of us to drive is more unusual rather than everyday now. What we tell ourselves in between getting in the car is important. If we start saying ‘is this a good idea, remember what happened last time?’ we’re already putting ourself in a negative frame of mind before we even get in the car.
Henpicked: What about brain fog?
Linda Gillham: No one really knows why it happens but when it does we react in different ways. If you panic if you can’t think of a word, your brain simply won’t let you think of that word. You need to think about buying yourself a bit of time, a pause and a breath. This can can help free up your brain’s capacity to find the word you’re looking for. If you go straight into self-critical mode, you’re even less likely to find the word you’re looking for. We need to challenge the negative critical thoughts that follow us around.
Henpicked: What role does sleep play in boosting our mental health?
Linda Gillham: Sleep is fundamental. During perimenopause and menopause so many women don’t get a good night’s sleep but still expect themselves to behave in same way the next day. But your cognitive functioning will be impaired, you’ll be slower, more likely to be snappy.
Linda Gillham: There are different problems with sleep. Some women can’t get to sleep, others are waking during the night, some wake up too early and can’t get back off. A good technique for all of these is the 4-7-8 method. Breathe in for a count of four, hold for a count of seven, then blow out of your mouth for a count of eight. Focusing and counting can help reduce some of the things keeping you awake. ‘I haven’t done this, I’ve got this to do’. Also, don’t look at the time. That’s just a trigger to set our minds racing. .
Henpicked: Is it common to feel emotional, too?
Linda Gillham: Yes and it’s really important for us to feel our feelings. We often think it’s not okay to cry, to be emotional, like there’s a ‘bad’ feeling and a ‘good’ feeling. This is a myth as all feelings are important, and all in response to something going on. If you cry regularly it may be hormone related. But you may have not worked out yet what is going on for you. Find someone to talk to, which helps you to bring these feelings to consciousness. It’s actually as beneficial to have a good cry as it is to have a good laugh.
Henpicked: Any thoughts on apps or online methods?
Linda Gillham: There are some brilliant apps out there that can teach you mindfulness. Personally I prefer visualisation, someone guiding me through a walk in the woods or along a beach. One I like on YouTube is a video of jellyfish in an aquarium. Sounds strange but it’s very calming. It’s really about finding what works for you. For those who like music, there’s a really good app called Cove where you make your own. Some people like talking, some like sleep stories – I’d encourage you to look through apps to find one you really like.
Henpicked: Are there any other ways we can support ourselves?
Linda Gillham: Sometimes we reach a point where we need to question our expectations of ourselves. Mindfulness keeps you in the present moment. Ruminating over the past isn’t going to change anything, nor is getting anxious about the future. We need to try to stay in the moment. But don’t try to learn mindfulness when you’re stressed. You’ll last about ten seconds then give up and think it doesn’t work. It’s a technique to learn and practice when you’re feeling calmer, then you’ll be about to put it into use when you need it.
Henpicked: Can affirmations help?
Linda Gillham: We can struggle with self esteem our whole life. But when menopause usually comes along, we’re starting to age, stuck between children and parents, and often don’t have time for ourselves. Spending a few minutes morning and evening saying affirmations can be very powerful. Be kind to yourself.
There are apps out there but it’s nice to come up with your own. Simply start with ‘I’m okay as I am’. Then magnify that. ‘I’m beautiful’. Point out your great attributes and focus on areas you like about yourself. And you can increase the power of affirmations by saying them to yourself in the mirror.
We can often be wired for negativity. But we can change our neural pathways. It takes time and practice but we can change them into a more positive frame.
Henpicked: Short-term memory loss can be scary. How can people get through it?
Linda Gillham: Stay away from Google! If you’re struggling and start searching online you’re going to get hits about Alzheimer’s and dementia. There may be a cause to get checked out if you’re really concerned, for reassurance. But if you put your memory problems with your other symptoms, it makes sense it’s likely menopause. So don’t panic, but do whatever it takes to keep yourself alert. I like to make lists, set reminders for everything, write stuff down. There’s no shame in it. It can be difficult when we don’t know how long to expect symptoms to last. But again, we really have to live in the present and not worry about next year.
Henpicked: Lots of women are prescribed antidepressants at this stage in life. What’s your advice?
Linda Gillham: Talking therapy can be beneficial. If you’re really struggling, you could start antidepressants alongside talking therapy, and decrease them as your therapy starts to help.
Finding a supportive group of other women is also a fantastic resource. You’re usually the only one going through this in your family, so sharing with likeminded others can make a real difference.
Henpicked’s Deborah Garlick will be joined by Linda Gillham, Healthy Minds Lead at Peppy – a digital healthcare benefit that supports employees during life’s big journeys, including fertility and menopause.
Linda is a Certified Transactional Analyst in the counselling field with over 15 years experience supporting people with their mental health. She is an NCS Registered & Accredited Counsellor and is a Transactional Analysis trainer and supervisor.