Menopause is a period of transition and any kind of transition can come with challenges. Menopause is something that tends to occur during a stage of life that often involves other changes which can have an emotional impact on the way you feel. It can often coincide with ‘empty nest syndrome’ where there is an adjustment to children leaving home. Responsibilities may also start to shift from caring for children to caring for ageing parents. You may not have children and find yourself developing mixed feelings about this. This may be a time where you move home, change career, or start to reprioritise things in your life. The interaction between life stresses and menopause symptoms can have an impact on mental health.
I’ve worked with many women over the years who have experienced anxiety and depression and after a number of sessions, have mentioned they are going through ‘the change’ and wonder if this may be playing a part in this. As soon as this is acknowledged, we able to explore their thoughts about menopause and identify how their associated experiences may be impacting their emotional and mental wellbeing.
How CBT Can Help with Menopause
The National Institute of Health and Care Excellence recommends Cognitive Behavioural Therapy (CBT) for Anxiety and Depression both during menopause and post-menopause. CBT is a practical psychological therapy that is centred on developing coping strategies and skills to support you towards your goals. It acknowledges that we can’t always change or control our situation or experiences, but we can change the way we think and behave in response to them. By understanding our patterns of thought and behaviour, we can learn how to make changes that improve the way we feel.
Anxiety and Menopause
Some of the symptoms of menopause may cause anxiety or stress. For example, you may feel worried about having a hot flush or breaking into a sweat in public or while at work. You may feel self-conscious about this and begin to avoid certain things you fear may trigger these symptoms. This can result in social embarrassment and develop into anxiety. In CBT, we introduce coping strategies for anxiety to build your confidence in managing and reducing anxiety symptoms. We also work together to challenging beliefs and behaviours linked to your anxiety, identify more helpful and realistic alternative beliefs and behaviours that help reduce anxiety.
Depression and Menopause
Menopause marks a stage of change in life. In the same way that momentous occasions like birthdays, anniversaries and new year can be a time of reflection, so can the menopause. You may find yourself thinking over your life and past experiences in a way that is unhelpful for your mood. You may become concerned or aware of ageing or become focused on a change in your reproductive status. You may hold negative beliefs about menopause or notice self-critical thinking. This may impact on your self-esteem, confidence and mood negatively. In CBT, we work together to identify patterns of thinking and behaviour that result in a low mood state and then introduce a series of exercises to help you make changes to move towards your goals and values and so improve your mood.
Symptoms of Menopause and Mental Health
Sleep plays an important function in mood regulation and ongoing difficulties in sleep can impact our mental wellbeing. Many women find that symptoms of menopause such as hot flushes and night sweats can cause disruptions to sleep. After periods of poor sleep, you may find yourself worrying about not being able to sleep which can cause further difficulties and create a vicious cycle of sleep and mood disturbances. Changes in sleep patterns and mood states can impact on our energy and appetite. A consequence of this can be changes in eating habits and associated weight changes. In CBT, we can focus on improving sleep hygiene, managing the anxiety and stress that can result from sleep disturbances, and address behavioural changes around eating.