Menopause and anxiety: How to manage change-of-life stress

During perimenopause and menopause, your body goes through many changes that can cause symptoms like hot flashes and the redistribution of body fat to the belly. However, the effects of hormone fluctuations may also impact your mind. Many women may develop anxiety and depression from menopause and perimenopause. If you’re one of them, managing anxiety and stress may help improve your symptoms.

Rates of depression among women double during perimenopause. This stage of life is also associated with an increased risk for anxiety. Many factors may contribute to mood changes during menopause, including:

Hormonal changes

During perimenopause, hormone levels fluctuate. After your menstrual periods stop, estrogen and progesterone levels decrease. These hormones not only affect your reproductive system but they also affect the production of serotonin, a brain chemical that plays a role in happiness, libido, sleep and body temperature regulation. As hormone levels change during menopause, serotonin levels may rise and fall in response, leading to mood swings, irritability, depression and anxiety.

Feelings and perceptions about menopause

Menopause is a natural stage of life but many people view it as a sign of growing old. For some, the end of the childbearing years can lead to thoughts of mortality or concerns about no longer being youthful. This line of thinking may negatively impact mood. Focusing on the freedoms and improved sense of self that come with age may be beneficial for those struggling with negative perceptions around menopause.

Sleep problems

Hormonal changes, night sweats and hot flashes can contribute to insomnia during menopause. Some people find it difficult to fall asleep at night, struggle to stay asleep or wake up frequently during the night. Over time, poor sleep can take a toll on mental and physical health.

Life stresses

During perimenopause and after menopause, women may be more likely to have chronic stressors in their lives, such as health issues, children leaving home, aging parents and work responsibilities. These additional sources of stress may compound the anxiety and depression that’s common during and after menopause.

Your body’s stress response is intended to be a defense mechanism. When you face a threat, your body responds by releasing hormones that increase your heart rate and central nervous system activity. As a result, you become prepared to flee from the threat or fight it off. Once the perceived danger has passed, hormone levels usually return to normal.

Most of the time, our stress isn’t caused by life-threatening situations that arise suddenly and resolve quickly. Instead, stressors tend to be ongoing. When stress hormone levels stay elevated for an extended period of time, you’re more likely to become depressed or experience anxiety.

If you’re already experiencing anxiety or depression from menopause, managing your stress may help. Follow these tips to better manage stress during menopause.

Try relaxation techniques

Actively promoting relaxation through the following techniques can ease stress in the moment. The benefits can also build over time, leading to an overall reduction of stress. Techniques to try include:

• Deep breathing: Extend the length of your inhaled and exhaled breaths. Mentally trace the path your breath takes in and out of your body. This relaxation technique can be done virtually anywhere.
  
• Mindfulness: Mindfulness is the practice of focusing on the present moment. It’s been shown to help reduce stress. Download a mindfulness meditation app or watch mindfulness-focused videos to get started.
• Yoga: Yoga is a form of exercise that involves moving through a series of poses while controlling your breathing. Look for stress-relief yoga videos or sign up for a yoga class aimed at stress management.

Engage in activities you enjoy

Enjoyable activities can serve as a powerful distraction from stressors in life. Some examples include:

• Getting back into a hobby or starting a new one
  
• Listening to music
• Gardening
• Hiking and spending time outdoors
• Reading books for pleasure
• Watching a funny movie or television show
• Cooking or baking
• Completing crossword puzzles
• Dancing
• Playing with pets

Exercise

When you engage in aerobic exercise, your body releases brain chemicals called endorphins, which support a positive mood. Exercise also helps regulate stress hormone levels. The key is to choose a form of exercise that you enjoy. If going to the gym isn’t your thing, try brisk walking, cycling, swimming or playing a sport like tennis.

Talk about your feelings

Anxiety and depression can be isolating, so reaching out to others and sharing your thoughts and feelings about the stressors in your life can be beneficial. Talk to a trusted friend or family member or see a licensed mental health professional. Talk therapy helps you explore your thoughts and feelings in a safe, supportive environment so you can better understand how your patterns of thought impact your behavior and mood.

There are many in-person and online support groups that provide information and resources for people going through various transitional life stages, including perimenopause and menopause. 

Reserve time for yourself

A hectic schedule can compound stress, so it’s important to make time for yourself each day. Even if you can only spare 5 or 10 minutes, block out a period where you do something for yourself, like taking a walk around the block, sending a text to a friend or simply sitting in your favorite chair relaxing. 

Practice good sleep hygiene

Poor sleep can contribute to anxiety, depression, and chronic stress. To get a better night’s sleep during perimenopause:

• Limit television, computer and mobile device screen time close to bedtime.
  
• Go to sleep and wake up at the same time every day.
• Exercise regularly, scheduling workouts in the morning or early afternoon.
• Create a quiet, dark environment with modifications like blackout curtains or a white noise machine.
• Reduce your intake of alcohol and caffeine, especially in the hours before bedtime.
• Start a bedtime ritual that you complete every evening.

Scale back if you feel overwhelmed

When your stress level is running high, don’t be afraid to say no to social obligations or additional responsibilities. Setting boundaries is a crucial part of self-care. Share household and work tasks with others to decrease your responsibilities and stress when you’re feeling overwhelmed.

Taking steps to manage stress can help reduce anxiety and ease depression from menopause. However, self-care may not be enough for some people. If feelings of anxiety or depression are interfering with your daily life, talk to your healthcare provider about your concerns. Together, you can explore potential treatment options, which may alleviate symptoms while you go through this stage of your life. These include medications, dietary supplements and hormone replacement therapy (HRT).

Published April 2023.