Perimenopause is the phase before the final menstrual period during which the body undergoes many physical changes. These changes in the body lead to the factors mentioned above that can lead to anxiety.
Menopause occurs when periods have ended for 12 months. Symptoms of perimenopause may continue in menopause but usually occur less often.
It is normal to feel anxious or depressed when perimenopause begins, but frequent, severe feelings of anxiety or panic attacks are not typical symptoms of menopause.
Anxiety and menopause
Changes to the body alongside concerns about growing older may contribute to heightened anxiety.
Some women may feel sad or troubled during menopause, because of the changes to the body that occur, such as the loss of fertility. Other women may feel relieved to no longer fear pregnancy.
In addition to this, women may undergo many significant life changes during the menopausal years. Their children may leave home, and their parents or partner may become unwell related to aging. These factors can all contribute to heightened feelings of anxiety.
These symptoms may go away when perimenopause ends, and women enter the postmenopausal period when hormones become more balanced.
It is not uncommon for women undergoing menopause to receive hormone replacement therapy (HRT) and other treatments for menopause symptoms. Some women are not good candidates for HRT and should make these decisions with their doctor.
If a woman is going through perimenopause and is experiencing high levels of anxiety, she may also be prescribed medication to treat the anxiety. A doctor may also recommend counseling.
SSRIs are often effective in improving symptoms of anxiety. According to the North American Menopause Society, however, about half of people who use these medicines experience side effects that affect their sex lives. These side effects can include reduced libido and difficulty maintaining arousal or achieving orgasm.
Other types of antidepressants are available for women who experience sexual side effects from SSRIs. These include newer types of antidepressants, such as bupropion and duloxetine.
Older types of antidepressants, such as tricyclic antidepressants and monoamine oxidase (MAO) inhibitors, are not linked to sexual dysfunction. However, they may cause other side effects.
Decreasing the dose may reduce the side effects for some people who experience sexual dysfunction from taking antidepressants. However, it is important for anyone considering lowering their dose of medicine to consult their doctor first, as stopping medication can have severe consequences.
A healthful lifestyle, which includes some gentle exercise, may significantly reduce anxiety.
Doctors believe that following a healthful lifestyle both helps with menopause symptoms and reduces panic attacks.
Regular, gentle exercise can significantly reduce anxiety. Women who are going through perimenopause should pick their favorite form of exercise and try to make it part of a daily routine. Whether it is walking, running, swimming, or yoga, regular exercise can help to burn off nervous energy and improve symptoms of anxiety.
People should try not to drink too much caffeine or alcohol. Caffeine can trigger anxiety and nervousness. Alcohol is a depressant that can also make the underlying causes of anxiety worse.
Getting good-quality sleep is important for reducing anxiety. However, women going through menopause often sleep poorly due to night sweats caused by hormone surges.
Some people with anxiety find keeping a "pre-sleep journal" can help improve sleep. In a pre-sleep diary, people write out any nervous thoughts they might have so that their mind can rest easier.
There are support groups for women going through menopause, and these can be helpful. In a support group, people with the same issues get together to discuss the problems they are facing. Sharing their experiences together can help them to overcome their anxiety.
If a woman is going through menopause and is experiencing anxiety but does not want to attend a support group, just talking to friends about what she is going through can also be very helpful.
Importantly, women should make sure that they take time out for themselves. Certain activities, such as gardening, reading, meditating, practicing mindfulness, or yoga, are all good ways to focus on oneself and create feelings of well-being and relaxation.
Dealing with a panic attack
Panic attacks may be a reaction to rather than a symptom of menopause. They may include physical symptoms, such as shortness of breath, weakness, and nausea.
Many women experience panic attacks during the menopause. Because people that have had panic attacks before are more likely to experience panic attacks during perimenopause, doctors think that panic attacks are a reaction to rather than a symptom of menopause.
When someone has a panic attack, they experience intense feelings of anxiety or "doom." These feelings may be accompanied by physical symptoms, such as:
- heart palpitations
- shortness of breath
- tingling sensations
Panic attacks most commonly last for 10-30 minutes, but they can also recur in a series of episodes that can last for hours.
Many people experiencing a panic attack for the first time worry that they are having a heart attack or a nervous breakdown. Panic attacks can be among the most terrifying experiences of a person's life.
If someone has panic attacks, they should speak to their doctor. They may either prescribe some medication or refer the person for a mental therapy that may be able to help.
Some people find that practicing mindfulness techniques can help prevent panic attacks. In mindfulness, practitioners focus on the thoughts and physical symptoms that accompany a panic attack and learn how to manage them.
Irregular breathing can cause panic attacks. For example, trying to breathe in more than your body can let you, or breathing too quickly. Learning to control breathing when experiencing high levels of anxiety can help people to control panic attacks.
Having someone with you during a panic attack is helpful. This person can reassure you, gently encourage you to slow your breathing down, and stay with you until the attack has passed.
As with anxiety more generally, some lifestyle changes are known to help reduce panic attacks. These include:
- eating a healthful, balanced diet with lots of fresh fruit and vegetables
- avoiding alcohol
- reducing consumption of caffeine
- learning self-relaxation techniques
- getting plenty of fresh air