Perimenopause Depression and Anxiety: Finding Peace (and Maybe Your Sanity) in Midlife Mood Swings
In mid life and feeling a bit more moody, anxious, or down than usual? Perimenopause may be to blame—welcome to the hormonal roller coaster! Let’s talk about managing these natural curveballs.
Perimenopause: where hot flashes, random crying, and existential crises become the norm. It’s not just the insomnia and hot flashes —it’s the surprise appearance of depression and anxiety, too. Many women find that as their estrogen naturally takes a nosedive, so does their usual ability to manage stress and stay cheerful.
What’s happening? Well, during perimenopause, hormonal changes affect mood regulation, bringing more irritability, sadness, and sudden nervousness. And if you’re dealing with everything else life throws your way (ahem—job, family, aging parents), it’s no wonder this phase can feel like a test of sanity.
But here’s some good news—you can get through this transition without surrendering your life to the mood swings. Let’s dive into why perimenopause impacts mental health and cover practical, research-backed strategies to get you back to feeling like yourself again. Or at least close!
Why Perimenopause Triggers Both Depression and Anxiety (and Why You’re Not Alone)
Let’s break it down: Perimenopause is your body’s way of easing you into menopause, and by “easing,” we mean juggling hormones like they are teenaged hot potatoes. Estrogen and progesterone levels start bouncing around unpredictably, which can disrupt the brain chemicals that regulate mood—like serotonin, the one that usually helps us feel calm and content. So, when estrogen dips, so does serotonin, and voila: you’re feeling more anxious, blue, or suddenly irritable (yes, even at the sight of an empty cereal box left on the counter).
Midlife isn’t helping either. Between managing work, relationships, and maybe even taking care of teenagers and aging parents, you’re probably feeling like a world-class multitasker—and a little overextended. Anxiety and depression tend to strike when we’re at our limit, making perimenopause a perfect storm. But here’s more good news-these feelings are common and manageable. There are ways to make this phase of life easier and to feel a bit more in control.
Why Talking to a Therapist Can Help (and No, You’re Not ‘Losing It’)
As a therapist, I hear from a lot of women who feel like they’re suddenly “not themselves.” These mood shifts can feel frustrating, especially if you’ve been the type to keep it all together. But perimenopause-related mood changes aren’t a sign that you’re unraveling—they’re a natural response to the new hormonal landscape.
A significant number of women — about 18% among women in early perimenopause and 38% of those in late perimenopause — experience symptoms of depression. And symptoms of anxiety appear to be even more common during this time leading up to menopause, including panic attacks.
One thing therapy offers is a space to unpack what you’re feeling and to understand it’s not just you. Techniques like Cognitive Behavioral Therapy (CBT) can help you learn to identify and shift negative thoughts, giving you a way to stay steady even when your mood feels anything but.
Therapy can also help you process those big life stressors, reminding you that sometimes, it’s okay not to be the rock for everyone. So if you find yourself crying at commercials or snapping at minor annoyances, therapy might just be the ticket to finding some peace—and maybe even a little humor in the journey.
How to Tackle Perimenopause Depression and Anxiety (Without Hiding Under a Blanket Forever)
Managing perimenopause-related depression and anxiety doesn’t require a complete life overhaul (thank goodness). But there are a few small, practical steps that can make a big difference. Here’s what to try:
Move Your Body: You don’t have to become a gym buff. Even a brisk walk or some dancing in your living room releases endorphins, helps combat anxiety, and can boost your mood. Bonus: moving helps with those perimenopause aches and pains.
Sleep Like It’s Your Job: Sleep can feel elusive during perimenopause, but a good night’s rest does wonders for mood. Stick to a regular schedule, keep the room cool, and (tough love here) turn off screens an hour before bed. A little sleep hygiene can go a long way.
Eat (Mostly) Well: Think mood-boosting foods. Omega-3s, leafy greens, and whole grains can help support mental health. Cutting back on caffeine and sugar can reduce those energy crashes that often make anxiety worse.
Phone a Friend: Perimenopause can be lonely if you’re trying to do it all in silence. Find a friend who gets it, a doctor who hears you out, or even just someone you can text when you’re feeling off. Connection helps normalize what you’re experiencing.
Try Mindfulness (Yes, It Works): While meditation isn’t for everyone, simple breathing exercises or 5-minute mindfulness breaks can reduce anxiety and give you some mental breathing room.
One of my clients going through this time in life started a “F-it walk” ritual with a friend every evening, which not only improved her mood but also gave her accountability to do something for herself daily. Another began tracking her moods, helping her notice patterns and understand her emotional rhythms.
Perimenopause depression and anxiety can be a lot to handle, but you don’t have to do it solo. With lifestyle adjustments and maybe some professional support, you can navigate this transition with a little more confidence (and fewer random crying spells). There’s no reason to feel stuck in the mood swings and “what if” spirals—relief is within reach.
If perimenopause depression and anxiety are weighing you down, don’t hesitate to reach out for support. Therapy can help you find personalized coping strategies, build resilience, and even get a laugh out of this phase. Ready to tackle perimenopause depression and anxiety? Contact me to schedule a consultation and start finding your way back to balance.
