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Over the past five or six years, we’ve seen a massive shift in the way women’s health in midlife is discussed. Women suffering from symptoms of perimenopause are finding relief in hormone therapy…so much so that there’s a shortage of estrogen patches. Women are talking publicly about their experiences on social media, television, and even on stage in The Menopause Monologues, which is coming to NYC later this month.
Hopefully all the attention will lead to better support and resources — including an understanding that perimenopause isn’t limited to hot flashes; that symptoms often appear much earlier than we’d been led to believe; and that the first sign of hormonal wonkiness is often psychological, not physical. This week’s feature is about worsening anxiety in middle age, and what to do about it. Read on for that, plus a few recommendations for your weekend.
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Your friends at Gloria
When I hit my late 40s, I started noticing something strange. Things that used to seem like no big deal were, suddenly, major sources of anxiety. I couldn’t make a routine phone call without a wave of nerves washing over me. Even putting my name in at a restaurant’s host stand made me feel uneasy, somehow overexposed.
My anxiety was about anything and everything; issues both big and banal. Even though my mother is alive and in generally good health, I found myself fixating on her eventual — hopefully distant — death. I worried about my own mortality, too. I was anxious about making idle chitchat in the coffee line, and the idea of trying a new exercise class freaked me out. What was going on? Why did I suddenly feel so paralyzed by fear, and at times, overwhelmed by existential dread?
According to Milissa Aronson, LCSW, of Magnolia Psychotherapy, this type of midlife anxiety isn’t unusual. In fact, many women experience a noticeable increase in anxiety during perimenopause and menopause. Why? Because, in part, “estrogen and progesterone levels decline at this time,” Aronson explains. “These hormones interact with serotonin, dopamine, and GABA — the feel-good neurotransmitters. Serotonin helps to regulate our mood; lower serotonin levels mean less emotional regulation.”
Other physical changes associated with menopause can lead to heightened anxiety, too, according to Aronson, especially when symptoms like hot flashes and night sweats affect women’s sleep. “When our sleep is off, our mental health is always off,” Aronson says. Add on issues like aging parents, financial stress, and the demands of raising children, and it’s easy to see how this stage of life can feel like an anxiety pressure cooker.
Trina Read, 57, experienced this shift herself. Read, who’s about one year into menopause, is a sexologist who describes herself as a “high achiever with high anxiety,” noting that her anxiety ramped up in recent years — particularly during bouts of PMS in perimenopause. “The anxiety and PMS [together made me feel] like, ‘I can’t take this,’” she recalls. At one point, the stress manifested physically, showing up as a rash that persisted for years.
Read finds herself feeling more stressed out about work and the well-being of her teenage sons. But she also notices that small things that wouldn’t previously trigger her can cause her to spin out. “Some days I can roll with it and other days, someone charges me an extra five cents and I'm spiraling because of it. I've been working really hard to even out those emotions, but it's a daily thing.”
Read describes herself as more “fragile and emotionally vulnerable” than she used to be. “Until I was maybe 40, I could bounce back from a really shitty day. I’m not bouncing back now. It takes me a couple days to recover,” she says.
PR professional Julia Sherwin, 52, says her menopause transition caused her to ponder deeper questions about identity and purpose. “The hormonal and biological changes, they’re all happening at the same time. It’s definitely a time when you start to question your identity and how you’re going to make a mark on this world,” she says. She too noticed an increase in anxiety, especially when it came to her kids. When her oldest was preparing to head off for college, she experienced an anxiety spike she couldn’t shake. “I didn't really understand the word ‘anxiety’ before. I was 49 years old, and I finally was like, ‘Wow, I know what anxiety is now.’ You just can’t shake this feeling; you wake up with it and sometimes you go to sleep with it.”
Writer Nina Camp, 53, was 49 when she began experiencing a dramatic anxiety increase and a sense of being utterly overwhelmed. “The first time it happened, when it spun out of control, the trigger was an ailing pet. I couldn't let go of the stress. I don't remember ever having that level of just being totally swept away by some kind of trigger,” she says. Being in a relatively new romantic relationship, she notes that relationship-centered anxiety is an issue for her, too. “The anxiety has increased to the level where I can't eat for a couple of days. That's new ... I just don't remember it ever being that bad to where I'm losing three pounds and I can't do any work.”
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Image via @offservicebookrecs.
TO READ We just entered the world of Geneen Roth via her newest book, Love, Finally: Untangling the Knot Between Mothers, Daughters, and Food. It’s a memoir about her painful relationship with her mother, the root cause of her lifelong struggle with food and dieting. After reading it, we understand why she’s such a big deal. Here’s an excerpt.
TO SHOP The Way Day Sale is Wayfair's biggest sale of the year, and it starts tomorrow, offering 80% off some of the site’s most popular items. They’ve got lots of deals on summery essentials, like beach towels, outdoor furniture, and this adorable umbrella we’ve been thinking about buying forever. Also in our cart: this very cute beach wagon to haul it all. Shop lots of great deals here. #partner
TO MAKE If you have leftover roast chicken, or a rotisserie from the store, this sandwich recipe is worth trying. It’s great on a baguette, but you could also turn it into a salad by adding more greens. It’s based upon the famous Zuni Café dish; no wonder it feels like what a friend with impeccable style would serve you for lunch at her house.
TO WATCH Reviews of I Swear, the film about a Scottish activist with Tourette syndrome that’s now in theaters, describe it as good, if a bit cloying. Look: Some of us need saccharine, feel-good entertainment! If you are made of tougher stuff, there is the new series Half Man (on HBO).
So, so much info on the pill and hot flashes. • A good review of Lena Dunham’s memoir – that last paragraph! • “The ‘dark and exploitative’ world of children’s beauty videos on TikTok.” • Meanwhile, the fashion world is embracing older women (for financial reasons, obvs). • Rage-bait from the WSJ on how the world’s richest divorce. • Nicole Richie talks Y2K fashion.
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