How the menopause can disrupt your mental health

You know the feeling. You can’t find your keys. For the third time this week they have somehow disappeared, and you have no idea where you’ve put them. At last, you find your keys… but then you can’t find your phone.

Anxious thoughts fill your head. Are you going mad?

After a search you find your phone, but now you can’t remember where you parked the car. Aargh! Meanwhile what’s that colleague’s name? Damn, it’s on the tip of your tongue. And that word that eludes you when you’re in the middle of an important work presentation or call, making you ‘um’ and ‘er’ as you bluster your way through? For some reason it has temporarily disappeared from your vocabulary.

Usually these things are well within your capabilities, so you have to wonder… Are you mentally falling apart?

If the above sounds familiar – or just a fraction of it – you will know how it feels to lose control of things you can normally rely on – your memory, your ability to function, your articulacy and clarity of thought. Is it menopausal brain fog?

Brain fog is decimating women’s careers, with large numbers feeling so overwhelmed with anxiety and loss of confidence that they are quitting the jobs they love. Linda Gillham, Healthy Minds Lead Practitioner at health app Peppy, says “One in four women consider leaving their job as a result of the menopause, and one in 10 do so”. And if you happen to be self-employed, brain fog can stymie the confidence and efficiency required to market and grow your business. Some days you may find you struggle to face the world.

Davina McCall’s new Channel 4 documentary Davina McCall: Sex, Mind and the Menopause, which aired on Monday, explores what happens to our minds during the menopause. But how would you know if your brain fog is caused by the menopause or something else?

Brain fog is decimating women’s careers, with large numbers feeling so overwhelmed with anxiety and loss of confidence that they are quitting the jobs they love

“Brain fog is that feeling when the word you want just isn’t there,” says Linda. “So you can be mid- sentence and you can suddenly think, ‘Oh, my goodness, I’ve got no idea what I’m talking about’. It can cause women to panic and get stressed out, and think, ‘Oh my God, everyone’s staring at me, I just can’t think of anything. They’re going to think I’m rubbish’…”. Needless to say, this can have a devastating effect on our careers.

“I love this quote by psychotherapist, Susie Orbach: ‘The menopause arrives, seeking out our vulnerability like a guided missile, just as we need all your strength to cope with daily life’. And I think that’s so true,” says Linda. “Some people don’t experience menopausal symptoms or brain fog. But I think if you’re already on that anxious edge, your anxiety may increase when you are peri menopausal or menopausal and it is it’s like a guided missile. It’s a bit like anxiety finds our vulnerabilities. And no two people experience it in the same way”.

And the forgetfulness of menopause, the way we think we’ve done something and then we realise we haven’t or we can’t remember someone’s name or whatever – this can be particularly distressing. Here, Linda advises on how to distinguish between menopausal brain fog and other loss of mental clarity.

But don’t we just get more forgetful as we get older?
“When you take forgetfulness in context with other symptoms, you can make a safe bet that it’s down to menopause. If you are taking it in isolation whatever you do, don’t do a search on Google – you will come up with all sorts of horrors. It could, of course, be a symptom of Long Covid. I’m sure there are many women who take it as far as going to get an actual memory assessment, and there’s nothing wrong with doing that. Fearing that you’re getting Alzheimer’s or dementia will not help with you forgetting things, so it’s better to get a diagnosis. We do, of course, become more forgetful as we get older”.

How would I know if it’s dementia?
“Key warning signs that your forgetfulness might be due to something like early onset dementia are actually hard for you to spot yourself. Often it’s other people that notice it in you when it’s Alzheimer’s or dementia – and not straightaway, but as it starts to progress. The person experiencing it is a bit oblivious. You may use a wrong word in a sentence, for example, and not think there was anything wrong with it. Or you may forget something and not realise you’ve forgotten it. Dementia is a degenerative disease that makes you ultimately unaware, so you are unlikely to realise it yourself if you were suffering from it”.

The sandwich generation impact
Often forgetfulness is a sign of excessive multi-tasking and feeling overwhelmed with responsibilities. Trying to do too much can ultimately make us forgetful, which in turns makes us feel panicky, like we’re losing control. Elderly parents, a career, our family, and a multitude of admin and must-do tasks can overwhelm us, so we end up becoming forgetful and absent-minded – especially after a few drinks. “Go back in history and at 50 we were probably approaching death. Well nowadays we’re living longer, having second careers and finding a new lease of life, but that only works if we haven’t got too much on our plates already”.

Can menopause be treated with antidepressants rather than HRT?
“Some of the symptoms can, but not the menopause itself, which is a change in hormones. But that doesn’t mean that if somebody menopausal is feeling depressed, that they can’t have antidepressants. But they may not be the solution – antidepressants can make you very unwell in some cases. There is not a one-size-fits-all solution with the menopause. If a woman walks in and bursts into tears because she’s waited so long to talk to somebody about her anxiety, she may well be handed a psychometric assessment, and potentially diagnosed with depression. And let’s face it, there are long waiting lists for therapy on the NHS”.

What can help women manage these feelings of anxiety and self-consciousness?
“CBT techniques can really help you lower your anxiety so you don’t get into that panicked state, because the other thing that will happen when you experience brain fog is your stress response will kick in. Maybe the blood will suddenly rush to your face, you’ll feel very sweaty, or you will look incredibly uncomfortable, which just exacerbates your brain fog because then you’re thinking ‘Now I know I look uncomfortable, and everyone’s noticed’”.

Are women who have had mental health issues predisposed to them during the menopause?
“It’s not a given. It’s not necessarily a predisposing factor. I hear more about women experiencing anxiety suddenly for the first time during the menopause. For example, it’s very, very common for women to suddenly develop a fear of driving, or even of leaving the house in some cases. It is caused by the fluctuating hormones, and there are good days and bad days, and getting that sorted can change their lives”.

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