The subtle changes that come with menopausal mental health

With so many physical changes taking place in menopause, it's time we also talked about menopausal mental health.

I want to talk about the subtlety of change. Imagine you take a woman who is happy, confident, and full of vitality, and you put her on the left-hand side of a room. And then you notice a woman who is depressed, anxious, tired, with zero confidence and low energy on the far right-hand side of the room. You look at these two women and realise they are the same woman. How does the woman on the left become the woman on the right?

Let’s put tragedies aside for the purpose of this exercise. Let’s put aside the deaths of loved ones, illness or general bad luck. Let’s assume life has been pretty normal for both versions of this woman. How did the woman on the left become the woman on the right, and why did she not notice it happening?

Quiet, but big, changes


Aspects of menopause can be very subtle — yet extremely powerful. They can shift your state of mind from the left to the right, and once you find yourself in that place, it can be very hard to figure out a way back.

One of the things I’ve thought a lot about over the last six months is how much I wish I could have seen and understood what was happening to me over the previous two years, as it was actually happening. How I wish I could have had the wiser Helen that I am now, standing by my side, explaining to me what was going on inside my body, and telling me how to take steps to support myself. That I didn’t have to hit an all-time low before I took a course of action that would restore me back.

“What happened to you?” said a friend one day. “You used to run the world; now you can’t even organize a cup of coffee.”

The signs you can see and the ones you can't

If you break an arm or a leg, you know you’ve broken it. You can see it, you can feel it, and you know you have to go to the hospital and that you’ll be in plaster for 12 weeks. Hormones are invisible shapeshifters. They see-saw up and down, they withdraw, they return, they morph into different versions of themselves. And as they do all this, they put pressure on your nervous system and your adrenal glands which affect all the magic things inside you. Magic things like happiness, confidence, self-worth, assertiveness. It’s like a series of earthquakes and tremors that get right in under your foundations, and while they may not necessarily topple the house, you suddenly find yourself standing on pretty shaky ground.

The obvious signs of menopause are easy. Hot flushes, vaginal dryness, headaches, sleep deprivation, dry eyes, itchy skin. These are the broken arms and legs of menopause. These are the things you can see. But the things you can’t see, are the things you really need to look out for.

What to do next


So if you’re reading this, and it’s striking a chord with you, then there’s a reason. If you have been feeling low or anxious; if you have been feeling flat, like all the joy has gone; if you’re wondering if you are suffering from depression, even though you never suffered from it before; if you’re discontent; if you’re fretting about things you previously would never have given a second thought to; if you’re simply not the you that you have always been; these are all signs that those subtle changes are happening inside your body. It’s not your imagination — these are physical changes beyond your control and there is nothing wrong with you.

Nor are you being selfish, self-indulgent or self-pitying. One of the things I felt in the middle of all these feelings was guilt. What had I got to feel down about? I have a very privileged life. Snap out of it. What’s wrong with you? Those were all thoughts I had, which only made me feel worse.

Don’t beat yourself up, and don’t ignore it. Do however, talk to an expert. Someone who has dedicated their life’s work to this subject, who wants to hear what you have to say, and who has the knowledge and understanding necessary to help you. Visit Dr Deirdre Lundy at

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