Perimenopause anxiety: what it is and how to help her

She used to take things in her stride. Now she lies awake worrying, panics over things that would never have bothered her, and sometimes can’t say what she’s afraid of. She may wonder if she’s losing it. You may be wondering the same. Often, she isn’t. Often, it’s perimenopause.

Anxiety is one of the symptoms nobody warns couples about. Everyone has heard of hot flushes. Far fewer people know that the hormonal shifts of these years can hit the nervous system just as hard.

Why perimenopause can bring on anxiety

Progesterone has a calming effect, and it often starts to fall first. Oestrogen swings up and down and affects the brain chemicals that regulate mood. Add poor sleep, night sweats and a full life, and the nervous system has very little buffer left.

The result can look like this:

• constant worrying, often about things that are fine,
• a sense of dread she can’t explain,
• a racing heart or a tight chest,
• sudden waves of panic, sometimes in the middle of the night,
• losing confidence in things she used to do without thinking: driving, meetings, social plans.

Many women who have never had anxiety in their lives experience it for the first time in their forties. That’s exactly what makes it so frightening.

What it isn’t

It isn’t weakness, and it isn’t her being dramatic. It also isn’t something she can switch off by thinking positively. Telling her to “just relax” is about as useful as telling someone with a broken leg to walk it off.

At the same time, anxiety and palpitations can have other causes, from an overactive thyroid to heart problems to depression. So it’s worth her getting checked by her GP, and palpitations in particular shouldn’t be ignored.

What helps, and what you can do

Take it seriously. The most important thing you can say is: “I believe you. This is real.” A lot of women hide their anxiety because they’re ashamed of it. If she feels safe with you, she’s already carrying less.

Don’t try to argue her out of it. Anxiety doesn’t respond to logic. “There’s nothing to worry about” doesn’t help. Being calm, staying close and listening does.

Protect her sleep. Poor sleep feeds anxiety, and anxiety wrecks sleep. Take the early mornings, keep the bedroom cool, and don’t start difficult conversations late at night.

Encourage her to see her GP. She doesn’t have to put up with this. There are options, from talking therapies to HRT, that she can discuss with her GP or a menopause clinic. Offer to go with her and help her write down what’s been happening.

Keep life manageable. When everything feels like too much, fewer commitments help. Take things off her plate without being asked. More on that in How to support your wife through perimenopause.

Look after yourself too. Living with someone who is anxious every day wears you down. Talk to a friend, a coach or a counsellor, so you can stay steady for both of you.

When not to wait

If she has chest pain, a racing heart that won’t settle, or feels faint, call 999. If she says she can’t go on, withdraws completely, or you’re worried she might harm herself, don’t wait either: call 999 in an emergency, NHS 111 for urgent advice, or Samaritans on 116 123, free and around the clock.

The whole thing in one sentence

Perimenopause anxiety is real, common and treatable, and the best thing you can do is believe her, stay calm beside her and help her get proper support.

Keep reading

• What is perimenopause? A plain explanation for men
• My wife’s perimenopause rage: what’s going on, and what actually helps
• All articles

And for her: if she’s carrying everything and no longer knows where she stands, show her the free self-check. Twelve questions, two minutes.

Jan Poulev is a coach and author. He has worked with people for more than thirty years, and for more than ten as a coach for women and men. This article does not replace medical advice.