Menopause and mental health: how counselling can help

Menopause is a significant stage of life, but for many women, it can feel like much more than a change in hormones.

You may notice changes in your mood, confidence, sleep, relationships or ability to cope with everyday life. You might feel more anxious, irritable, emotional or overwhelmed. Perhaps you find yourself worrying more than you used to, struggling to concentrate, or wondering why things that once felt manageable suddenly seem much harder.

You may even find yourself thinking, “I don't feel like myself anymore,” “Why can't I cope as I used to?” or “Everything feels too much.” If this sounds familiar, counselling can provide a safe and supportive space to explore what is happening and help you find ways forward.

Menopause affects more than our physical health

We often associate menopause with physical symptoms such as hot flushes and night sweats. However, women can experience a wide range of changes, including difficulties with sleep, fatigue, changes in mood and increased stress.

At the same time, menopause can happen during a particularly demanding period of life.

You may be balancing:

• work and career pressures
• children or teenagers
• caring for ageing parents
• relationship difficulties
• changes in your family
• financial pressures
• a busy household
• expectations from other people
• changes in how you see yourself and your future.

It can sometimes feel as though everyone needs something from you, while you have very little left for yourself. When physical symptoms and the pressures of everyday life come together, it is understandable that your emotional wellbeing can be affected.

The connection between stress and menopause

Stress can make symptoms feel worse, while experiencing difficult symptoms can itself create more stress.

For example, imagine having an important meeting at work when you suddenly experience a hot flush. You might immediately think:

• “Everyone can see me."
• “I'm going bright red.”
• “What are they going to think?”
• “I can't cope with this.”

You may become embarrassed and anxious, focus intensely on what your body is doing and worry about it happening again. You might then begin avoiding situations where you think you could have a flush. Over time, this can affect your confidence and make everyday situations feel increasingly difficult.

Counselling can give you the opportunity to explore these experiences without judgement and understand what may be contributing to the cycle of anxiety, stress and avoidance.

When you don't feel like yourself anymore

One of the most difficult parts of menopause can be the feeling that you have somehow changed. Perhaps you used to be confident, but now you question yourself. Perhaps you were able to manage a busy life but now feel overwhelmed. Perhaps you are more emotional or irritable than you used to be. Or perhaps you simply can't explain what is happening – you just know that something feels different.

These feelings can be difficult to talk about, particularly if people around you don't understand what you're experiencing. Counselling gives you somewhere to talk openly about these changes. You don't need to have everything worked out before coming to counselling. Sometimes simply having someone listen and help you make sense of what you're experiencing can be an important first step.

Learning to recognise when you are doing too much

Many women are very good at putting everyone else first. You may be the person who organises everything, looks after everyone, solves problems and keeps things moving. You may tell yourself: “I'll rest when everything is done.” The problem is that everything is rarely done.

This can lead to what is sometimes described as a “boom and bust” cycle – pushing yourself to get everything done, becoming exhausted, recovering, and then pushing yourself again.

Counselling can help you explore why it may feel difficult to slow down, ask for help or put your own needs higher on the list. Sometimes the challenge isn't knowing what you need. It's giving yourself permission to have those needs.

What if you're becoming increasingly anxious?

Anxiety during menopause can take many forms.

You might experience:

• constant worrying
• racing thoughts
• feeling overwhelmed
• irritability
• difficulty relaxing
• feeling on edge
• worrying about your health
• worrying about ageing
• losing confidence
• avoiding situations
• feeling unable to switch off
• difficulty sleeping.

You may also find that your thoughts become increasingly negative:

• “I can't manage this.”
• “I'm failing.”
• “I'm not good enough.”
• “I should be able to cope.”
• “Something is wrong with me.”

Counselling can help you step back from these thoughts and explore where they come from, whether they are helping you and how you might develop a kinder and more realistic way of talking to yourself.

Counselling can give you space to put yourself first

Sometimes women come to counselling because they feel they have spent years looking after everyone else. Menopause can be a point at which they finally realise: “I need to look after myself too.”

Counselling isn't about telling you what you should do. It is about creating a confidential space where you can explore what matters to you, understand your feelings and consider what changes might help.

Together, we can explore areas such as:

• anxiety and stress
• low mood
• confidence and self-esteem
• relationship difficulties
• work pressures
• feeling overwhelmed
• boundaries
• caring responsibilities
• changes in identity
• worries about ageing
• sleep difficulties
• emotional changes
• feeling that you have lost yourself.

You don't have to go through menopause alone.

There is no single way to experience menopause. For some women it is relatively straightforward. For others, symptoms and the circumstances surrounding this stage of life can have a significant impact on emotional wellbeing.

If you are struggling, it doesn't mean you are weak or that you aren't coping well enough. You may simply have been trying to cope with too much for too long. You don't have to wait until you reach a breaking point. Sometimes asking for support is the first step towards feeling like you again.