Navigating neurodiversity and menopause

As a therapist specialising in women's health, I've seen firsthand how the link between menopause and neurodiversity is an area that continues to unfold through research. 


In the course of my practice, I have had the privilege of listening to and learning from the narratives shared by individuals. I have composed a composite voice from the shared experiences of women, without revealing any identities. This aims to offer support and understanding to others on similar journeys.

This intersection of neurodiversity and menopause and the journey of adapting and discovering oneself within it is a powerful reminder of our capacity to navigate life's challenges.

At 52, after years of subtle suspicions, I came to understand that I was on the autistic spectrum. This wasn't apparent to everyone around me, thanks to a lifetime of mastering self-management strategies and carefully limiting my exposure to potential triggers. 

However, in recent years, my ability to manage these strategies began to falter significantly. What was happening? Was my autism worsening, I started googling 'Can autism get worse?' Of course not, OK, was I having a breakdown? I was struggling with heightened sensory overload, anxiety and a hatred of social interactions.

The turning point in my understanding came with the realisation that it wasn't my autism intensifying, but rather the onset of menopause exacerbating my autistic traits. It felt as though the filters and tolerance I had painstakingly built over the years were disintegrating. The coping mechanisms that once helped contain my challenges within manageable bounds seemed ineffective against the surge of sensory and emotional intensities unleashed by menopause.

Adapting to this new reality has meant making significant changes in my daily life. Simple tasks like food shopping now require headphones to drown out overwhelming noise and social gatherings have become increasingly challenging. 

Things that took over:

Sensory overload, anxiety, noises, smells, people, lights, large crowds, driving or being in the car, tolerating noises or smells in the house, retaining the thoughts in my head without saying them out loud, this can be to strangers and even if they are inappropriate. Manage my anxiety, have panic attacks, listen to the same song over and over again, watch the same box set over and over again, thinking about the big stuff, the small stuff and everything else in between.

A hatred of changing plans, being distracted when in the middle of something without being annoyed, being too hot or too cold, having certain fabrics or labels near my skin, and skin picking. It feels like this beast has been inside me and menopause seems to have unleashed and unlocked the door! 

Despite these challenges, I have to be a wife, mother, grandmother, friend and functioning member of society. This transformation has not been easy, but it has been possible, in part, thanks to the indispensable role of counselling.

My experience is not unique and it's crucial for other women to know they're not alone. The intersection of neurodiversity and menopause can unveil previously hidden challenges, but it can also open the door to deeper self-understanding and acceptance. The fluctuating hormones of menopause can amplify neurodivergent traits, but with the right support, these changes can be managed.

Continuing from our foundational approach, the journey of helping this particular client navigate her unique intersection of neurodiversity and menopause was both insightful and transformative. Our therapeutic sessions unfolded in layers, each building upon the last, as we delved deeper into understanding and managing the nuances of her experience.

Recognising the impact of menopause on ASD

Our initial sessions were dedicated to exploring and acknowledging how menopause was affecting her autism spectrum disorder (ASD). It was crucial for her to understand that the intensification of her sensory sensitivities, social anxieties and emotional fluctuations were not anomalies, but rather a natural part of her menopause journey. This realisation brought a sense of relief and validation to her experiences, which had previously been mired in confusion and self-doubt.

Developing tailored management strategies

Armed with this understanding, we transitioned into the heart of our work: strategising. Together, we crafted personalised strategies that addressed her specific triggers and challenges. This included practical adjustments, like planning outings during less busy times to avoid crowds and sensory overload, using headphones in noisy environments and creating a comfortable, sensory-friendly space at home.

Empowering communication and self-advocacy

A pivotal moment in our sessions was empowering someone to openly communicate their needs and boundaries, especially in social situations. For someone who had spent a lifetime masking her traits to fit into a neurotypical world, the thought of disclosing her ASD was daunting. However, through gentle encouragement and role-playing exercises, she gradually found the confidence to say, "Hi, I have ASD, and I find certain situations difficult." This simple act of self-advocacy was a game-changer for her. It not only helped others understand her needs and limitations but also fostered a deeper sense of self-acceptance and belonging.

Enhancing emotional regulation and anxiety management

As we progressed, a significant focus of our sessions was on enhancing her emotional regulation and managing anxiety. Techniques such as mindfulness, deep breathing exercises and cognitive restructuring became valuable tools in her arsenal. These strategies helped her navigate moments of overwhelm with greater ease and provided a sense of control over her reactions and emotions.

Fostering resilience and self-compassion

Throughout our journey together, fostering resilience and self-compassion remained central themes. We explored the concept of neurodiversity as a spectrum of unique strengths and challenges, rather than a set of deficits. Celebrating her achievements, no matter how small and acknowledging the courage it took to face her challenges each day, bolstered her resilience. Simultaneously, practising self-compassion helped mitigate self-criticism and nurture a kinder, more forgiving relationship with herself.

Collaborative reflection and continuous support

Our sessions were not just about implementing strategies; they were also spaces for reflection, adjustment and continuous support. We regularly reviewed her experiences with the strategies we had put in place, celebrating successes and learning from setbacks. This ongoing dialogue ensured that her coping mechanisms evolved in line with her changing needs and circumstances.

In conclusion, the journey with this client underscored the profound impact of a tailored, empathetic therapeutic approach in navigating the complexities of neurodiversity and menopause. 

By validating her experiences, empowering her with practical strategies and fostering emotional resilience, we not only navigated the challenges at hand but also embarked on a path of self-discovery and empowerment. For women navigating similar paths, know that with the right support and strategies, you too can find balance and fulfilment amidst the challenges.

How can counselling help you?

Creating a safe space: A non-judgemental environment where feelings and experiences can be shared openly is the foundation of effective counselling. Recognising and validating the unique challenges faced at the intersection of neurodiversity and menopause is crucial.

Personalised coping strategies: From sensory management techniques, such as using headphones in noisy environments, to cognitive strategies for handling overwhelming thoughts, personalised coping mechanisms are key. These strategies are developed in collaboration with clients, ensuring they align with their personal experiences and needs.

Navigating social challenges: Guiding clients through the nuances of social interactions, especially when traditional cues and norms become more challenging to navigate, is essential. This includes developing scripts for difficult conversations and strategies for managing social anxiety.

Embracing change: Helping clients accept and embrace the changes in their lives, rather than fighting against them, fosters a sense of peace and empowerment. This includes recognising the strengths that neurodiversity brings, such as deep focus and unique perspectives

Building a supportive network: Encouraging clients to build a supportive network of friends, family, and peers who understand and respect their journey is vital. This network can provide emotional support, practical assistance, and a sense of belonging.

To women on this journey, know that you are not alone. Your experiences, while uniquely challenging, can also be a source of strength and growth. In the intersection of neurodiversity and menopause, there lies an opportunity for deeper self-understanding and acceptance. As a therapist and fellow traveller on this path, I am here to guide, support, and walk with you towards a life of balance and fulfilment.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Guildford GU5 & GU2
Guildford GU5 & GU2

Donna Morgan is a highly experienced Humanistic Mental Health Therapist with 26 years of practice. Her passion for helping individuals with their mental health has driven her to develop a compassionate and holistic approach to therapy. Donna firmly believes in treating each client as a unique individual and providing them with personalised support.

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