Navigating Midlife and Perimenopause on World Mental Health Day

On World Mental Health Day, it’s important to recognise the impact perimenopause can have - not only on a woman’s body, but also on her mind.

Although some women sail through perimenopause, many don’t. For midlife women, it’s a time of higher risk for both first-time depression and recurrence of previous episodes. An estimated 40% of perimenopausal women present to their primary healthcare provider with depressive symptoms (Her Centre).

There’s a lot going on at this time of life.

Alongside the hormonal rollercoaster and the brain’s rewiring process during menopause, there’s often a long list of external stressors - teenagers navigating puberty, kids leaving home, ageing parents, work demands, household responsibilities, and facing your own mortality.

Life is busy, life is stressful, and there’s rarely time to actually ‘pause’ during perimenopause. It can all feel distressing, overwhelming, and lonely.

When I think back to my own perimenopause journey, I remember how unpredictable it felt. One moment I was fine, and the next I was looking at myself, wondering who this person even was. My emotions ran wild - sometimes anger, sometimes sadness, often both in the same day. I don’t believe I had clinical depression, but I definitely struggled mentally in a way I never had before.

Looking back, what I’ve learned since then is that I was far from alone.

We often associate perimenopause with physical symptoms - hot flushes, sleep disruption, changing cycles - but what’s not spoken about enough is what happens inside our minds.

I speak with women all the time who say they feel flat, anxious, and just not like themselves anymore. There can be sadness - about many things: a changing body, shifting roles, the loss of fertility, or the realisation that at least half of life may be behind you. Add in poor sleep, and things can quickly snowball.

You might still be doing all the things, but it takes more effort. Small things feel big. Patience wears thin. Motivation disappears, and you don’t know why. Then there’s the brain fog, forgetfulness, and a sense of detachment - like you’re watching your life from a distance, unable to fully take part.

What I found myself doing (and what many women share) during all this confusion was retreating. It can feel like you’re the only one going through it.

That loss of connection only worsens what’s already happening. You might know it’s not helpful, but it can feel impossible to turn things around. It’s easy for everything to feel too hard and out of control.

This is one of the reasons we created the Midlife Women’s Clinic - to provide holistic care for women navigating the complexities of perimenopause. Our practitioners include Lifestyle GPs who can prescribe MHT and/or antidepressant medication, alongside other professionals who support women’s mental health through various modalities including psychologists, psychotherapists, nutritionists, naturopaths, and health coaches.

I often tell women: if you feel off, don’t dismiss it. It’s rarely ‘just stress’ or ‘just hormones’ - it’s your mind and body asking for care. And that care might look different for everyone. For some, it’s therapy or counselling. For others, it might include medication or hormone therapy. And for many, lifestyle foundations of sleep, movement, nutrition, and connection, play a huge role.

If your mood is low, your anxiety is creeping up, or you simply don’t feel like yourself, please reach out for support.

Perimenopause can be a challenging time mentally - but it’s also an opportunity to pause, reassess, and build the kind of support that will help you now and in the years ahead.

Your mental health matters. Talking about it matters.

You’re not alone - and there is help and hope available.