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Managing Mental Health and Menopause

Managing Mental Health and Menopause


Kamili Wilson / Founder of Menopause Made Modern / On Pause

May was Mental Health Awareness Month in the US, so it was pretty timely (or perhaps the obvious wake-up call) that at the start of the month I’d come to the realization that I needed some pharmaceutical help to deal with the anxiety that had become more acute over the past few months. I’m about five years into perimenopause and up until recently, I’ve been successfully (sufficiently, anyway) managing my ever-changing symptoms – night sweats, sleep problems, irritability, vaginal dryness, acne, etc. – without medical intervention.


For the last couple of years my menopause management journey has played out like a series of a trial-and-error experiments, with me making some small changes “here and there” to my diet and lifestyle. I’ve largely been treating my whack-a-mole symptoms through the daily integration of essential vitamins and minerals including C, D3 (Black women living in North America are especially prone to vitamin-D deficiency), potassium, and magnesium.


Add to that, daily seed cycling and probiotics, and eating more protein (though not enough), and less refined sugar (still too much). There were also the cathartic 30 to 40-minute walks with my dog each morning and the quality CBD tinctures that worked in concert to keep my persistent anxiety at bay…until they didn’t.

Getting the Help I Needed

It took me a few months to recognize that the intermittent feelings of gloom-and-doom that had begun surfacing around the time of my period, had become a constant foreboding that was with me from the time I woke up, until the time I settled into the sanctuary of my bedroom at the end of each day. I felt like I was on the constant verge of a panic attack, and in hindsight, I may have had one or two. There was also a constant fear of losing control of my emotional responses in social situations or worse, at work, which only ramped up my anxiety. It had become an unrelenting cycle that I didn’t know how to break.  


After three or four months of spending at least half of the month feeling like an anxiety-riddled, panic-fraught, “the sky is falling”, Eeyore, I reconciled that when it comes to managing my anxiety, at this stage of my journey I NEED HELP.


I've experienced anxiety off and on for most of my adult life, but this most recent bout has been strangely unfamiliar – specifically, the feelings of fear and dread – and left me feeling particularly vulnerable. After speaking with an Integrative Gynecologist, I was interested (but not surprised) to learn that the feelings of "doom and gloom" and loss of control are pretty common for the type of anxiety associated with the later stages of perimenopause. After talking through my treatment options – including hormone therapy – I opted to start with a low-dose antidepressant to see if and how that helps

Of course, the natural stuff is good and the modifications to my diet and lifestyle have all been for the better. I’ll continue to nurture those practices because apart from life and death, very few things are binary. That includes my approach to managing my mental health and general well-being. I also recognize that I’m privileged to enjoy pretty good health insurance with ready-access to physicians and prescription drugs that can help me feel better, so why wouldn’t I add them to my treatment plan?

Normalizing Menopause and Mental Health

It’s important to understand that menopause is a not a disability or disease – physical, mental or otherwise. It’s a natural biological process that all individuals born with a female reproductive system will experience. During menopause transition our fluctuating hormones can affect our mood and leave us feeling irritable, agitated, anxiety-ridden or depressed. The stress associated with other perimenopausal symptoms like sleep disturbance and hot flashes can amplify these feelings.


While there’s ongoing debate in the medical community about whether or not menopause actually causes depression, a 2019 progress report from the Study of Women's Health Across the Nation (SWAN) found that women in perimenopause and early post-menopause are two to four times more likely to experience major depression. The report also found that a medical or family history of major depression or other mood disorders indicated a strong likelihood of major depression during menopause transition.


Started in 1994, the SWAN is a U.S.-based longitudinal multiracial, multiethnic cohort study of women ages 42-52. A research review of 25 years of SWAN data published earlier this year, found that Black women reach menopause several months earlier than White women and have worse symptoms including depression and sleep disturbances. According to the analysis, we are also less likely to receive hormone therapy or seek out medical and mental health services like therapy or antidepressants. This means that many of us are likely suffering through our symptoms when there are treatment options that can help.


As I write this, it's been a little over three weeks since I started my prescription of a low-dose SSRI. As with most of these drugs, it can take up to three or more weeks to kick in. After about 12 days, I woke up without a feeling of dread, which thankfully, has been the case for most of my mornings since. I still have moments when I feel the anxiety ramping up, but the overwhelm of panic and doom has abated and I’m able to calm my mind and de-escalate my spiral.


I don't know how long I'll take the antidepressants, but it's where I'm at for now and I'm glad I was able to get the help I needed.

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Kamili Wilson is a friend of State of Menopause and the founder of Menopause Made Modern, a resource, blog and community for women of color navigating menopause transition. The information provided on is not intended and should not be construed as medical advice, treatment, or diagnosis. Always seek the guidance of a qualified healthcare provider with any questions or concerns regarding your health.

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