Let's Make Sense of... Perimenopause & Mental Health

"I don't feel like myself anymore."

It's one of the most common things I hear women say.

Maybe you've always been calm, organised and emotionally steady. Then suddenly you're anxious all the time.

You're snapping at your family, forgetting simple things, waking at 3am every night, crying over things that never used to bother you, or feeling completely overwhelmed by life.

You start wondering...

"Am I depressed?"

"Is this anxiety?"

"Am I burning out?"

"Is it ADHD?"

"Am I just getting older?"

Or perhaps the most heartbreaking thought of all...

"Am I losing myself?"

If this sounds familiar, you're not alone.

And more importantly—you might not be "going crazy."

You might be in perimenopause.

Perimenopause is More Than Hot Flushes

When most people think about perimenopause, they think about irregular periods and hot flushes.

But for many women, the emotional and cognitive changes arrive long before those classic symptoms.

Hormones influence far more than our reproductive system. They also affect neurotransmitters like serotonin, dopamine and GABA—chemicals involved in mood, motivation, focus, sleep and emotional regulation.

As hormone levels fluctuate, many women notice changes in:

• Anxiety

• Mood

• Motivation

• Memory

• Concentration

• Stress tolerance

• Emotional sensitivity

• Sleep

• Confidence

It's no wonder so many women say,

"I just don't feel like me anymore."

The Challenge Is... It's Rarely Just One Thing

As an integrative counsellor, I rarely look at one factor in isolation.

Our experiences are shaped by multiple systems interacting together.

Sometimes what looks like anxiety isn't "just anxiety."

Sometimes burnout isn't only about work.

Sometimes depression isn't simply depression.

Instead, we need to zoom out and ask:

What else is happening?

Because during perimenopause there can be a perfect storm of factors occurring at the same time.

Perhaps you're:

• Working full-time

• Caring for children or teenagers

• Supporting ageing parents

• Navigating relationship changes

• Managing financial pressure

• Processing grief or loss

• Living with ADHD or Autism

• Recovering from trauma

• Sleeping poorly because of hormonal changes

Each one affects your nervous system.

Together, they can leave you feeling completely overwhelmed.

Looking at the Whole Person

This is why I love an integrative approach.

Rather than asking,

"What's wrong with you?"

I prefer asking,

"What might be contributing to what you're experiencing?"

Together we explore the whole picture.

That may include:

• Your biology

  Hormones, sleep, nutrition, exercise, medical conditions and medications.

  
  

• Your psychology

  Thought patterns, beliefs, emotions, coping strategies and personality.

  
  

• Your nervous system

  Stress, trauma history, emotional regulation and recovery.

• Your relationships

  Family dynamics, friendships, work, parenting and support networks.

• Your lifestyle

  Workload, boundaries, rest, movement and daily rhythms.

• Your values and identity

  Who are you becoming in this season?

  What matters most now?

Sometimes Counselling Isn't the Only Answer

Counselling can be incredibly helpful.

But sometimes it isn't the only piece of the puzzle.

As counsellors, we also recognise when further assessment or support may be beneficial.

Depending on your situation, this might include speaking with your GP about:

• Hormonal changes

• Blood tests

• Mental health support

• Perimenopause assessment

• Hormone Replacement Therapy (HRT), where appropriate

• Medication options if needed

You don't have to figure it all out alone.

Sometimes the most effective care comes from the right team working together.

You Don't Need to Become Who You Were

One thing I often tell women is this:

Perhaps the goal isn't getting back to who you used to be.

Perhaps it's discovering who you are becoming.

Perimenopause is a significant life transition.

Like every transition, it asks us to slow down, reassess, adapt and sometimes rewrite the expectations we've carried for years.

That can feel unsettling.

But it can also become an opportunity for growth.

Let's Make Sense of It Together

If you've been feeling overwhelmed, emotionally exhausted, anxious, flat or unlike yourself, there may be more to the story than you realise.

Together we can connect the dots, understand what's contributing to your experiences, and develop practical strategies that support your mind, body and wellbeing.

My approach is collaborative, integrative and evidence-informed. Rather than focusing on symptoms alone, we'll explore the whole picture—because lasting change often begins with understanding.

Sometimes the most powerful question isn't:

"What's wrong with me?"

It's: "What makes sense about what I'm experiencing?"

This article is intended for general information and is not a substitute for medical advice. If you're experiencing significant changes in mood, thoughts of self-harm, or symptoms affecting your daily functioning, please seek support from your GP or another qualified healthcare professional.