Menopause anxiety & panic attacks (how to manage)

In this article, we will talk about menopause anxiety and panic attacks. We will also talk about the main psychological problems that may accompany the onset of menopause, but also how can they be avoided.

Menopause anxiety and panic attacks 

Menopause can be a trigger for anxiety and panic attacks. Researchers found that hormonal changes specific to this period in a woman’s life increase the risk of panic disorder and anxiety in general.

Menopause is a natural period in every woman’s life. As natural as it is on an objective level, as stressful and bizarre it can be felt on a subjective level. Often accompanied by intense and unstable emotional states, the period of initiation of menopause brings with it an increase in vulnerability to the development of certain mental and emotional disorders. 

During menopause, the level of estrogen and progesterone fluctuates, this having a major impact on the body, but also on the mood.

Estrogen inhibits the production of cortisol, also known as “stress hormone”. When estrogen levels drop, which happens at menopause, cortisol levels rise, as does blood pressure and blood sugar levels, increasing the risk of panic attacks.

Moreover, estrogen also has a major effect on serotonin, which in turn is responsible for mood and goodwill. As a result, the dramatically decreasing level of estrogen lowers serotonin levels, causing an unstable mood that predisposes to anxiety and panic attacks.

Progesterone, a hormone that also decreases at menopause, also helps to cause the panic disorder. This hormone has a calming effect on the individual, and when it is missing it causes a predisposition to anxiety.

How does a menopausal panic attack manifest itself?

It is very possible for the woman to notice that she has a sudden and intense state of worry or anxiety, she has the feeling that things will end here and now. Physical symptoms can sometimes be:

• heart palpitations
• discomfort or difficulty breathing
•  Dizziness
• Weakness
• Sweating
• Nausea
• a tingling sensation in the hands or feet.

Some symptoms, experts say, such as anxiety, sweating and palpitations reflect those symptoms that many women have during perimenopause and menopause. It is possible for the woman to go to several specialist doctors, who will not reach the correct diagnosis.

For example, palpitations may cause a woman to go to a cardiologist, but the results of investigations will often be normal. The neurologist may not discover a clear cause for dizziness or headaches, but from time to time, the patient will be diagnosed if she goes to a psychologist or psychotherapist.

Menopause and mood disorders

Menopause is not an acute physiological event, but rather a sequential one, which includes several distinct periods:

Perimenopause – with a duration of 4-6 years (the average is 2 years), is a transition period in which the cycles become irregular, the frequency of anovulatory cycles increases (without removing an egg), and estrogen production decreases.

Postmenopause – this is the 12-month period in which the woman has no menstruation at all.

Prolonged menopause – Permanent cessation of ovarian function.

Psychological and emotional difficulties appear mainly in the first two stages, and the risk of developing an emotional disorder due to this period decreases with the onset of menopause itself.

What are the main psychological conditions that can occur during menopause?

The menopausal period was associated with depression, anxiety, low self-esteem, the perception of loss of femininity and the installation of the ageing process. At menopause, women may also experience changes in memory and attention, decreased decision-making capacity, the installation of inferiority complexes, emotional instability.

Also worth mentioning are insecurity, nervousness, melancholy, aggression, indifference or the tendency to isolate.

Depression

Depression is the most common mental disorder worldwide, and the number of people suffering from this disorder continues to rise. Depression can have negative effects on interpersonal relationships, on professional functionality, on a person’s financial situation, and even more, it represents an increased risk of self-harm and suicide. 

In addition to the impact on emotional state, depression has serious implications for physical health.

Depression is twice as common in women as in men, which has led to the idea that women may be at increased risk during periods of hormonal changes, such as puberty, pregnancy, and the transition to menopause. The reason for the increased risk of depression during this period is the decline in estrogen levels.

 Estrogen has the ability to stimulate the increase in serotonin levels, which is considered to be the “happiness hormone”. Thus, the decrease in estrogen levels will lead to a decrease in serotonin levels, which at the emotional level can be felt through feelings of sadness or inadequacy.

How can we recognize depression?

According to DSM IV (Diagnostic Manual of Mental Disorders) having depression means that at least five of the following symptoms (of which at least one must be symptom 1. or 2.) persist for most of the time, at least two weeks:

• Depressed mood, an acute feeling of sadness
• Decreased interest or pleasure in activities that we used to enjoy
• Sudden weight loss or gain, decreased or increased appetite
• Insomnia (you can’t sleep) or hypersomnia (you feel like sleeping continuously)
• Psychomotor agitation or slowness
• Lack of energy/feeling of chronic fatigue
• Feelings of worthlessness or excessive guilt
• Decreased ability to think or make decisions
• Thoughts about death, suicidal ideation, a suicide attempt or plan

Recent research has found that the onset of depression in women during menopause can be influenced by the following psychosocial factors:

• Existence of a previous affective disorder
• Negative attitude towards menopause and the ageing process
• High-stress level
• Sleeping disorders
• Experiencing more severe menopausal symptoms
• Early menopause
• Lack of physical activity
• Smoking
• Dissatisfaction in social relations / with the partner relationship/lack of a partnership relationship
• Marital stress and domestic violence
• Lower level of education
• Low socioeconomic status/unemployment

Anxiety

Hot flashes are a common symptom of menopause, which occurs with night sweats, sleep disorders and vaginal dryness. 74% of menopausal women report the presence of hot flashes. Therefore, a woman in the menopausal transition experiences an uncomfortable and sudden rise in whole-body temperature.

 These are called vasomotor symptoms. There are similarities between the physical symptoms of anxiety, especially panic attacks, and vasomotor symptoms. As symptoms, the panic attack involves at least 4 of the following changes:

• palpitations
• sweating
• tremor
• Shortness of breath
• Feeling suffocated
• Precordial pain or discomfort
• Nausea or abdominal discomfort
• Feeling dizzy
• Depersonalization (feeling that you are not experiencing everything you feel)
• Fear of losing control or going crazy
• Fear of death
• Chills or heat waves

Thus the feeling of fear that “something bad is happening to me”, and hypervigilance towards any symptom that our body feels, can degenerate into a panic attack.

Menopause and sleep disorders

The main sleep disorders are insomnia and hypersomnia. Insomnia refers to difficulty falling asleep or shorter sleep due to waking up during the night, inability to fall asleep again or waking up very early.

 Hypersomnia refers to prolonged sleep, more than nine hours a night, or prolonged and excessive sleepiness during the day, without the person feeling refreshed and rested on waking, followed by continued drowsiness after waking up.

Decreased sleep quality can be another cause of menopausal anxiety. Many women who suffer from anxiety report experiencing regular insomnia. Menopausal anxiety may also be a reflection of a pre-existing disorder, an anxiety that has been exacerbated by this transition phase. 

During perimenopause and menopause many women may feel anxious due to changing social and professional roles, respectively due to their attitude towards the ageing process.

Body dysmorphic disorder

Etymologically speaking, the concept of menopause comes from the Greek language, being composed of the words “pause” (end) and “menos” (haemorrhage). Thus menopause announces the end of menstruation and NOT the end of femininity! 

However, many women experience the feeling of the annihilation of their femininity, decreased aesthetic value, decreased libido, things that can lead to the installation of a personal crisis of the woman. As a result, negative reactions of non-acceptance, panic, regret or even revolt can occur. 

Body dysmorphic disorder is the imaginary belief of a person that he has a major physical defect or exaggeration of an existing defect and excessive concern for this aspect. 

In this case, a more realistic image of oneself and the belief that it is not necessary to be role models in order to be loved and happy can be two of some of the help in overcoming the difficulties related to this period.

How to manage menopause anxiety and panic attacks

Now that we have mentioned the main psychological problems that can occur with menopause, let’s see what are the things that can keep us away from such problems or that can balance us mentally:

An active social life – A rich and active social life is essential to convince yourself that you are worth much more than you think during this period. Menopause is a time when women have low self-esteem, so it is very important that they play multiple social roles in order to compensate for the “losses”. 

Isolation and lack of social contact Outside the home, there are factors that significantly increase the risk of developing an emotional disorder such as depression or anxiety.

Family support – The support of the life partner of the family members is also very important. Their support and empathy can show you that you are not alone and that the stage you are going through is one in which the warmth and understanding of your loved ones accompany you! 

However, in order to have access to these resources of theirs, you will have to openly communicate to them the difficulties you are going through and accept their help.

Menopause is an absolutely normal stage in any woman’s life. Accept it! – The onset of menopause should be seen as an absolutely normal stage, characteristic of a beautiful and mature age. In this situation, the psychological symptoms will diminish significantly. 

Moreover, a balanced life, which does not lack a diet rich in vitamins and minerals, which you can find in fruits, exercise, rest and relaxation is important for both physical and mental health. Also, the support of a specialist can be helpful. You can add mushroom to your diet, check the best Mushrooms supplements for anxiety.

Check our extensive list of 10 Vitamins for Anxiety.

If you have a lack of minerals, check which are the Best Minerals for Anxiety.

Tips for menopause struggles

To improve sleep quality:

• go to bed at the same time every night and wake up at the same time every morning. If you want to wake up and start your day calm, find out the best alarm clocks for anxiety.
• avoid exercising before bed
• beware of computer screens at least 30 minutes before bedtime.

To get rid of anxiety and depression:

• slow down and try relaxation or yoga techniques. If you’re open to trying yoga for anxiety and stress relief, check out these top Yoga DVDs.
• exercise 30 minutes a day for the body to release endorphins, which will give you a natural boost
•  keep a diet rich in vitamin B, zinc and magnesium.

For hot flashes and night sweats you can:

• wear clothes made of natural fibres
• wear clothes in several layers, easy to remove if a hot flash occurs
• try to reduce stress levels with relaxation techniques
• keep the bedroom cool at night
• use bedding made only of natural fibres
• avoid known triggers, such as red wine and spicy foods.

Women are more lively to suffer from anxiety disorder overall, as compared to men. This is because they experience such events in life that can easily make them anxious. One such event, other than menopause is labor. The pain a mother bares during labor is immense, therefore it is very important for them to learn ways of not feeling nervous when in labor.

FAQ on menopause anxiety

Conclusions

In this article, we talked about menopause anxiety and panic attacks. We also talked about the main psychological problems that may accompany the onset of menopause, but also how can they be avoided.

Etymologically speaking, the concept of menopause comes from the Greek language, being composed of the words “pause” (end) and “menos” (haemorrhage). Thus menopause announces the end of menstruation and NOT the end of femininity! 

However, many women experience the feeling of the annihilation of their femininity, decreased aesthetic value, decreased libido, things that can lead to the installation of a personal crisis of the woman. 

During menopause, the level of estrogen and progesterone fluctuates, this having a major impact on the body, but also on the mood.

Estrogen inhibits the production of cortisol, also known as “stress hormone”. When estrogen levels drop, which happens at menopause, cortisol levels rise, as does blood pressure and blood sugar levels, increasing the risk of panic attacks.

If you have more questions or comments, please let us know!

References

Medicalnewstoday.com – What is the link between menopause and anxiety?

Centerforanxietydisorders.com – Menopausal Anxiety

Health.clevelandclinic.org – Can Menopause Cause Anxiety, Depression or Panic Attacks?

Nhs.uk – Menopause Treatment

DSM IV (Diagnostic Manual of Mental Disorders)