The dark days of the menopause

It's 3 years since the onslaught of the menopause and the past few weeks have been trying to say the least - debilitating tiredness and a severe deterioration in my mental health. 

3 weeks ago, something broke in me, the tears came like an unannounced tsunami, all I could do was retreat to my bed, I could not bare the thought of interaction with anyone or anything and I was simply not able to function, not even to feed myself anything other than crisps. I slept and binge watched netflix all day and contacted my GP and endocrinologist for support and advice, as the dark clouds that have once again entered my world, refused to disperse.

As a result, I have started on a course of anti-depressants, I simply do not have the energy or mental capacity to keep going 'cold turkey'. Even as I sit here, I am struggling to find the words to express how I have been feeling these past few weeks, it's almost incomprehensible which is why so many women suffer in silence, alone, without support and why I believe, the suicide rate for middle aged women is on the increase. The menopause is a complex beast and a constantly changing one too. Right now it has brought me to my knees, I have been here before and I am no fool, I do not for one minute under-estimate the power of my hormones, the tricks they can cause my mind to play on me and the debilitating effect they can have on my life. I know when I need help and right now I need help, lots of it.

I am so tired it is untrue. It does not matter how long I sleep, it is never enough, I cannot even walk the dog without a rest en-route. I wake up crying and go to bed crying. I am overwhelmed by the slightest thing, a question from the kids on the where the toothpaste is, the thought of having to get out of bed and face the day ahead, emptying the washing machine, answering my emails, anything no matter how large or small. My body aches relentlessly, like it has just run several marathons. I have forgotten what desire or motivation feels like, everything is such hard work. I cannot bare noise, my senses simply become overloaded and I have a deep seated desire to retreat, to solitude, peace and quiet. I am blinded to the beauty and opportunities that surround me, I can only see a bleak, manic reality, that I drag myself through everyday, desperate to simply to get to the end of it so that I can once again sleep.

And of course, it all becomes a viscous circle, the less motivation I have, the more pain I am in and the longer this goes on, the harder it becomes to force myself to do things, to interact with life and with myself, to reach out to others for support and advice and therefore the more tired, withdrawn and sad I become. And I grieve, incessantly for who I used to be, for what I used to be able to do and for some sense of hope.

And you may wonder, how I have managed for 3 years feeling like this? Well I have not. This is how I felt at the start of my menopause - it took a while to realise what was going on, my dad had just died so we thought it might be the grief, or even chronic fatigue syndrome, but after a period of investigations and failed treatments, I had the good fortune to be introduced to a private endocrinologist, who read my blood results, joined the dots with my symptoms and finally got to the root cause of what was really going on - the menopause. The first year was spent getting my insulin resistance under control (insulin being your largest hormone and therefore pretty important), getting some much needed vitamins into my body, changing my diet and finding the right HRT, to help me regain my quality of life. And I did, for the next 2 years I returned to running, swimming, regained much of my motivation and zest for life and lost a serious amount of weight, even during the dreaded lockdown and home bloody schooling. But since Christmas, I have been on a steady decline - my brain fog became bad, really bad, I could not even remember where I was meant to be going some days, so my insulin resistance medication was reduced - your brain needs sugar to react real time, so it's important to manage my insulin levels correctly and my reduction in weight also meant a reduction in my insulin, hence my medication had become too strong, creating a delayed reaction in my brain responses. This worked well but then around end Feb/early March my physical and mental health took a steep descent.

As it turns out, your menopause does not stand still - which is of course why women need to be reviewed frequently and their treatment plan constantly updated in line with their new, reoccurring or worsening symptoms. What bit of natural estrogen that was left in my body had declined significantly, my insulin was once again out of control and it turns out that I had developed a vitamin D deficit, all of which conspired to make me feel pretty shit most of the time. But the area that remains somewhat blurry and where research is constantly on-going, is the true relationship between the menopause and our mental health. We know that estrogen is pretty damn important for our brain neurones and therefore affects our motivation and overall sense of well being, but we then need to add in the affects of feeling shit for longer periods of time, the trauma and anxiety everyone has been subjected to with the global pandemic, the disconnect between our environment and our biological evolution (many women including myself, have children later in life therefore enter the crone phase still with dependants and indeed the experience of the menopause itself is evidence that our bodies out of sync with our brain, which is still requesting hormones that are no longer being manufactured in-house, so to speak), the awakening of past traumas and last but certainly not least, the manic, pressurised, results driven, materialistic and often inhumane world we all now inhabit - you certainly do not need to be experiencing a menopause to experience mental health challenges given the environment we are all faced with on a daily basis. So, all in all it's a shit load of stuff to deal with and therefore hardly surprising so many women and men are crawling through life, with some tragically not making it at all.

So, I find myself in yet another transitional phase - it will take a good 3-4 weeks for my body to stockpile the vitamin D and for me to feel any real benefits from the huge doses I have now been prescribed, similarly the insulin imbalance and estrogen deficit will also take time to reconcile. But I'm also pretty sure that there maybe something else going on with my mental health too - normally my hormonal depressions, whilst severe, are thankfully fairly short lived, usually no more than a week, but sadly this latest overwhelming bout of sadness, anxiety, feeling of general overwhelm and constant crying has been with me for a few weeks and seems to be getting worse not better. There are some factors in my life which are challenging and I am ground down by either feeling unwell, or having to restrict my life so that I do not become unwell. It just all feels too much right now, I long for a break, a chance to retreat someone quiet and alone, not to have to think of so many things to do, places to be, or balls to juggle. I think my brain is quite simply overwhelmed with the demands of life, the volatile environment we all find ourselves in and the challenge of a long-term and at times, very debilitating menopause. So, I believe one of the worst things I can do, is to simply keep doing what I have been doing and ignore what my mind and body is so desperately trying to communicate to me. I need to heed the warnings and make some changes. Now they will be different for each of us, but given my circumstances and support network here are a few of the changes I have implemented to ride out this storm:

• I have cancelled anything that is not critical or necessary for my well being. I have vastly reduced my to do lists and make sure there is a rest period in between jobs.
• I have spoken to my GP and menopause consultant and agreed a course of medication with regular check points to establish whether they are improving my quality of life.
• I am going to bed very early and rising early to have some peace and quiet and a gentle introduction to the day.
• I have no expectations of myself other than to get through the bare essentials of washing, eating, looking after the kids and resting, anything over and above this is a bonus.
• I am honest with others about how I feel and why I am somewhat dis-engaged from things at the minute.

And there are no magic quick fixes or no one size fits all. It is a matter of being truly honest with yourself, not being afraid of the darkness that comes at times, reaching out to others who you trust when it feels more than you can bear and being patient, extremely patient with yourself. Do not look at what others are or are not achieving, do not beat yourself up and pressure yourself into what you are told you need to do - indeed part of why I find myself in this position is because of external pressures, narratives and judgements of what we are expected to do, what the norms are, the perceived solutions to often complex and extremely unique mental health challenges. When for me, the real solution lies in not listening and feeling pressurised by well meaning but often unhelpful advice - if I could do it I would. My mind and body is screaming for rest, simplicity, silence and the chance to hear myself think, to have the time to feel and process those feelings, to sit with my fears, my shadow self and to learn to accept, heal and move on. And when I am ready, I will re-engage and I will rediscover my joie de vivre. But for now, I am on the outside of life looking in, the medication has brought some calm to my troubled mind, to give me some space to be a more detached observer of myself, so that I can understand what it is that I can and cannot take back on and how I have ended up feeling like this in the first place.

And that is the best I can do right now - is to simply get through each day at a time and when that feels too much, get through each hour at a time. That is it - simplicity and space, the rest can come later.

With love

Nik x