I always thought of myself as someone who had “her emotions under control”—that is, of course, until I entered menopause prematurely. From ugly-crying in public to uncontrollable rage to forgetting, well, everything, the mental experience of menopause was deeply humbling to say the least. And I am not alone in this one. Although we often think of menopause as only hot flushes, the reality is that the other four of the top five symptoms women report as most bothersome are related to mental health.

The most common mental experiences during menopause include mood swings, irritability and rage, anxiety, depressive states or low mood, cognitive issues like brain fog (trouble concentrating or remembering things), and sleep disturbances such as difficulty falling asleep or poor-quality sleep.

Not surprisingly, these can lead to a lack of confidence and identity confusion. Not being in control of one’s emotions can be scary and frustrating—not to mention a burden on relationships. Many people going through menopause fear they’re developing dementia or Alzheimer’s when they experience brain fog or forget—AGAIN—where they left their keys (it’s the freezer, the answer is almost always the freezer, ask me how I know). This sudden sense of disconnection from your own mind, or apparent changes in personality, can feel overwhelming.

Another not-so-fun fact: many of the mental experiences during menopause can mimic or overlap with burnout. This leads to many women being diagnosed with burnout when in fact they’re in perimenopause—or vice versa. The distinction isn’t always clear, especially when you’re also juggling caregiving responsibilities, work stress, and everything else. As always when we talk about menopause, it’s nearly impossible to draw clean lines between “menopause” and “the rest of your life.” That’s why it’s so important to be aware of these experiences and listen to what they might be telling you.

Time matters

Another important factor is time and how the experience changes depending on where we are in the menopause process. During perimenopause, when hormones are fluctuating most violently, the risk of mental distress is highest. The image I think best represents perimenopause is that of a rollercoaster. Hormones are all over the place, and so are moods. Add to that managing unpredictable cycles, juggling most of the care work in society plus a job, and we’ve got a recipe for disaster.

This alone can strain a person’s mental health. And what’s worse, many women don’t even know they’re in perimenopause—either because they haven’t heard of it, or because their experiences don’t match the stereotypes. That can cause them to think there is something wrong with them, instead of realising it’s something going on hormonally.

In postmenopause, hormones stabilise, but some mental symptoms can linger or shift. Depression or anxiety can stick around if left untreated. The brain does adjust to a new hormonal baseline over time but lifestyle changes or therapeutic support are often still needed.

That’s why I always remind clients that the experience of menopause is not linear. Mental symptoms may come and go. Keeping a record of them can be incredibly useful to help you stay aware, notice their impact on your daily life, and seek the support you want, need, and deserve.

It’s also worth saying that many women report their mental clarity improves postmenopause. So yes, there is light ahead.

Educate yourself

One of my most important roles as a menopause doula is to provide education so that women can make informed choices that work for them.

Although we’re starting to talk more openly about menopause, there’s still a lot of confusion. Long lists of symptoms can be overwhelming and contribute to overproblematising the menopause experience—but they also have value. They can help you recognise what’s happening, understand that it is common, and feel less alone.

When you understand what’s normal, and what might need support versus what doesn’t, it reduces fear and stress. It also reduces shame. Mental health challenges are part of the process for many people. That doesn’t mean we ignore them—it means we name them and learn to work with them.

Unfortunately, most healthcare systems and workplaces still don’t understand menopause well. So we need to be informed to advocate for ourselves—whether with our doctors, our employers, or even our own families.

Time for a mindset change

Still, knowing something is normal doesn’t make it easier to live with it, especially when your work or daily life is being affected.

The first thing I usually recommend is trying to shift your mindset. Research supports what many of us intuitively know: what we resist, persists. The more we try to fight or suppress symptoms, the louder they tend to get. On the other hand, approaching them with acceptance—or even humour if that’s something you can do at this point—can make a huge difference.

You are not “going crazy” or losing yourself. You are going through something real and deep. Think of it as a recalibration. You are birthing yourself anew, and far from becoming someone else, this new version might feel more “you” than ever before once this adjusting phase passes.

This kind of inner work is essential for a smooth process and I recommend you don’t skip it. But that doesn’t mean there aren’t other tools and supports that can help too.

The basics still matter

Let’s revisit the foundation: food, movement, and sleep. I know I’m repeating myself, but I can’t stress enough how important it is to build this base in the pyramid of your health. These tools are just as critical for your mental health as they are for your body.

• Food – Support your mood and nervous system by eating as naturally and consistently as you can. Think fresh, seasonal, not processed. Pay attention to how sugar, alcohol, and caffeine affect your sleep and mental state. Don’t stress about having to make ALL THE CHANGES now, but orient yourself in the right direction and take a baby step whenever you can.
• Movement – Gentle, regular movement helps regulate emotions and builds resilience. Strength training is especially helpful during menopause, but thinking from a mental health perspective, I strongly advocate for anything that brings you joy—dancing, walking in nature, rediscovering a hobby from your younger days that was fun. Let’s move away from the “no pain, no gain” mindset.
• Sleep – Disturbances in sleep are common in menopause, but that doesn’t mean we give up. A consistent bedtime, a cool and dark room, and calming rituals (like a warm bath or sesame oil on the feet) can really help. I swear by aromatherapy and earplugs.

Some other useful tips

Cognitive behavioural therapy (CBT) has been shown as especially helpful in navigating the mental health challenges of menopause. With the right support, you can develop strategies for dealing with emotional overwhelm, brain fog, or memory issues.

This is also a good time to rethink your time and self-organisation systems: write things down, use planners or reminders with gusto, and let go of the expectation that your brain should hold it all.

Meditation can also help reduce stress and reconnect you with your inner self. So can community. Talk to friends. Join a women’s circle. Attend a peri/menopause workshop. Being in a space where others “get it” is powerful…so go and get your dose of sorority.

And if you need more support, talk to your doctor. Whether it’s adaptogens, natural supplements, hormone therapy, or antidepressants, there are many options available. You don’t have to do this alone.

Out of your mind… and into your heart

Mental health is a major part of the menopause journey but it’s often overlooked or dismissed. The truth is, many of us feel off, foggy, or unstable during this time. The important thing is to remember that this too shall pass, and that there are many resources to support you.

I invite you to think of this as a time to rely less on your intellectual self and open yourself to your intuition and your heart so that you can love and hold yourself as well as you deserve during this amazing transformation.

Photos by Tara Winstead on Pexels