I’m in a formal online meeting waiting for my slot to speak. I’ve got notes in front of me, nothing remotely challenging to present, and I’ve been attending these meetings for years without a second thought. But all of a sudden, the most intense, uninvited anxiety rudely barges in, ravaging through every cell in my body, thieving my composure and replacing it with the most crippling self-doubt imaginable. As my turn approaches, sweat literally drips down my arms (thank God it was online) and my heart is pounding so hard I can’t get a word out. A full-blown panic attack and I’m seconds away from delivery. As the floor is handed over to me, I fake an out-of-control coughing fit, then try to talk while gasping for air and dying inside of embarrassment.

What the actual F?

That was the start of it – 5 years ago. I was 44. Anxiety wasn’t new to me but this was next level and completely unpredictable. Over the following months, the beast kept showing up in similar performance-type situations. Eventually I went to my GP, convinced I was losing myself. Once we pieced together the other symptoms I’d dismissed (poor sleep, thinning hair, volcanic anger and memory glitches), she made the link with peri-menopause and offered HRT. I promptly agreed whilst silently berating myself for missing something so obvious.

What was happening - and why don’t we know this?

There is nothing striking about my experience. Anxiety rocking up when hormones are having a behind the scenes rave is incredibly common. Thankfully, the emotional and psychological impacts of peri-menopause are finally being recognised, so much so that The Royal College of psychiatrists (2026) has released a position statement, calling for greater understanding and awareness of the relationship between menopause and mental health.

Whilst it’s great that menopause is now a hot topic and general awareness is increasing, I still get really fired up that most of us have had zero education about what’s happening biologically, or how to manage it. How many of us have questioned our sanity, harboured fears of dementia, felt disconnected from partners, or simply can’t experience joy in life anymore… and never made the link with peri-menopause? Worse still, how many of us have gone to our GP, only to be told it’s ‘stress’ or handed antidepressants (I was one of the lucky ones)? Imagine of all of us – women, men, young people – were taught what to expect, why it happens and what we can do about it. Let’s take a quick look behind the scenes.

The science

When women hit peri-menopause, it’s not ‘just hormones dipping’; it’s a full neurochemical reshuffle which the brain feels first. Here’s the nerdy (but really important) bit: Normally, oestrogen boosts serotonin levels (your emotions stabiliser) and BDNF (Brain-Derived Neurotrophic Factor, which supports the growth and repair of neurons, effectively acting as a ‘fertiliser’ for learning and clear-headedness), so when it starts swinging wildly, those systems swing too. That’s why anxiety spikes on a random Tuesday and why words fall out of your head mid‑sentence.

Meanwhile, falling progesterone means less GABA – the calming neurotransmitter that helps you wind down and get deep sleep.   Cortisol becomes jumpier because oestrogen usually helps regulate the stress system (cue that ‘tired but wired’ feeling). Oh and the autonomic nervous system becomes more sensitive, so everyday stressors feel bigger and recovery feels slower. Put all of that together and it’s no wonder we feel foggy, anxious, depleted and overwhelmed.

The so-what of the science

The important point here is this: women tend to dismiss these changes as just being too busy, too stressed or not sleeping enough. In other words, we blame ourselves instead of recognising a natural - but pretty tectonic - biological transition. For many high-achieving perfectionistic women (watch out for my next blog on this), the instinct is to grind even harder. But that only pushes us deeper into so-called ‘sympathetic drive’ (think fight or flight). When that stays high for too long, it becomes the kind of stress load that quietly pushes your system into dangerous territory. It’s like the accelerator pedal stays jammed down and the consequences can show up everywhere - gut issues, hair thinning, stubborn weight gain, low iron, headaches… the list goes on.

This is depressing - where are the positives?

Ok, so it’s not the prettiest picture (and I can hear the sceptics scorning, ‘dry your eyes and get on with it’), but there are real positives. The first thing is that the changes are temporary. Things do settle. For many, the emotional turbulence is at its peak during peri-menopause and eases post-menopause. Secondly, once you understand what’s actually going on in your brain and body, it feels easier to stop blaming yourself and to stop pushing through. You start working with your biology instead of against it. Remember, nothing about your anxiety, brain fog or emotional wobbliness is a sign you’re failing; it’s your brain responding to a hormonal rollercoaster it didn’t ask for.   

And here’s the big one – this stage of life can be a catalyst – a powerful invitation to reassess, reset and rebuild in a way that actually supports you. Not cheesy ‘new you’ nonsense, just a deeper, clearer understanding of what you need and what no longer serves you, and that’s incredibly empowering.

In my next articles, I’ll share the evidence-based lifestyle changes that genuinely help – the ones that support mood, energy, longevity and overall health.

In the meantime, please take good care. And now you know what’s going on behind the scenes, and the risks of running yourself into the ground, try to give yourself permission to ease off the accelerator a little. It’s not indulgent – it's intelligent. And of course, you’re absolutely worth it ❤️.

If this resonated, I’d love to hear your thoughts. You can comment below as a guest — no sign‑in needed 😊.