Anxiety and the Menopause; learning to take back control

Anxiety can be a very real and challenging symptom of the peri menopause and menopause for some women.

It is incredibly dis-empowering. It dramatically impacts the quality of your life and can ripple out into all areas including your relationships, your ability to work, and your ability to simply find joy in life.

It is crucial therefore to understand what is happening, and to learn techniques to overcome it so that you can take back control.

I struggled with anxiety when I entered the early menopause. It is perhaps why I feel so compelled to help others reduce stress and anxiety, and to support women during the menopause.

I did seek support with my anxiety, and I also chose to take HRT which has really helped me. However, I also learnt strategies to manage anxiety with lifestyle which is crucial. There are many women who choose not take HRT. Whichever path you choose, learning to manage anxiety with lifestyle is key.

The message I am keen to share is that it won’t last forever and there are things that we can do to change our physiology and take back that control.

There is no disputing it; anxiety is horrible. It can strip us of our power. It makes us feel that everything is out of our control. It can make us literally want to run away, or dig a big hole to hide in. It can also feel insurmountable, which leaves us feeling despondent and desperately low. Even seeking help can also feel pointless simply because we know that no one else can change how we intrinsically feel inside……

However, so often in life our biggest challenges are also often our biggest opportunities to grow.

So, why does the menopause make us more susceptible to anxiety and how can our lifestyle choices help?….

The menopause is a time of huge physiological change, and it can affect many organs and systems of the body. It is not just the reproductive organs that use oestrogen; many other organs in the body require oestrogen including the brain and nervous system. It can take time for our bodies to adapt to the reduction in hormones, which it is why it is crucial that we make choices that support the brain and nervous system during this time. It is also vital that we reduce stress as the adrenal glands which produce our stress hormones also continue to produce oestrogen after the menopause. However, if our adrenals are continually producing stress hormones this will prevent them from producing oestrogen… We therefore need to be conscious more than ever to reduce stress and cortisol levels in our body.

Our lifestyle choices can literally switch on the sympathetic nervous system (stress response) or the parasympathetic nervous system (relaxation response). I suspect we can all recognise how we create stress in our lives. However, we perhaps do not associate it with the real physiological changes that occur in our bodies. Stress hormones have a vital role in helping us to react to short term danger. However, chronic persistent stress creates consistently raised cortisol levels which causes havoc in our bodies: it suppresses the immune system, disrupts sleep, creates inflammation in the body (the biggest cause of disease) and generally leaves us feeling depleted and exhausted.

So, we need to break that stress cycle, and bring down damaging levels of cortisol in the body. Thankfully there are many ways that we can do this; and this is where we can start to take back control with our lifestyle habits.

We all intuitively know what makes us feel better; reaching out to a good friend, getting out into nature, creating space for peace and quiet to practice yoga or to get lost in a book or a creative activity…. Quite simply slowing down and creating stillness and calm is not only crucial to our well-being, but it causes real physiological changes in our body. It literally reduces levels of cortisol and switches on the parasympathetic nervous system. So much lifestyle advice is just so simple and intuitive, but it is also accessible to us all and massively powerful! If I was to offer just one piece of advice to women in the menopause it would simply be to slow down.

However, if we are experiencing acute anxiety, we first need to be able to reduce the panic and overwhelm before we feel able to engage in these activities, and there is one very powerful tool that we all have access to, and that is our breath!

The most powerful tool of all… our breath…

Breathing has gained more attention recently and there are many different techniques that people are able to access through technology and via yoga and well-being practitioners. However, all this information can also make people overwhelmed and confused, and unsure where to start.

If you do want to read more I would highly recommend James Nestor’s book Breathe, or listening to this podcast about it. He is a journalist who spent 10 years delving deep into all the various techniques and scientific studies on breathing that have been conducted over hundreds of years..

In the meantime, I would like to share with you what I have learnt in hopefully a simple and accessible way so that you are able to experience the benefits immediately…

Focus on the exhale to reduce stress

When you think about breathing.. what messages are you familiar with?  In the past I previously thought that I should focus on taking slow, deep breaths. …. I also tended to instinctively focus on the inhale. However, this is not quite correct. It is important to breath slowly, but it is also important to breathe less. James Nestor is keen to point out that many of us are over-breathing, and the perfect regular breath has actually been shown to simply breathe in and out to the count of 5.5.

It is also important to understand that to reduce stress and anxiety we should focus more on ‘breath holding’ and a longer exhale, rather than the inhale. The reason being that when we inhale, we switch on the sympathetic nervous system, whilst holding the breath and exhaling switch on the parasympathetic nervous system.

We can also personalise our breathing techniques to suit our individual needs. During my health coach training, I was introduced to the ‘5,5,7 breath’ (breathe in for 5, hold for 5, and breathe out for 7). This is clearly great for switching on the relaxation response. However, at times I sometimes find this long out-breath quite challenging. It is therefore vital you start where you are at, whether that is the ‘3,4,5 breath’ that Dr Chatterjee recommends, or the box breathing technique.. ‘4,4,4 breath’…. The key point is to start where you are at and continue to extend the out -breath longer when you are able….

Whatever version we choose is up to us but practising 10-20 cycles of these breaths will have a real physiological effect on our body, and will make help us feel significantly calmer in minutes. There are years of research studies and numerous devices available to us that can physically demonstrate the physiological changes that occur within the body.

Learning to breathe properly is simple, and accessible to all, and most importantly in the anxiety equation, its effects are felt in minutes…However the key word is ‘practice’. It is vital that we practice these techniques consistently to experience the benefits.

James Nestor’s book is packed with knowledge and practical advice, but another crucial other thing we might easily overlook, is the power of nasal breathing.

Close your mouth

Have you ever stopped to consider whether you breathe through your mouth or your nose? Our noses are designed to filter any unwanted particles, whilst breathing through our mouths makes us vulnerable to inhaling pollution, allergens, and viruses. By simply closing our mouths and nasal breathing we can protect our lungs, breathe more efficiently and reduce our heart rate. Yet it is thought that 25-50% of us breathe through our mouths, and 60-70% breathe through our mouths at night, making us susceptible to sleep issues and snoring. Simply closing your mouth can have huge benefits for your health.

Consciously slowing down our breath, breathing less and breathing through our nose will enable us to simply breathe properly, and this is just so crucial to our health and well-being,

Breathing properly engages your whole diaphragm and enables you to use your whole lung capacity. In his book, James Nestor states:

‘A typical adult engages as little as 10 percent of the range of the diaphragm when breathing, which overburdens the heart, elevates blood pressure, and causes a rash of circulatory problems.’

Breathing properly, assuming the correct posture, and regular exercise can increase our lung capacity, and allow our bodies to work more efficiently. There is so much we can do to positively influence our health and well-being, but it doesn’t have to be complicated.

The mind/ body connection

When talking about anxiety we cannot overlook the power of the mind- body connection.

Breathing and relaxation techniques clearly enable us to make real physiological changes in the body. However, when we are gripped by anxiety it can be difficult to access these practices if we are stuck in the negative and self-defeating storylines in our head.

Anxiety is caused by worrying about something in the future. It can feel very real and very frightening. However, in reality it is essentially caused by worrying about something we have created in our imagination! Unfortunately, our brain is unable to distinguish between what is real and what is imagined.

We also often find ourselves worrying that something that happened previously might happen again. This is an innate survival mechanism, our inbuilt system for safety and belonging.

It can therefore be really challenging to overcome anxiety. There is simply no ‘quick fix’.

However, if we are given the space to be able to step back from it and gain some all-important perspective, we can start to see it for what it is… our imagination!!

To start to overcome anxiety we need to find a way to take back control of the things that we can control. When we are trapped in a cycle of anxiety, we can lose all perspective. However, when we are given the space to step back, we can start to see what is possible and what is within our control. There are many things we can’t control in life, but as Charlie Mackesy so brilliantly wrote:

‘One of our greatest freedoms is how we react to things.’

In the overwhelm when we lose perspective, it is easy to lose track of the fact that our feelings are fleeting: they come and go. Even though it seems impossible at the time, it is crucial to start to recognise that this will not go on forever…. we will feel better.

Also, when we realise that anxiety is worrying an imagined future scenario that hasn’t happened yet, we can start to see the true value in mindfulness practices, and being in the present moment. I have written previously about mindfulness, and I am grateful to have learnt from some brilliant teachers. Please do take time to read this previous blog if you would like to read more. Mindfulness is a very powerful tool for anxiety, as are affirmations, re-framing, and gratitude practices.

There is clearly so much to talk about, but I hope that you are now starting to appreciate that there is so much you can do to take that power back. If you would like any support to access these practices, I would be honoured to help you, so please do get in touch.

Lifestyle practices can often seem too simple to be effective. However, this simply isn’t true.  Greater knowledge and the right mindset can empower us, whilst engaging in regular breathing practices, and other relaxing activities can literally change our physiology and switch on the relaxation response in the body.

You really can do this!

With acceptance, awareness, and consistent practice we really can begin to see what else is possible!!



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