When Your Mind Feels Like It’s on Fire: Mental Health in Perimenopause
- Lurah Patrick
- Sep 2
- 5 min read
Updated: Sep 14
Perimenopause: The sequel to puberty that absolutely no one wanted, yet here we are, starring in our own hormone-fueled sitcom.
If you’re between 35 and 55 and lately your moods flip faster than Netflix previews, your brain feels like it’s stuck on buffering, and you keep wandering into rooms with zero memory of why, you’re not losing it! You’re in perimenopause. Your body and mind are moving through one of the biggest hormonal shifts of your life, and it can mess with everything from sleep to self-esteem.
Here’s the part we don’t say enough out loud: perimenopause isn’t just about hot flashes. It’s about mental health. It’s about mood, anxiety, sleep, and how you see yourself. And you don’t have to white-knuckle your way through it. There are things that help, science-backed and practical, real-world solutions.
Why Your Brain Feels Different
Perimenopause isn’t just about physical symptoms—it can can challenge your emotional well-being too. Research shows women are more likely to experience anxiety and depression during this transition. And it’s not just because life is already a juggling act with careers, kids, aging parents, and shifting relationships. Hormones are right in the mix.
Estrogen, which helps regulate mood and stress, doesn’t simply decline; it bounces up and down unpredictably. That hormonal chaos can make stress and mood changes feel way more intense. Add in night sweats that rob you of sleep, and it’s no surprise your anxiety or sadness feels louder.
Cognition can take a hit as well. Many women describe brain fog and trouble with memory, focus, and finding the right words. The encouraging news? Research suggests these changes are usually temporary and often improve after the transition.
Bottom line: you’re not imagining it. Perimenopause really can shake your mood, your memory, and your sleep. But knowing why can help you feel more grounded and less alone.
Simple Tools That Make a Difference
This isn’t about overhauling your whole life. It’s about small, consistent moves that protect your mental health while your body does its thing.
1. Track it to tame it
Spend five minutes at night jotting down your sleep quality, mood, hot flashes, and stress level. Patterns pop up fast: “My mood tanks after bad sleep,” or “Wine = instant heat wave + anxiety.” Once you see the patterns, you can work with them. Knowledge really is power.
2. Reframe the flash
Hot flashes feel like ambushes, but even tiny mindset shifts help. Try telling yourself, “This is a hot flash; it will pass.” Pair that with practical cooling tricks: wear layers, keep ice water nearby, stash a mini fan in your bag.
3. Guard your sleep like your sanity depends on it (because it does)
Get up at the same time every day, even after a rough night.
Keep your bed for sleep and sex only.
Ditch screens and dim the lights before bed.
Limit alcohol and caffeine later in the day.
Better sleep = steadier moods.
4. Move your body—even a little
Exercise doesn’t have to mean a bootcamp. A 20-minute walk counts. Regular movement
has been shown to lower anxiety and depression in midlife women.
At Her Time Therapy, we’re so committed to this connection between mind and body that we now offer online personal training alongside therapy—so you can strengthen both your emotional and physical resilience, safely and supportively.
5. Outsource your memory
Brain fog is real. Sticky notes, phone reminders, and shared calendars aren’t weaknesses. They are survival tools. Use them guilt-free.
Treatment Options (Because Grit Alone Isn’t the Answer)
Self-help strategies make a difference, but sometimes you need more support. And that’s okay. Here are a few additional options to check out:
Hormone Therapy (MHT): The most effective treatment for hot flashes and night sweats. For some women, it may also reduce depression risk. Whether it’s right for you depends on your health history. Talk it through with a provider you trust.
Non-hormone options: If hormones aren’t for you, certain antidepressants (SSRIs, SNRIs) or newer medications like fezolinetant can ease both hot flashes and mood symptoms. Talk to your therapist about getting a referral to a trusted psychiatrist.
Therapy (especially CBT): Cognitive Behavioral Therapy tailored for menopause (sometimes called CBT-Meno) can reduce hot flash distress, improve sleep, and lift mood. A therapist who understands this stage of life can be a game-changer.
If you’ve been feeling down or anxious most days for more than two weeks, if sleep loss is making life unmanageable, or if thoughts of self-harm creep in – DO NOT wait it out. Reach out to a doctor, therapist, or crisis line. You are not supposed to carry this burden alone.
The Reframe: Not Broken, Just Transitioning
Here’s the big reframe: Perimenopause and menopause aren’t signs of weakness or decline. They’re a biological transition. Think adolescence, but later in life. Like adolescence, it comes with mood swings, body changes, and identity questions. And just like adolescence, you will come through it.
So instead of fighting your body, consider this an invitation: to rest more, to track what matters, to set boundaries, to ask for help. Your story doesn’t end here. It can be reimagined!
This Transition Wasn’t Your Choice—Support Can Be
Perimenopause doesn’t have to be something you “just get through.” With the right support, you can navigate this transition with steadiness, clarity, and resilience.
At Her Time Therapy, our therapists understand the unique challenges women face in midlife—from mood changes and sleep struggles to stress, anxiety, and identity shifts.
You deserve support, relief, and a space where your story is heard.
Call/Text (720) 255-1667 | info@hertimetherapy.com | www.hertimetherapy.com
Further Reading
How hormone swings affect mood and stress – Research shows that fluctuating estrogen levels during perimenopause can make emotional ups and downs feel more intense, even in women without a history of depression. Link
Hot flashes, sleep, and mood – Hot flashes and night sweats often disrupt sleep, which in turn may amplify anxiety and depressive symptoms. Link
Why brain fog usually clears up – Cognitive symptoms like forgetfulness or fuzzy thinking tend to improve once the transition settles. Link
Move your body, help your mind – Even light activity like a daily walk can significantly ease anxiety and depression during perimenopause. Link
Hormone therapy and mood – Estrogen therapy (MHT/HRT) may reduce depressive symptoms and hot flashes when timed and prescribed carefully. Link
CBT can help with hot flashes and mood – Cognitive Behavioral Therapy tailored for menopause (CBT-Meno) can help reduce distress, improve sleep, and lift mood. Link
About the Author
Lurah Patrick, M.A. Candidate in Clinical Mental Health Counseling at Adams State University, is a graduate student therapist offering affordable telehealth services in Colorado under licensed supervision with Her Time Therapy. She brings a narrative and existential lens to counseling, helping clients slow down, feel heard, and reconnect with their own wisdom. With a special interest in life transitions, including menopause, ADHD in adulthood, shifting family roles, and the search for personal meaning, Lurah creates a collaborative space where clients explore their stories with curiosity and compassion. Her approach is rooted in the belief that healing begins with connection: to self, to others, and to possibility. She guides clients in uncovering resilience, reframing limiting stories, and cultivating confidence to move forward on their own terms. When she's not counseling, Lurah can be found hiking in Colorado with her wonderful therapy dog, sculpting stone, or dreaming up her next adventure as a writer and traveler.
Disclaimer: This blog does not provide medical advice; the information contained herein is for informational purposes only. Always seek the advice of a licensed health provider before starting a new treatment regimen.
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