Perimenopause and My Anxiety Disorder. Learning to Manage Both.

Where I Started

I've had generalized anxiety disorder since my 20s. I've managed it with therapy and medication. It wasn't perfect, but it was stable. I had tools. I had coping mechanisms. Then perimenopause hit at 44, and my anxiety spiraled. The baseline anxiety increased. The panic attacks became more frequent. The anxious thoughts became more intrusive. It was like someone had turned up the volume on something that was already loud. I was doubling my anxiety medication and it still wasn't enough. I felt like I was losing control again in a way I hadn't since I was first diagnosed with anxiety. And I didn't know if it was the anxiety disorder getting worse or if it was perimenopause amplifying it or some combination of both.

The Turning Point

I was seeing both a therapist and a psychiatrist, but they weren't communicating. The therapist was addressing the behavioral aspects of anxiety. The psychiatrist was adjusting medication. But nobody was looking at the whole picture. The whole picture being that I had an anxiety disorder AND perimenopause happening at the same time. I asked if they could coordinate care. They agreed to have a conversation.

Here's What I Did

My psychiatrist and therapist had a conference call in November. They discussed my symptom pattern. We realized that some of my anxiety was perimenopause-related (the physical hot flash anxiety, the hormonal mood shifts) and some was anxiety disorder (the ruminating thoughts, the catastrophizing). The solution was to increase my antidepressant (which helps both conditions) and add something specifically for the anxiety. The therapist also tweaked my therapy to address both the underlying anxiety disorder patterns AND the perimenopause-related anxiety. By December, I was noticing that some of the anxiety was responsive to the medication adjustment. By January, my baseline anxiety had decreased. By February, I could distinguish between the anxiety from my disorder and the anxiety from perimenopause. That distinction helped me manage both.

When It Worked

The moment I knew this was working was in March. I had a stressful situation at work that would normally have triggered a panic attack. And I could feel myself getting anxious, but I could also feel myself managing it. I could use my coping tools. I could remember that it would pass. I could function through it. That never would have been possible in January. The integrated care approach actually worked.

What Changed for Me

Having my providers communicate was game-changing. Instead of treating anxiety disorder and perimenopause as separate things, they were treating them as interconnected. My medication strategy accounts for both. My therapy accounts for both. I'm not bouncing between doctors with different plans. Everyone is on the same page. And because of that, I'm actually getting better instead of just treading water.

For You

If you have a pre-existing anxiety disorder and perimenopause is amplifying it, you need integrated care. Make sure your providers are talking to each other. Make sure your treatment plan addresses both conditions. You deserve comprehensive care that treats you as a whole person, not separate diagnoses.

This is one woman's personal experience and does not replace medical advice. Everyone's perimenopause journey is different. Consult your healthcare provider before making significant changes to your health routine.