Ask An Expert: Carmel Shealy, Psychotherapist

Why does menopause cause anxiety, and what can you do about it? Psychotherapist and counsellor Carmel shares how talking cures can help.

We know from the discussions in our private Facebook group that anxiety is a huge challenge in the menopause years. So why does menopause cause anxiety? And what can you do to help yourself through it?

For wisdom, we’ve turned to Carmel Shealy, a psychotherapist at, a therapist and coach-matching service. Welldoing helps you find the best therapist for your needs, and that includes dealing with the emotional and psychological issues around the menopause and mid-life. There are 1200 online and face-to-face verified practitioners from all over the UK, with a focus on diversity and accessibility. You can search for those therapists who offer support for women around menopause, or use the Personalised Matching Service, to ensure the best match for your individual needs.

READ MORE What causes menopause anxiety?

Carmel’s advice is smart, wise and truly helpful for any woman enduring the anxiety that menopause can bring on. As she says, anxiety associated with menopause is still anxiety, and it needs to be recognised and managed in the same way. We hope you find her recommendations helpful.

Is anxiety during perimenopause and menopause something that women seek help with you for?

I think what is interesting for me as a psychotherapist in private practice, is that some of my female clients often do not associate their feelings of anxiety with either perimenopause or menopause.

Often, they have been to their GP who has offered them anti-depressants. This can make them feel worse about their symptoms as being something that is “wrong” with them that needs to be cured rather than a symptom for a condition that can be better managed in a more holistic way.

Conversely, some of my clients are extremely aware that their anxious feelings are related to their being perimenopausal or menopausal as often they have not had to seek help before for their anxiety – they haven’t needed to seek help.

READ MORE What are the 34 symptoms of menopause?

What does menopause anxiety feel like for these women?

Each client is different and as such their feelings of anxiety differ. For some clients, their anxiety can have a completely debilitating affect, whereby they are left unable to make any kind of judgment or decision. This can be really frightening for some women especially if they are in senior roles and have a good track record of delivery at work.

For some clients, their anxiety can have a completely debilitating affect.

It can leave a lot of women feeling like they are failing because they’re not able to do all the things they once could do anymore – multi-tasking, juggling lots of demands, managing their work-life balance.

Some clients describe it as ‘feeling out of control’. This can have a detrimental impact on their quality of life and wellbeing and may also have a significant impact on their personal relationships and work relationships.

What are the most common menopause anxiety symptoms that you have seen?

As we know there are over 33 formally recognised menopause symptoms including hot sweats, low libido and disturbed sleep to name a few. All of these symptoms have an impact on day-to-day life and how we engage with others at home and work.

It is the impact of the symptoms which causes clients the most anxiety as they try to navigate the demands of work and family whilst maintaining a sense of themselves as a woman changing in every sense of the word. It can be quite tough to come to terms with some of the losses associated with being menopausal and adjusting to a new way of being.

READ MORE What employers can do to support menopause at work.

As well as the hormonal shifts of menopause, are there other pressures in midlife that can commonly cause anxiety for women?

The timing of the menopause for some clients often coincides with children going to university, parents needing care or changes in their careers. And there are more demands and pressure, like redundancy, family breakups or loss and bereavement.

I often work with clients in a way to reframe some of the acute anxiety being experienced, against some of these life challenges which coincide with the menopause. I help clients to ‘notice’ what is going on for them and around them rather than to compare or judge themselves against a way of being previously that would have breezed through some of these midlife pressures.

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How can talking therapies help ease menopause anxiety in the long term, and what sort of themes do you explore with your clients?

I often reflect on therapy being referred to as the ‘talking cure’. Quite simply, it really does help to talk to someone. Just being able to meet with and be with another person in a neutral setting with no judgement or expectation and be able share what is going on for them can really help to ease feelings of anxiety.

I am very much client led in my work. What that means is that I allow them to use the session to explore what is most important for them in a way that best suits them, rather than trying to work in a systematic or formulaic way as often this is unhelpful for clients who are struggling with memory and brain fog.

In the short term, how do you advise your clients to cope if they’re feeling overwhelmed in the moment?

This is a tough one to answer, not least because therapy and being a therapist is not about advising someone how to cope.

It really does help to talk to someone.

Sometimes clients can and do arrive in an extremely anxious state and usually by the end of the session feel very differently. This is noticeable in their breathing, their posture, being and feeling more composed. 

Sometimes it can be helpful for clients to be able to acknowledge that they aren’t coping very well at times and that is also OK. I do usually find the opportunity to reflect back some of the content of previous sessions to clients, where they have coped and managed to navigate extremely challenging situations which can be grounding for them and help them to bring their own sense of resilience into their awareness.

READ MORE 10 ways to exercise to beat anxiety.

Finally, how long does menopause anxiety last, and does it go away?

Well, if I could answer this one, I would probably have written an article for the British Menopause Society’s post reproductive health journal!

On a serious note, anxiety associated with the menopause is anxiety.  As such it needs to be recognised and managed in the same way.  Talking therapies, diet, lifestyle, stress management, HRT are all levers we have to pull on.

READ MORE HRT, is it safe? Everything you need to know.

The perimenopause and menopause and anxiety is being more openly discussed which is such a positive way forwards for all women suffering through this phase of our lives. Rather than viewing anxiety as something that needs to be cured or remedied, I like to position it as something we have to learn to live with. How we learn to live with anxiety will be different for each and every one of us. 

READ MORE Meet Carmel and read about her approach to therapy here.

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Join our private Facebook group, Women With Ambition, Attitude & Brain Fog, for support with all your health and wellbeing challenges.