Can Perimenopause Cause Anxiety or Depression?

Short answer? Yes.

But like most things with perimenopause, it’s more complicated than that.

Let’s get into it.

Perimenopause Anxiety

The Moment Things Start To Feel… Off

Maybe you’ve started waking up in the night, heart racing, with that sinking sense of dread you can’t explain. Or you’ve found yourself crying in the car after work, from holding it together through another back-to-back day of meetings, decisions, and trying to remember what you walked into the room for, wondering why everything feels a bit too much lately.

Maybe you’ve always been the calm one, the capable one, the one who just gets on with it.

Now, suddenly, your confidence feels shaky, you can’t think straight, you feel flat, irritable, disconnected, you don’t feel like you anymore.

And no one else around you seems to be talking about it.

So you wonder: Is it stress? Am I burned out? Is this just what getting older feels like?

What’s Really Going On When You Feel Anxious

Perimenopause is the hormonal rollercoaster that happens before menopause. It can begin years before your periods stop, any time from your late thirties naturally, and for many women, the first signs aren’t physical at all; they’re emotional and for many that will result in Perimenopause Anxiety.

I know, why did no one tell us?

What most people don’t realise is that oestrogen doesn’t just regulate your cycle. It plays a key role in your brain chemistry, too, including how you produce and process things like serotonin, dopamine, and cortisol.

So when your hormone levels start to fluctuate, which is normal but not always helpful, you might start to feel:

• Sudden, unexplained anxiety (often with heart palpitations)

• Low mood or emotional numbness

• Crying for no reason that you can explain

• Increased irritability or emotional sensitivity

• A sense of dread or panic that comes out of nowhere

• Feelings of hopelessness, self-doubt or shame

  
  

Even if you’ve never had anxiety or depression before.

Even if your life looks great on paper.

Even if everyone around you thinks you’re smashing it.

This isn’t a mindset issue. It’s a hormonal and neurological shift that affects how you experience the world, and how the world experiences you.

But if you have already struggled with imposter syndrome or levels of self-doubt of any kind, then fluctuating hormones only act to make matters worse.

Why Perimenopause Anxiety Gets Missed

Because the messaging around perimenopause is still completely outdated.

We’ve been led to believe that menopause is a hot flush and a few mood swings in your 50s.

No one tells you that in your early 40s, you might suddenly feel like your mental health is slipping, even though you’re doing everything you thought was right.

Women often end up on antidepressants, referred to therapy, or told to manage their stress better. And while all those things can help, they don’t address the root cause if hormones are playing a role.

Worse still, many women blame themselves. They think they’ve become lazy, weak, and unmotivated, and they keep going, pretending everything’s fine, while underneath they feel like they're broken.

You Don't Have To Pretend You're Fine

This is not about putting a brave face on for a few years to get through it, and this is definitely not about being fixed; you're not broken, you do not need fixing.

This is about understanding what your body and mind are going through, and permitting yourself to get the right kind of support.

This is a transition from a fertile to a non-fertile stage of life. It is completely natural and completely normal. But putting up with symptoms that often come with this transition, for up to 10 years, does not need to be normal in the 21st century.

What you actually need is time, attention, and space to adjust.

That’s exactly what I offer inside my programme, Navigating Menopause.

A space where you can stop guessing, start understanding, and finally feel like yourself again.

We work together for a minimum of 12 months, so you're not rushing to feel better. You’re building real, lasting support that sees you through this phase and beyond.

Final Thought

If you’re lying in bed with your heart racing at 2 am, or wondering why you don’t feel excited about life anymore, and constantly second-guessing yourself in meetings, it might not be “just life”. It might be your hormones.

And that’s something you can do something about.

You deserve to feel good again. You deserve to feel like you again.

Whatever you choose to do about it, don't leave it. Your body is telling you it needs attention, you've ended up here, reading this for a reason.

It's time to listen.