Menopause and how it affects the Brain and Anxiety

Lowering Oestrogen levels in women and how it affects the brain and anxiety

There is a lot of information about perimenopause and ‘the change’ out there which can be helpful and in the case of a menopausal brain, sometimes overwhelming. With the help of ‘AI’ I wanted to post some salient facts which I hope will help you understand what may be going on.

Lowering oestrogen in women commonly increases risk of anxiety and alters brain function – especially during rapid declines (perimenopause, surgical menopause). The effects vary by age, individual vulnerability, and how quickly levels fall.

Key brain mechanisms

Serotonin system:
- Oestrogen upregulates serotonin synthesis, receptor expression, and transporter function. Lower oestrogen → reduced serotonergic tone, which can increase anxiety and mood symptoms.
GABAergic inhibition:
- Oestrogen modulates GABA (brain’s primary inhibitory system). Loss of oestrogen can reduce GABAergic regulation, increasing neural excitability and anxious arousal.
HPA axis / stress response:
- Oestrogen normally buffers stress reactivity. Low oestrogen → exaggerated cortisol responses and prolonged stress signalling.
Amygdala / prefrontal cortex balance:
- Reduced oestrogen is associated with greater amygdala reactivity to threat and weaker prefrontal regulation, promoting anxiety and impaired emotion regulation.
Neuroplasticity and neurotrophic support:
- Oestrogen promotes BDNF and synaptic plasticity (hippocampus, prefrontal cortex). Declines can impair cognitive flexibility and increase vulnerability to mood/anxiety symptoms.
Neuroinflammation:
- Lower oestrogen may increase pro-inflammatory signalling that can affect mood and cognition.

Clinical patterns and evidence

Perimenopause (fluctuating then falling oestrogen) is a high-risk window for new or worsened anxiety and depression.
Surgical menopause (oophorectomy) or abrupt treatment-induced menopause produces more pronounced mood/anxiety effects than gradual decline.
Many women report worry, panic symptoms, irritability, sleep disturbance (which itself worsens anxiety), and cognitive complaints (concentration, memory).
Not all women develop anxiety – risk is higher with prior mood/anxiety disorder, stressful life events, poor sleep, or lack of social support.

Implications for management

Hormone replacement therapy (HRT) can reduce vasomotor symptoms and often improves mood/anxiety for many women when started appropriately; benefits vs risks depend on age, timing, and medical history.
Antidepressants (SSRIs/SNRIs) can treat anxiety symptoms and are often effective during perimenopause/menopause.
Counselling / Psychotherapy for anxiety, sleep interventions, exercise, and addressing lifestyle factors (sleep, caffeine, alcohol) help substantially.
If symptoms are new, severe, or disabling, evaluate with a clinician to rule out other causes and to discuss HRT risks/benefits and psychiatric treatment options.

Behavioural strategies for anxiety and menopause-related symptoms

Sleep hygiene:
- Regular sleep schedule, cool bedroom, limit screens before bed, avoid heavy meals/caffeine/alcohol near bedtime. Treat hot-flash-related sleep disruption (layered bedding, fan).
Therapy for insomnia such as Cognitive-behavioural (CBT-I) techniques:
- Stimulus control, sleep restriction, relaxation.
Counselling / Pshychotherapy for anxiety:
- Cognitive restructuring, exposure for panic/avoidance, worry-management, problem-solving.
Relaxation and mind-body:
- Progressive muscle relaxation, diaphragmatic breathing, mindfulness meditation, guided imagery. Short daily practice (10–20 min) reduces physiological arousal.
Exercise:
- Regular aerobic exercise (150 min/week moderate) and resistance training; helps mood, sleep, and overall health.
Weight, diet, caffeine, alcohol:
- Maintain healthy weight; reduce caffeine and alcohol if they trigger anxiety or hot flashes.
Social support and stress management:
- Peer groups, counselling, time-management, and reducing chronic stressors where possible.
Behavioural strategies for hot flashes:
- Layered clothing, portable fans, paced breathing, avoiding triggers (hot drinks, spicy food, alcohol).

Benefits of Counselling / Psychotherapy for anxiety in perimenopause

Combined approach:
- Psychotherapy plus HRT or medications (SSRIs/SNRIs) often yields better outcomes than either alone for significant symptoms.
Efficacy:
- CBT is well-supported for generalized anxiety, panic disorder, and insomnia across ages and retains effectiveness during menopause.
Targets:
- Reduces worry, catastrophic thinking, avoidance behaviours, and physiological arousal; improves coping with menopausal symptoms (hot flashes, sleep loss).
Symptom improvement:
- Reduces anxiety severity, panic frequency, and depressive symptoms; improves sleep quality and quality of life.
Durability:
- Benefits often persist after treatment through learned skills; booster sessions can maintain gains.
Mode and access:
- Effective in individual, group, and guided self-help formats.

I hope this no nonsense straight talking blog will help you understand what is happening to you. If you are struggling with change and you feel that talking with a Counsellor will support you please get in touch.

Remember, you are not alone in this and there is a lot of great support out there you. Do not suffer in silence, reach out and grab the support. Take care of you.

Menopause support

If you are experiencing menopause issues, you are not alone, there are many people who are here to support you. There are helplines and support groups who will offer support, below are some of those who can offer expert advice.

The Menopause Charity – https://themenopausecharity.org/
The British Menopause Society – https://thebms.org.uk/
Menopause Support – https://menopausesupport.co.uk/

This blog was collated from internet sources for information by a counsellor in Fleet, Hampshire – Caroline at Caroline Ellison Counselling – this is my experience and these are my opinions. Carpe Diem.

Panic Attacks and what happens to our Brain

What is Panic?

Panic is a form of extreme anxiety and is characterised by intense and sudden feelings of fear and distress. When we experience panic, our brain undergoes several complex physiological and psychological changes in response to a perceived threat or danger.

What happens to our brain when we panic ?

Amygdala Activation: The amygdala is a small, almond-shaped cluster of nuclei in the brain responsible for processing emotions, especially fear and threat detection. When we perceive a potential threat or danger, the amygdala becomes highly activated. This triggers a rapid emotional response, including the release of stress hormones like adrenaline.

Hypothalamus Activation: The hypothalamus, another brain structure, is responsible for regulating the body’s stress response. When the amygdala signals danger, it communicates with the hypothalamus, which in turn stimulates the release of stress hormones, including cortisol and adrenaline. These hormones prepare the body for a “fight or flight” response.

Increased Heart Rate: As adrenaline is released into the bloodstream, it causes the heart rate to increase. This helps pump more oxygenated blood to the muscles and vital organs, preparing the body for quick action.

Rapid Breathing: Panic often leads to shallow and rapid breathing, a response designed to increase oxygen intake for the body’s heightened state of alertness and physical readiness.

Muscle Tension: Muscles may become tense and primed for action during a panic episode, which can lead to physical symptoms such as trembling or jitteriness.

Tunnel Vision and Heightened Focus: During panic, people often experience a narrowing of their focus, known as tunnel vision. This hyperfocus is meant to concentrate attention on the perceived threat but can lead to difficulty processing peripheral information.

Impaired Rational Thinking: Panic can impair cognitive functioning, making it difficult to think clearly or logically. This can result in irrational thoughts and actions.

Decreased Activity in the Pre-Frontal Cortex: The prefrontal cortex, responsible for decision-making and rational thought, may become less active during panic. This can lead to impulsive behaviour and poor decision-making.

Activation of the Autonomic Nervous System: The autonomic nervous system controls involuntary bodily functions. Panic triggers the sympathetic branch of this system, responsible for the “fight or flight” response, leading to the release of stress hormones and physiological changes mentioned above.

Heightened Emotional State: Panic often leads to intense feelings of fear, dread, and a sense of impending doom. These emotions can be overwhelming and difficult to control.

How to support Panic

It is important to acknowledge that it can be disruptive and distressing having a panic attack or chronic panic disorder. If you experience recurrent panic attacks you are likely to benefit from professional help, such as counselling or medication. Understanding the physiological and psychological processes involved in panic can be a first step in learning how to cope with and manage your panic.Understanding your triggers and working through them may be supportive in reducing the frequency of your panic attacks and this can be done in Counselling.

For individual counselling I am here for you. Contact me to book an initial session and I will support you.

If you are in crisis and want immediate support please call the Samaritans who offer a free 24 hour helpline – Phone: 116 123 – Website: www.samaritans.org

Written by your local counsellor in Fleet, Caroline at Caroline Ellison Counselling – this is my experience and these are my opinions. Carpe Diem.

What is Burnout and How to Manage it

What is Burnout and How can I Manage it?

What is Burnout?

Burnout is when you are emotionally, physically, and mentally exhausted often as a result of prolonged periods of chronic stress and overwork. Burnout usually happens when individuals feel overwhelmed by the demands of their work or personal life and find it challenging to cope with those demands effectively. Essentially it is all too much!

Burnout can affect various aspects of your life, including work, relationships and overall well-being. It is characterized by symptoms such as:

Exhaustion: Feeling drained and lacking energy, both physically and emotionally.
Cynicism and detachment: Developing a negative and detached attitude towards work, colleagues and responsibilities.
Reduced performance: A decline in job performance, productivity and overall effectiveness.

How to manage Burnout?

To manage burnout, consider the following strategies:

Recognise the signs: Pay attention to the early warning signs of burnout, such as feeling constantly stressed, irritable or physically unwell. Recognising and acknowledging these signs is the first step in addressing burnout.
Set boundaries: Establish clear boundaries between work and personal life. Avoid overextending yourself by taking on too many tasks or working excessive hours. Learn to say no when necessary.
Prioritise self-care: Make self-care a priority. Engage in activities that promote relaxation and well-being, such as exercise, meditation, deep breathing or hobbies you enjoy.
Manage stress: Develop effective stress management techniques, such as mindfulness meditation, yoga or regular exercise, to help reduce stress levels.
Seek support: Talk to friends, family members or a mental health professional such as a counsellor, about your feelings and experiences. Sometimes, simply talking about your situation with someone you trust can provide relief and new perspectives.
Delegate and ask for help: Do not hesitate to delegate tasks at work or seek assistance when you are overwhelmed. You don’t have to do everything on your own.
Set realistic goals: Avoid setting unattainable or overly ambitious goals for yourself. Break down larger tasks into smaller, manageable steps and celebrate your achievements along the way.
Take breaks: Ensure you take regular breaks during the work day to recharge. Short breaks can improve focus and productivity.
Change your environment: If possible, make changes to your work environment that promote well-being, such as adding plants, personalising your workspace or improving lighting and ergonomics.
Consider professional help: If burnout symptoms persist or become severe, it may be necessary to seek help from a mental health professional, such as a counsellor. Counselling can provide guidance and therapeutic interventions to address burnout effectively.

Remember that managing burnout is an ongoing process and it may mean you will need to make significant lifestyle changes. It is crucial to prioritise self-care and make changes in your life to prevent burnout from recurring. Additionally, developing resilience and stress-coping skills can help you better navigate the challenges that lead to burnout in the first place.

If you have read this and recognise you experiencing burnout please reach out for support. For individual counselling I am here for you. Contact me to book an initial session and I will support you.

Written by your local counsellor in Fleet, Caroline at Caroline Ellison Counselling – this is my experience and these are my opinions. Carpe Diem.

What is Anxiety?

Anxiety feels like fear! It can cause palpitations of the heart, sweaty hands, knots in the stomach, a feeling of being uneasy, an inability to function properly. It can come into our lives and take us over to the point of not being able to cope at all. Anxiety is Continue reading “What is Anxiety?”

What is Shame?

“I am bad. The focus is on self, not behaviour. The result is feeling flawed and unworthy of love, belonging and connection. Shame is not a driver of positive change.” – Atlas of the Heart – Brene Brown.

Shame is systemic, we feel it in our whole body. Shame is often delivered from our primary carer from infancy to teach us a moral code. It can be constructive, supportive and guiding when used for good. However, Continue reading “What is Shame?”

What is Emotional Intensity Disorder?

Emotional Intensity Disorder (EID) is sometimes known as:

Emotional Unstable Personality Disorder (EUPD) or
Borderline Personality Disorder (BPD).

Emotional Intensity Disorder is a mental health personality disorder that affects the regulation of emotions. Emotional dysregulation is when a person experiences intense emotions that they are unable to manage in constructive ways. Continue reading “What is Emotional Intensity Disorder?”

Being a Counsellor

Before I was a counsellor I had a career as a photographer. Through the lens of a camera I would seek a person’s external beauty and take a photograph with the best light and angle. Portrait and Wedding photography was my trade Continue reading “Being a Counsellor”

Tug of war with Dementia – Living Grief

The tug of war with dementia

The grey hair sprouts
The bottom lip pouts
Sadness lingers
I’m typing with my fingers
To get this feeling out!
~ Caroline Ellison (not a poet!)

Sadness Creeping in

The tug of war with dementia is cruel, profound, deeply moving and today has been tough! Continue reading “Tug of war with Dementia – Living Grief”

What is Anger?

Anger is one of our core emotions. Emotions are complex feelings we experience mentally, physically and behaviourally:

Mentally we experience our emotions and feelings.
Physically we feel them through awareness, tension and feelings in our body from the pit of our stomach to the tips of our fingers.
Behaviourally we experience our feelings and emotions as an impulse to act.

Continue reading “What is Anger?”

What is Overwhelm?

Overwhelm is the emotional feeling of being overwhelmed. It is an emotional feeling which can take over with an intensity that feels difficult to manage. It can affect your ability to think and act rationally and evoke anxiety and stress. Continue reading “What is Overwhelm?”