For World Mental Health Day, I'm sharing some of my own experience of perimenopause and mental health, and what I've since learned from menopause research, positive psychology and the science of resilience.

This year's World Mental Health Day theme is Lived experiences heard: real voices, real change.

So rather than start with the research, I thought I'd start with mine.

A few years ago, my mental health was suffering.

I was grieving the death of my husband, raising two pre-teen boys, trying to keep a business and a household moving, and in the middle of all of that, I was also going through perimenopause.

Looking back now, I can see how much was happening in my body and brain at the same time. At the time, it was nowhere near that tidy. It was a hot mess.

Was I anxious because I was grieving? Was I exhausted because I was parenting two boys alone? Was my brain fog hormonal, sleep deprivation, stress, or the sheer cognitive load of trying to remember who needed to be where, while running a business and figuring out what our lives looked like now?

The answer was probably: all of it.

And I think that's something we're missing in the way we sometimes talk about women's mental health in midlife.

We like explanations. We particularly like explanations that come with a nice label and preferably a solution.

Real life rarely behaves itself quite so well.

Perimenopause doesn't happen in a vacuum

The average age of menopause in Australia is around 51, with perimenopause often beginning years earlier.

Now think about what else can be happening in a woman's life during those same years.

Children may still be at home. Parents are getting older. Careers can be at their most demanding. Relationships change. Financial responsibilities are significant. Some women are dealing with divorce, illness, bereavement or caring responsibilities.

And then, into this already fairly busy ecosystem, we introduce fluctuating hormones.

For some women, psychological changes are among the first things they notice.

Anxiety can appear or increase. Mood can change. Irritability, difficulty concentrating, low mood, reduced motivation and brain fog can become part of everyday life. The menopausal transition is also associated with increased vulnerability to depression and anxiety in some women, including women without a previous history of major depression.

Sleep often joins the party, which is particularly unhelpful.

Hormonal changes can affect sleep directly, while night sweats, stress and anxiety can make it worse. Then poor sleep affects mood, cognition and emotional regulation the following day.

It's not difficult to see how the whole thing can become circular.

Sometimes “I don't feel like myself” is useful information

This is why I think one of the most important things we can do is listen when a woman says:

“I don't feel like myself.”

For years, women's experiences around menopause were minimised or poorly understood. Better menopause literacy means recognising that a sudden change in anxiety, mood, sleep or cognition in our forties deserves curiosity.

It doesn't automatically mean menopause.

Depression is real. Anxiety disorders are real. Burnout, trauma and grief are real. Other health conditions can affect mood, cognition and energy.

In my case, grief was very real. Perimenopause didn't explain away what had happened to me or how I felt about it.

But hormones were another layer in a nervous system already carrying an enormous load.

Understanding that mattered.

What I learned about resilience

Years later, studying positive psychology changed the way I understood some of this.

Positive psychology doesn't ask us to pretend difficult things aren't happening. At its best, it asks a much more useful question: what helps human beings remain psychologically well and adapt when difficult things do happen?

There is some fascinating research specifically in perimenopausal women.

Studies have identified optimism, emotional regulation, self-compassion, self-esteem and emotional stability as psychological resources associated with greater resilience. Women with more of these resources have reported greater life satisfaction, lower perceived stress and psychological distress and fewer depressive symptoms.

I want to be careful here, because there is a very short road from this research to telling women to think positively and buy a gratitude journal.

That is absolutely not the point.

When my husband died, gratitude did not make grief disappear. Yoga didn't make being a solo parent easy. Meditation didn't stop perimenopause.

What those things sometimes gave me was somewhere to stand.

And I think that's an important distinction.

We don't have to wait until everything is good to experience something good

One of the ideas from positive psychology I keep coming back to is Barbara Fredrickson's broaden-and-build theory.

Her research suggests that positive emotions like joy, interest, amusement, gratitude and connection can broaden the way we think and respond in the moment and, over time, help us build psychological and social resources.

This doesn't require life to be going well.

Some of my happiest moments existed right alongside some of my saddest ones.

I could be grieving and laugh with my boys. I could feel completely overwhelmed and still notice the ocean on a walk. I could be struggling and still feel curious about something, enjoy movement, have dinner with a friend or find something ridiculous funny.

One emotion didn't cancel out the other.

That's something I understand much better now.

Mental health isn't a binary state where we're either well or unwell. Human beings have an extraordinary ability to hold grief and joy, anxiety and hope, exhaustion and curiosity at the same time.

Sometimes those small moments of positive emotion are part of what helps us keep going.

Then there's the nervous system

This has become another huge part of how I understand midlife health.

When the body has been responding to stress for a long time, the accumulated physiological burden is described as allostatic load.

Perimenopause can arrive when that load is already considerable.

So I've become much less interested in the idea of trying to create a perfectly calm life and much more interested in building a nervous system capable of moving between activation and recovery.

For me that has meant movement, strength, yoga, meditation, time outside, sleep, connection and deliberately making room for things that bring me joy.

They're not treatments for grief, depression or anxiety.

They're part of how I look after the system carrying me through them.

And when medical or psychological support is needed, we should seek that too.

Maybe lived experience is part of the evidence

The World Mental Health Day theme this year asks us to recognise that lived experience brings knowledge that research or professional training alone cannot provide.

I love that idea.

Science matters enormously to me. It's why we formulate Eir the way we do, and why I went back to university to study wellbeing science.

But increasingly I think the interesting work happens when we put the two together.

The evidence tells us that perimenopause can increase vulnerability to mental health changes.

Positive psychology tells us something about the psychological resources that can help protect wellbeing.

And lived experience tells us what it actually feels like when hormones, grief, parenting, work, identity and an ordinary Tuesday all arrive in the same nervous system.

For me, the question eventually changed from “Why am I not coping better?” to something much kinder and more useful:

“Given everything I'm carrying, what do I need?”

Sometimes the answer was help.

Sometimes it was rest.

Sometimes it was movement, people, sunlight, therapy, meditation or getting outside.

And sometimes it was joy, without feeling guilty for experiencing it while I was grieving.

If you're in the middle of perimenopause and don't quite recognise yourself at the moment, I hope you'll get curious rather than critical.

There may be more than one thing going on.

You don't have to figure it all out alone.

And you certainly don't have to wait until life becomes easy before you start building the things that help you feel well again.

Lisa x

If you're experiencing persistent anxiety, depression, significant changes in mood or thoughts of self-harm, please seek support from a GP or qualified mental health professional. Perimenopause can affect mental health, but significant symptoms deserve appropriate assessment and care.