5-minute read
I am Gen X. Solidly – born in the 70s, raised in the 80s, and a young adult during the golden 90s. We are fiercely independent and collectively not very good at feeling our feelings…or talking about them.
That's why I had no idea that menopause can start – much less end – in your 40s. The anxiety and depression loop was one of my first major signs and I couldn't name it. I actually thought it was post-partum depression, even though my son was 2 when it started. I honestly didn't know what else it could be.
The Number That Changed How I Understood My Own Story
Did you know women are 14x more likely to experience depression during the menopause transition than at any other time in our lives*? 14 x.
During my time as a high-growth start-up operator, I would have given anything for a 14x multiple. During my experience with the menopause transition, not so much.
Perimenopause Depression Doesn't Always Look Like Depression
Importantly, perimenopause depression doesn't always look like sadness, especially the traditional understanding of not being able to get out of bed. Women in midlife typically cannot hide under the covers, even if we want to. We have work to do. People to care for. Schedules to make, and plans to run - both personally and professionally.
Like I said, I had a 2-year old, a fulltime CMO role, a relationship to make work, and the global pandemic uncertainty we all remember not so fondly during that time period.
For me, it looked like 3 am wakeups, endlessly racing thoughts, and a shrinking world. Where I once would drop everything to jump on a plane for new adventures, I was afraid to drive to the next town for a conference.
What Happens When No One Asks About Your Period
A doctor prescribed an antidepressant that worked for me during a previous period of depression in my 20s. She figured if it worked then, it would probably work again. And it did, for a while.
My sleep didn't improve, but my mood did. Which was helpful…until it wasn't. I spent $500 for one hour with a Psychiatrist to help me get off the medication. She didn't ask about my period or anything else related to women's health. I left with a prescription for two additional medications instead of a plan to get off the first one like I wanted.
Your Mental Health History Is Part of Your Menopause Transition Picture
One in two women experience depression as part of their menopause transition, and a previous history like mine in my 20s, postpartum depression, or PMDD increases your risk.* Even though I was 44, I thought it was postpartum depression because I had no other context. I legit remember thinking, "It's weird that I have postpartum depression and anxiety when he's 2, but what else could it be?"
If you are in your 40s or 50s and experiencing irritability, anxiety, panic attacks, brain fog, fatigue, or sleep disruption that might read like "toddler life," talk to your doctor. It could very well be perimenopause.
What Changes When the Right Doctor Finally Hears You
After 6 years of struggling, I found a menopause certified doctor and waited 6 months to see her. I nerded out before my appointment with a complete health history from the day I was born up until the day I walked into her office.
She spent time with me. She listened. She prescribed HRT. Within three days – THREE DAYS – of putting the first patch on my body, the anxiety that haunted me for years was gone. Just gone. I could search deep inside my brain and find it, but it was like a ghost.
That's what's possible when the right doctor hears you. Bring specifics — your symptoms, your women's health history, all of it. And if your doctor doesn't hear you, find one that does at menopause.org.
My new doctor put me on the path to getting unstuck and I am forever grateful.
Disclaimer: I'm not a doctor or medical professional. This post reflects my personal experience and is intended for informational purposes only. Please talk to your doctor (#TTYD) or a qualified healthcare provider about your specific symptoms and health history.
Frequently Asked Questions
1. Can perimenopause cause depression and anxiety?
Yes. Women are 14x more likely to experience depression during the menopause transition than at any other life stage, and 1 in 2 women experience depression symptoms during the transition. It doesn't always look like sadness — it can show up as irritability, anxiety, panic attacks, brain fog, fatigue, or disrupted sleep.
2. How do I know if my anxiety is perimenopause or something else?
If you are in your 40s or 50s and experiencing mood changes alongside other symptoms like sleep disruption, fatigue, or brain fog — especially if you have a history of postpartum depression, PMS, or PMDD — it's worth discussing the menopause transition with your doctor. A menopause-certified practitioner can help you connect the dots.
3. Does a history of postpartum depression increase my risk for perimenopause depression?
Yes. Research shows that women with a history of postpartum depression, PMS, or PMDD are at higher risk for depression during the menopause transition. Hormonal sensitivity tends to show up across life stages.
4. How do I find a menopause-certified doctor?
The Menopause Society maintains a directory of certified menopause practitioners at https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspx
* Source: Erin Bondy, PhD, LP — UNC Center for Women's Mood Disorders / WakeMed 4th Annual Women's Health Conference, February 2026. Statistics include: women are 14x more likely to experience depression during the menopause transition than at any other life stage; 1 in 2 women experience depression symptoms during the transition.