The Emotional Rollercoaster of Perimenopause: Why You’re Not Losing It & How Therapy Can Help
Welcome to Perimenopause: The Land of Mood Swings, Mystery Symptoms, and WTF Moments
One minute, you’re singing along to your favorite 90s throwback song, feeling like a boss. The next? You’re in the car sobbing because a flock of geese crossed the street too slowly, and now you’re spiraling into existential dread about the fleeting nature of time. Sound familiar? Welcome to perimenopause—the wild, unpredictable prequel to menopause that no one warned you would feel like emotional whiplash.
Let’s break down what’s happening, why you feel like a different person, and how therapy (especially Brainspotting and IFS/parts work) can help you reclaim your sanity, one hormone-fueled meltdown at a time.
What is Perimenopause?
Perimenopause is the transitional phase before menopause when your ovaries start slowing down production of estrogen and progesterone—but they don’t do it gracefully. Instead, your hormones rollercoaster up and down, making your body and brain feel like a malfunctioning theme park ride.
This phase can last anywhere from a few years to a full decade (yep, a DECADE). It typically starts in your 40s but can begin as early as your late 30s.
Key signs you’re in perimenopause:
- Irregular periods (they ghost you, come back, then overstay their welcome)
- Mood swings that rival a toddler’s tantrums
- Hot flashes and night sweats
- Brain fog so thick you forget why you walked into a room
- Anxiety, irritability, or feeling like you just don’t feel like yourself
What is Menopause? And How is It Different from Perimenopause?
Menopause is the official end of your reproductive years—defined as 12 consecutive months without a period. No more ovulation, no more menstrual cycles, no more surprise visits from Aunt Flo.
The difference? Perimenopause is the chaotic, messy lead-up to menopause, full of hormonal shifts and unpredictable symptoms. Menopause is when the dust settles, and your body fully transitions into its new normal (which comes with its own set of challenges, but at least the rollercoaster slows down!).
Mental Health Symptoms of Perimenopause & Menopause
Your hormones don’t just affect your body—they run the show in your brain, too. When they fluctuate, so do your emotions, energy, and overall mental state.
Common mental health symptoms include:
- Mood swings (one moment you love your partner, the next you’re plotting their demise because they chewed too loudly)
- Increased anxiety or panic attacks (racing thoughts, doom-scrolling at 3 AM, feeling like you forgot something but don’t know what)
- Irritability & rage (Why is the sound of people breathing suddenly intolerable?!)
- Depression & low motivation (Feeling ‘meh’ about everything, even things you used to love)
- Brain fog & forgetfulness (Wait, what were we talking about?)
- Sleep disruptions (Because your body thinks 2 AM is the perfect time for an existential crisis)
The problem? Many women assume these symptoms are just stress and burnout rather than hormone-driven shifts. And while life is stressful (because, well, kids, work, and life in general), perimenopause amplifies everything. If you feel like your emotions are dialed up to an 11 for no apparent reason, hormones might be the culprit.
How Therapy Can Help You Navigate Perimenopause Without Losing Your Mind
Here’s the good news: you don’t have to white-knuckle your way through perimenopause. Therapy—especially with someone trained in Brainspotting, IFS (Internal Family Systems), and perimenopausal mental health—can help you make sense of what’s happening and give you tools to cope.
How Therapy Helps:
- Brainspotting Therapy helps process the deeper emotional overwhelm that perimenopause dredges up, especially if old trauma or past wounds resurface.
- IFS/Parts Work helps you connect with the different parts of yourself (like the exhausted mom part, the anxious part, or the rage-filled part that wants to throw things) and bring more balance.
- Cognitive & Emotional Coping Skills give you real-life strategies to handle the unpredictability of your moods, anxiety, and shifting identity.
- Validates Your Experience because sometimes you just need someone to say, “No, you’re not crazy. Yes, this is real.”
Coping Skills for Perimenopause (AKA Your Survival Guide)
- Name It to Tame It – When emotions surge, say out loud, “Oh hey, perimenopause, I see you.” Labeling what’s happening helps reduce overwhelm.
- Deep Breathing & Mindfulness – When the irritation hits, pause, breathe, and remind yourself that murder is still illegal.
- Exercise (Even When You Don’t Feel Like It) – Movement helps regulate hormones and reduce anxiety. A walk, Pilates, or dancing to Beyoncé in your kitchen counts.
- Cut Back on Caffeine & Alcohol – I know, I know. But both can make anxiety and sleep issues worse (try decaf or herbal teas that won’t betray you).
- Journaling or Brain Dumping – Write out the chaos in your head. It’s like spring cleaning for your brain.
- Prioritize Sleep – Nap like it’s your job. Use blackout curtains, white noise, and kick your snoring partner to the couch if necessary.
- Set Boundaries & Say No More Often – You’re not here to be everyone’s emotional support human.
- Find a Therapist Who Gets It – You need support from someone who knows perimenopause isn’t just “mood swings” but a full-body and mind transition.
Perimenopause and Its Many Faces
- Perimenopause and Anxiety – Hormonal shifts can spike cortisol levels, making anxiety feel relentless.
- Perimenopause and Depression – Lower estrogen can mess with serotonin, increasing depression symptoms.
- Perimenopause and Sleep – Falling and staying asleep becomes a challenge thanks to night sweats and hormone fluctuations.
- Perimenopause and Headaches – Estrogen dips can trigger migraines and tension headaches.
- Perimenopause and ADHD – If you’ve always been a little unfocused, perimenopause can make it worse.
- Perimenopause and Brain Fog – Forgetfulness and losing your train of thought are common struggles.
- Perimenopause and Exhaustion – Fatigue hits hard, even after a full night’s sleep.
- Perimenopause and Emotional Symptoms – Crying, irritability, rage, and sadness often come out of nowhere.
- Perimenopause and Crying – If you’re tearing up over commercials, blame the hormonal rollercoaster.
You’re Not Crazy, It’s Perimenopause (And Therapy Can Help)
Perimenopause is a wild, messy, hormone-fueled transition that no one prepares us for. But you don’t have to go through it alone. Therapy can help you process the emotional upheaval, find balance, and reclaim your sense of self—even when your hormones are doing their best to sabotage you.
So if you’re feeling like a stranger in your own body and brain, know this: It’s not just you. It’s perimenopause. And with the right support, you will get through it. Even if you cry over a flock of geese crossing the street too slowly.
Eleena Hardzinski is a Licensed Marriage and Family Therapist and a Certified Brainspotting Therapist who practices online in North Carolina, South Carolina, and Wisconsin.
Eleena supports women struggling with anxiety, motherhood, parenting, relationships, past traumas, ADHD, and more. She helps overwhelmed moms find balance, overcome guilt, establish healthy boundaries, heal from past traumas, improve family communication, and regain confidence and joy in their lives.
