The kids have gone off to college, you've climbed the career ladder, and your personal life is on track. So why are you feeling so burnt out and on edge?
Stress doesn't have to get the better of you. The secret is to find a calming technique that can become a part of your everyday life.
The wake up call came in the form of sheer embarrassment for Allison Nichols, a 51-year-old architect from Plymouth, Minn. "I had a million things on my mind. Running late for a morning meeting, pulling into the parking lot, the lever wouldn't go up to allow my car to pass, and I just about had a meltdown with the parking lot attendant. My heart was racing, I was breaking out in a sweat, and I just felt complete panic. I mean this is a guy I see every morning and I just lost it with him, and right behind my car was my client. I could have died on the spot."
Nichols learned to manage her stress levels with relaxation techniques, regain control of her short fuse, and the panic attacks subsided. But her experience is common, say experts, who utilize such techniques to help women cope with midlife stresses.
It's not menopause itself that is the main stressor, but rather the fact that menopause occurs at a time when most women's lives are incredibly full, juggling career, family, and aging parents. Women are typically incredible multi-taskers, but they may need time to develop coping strategies for the new challenges that menopause brings.
Not only are some menopausal symptoms unpleasant in themselves, but midlife stresses may also aggravate the symptoms of menopause, according to research. But there is good news. Learning to better manage your stress can also help minimize your menopause symptoms.
Stressors Everywhere
The stressors that perimenopausal women confront are as varied as women themselves. To begin with, the symptoms of perimenopause itself-hot flashes, menstrual irregularities, and poor sleep from night sweats-can be tremendously stressful, says Leslee Kagan, M.S., N.P., coauthor of Mind Over Menopause: The Complete Mind/Body Approach to Coping with Menopause and director of the menopause program at the Benson-Henry Institute for Mind Body Medicine in Boston, Mass. Her program is designed to help women use stress management tools such as breathing techniques or meditation to manage their symptoms.
Plus, perimenopausal women have to cope with growing older in a society that often views older women negatively, she says. Tack on aging parents, family changes as children leave home for college or adult children return home, late-in-life moms who are still raising kids, and the financial stress of trying to pay for college while saving for retirement, and it's no wonder those stress hormones go a bit wild.
So What's Menopause Got to Do with It?
OK, so midlife is a stressful time. Does menopause itself-that is, the petering out of your body's production of estrogen and progesterone-actually add to that? To understand that question, you need to understand how stress and your health fit together in the first place.
Although stress has gotten a bad rap in recent years, it's actually a valuable reaction designed to keep us alive when we're in danger. Called the fight-or-flight response, danger triggers a hormonal cascade that releases chemicals (including adrenalin) designed to help you focus, speed your reaction time, and increase your strength.
This is great if you're facing an out-of-control car. Unfortunately, everyday situations like a nasty boss, grumpy teenager, or overdue credit card bill can also trigger this response. Even your own thoughts and worries can initiate the release of adrenalin.
Such constant stress means your body doesn't get a chance to rest and recuperate. Over time, that damages your health. Studies find such chronic stress also increases your risk of obesity, insomnia, heart disease, depression, and digestive problems, while suppressing parts of your immune system, making you more susceptible to illness such as cancer.
Long-term or chronic stress is also biologically linked to your reproductive system, says Kagan, with the ongoing stress response exacerbating menopause symptoms such as hot flashes.
The Study of Women's Health Across the Nation (SWAN) researchers, who followed more than 3,300 women through their perimenopausal years, found that women with higher levels of perceived stress were more likely to report hot flashes and night sweats than those who had more relaxed lives. Other clinical trials found that breathing techniques designed to reduce stress (taking slow, deep breaths when a hot flash is starting) can significantly reduce the frequency of hot flashes, while other stress reduction techniques such as yoga or meditation can also reduce their severity.
The body has an innate ability to calm itself through its relaxation response-a state of deep relaxation that lowers your heart and breathing rates while reducing muscle tension. If you elicit this response every day, research shows that, over time, your body becomes less responsive to stress hormones, says Kagan. This can both curtail symptoms such as hot flashes and help you cope better when stressful events occur, she says.
Eliciting the relaxation response is simple, says Kagan. Meditation, certain breathing and other relaxation exercises, yoga, various religious traditions, and even knitting can bring it on. In fact, any soothing activity you enjoy can be turned into a relaxation therapy simply by focusing on repetition, be it a word, a prayer, or a motion.
One way to do this is through tai chi, a gentle, low-intensity form of exercise that is often recommended in the transition to menopause. Indeed, a report by Natural Standard and the faculty of Harvard Medical School found that practicing tai chi regularly may not only reduce anxiety and depression, but may also increase bone mineral density after menopause.
You also need to cultivate a nonjudgmental awareness that allows you to gently dismiss any upsetting thoughts without getting drawn in to negative thinking, says Kagan.
Long-Term Benefits Last beyond Menopause
Learning to bring about a state of relaxation certainly worked for Nichols, who joined a yoga and meditation program that focused on breathing techniques. "I use some of the breathing techniques I learned in class whenever I feel myself getting worked up," she says. "I don't feel so stressed, my fuse isn't so short, and my hot flashes seem to pass more quickly."
That response is common, says Kagan. Just having a tool to use when a hot flash occurs reduces women's anxiety. Kagan's program takes a holistic approach to stress management, emphasizing nutrition, exercise, and cognitive approaches that help women take a more positive approach toward menopause.
Plus, such an approach helps women learn to reframe their worries about symptoms so they focus on curtailing them rather than anticipating them, says Kagan. This can reduce the stress response when symptoms strike. It's not a question of eliminating all stress from your life; it's how you handle it that matters.
For Crying Out Loud
Uncontrollable crying jags are common during the menopause transition. You may find that everything makes you cry-whether out of sadness, frustration, being tired, or even for no reason at all. It's not something to worry about, although it can be embarrassing and cause you to withdraw.
One way to deal with this is to provide yourself with a routine and stick to it, even if you don't feel like it. This will distract your mind and help you focus your energies in a positive way. Light exercise, such as stretches or going for a walk, can also clear your head. Your tears may be simply related to unstable hormone levels of perimenopause, poor or interrupted sleep, or sleep deprivation associated with nighttime hot flashes, but if you feel it could be related to depression, talking with a therapist may be helpful. (For more on getting sound sleep, see "A Good Night's Sleep" on page 36.)
Relaxation Techniques
Progressive Muscular Relaxation
When you find your shoulders up against your ears, try this simple but effective technique. It allows your muscles to relax more fully than they would when you try to relax them normally.
Tense a group of muscles as tightly as you can for a few seconds. Then relax the muscles normally. Consciously relax the muscles further, to fully release tension. You may like to try this lying down and working down the body from your head and neck, through your shoulders and back, arms and hands, and so on. Aim to include both large and small muscle groups. For example, when focusing on your head, tense and relax the muscles of the eyes, eyebrows, lips, tongue, nose, forehead, and jaw, and so on.
Deep Breathing
It can be difficult to slow yourself down and focus on breathing when you're in a state of agitation, but this exercise can help.
Sit quietly, or lie on the floor, and close your eyes. Begin by relaxing the muscles in your feet and work your way up the body. Focus your attention on your breathing. Breathe in deeply and exhale. As you continue to breathe, count down from 10, imagining with each number that you are taking a step down on a staircase. Allow yourself to relax more fully with each step, and imagine the light is fading progressively, until you are in absolute darkness at zero. Enjoy the state of total relaxation, and allow yourself to become aware of your breathing. Only open your eyes when you are ready.
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