hormones, anxiety and academic work

[Disacappointment]

i used to be super confident in my work, academic and practical knowledge and would rarely shy away from big opportunities (e.g. broadcast).

i m a prof in a RG uni, i have a lot of PGR students, a lot of funding, am invited to loads of collaborations, yet the confidence has melted away.

There has not been any particular event, and i can t really entirely blame covid, although it s been a lonely time.

I just dread work, and I doubt everything i do, from big decisions on big projects, to very basic things like not replying-all in emails.

The constant second guessing myself is exhausting.

i m not sure i ll be able to stick at it if things don t improve. I have a feeling it's hormonal (for plenty of reasons and symptoms) but my GP is only interested in pushing ADs (i ve never found to right one that made me feel better).

is this common for "ageing" female academics?
i m not that old - 44

Sounds very menopausal to me! I have always doubted myself but probably more so in recent years (I'm 48). Have a look at the balance website. HRT is the go to treatment for mental health problems in peri.

I am 50 and can relate to much of what you are saying. Given your age and previous confidence it might be hormonal. I went through a really bad period of anxiety in my mid-40s and was not very productive for quite a while. The reason wasn't immediately obvious to me as I had no other peri menopause symptoms at that time. I have now been on HRT for nearly 2 years and my life would have been better if I had started it earlier. HRT has led to some improvements and I am now more productive again though I have not regained the self-belief I had in my younger days and still have some difficulty with decision making. I still have regular periods so for some women peri-menopause is very slow progressing as well.

To get prescribed HRT you will probably need to say you are having hot flushes. Otherwise most GPs want to prescribe ADs, as you have already realised.

Totally relate. Doctors have been no use so far, I suppose I will have to demand HRT, difficult to do with all the self-doubt. Currently feel I must have always been rubbish and should be glad the luck lasted this long in my career.

@Disacappointment . I am a senior academic. Happened to me. Please demand to see a doctor who specialises in menopause. Don’t be fobbed off. When I first spoke to a doctor I was offered anti depressants by a very dismissive young (female) doctor. I was not depressed, I have never been depressed. Having always been fairly confident and in control it was horrible. Anxiety appeared from nowhere and I thought I was going mad.

After doing some research and reading the menopause threads on here I made an appointment to see a GP who specialised in women’s medicine (I was lucky there was one in my GP practice) and was prescribed HRT. Before I spoke to her I had no idea about the peri menopause (I was 46) and the range of symptoms.

HRT restored my confidence, got rid of the rage, and mostly cured the anxiety and indecision.

It is terrible that you are suffering like this. There is no need.

Two things op:

1. I have found the older I get, the more I realise I don't know and that needs resilience itself.

1. I'm not sure if menopause affected me like that. However I think it often starts at a time in a woman's life when confidence may be ebbing for all sorts of reasons and this is conflated by most GPs as "depression and/or anxiety". The best money I ever spent was £500 on a private gynaecologist who started me on an HRT regime of tablets and patches and titrated it after assessing how I was getting on and then wrote to my GP to confirm what was required and what they needed to prescribe and noted very clearly that if they wished to change it without clinical evidence, they were to refer me back to him for further advice.

thanks all for the input and support.

I have an appointment this week for bloods - i guess that because of my age, they won t go on symptoms alone, but at least i can start the conversation.

I have very little doubt that it isn't related to knowing my limits better or - ok, i ve always been very self-critical, but it never stopped me sending an email. When that type of anxiety comes up (not being able to press the send button on an email by pure anxiety of having messed up who it s addressed to) it totally throws me.

i ll report when i ve seen the GP. I am in a new practice and my neighbour had success with them for HRT and migraines (she s a bit older than me though).

Yes this was me! HRT really has helped. Not a magic bullet that worked immediately but a couple of years on I've mostly recovered my confidence. It did really knock me, I'd only just come back from a maternity leave too and between trying to fight my way back from that and being hit by peri-menopause I was a mess and spent a LOT of time googling 'symptoms of early dementia'. It's tough as hell, solidarity, but there is light at the end of the tunnel!

Not just you. I'm struggling with peri. Can't take hrt. Other health issues. Just came in to start my own thread! Hope you can get hrt and some help.

i ll let you know on Wednesday how the GP appointment goes. Insuspect bloods with not much of a consult, followed by a non significant finding and being fobbed off as "all normal".

i might be surprised, you never know!

Don't be fobbed off (I was for several years and suffered needlessly). Do tell them hot flushes are disturbing you. Good luck!

You might have to get bloods taken a second time before they do much.

My levels were low the first time but not the second time - apparently the fluctuation was important evidence anyway.

I was so keen to get my phd sorted before starting menopause (bit late to academia) but peri started about 6 months before I started the PhD.
It's probably a blessing in some ways as it isnt catastrophic if I drop the ball at this stage, but I do feel it's harder to think just now, even with hrt.

How did it go, OP?

This has got me thinking. I get more anxious all the time—not just work, but everything. It doesn’t even have to be about anything at all—just a feeling of being on edge. I’m 46. I’ve been getting night sweats for a few years and my periods are completely out of whack. My mum went through the menopause at 39.

My problem is that I have bipolar disorder & I’m concerned that everything will be put down to that. But everything is stable with regard to that and anxiety has never been a feature of it. I’m not sure where to start.

I began to realise I was peri in my writing up year. Terrible anxiety like nothing I have ever experienced before. My bloods showed no fluctuation in hormones but the combination of night sweats and anxiety were ringing alarm bells. I pushed and pushed and got hrt prescribed at 41. Life changing, and means I am no longer floored by the thought of standing in front of a class. Hrt is wonderful but sadly doesn’t fix the general shit show of the HE landscape!

Historyrocks, I was maybe in a similar situation as I'm autistic so anxiety was put down to that and I got a prescription for an anti depressant for over a year instead of hrt.
But I got the Balance app and logged menopause symptoms and showed that to my GP. That was enough to get the blood tests, which then showed fluctuating hormones.

Thanks @SuperLoudPoppingAction I think I’ll try my GP—there’s one woman who is generally very good. I’ve had enough of this anxiety. It’s starting to really take over.

results finally came back. Thyroid is fine, and FSH is 9.2. GP not keen to discuss further on this basis, despite the symptoms.
Other bloods are ok, except ferritin which is borderline low at 17 (sadly not a new thing, which i manage with ferrous fumarate with very limited success).

Normal GP appointments not before end of May, unless I ring for an emergency one, which seems wrong. I am half considering going to private GP not to feel like I am a nuisance.

Not sure how it s possible to be an effective academic when anxiety freezes me over all my decisions.

It could be (peri)menopause, but also (peri)menopause is now turning into the go-to reason for every problem women have from the day they turn 40...

Is there any chance you are just a bit burnt out after the pandemic and many years of working at a high level? Being over tired, worn out, burnt out or stressed can all have exactly the same symptoms. The pandemic was pretty hard work for academics.

If I were you I would practise self-care of the type a good GP would diagnose for stress/burn out as it can't hurt and would probably help.

What is your average day like? How much fun do you have? How much relaxation? How much exercise? What is your diet like?

If in doubt the basics of self care never hurt. You can pursue the private appointment at the same time.

Did your GP just take bloods once? Mine said they were meant to do it twice.

i ll have to see them again first. I think i got dismissed due to normal bloods. i ll have to chase to speak to them in a hopefully not too distant future.

re burnt-out- yes, it s always a possibility. I exercise a bit, eat quite well, but work is def all consuming and made really unpleasant by the sheer amount of admin and petty firefighting tasks.

the anxiety tells me it s not just burn out though - very very stupid stuff to be anxious about (emails, doubting how to carry out very basic calculations, etc).

at this point, self care would be quitting, to cull silly little concerns and anxiety over nothing much.

I spoke with my fantastic GP this morning and described how I’ve been feeling. She was happy to prescribe HRT based on my symptoms. She said they could do blood tests if I want to, but they’re not a requirement as they’re supposed to go by symptoms. She explained HRT, the different types yiu can get, what she’d give me and why

Only problem right now is that the tablets look like they’d interfere with two medications I take for bipolar, but she’s going to speak with a pharmacist and look into it as she doesn’t know how it affects the medications. I think she said that if I can’t take the tablets, I may be OK to take the patch.

I am sorry so many of us are in the same position but reading this is making me feel a bit more normal. I have been diagnosed both with burnout and menopausal and am currently not working. It's such a shock when you have been the reasonably high flying (not prof level though) person who just copes with everything- and suddenly you can't. I don't have any solutions yet, I am on HRT but didn't quite get the dose right to start with and anti-depressants on a low dose as well. I also think it takes time to recover from such an episode, in my case anyway, I just don't have the bounce back I normally have and even a couple of weeks off has not restored it. No solutions, just solidarity, losing your confidence and experiencing anxiety like this is incredibly disconcerting and you do wonder if you can carry on. I'm going to concentrate on getting better and then reassess.

@Disacappointment I know it's another thing to do but I would look into going to a private menopause clinic or consultant and getting more advice there- this anxiety/loss of confidence is very typical of peri/menopause- as someone else said, it could be burnout as well, that's the case with me, a combination of both, but it's worth getting a second opinion I think and maybe some time off will just have to happen, whether work or you like it or not.

I’m so glad to see this thread! I’ve been experiencing this really strongly. Huge self doubt and anxiety, worrying incessantly about what people think of me at work, doubting every decision. Making a new decision, then doubting that… it’s exhausting. I’m not on HRT yet but did get a Mirena a year or so ago to address hormonal migraines - so there is obvious quite a bit of hormonal fluctuation / perimenopause.

anyway, I don’t have any answers but it’s oddly reassuring to know so many others are going through it too. I have been wondering how I can possibly sustain my academic career when I get crazily crazily obsessively stressed out over every detail and decision.

@Weneednewnames the thread is from 2022. If I can offer any reassurance a few years on...I didn't go on hrt (well I did but had to come off ...)

I think I'm almost through the other side of menopause.... Almost at the year since the last period which is the official marker of menopause and not peri.

I'm doing a lot better mentally. I have other health issues but largely I feel quite liberated. I don't think I care what others think at all now. I don't want approval from anyone. I don't need to impress anyone. I just don't care. If this is what losing oestrogen does then it's an upside 👍🏻