Perimenopause, anxiety or panic disorder?

[EarlyBlue]

For the last few months I've had severe anxiety and panic attacks. I have a history of anxiety, but never as bad as this. I've had periods of almost daily panic attacks, and being in a constant state of fight or flight. Things have eased at times, and I've had days/weeks where I feel 'normal'. Then almost overnight the severe anxiety and attacks come back for a period of a few days. Then cycle repeats. I've begun to get very depressed with this.

I've seen a psychiatrist and have been given ADs and am having CBT. But I'm struggling.

I've suspected before this, that I may be perimenopasial due to other symptoms; I'm 43 in a couple of months, am sweating a lot more, have hot flushes, skin/eye/vaginal dryness, fatigue, bad pmt, shorter cycle (from 28 down to 23/24 days). I've also had a blood test for something else and discovered I have raised cholesterol (unusual given my diet), and I've recently read that can also be a symptom of peri.

I'm just curious about the anxiety/panic attacks... Could the peri cause such severe anxiety and panic disorder symptoms? I'm aware it can cause anxiety but my symptoms have been so severe.... I was unsure if peri could really cause all that.

My GP has agreed I'm in peri and happy to start me on HRT once my ADs have had time to settle. I've got to wait it out for the time being but I'm feeling low. I'm hoping to find a way through all of this.

I've always suffered anxiety but it ramped up due to perimenopause. I started getting panic attacks in situations like sitting on trains, or being in work meetings. It was horrible. I haven't yet tried HRT but I started taking Menopace and my anxiety has calmed down. Sounds like you gave a lot of other perimenopausal symptoms.

Short answer, yes. I was not an anxious person until I was in perimenopause an then it became huge - and then went away again after about ten years when everything calmed down.

I also took Menopace but what really helped my anxiety was magnesium - a lot of a good quality supplement at night + salts in the bath + spray. But with the usual disclaimer that different things might work for you, so try it and see.

Thank you both.

I'm just so stunned and confused by the severity of the anxiety and panic attacks. It's really turned my life upside down. I've been off work for some months now and am desperate to get back to some normality. But I keep getting these periods of days where I can barely function because of a constant high level anxiety. I'm very tearful and depressed. Then symptoms ease for a bit and I have a string of days where I feel mostly ok... But the anxiety is always there and I've lost such a lot of confidence because of the panic attacks.

Psych hasn't mentioned perimenopause, and is treating me for generalised anxiety disorder, panic disorder and depression. I've been on ADs for 5 wks now, and panic attacks are easing thank god, but anxiety still pretty brutal. Which is why I'm wondering if peri could be behind all this. I just didn't know if it could anxiety/panic to this extent. Hopefully I can try HRT soon.

A friend recommended magnesium, I will look into that.

Thank you.

What are you anxious about, specifically? It is possible to control anxiety and to stop panic attacks but you need to know what your mind is telling you to worry about first (and also where those fears came from, preferably).

TBH at 42 your should consider HRT as your symptoms are coming quite early.
You have all the symptoms of peri menopause.

HRT is the first line treatment for psychological moods/ anxiety as often ADs just don't work. This is NICE menopause guidance. Too many women are put onto ADs etc when they need estrogen.

I'd recommend reading as much as you can on the evidence for this from the Balance app/ website by Dr Louise Newson.

I'm surprised your GP referred you to MH and a consultant psych rather than suggesting it was hormonal and going down that route first.

Have they done thyroid bloods OP?

This is a common misconception with anxiety. It’s not always ‘worrying’ about anything. Panic disorder for example comes on like someone has flicked a switch in your head. You won’t have been worrying about anything. Your brain (usually subconsciously) detects a ‘threat’ and off it goes!

OP, I was diagnosed with GAD, PTSD and Panic Disorder in perimenopause. I didn’t know that it was menopause related at all. It was only when I had my ovaries removed and my anxiety disappeared literally overnight that I made the connection.

I agree, although not about the misconception bit 😉, but when someone is anxious there is a thought in the persons head. It’s not possible to be anxious if you have no thoughts.

I had my anxiety well controlled for nearly two decades without medication.

It’s getting worse and worse as I enter the peri. I am relying on a cocktail of expensive supplements to try to control it.

I don’t want to go back on medication but I am struggling.

I'm 43. My levels of anxiety have been getting worse over the past 5 years. The past 2 years I've been suffering pretty bad with panic disorder, it's felt unbearable at times.
I've just been diagnosed as having an early menopause so from everything I've read it's clear that perimenopause has been causing the problems I'm having. Some of it is clearly my own thought patterns, eg trying to control my symptoms including irregular periods through trying anything and everything I read on the internet.
I'm currently having counselling and I'm probably going to start on hrt as if you have an early menopause you are meant to as it reduces the risk of osteoporosis. The counselling has already helped with the panic attacks as did reading everything I could find that Clare Weeks wrote. My general anxiety is still very high though and I think hormones are definitely contributing. I do keep getting stuck in a fight or flight loop.
I think you should feel confident that it's perimenopause causing the panic and that it will settle soon regardless of what you do, but hrt might speed up the process.

Thank you so much for your replies. Giving me some hope that maybe there is another way to tackle this. I'm feeling so low, and hopeless.

Re. The finding out the reason for my worry, and any misconceptions about anxiety.... I have had counselling for the last year, and now CBT. I have explored reasons for my anxiety in depth. And my reactions to it. But the panic disorder is as previous posters have said... It's like a switch that I can't control. It's the most frightening thing. It's a body response that takes over. Pure adrenaline rushes and fight or flight responses. But, the anxiety... Some days I can be (mostly) free of it. Other days it just gnaws away at me, and consumes me. I don't have any pressing worries or thoughts. I do all the CBT tools I've learned, I've read Claire Weekes' books too (which have been SO helpful), I do mindfulness, meditation etc. But the anxiety stays. It distracts me from my life, I'm detached from my kids and my partner. It's crippling me and I'm becoming so depressed. I'm struggling to see a way through this.

I do have support, I have a psychiatrist, I have a therapist, and Claire weekes books have been so so helpful. I do recommend them. But it's still so bloody hard. Thankfully GP is in support of trying HRT so will hopefully get that going in the coming weeks.

Thanks again everyone.

I hear you re panic attacks. Try this video to understand why they start, why you then fear them and how to stop them;