Menopause Isn’t Just Hot Flashes — Let’s Talk Mental Health

Published on May 14, 2025 by Zencare Team. Clinically Reviewed and Contributed to by Adrienne Figueiredo, LCAT.

So What Happens to Your Mental Health During Menopause?

When most people hear “menopause,” they picture hot flashes or night sweats. But for many people, the emotional symptoms are the ones that really take center stage — and not in a good way.

What often gets ignored is how menopause messes with your mind. We’re talking anxiety that comes out of nowhere, mood swings that feel like they belong in a teen drama, and even moments where your memory suddenly blanks out. Yep, menopause and mental health are closely linked, and most people don’t see it coming.

This guide breaks it all down — what’s happening in your brain, why it feels like everything’s off, and what you can actually do about it — along with clinical insight from Licensed Creative Arts Therapist, Adrienne Figueiredo.

Why Do Hormones Mess With Your Mood?

Estrogen Does More Than Manage Your Period

Estrogen isn’t just about your monthly cycle — it actually helps your brain stay balanced. One of its big jobs? Boosting serotonin, the chemical that helps you feel steady, content, and emotionally grounded.

But during perimenopause (the stage before menopause officially kicks in) and into menopause, estrogen and progesterone start acting up. Some days they’re high, some days they drop — and your brain’s trying to keep up the whole time.

This hormonal chaos affects:

Even if you’ve never had issues with mood before, menopause mental symptoms can hit hard and fast.

Takeaway:

Hormone shifts during menopause don’t just cause physical symptoms — they can seriously shake up your emotional world.

What Mental Health Symptoms Should You Watch For?

Let’s get real: this is where things start to feel unfamiliar, even scary. But knowing what’s common helps take away some of the fear.

1. Sudden Anxiety and Panic Attacks

Feeling anxious out of the blue? Heart racing, chest tight, like something bad’s about to happen — but there’s no reason for it?

Welcome to one of the most under-talked-about symptoms: menopause panic attacks. These can come out of nowhere and feel like a full-on emergency. Some people even think they’re having a heart attack. It’s not all in your head — it’s in your hormones.

“Many women are caught off guard by how early in life these panic attacks can come on. While perimenopause typically begins in the late 40’s, it can start as early as the mid-30’s. So that compounds the difficulty, because knowing the root of these panic attacks is the first step! When you do have the insight to know that they’re perimenopause or menopause related, you can remind yourself of that context and then respond similarly to other panic attacks. Grounding exercises are helpful, as are interventions such as reducing your body temperature and reversing the blood flow in your body, which can be achieved by touching your toes or laying on the floor with your legs up against a wall. The most important step is knowing your own escalation stages and intervening early,” says Adrienne Figueiredo, LCAT.

2. Depression That Feels Different

You might be asking, does menopause cause depression? Short answer: yes, it absolutely can.

It’s not just being in a funk. It can show up as:

If you’ve had depression before, menopause can stir it back up. If you haven’t, it can come on for the first time — and it’s no less real.

Adrienne Figueiredo, LCAT also shares that if you already had PMDD (Premenstrual Dysphoric Disorder), you may be more aware of hormonally induced mood issues. If not, giving yourself context for your depression can be very helpful, as can processing your life changes with a therapist who specializes in treating depression.

3. Mood Swings That Come Out of Nowhere

Laughing one minute, snapping the next? Feeling like your emotional dial is stuck on “extreme”?

Menopause mood swings are real — and brutal. One unexpected comment can trigger tears or a wave of irritation that feels way bigger than the situation.

This doesn’t make you “too sensitive” or “dramatic.” It means your brain’s chemistry is in flux.

4. Brain Fog and Forgetfulness

Misplacing your keys is one thing. Losing your train of thought mid-sentence, forgetting words, or zoning out during meetings? That can feel scary.

This kind of brain fog is super common during menopause. You might:

The good news? It’s usually temporary. Your brain isn’t broken — it’s adjusting.

Takeaway:

From menopause anxiety to brain fog, these mental health shifts are part of the hormonal picture — not a sign you’re “losing it.”

Why Are Women So Often Ignored or Misdiagnosed?

You go to the doctor, explain your anxiety or low mood, and they shrug it off. Or worse — they suggest it’s just “stress.”

Sound familiar?

Too many women say their mental health concerns during menopause were downplayed, misunderstood, or dismissed entirely. Here’s why:

This can leave women feeling invisible — like they’re making a big deal out of nothing.

But your experiences are valid. And you deserve care that sees the full picture.

Takeaway:

If you feel dismissed, you’re not alone — and you’re not overreacting. Misunderstanding menopause mental symptoms is far too common.

What Can Actually Help?

You don’t need to suffer through this stage alone. There are real tools and treatments that can help you feel like yourself again.

1. Therapy Makes a Huge Difference

One of the best things you can do? Talk it out — especially with a therapist who understands menopause and mental health.

Cognitive Behavioral Therapy (CBT) is especially effective for managing:

Adrienne Figueiredo, LCAT likes to pair Art Therapy with CBT, “You have both the exploratory aspect with the art therapy piece, which is great for understanding the massive life changes/shifts in your sense of self that occur at this time, and the more structured way to address depression. Some DBT techniques can also be helpful for managing intense emotions, especially the concepts of radical acceptance and urge surfing.”

Therapists can also help you process identity shifts that come with midlife — something often overlooked in medical settings.

2. Hormonal and Medical Support

For some people, Hormone Replacement Therapy (HRT) makes a massive difference in emotional stability. It works by leveling out those estrogen fluctuations that are wreaking havoc.

Other medical options include:

Adrienne Figueiredo, LCAT says that because many doctors brush off the emotional symptoms of menopause, she is happy to advocate for her clients so that they can get the care they need from physicians. She shares anecdotally, “HRT has helped me personally quite a bit, and since there has been some negative attitudes & research about that in the past, it was important for me to read the research myself. I recommend that my clients do the same!”

Every woman’s body responds differently, so this part might take some experimenting — but it’s worth exploring with a doctor who gets it.

3. Lifestyle Shifts That Support Your Brain

The basics really do help — especially when they’re consistent:

None of this is a cure-all, but together, these habits can lower the intensity of your symptoms.

4. Who Should You Talk To?

Start with your primary care physician or gynecologist. But if they aren’t taking your concerns seriously, don’t hesitate to look elsewhere.

The key is finding someone who listens — and knows the science.

Takeaway:

Support is out there. The right combination of therapy, medical care, and lifestyle changes can make a huge difference in how you feel.

Why It’s Time to Change the Way We Talk About Menopause

We’ve spent way too long pretending menopause is just a few hot flashes and calling it a day.

But here’s the truth: Menopause and mental health go hand-in-hand. The emotional and cognitive shifts people experience are real — and they deserve real attention.

This phase doesn’t mark the end of your vitality or your value. It’s just a transition. With the right tools and conversations, it can even be a period of growth, clarity, and strength.

So let’s rewrite the story:

You’re not alone. And you’re not broken. You’re moving through something big — and you deserve support every step of the way.

Takeaway:

Menopause isn’t the end of the story. It’s a new chapter — and with the right support, it can be a powerful one.

FAQs: What Women Ask Most About Mental Health and Menopause

Does menopause cause depression, or is it just stress from life changes?

Hormonal changes during menopause can absolutely trigger depression. Even if your life circumstances are stable, your brain chemistry may not be — and that’s not something you can “positive-think” your way out of.

Can panic attacks really be a symptom of menopause?

Yes. Sudden panic, racing heart, and a wave of dread are all part of menopause panic attacks — especially if estrogen is fluctuating. You’re not imagining it.

Why am I crying more than usual during menopause?

Emotional sensitivity increases when estrogen drops. Those tears aren’t weakness — they’re part of how your body is adjusting.

Will the brain fog go away?

For most women, yes. Once your hormones stabilize (either naturally or with treatment), your memory and clarity tend to bounce back. If it doesn’t, definitely check in with your doctor.

Can therapy help with menopause symptoms?

Definitely. Therapists can give you tools to handle everything from mood swings to anxiety. Plus, just having someone listen — and believe you — can be powerful.