Latest / What The Peri? - With Kirsten Cooke / Perimenopause & Mental Health - Mood, Anxiety, Depression & The Mental Load (Ep 7)

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Perimenopause & Mental Health - Mood, Anxiety, Depression & The Mental Load (Ep 7) · What The Peri? - With Kirsten Cooke

• 0:07
  SPEAKER_00: Welcome to What the Perry.
• 0:09
  SPEAKER_00: I'm your host Kirsten Cook, personal trainer, menopause coach, and a woman living it right alongside you.
• 0:16
  SPEAKER_00: This is the podcast for women navigating perimenopause and menopause.
• 0:20
  SPEAKER_00: The change you didn't ask for, but the conversations you need.
• 0:24
  SPEAKER_00: Let's get into it.
• 0:35
  SPEAKER_00: There's a particular kind of tired that I don't think has a name yet.
• 0:39
  SPEAKER_00: It isn't the tired you feel after a big week.
• 0:42
  SPEAKER_00: It's the tired of waking up already depleted, before the day has asked you for anything and having absolutely no idea which version of yourself you're going to get that day.
• 0:52
  SPEAKER_00: That was my life for years.
• 0:55
  SPEAKER_00: And the hardest part of it, the genuinely hardest part, wasn't any single symptom.
• 1:00
  SPEAKER_00: It was that I didn't feel like myself and I had absolutely no idea how long it was going to last.
• 1:07
  SPEAKER_00: Let me try and describe what that actually looked like because I think some of you are going to recognize yourselves.
• 1:12
  SPEAKER_00: Some days I was flat and sad for no particular reason.
• 1:17
  SPEAKER_00: Some days I was snappy, a fuse, far shorter than anything I recognised as mine, going off at people who'd done nothing to deserve it.
• 1:26
  SPEAKER_00: Some days it was anxiety, which was completely new for me.
• 1:29
  SPEAKER_00: I've never been an anxious person in my life.
• 1:32
  SPEAKER_00: There's days where the phone would ring and I'd look at the name of somebody I loved, somebody I'd normally be delighted to hear from.
• 1:39
  SPEAKER_00: And I just couldn't.
• 1:41
  SPEAKER_00: I did not have the capacity to have a conversation.
• 1:44
  SPEAKER_00: So I'd let it ring out and then feel awful about it afterwards.
• 1:48
  SPEAKER_00: But it was never only the mood.
• 1:50
  SPEAKER_00: That's the bit I really want to get across.
• 1:53
  SPEAKER_00: Because if it were just your feelings, you might be able to talk yourself around.
• 1:57
  SPEAKER_00: The problem was so many perimenopausal symptoms all at once.
• 2:01
  SPEAKER_00: So picture the whole thing.
• 2:03
  SPEAKER_00: You've barely slept, horrible broken sleep, waking at three, waking drenched, then lying there wide awake.
• 2:10
  SPEAKER_00: You get up already feeling smashed with a bone-crushing fatigue that has nothing to do with how many hours you were in bed.
• 2:16
  SPEAKER_00: Your joints ache.
• 2:18
  SPEAKER_00: Mine did.
• 2:19
  SPEAKER_00: My hips, knees, hands, and tennis elbow that came from nowhere and would not settle.
• 2:25
  SPEAKER_00: In an arm I hadn't even injured.
• 2:27
  SPEAKER_00: You're bloated and uncomfortable in your own clothes.
• 2:30
  SPEAKER_00: Your brain is thick with fog.
• 2:32
  SPEAKER_00: So words go missing and whole thoughts vanish mid-sentence.
• 2:36
  SPEAKER_00: And you have no motivation for any of the things that used to be easy.
• 2:40
  SPEAKER_00: Now stack the mood on top of that.
• 2:42
  SPEAKER_00: The sadness, the short fuse, the anxiety, the overwhelm, landing on a woman who's already exhausted, already sore, and already can't think straight.
• 2:52
  SPEAKER_00: And that's what nobody explains.
• 2:54
  SPEAKER_00: It isn't one symptom you could name and manage.
• 2:57
  SPEAKER_00: It's 15 of them at once, feeding each other, and the sum of them is something much stronger than any item on the list.
• 3:03
  SPEAKER_00: You stop recognizing yourself.
• 3:06
  SPEAKER_00: You're living in a body you don't know, running a brain that isn't behaving like yours, feeling things that don't belong to you, feeling like you're lost inside somebody else's life.
• 3:16
  SPEAKER_00: And underneath all of it, that heavy grey overwhelm.
• 3:21
  SPEAKER_00: But here's the part I think that does the most damage, and it's the part nobody ever describes properly.
• 3:26
  SPEAKER_00: None of it was predictable.
• 3:28
  SPEAKER_00: It wasn't the same every day.
• 3:30
  SPEAKER_00: Instead, you get glimmers.
• 3:32
  SPEAKER_00: You have a morning where you almost feel like yourself, where you catch yourself laughing at something, or you get through teaching a class and think, oh, there she is.
• 3:40
  SPEAKER_00: Maybe we're coming out of it.
• 3:42
  SPEAKER_00: And then, for no reason, you'll be able to find you didn't sleep differently, you didn't eat differently, you didn't train differently, nothing happened.
• 3:51
  SPEAKER_00: It just flips.
• 3:52
  SPEAKER_00: Late morning, out of nowhere, and you're right back into a body you don't recognize, running on a brain that isn't behaving like yours.
• 4:00
  SPEAKER_00: No warning, no trigger you can pinpoint, and no idea when it's going to lift.
• 4:06
  SPEAKER_00: Sometimes it's a couple of hours, sometimes it's half a day, sometimes it's days or weeks on end.
• 4:12
  SPEAKER_00: Now I want to be honest about what that actually does to a life, because it was very, very hard, and I also want to be precise about where the damage lands, because I don't think anyone describes that part properly.
• 4:24
  SPEAKER_00: Life goes on, it does.
• 4:27
  SPEAKER_00: You keep going, I certainly did.
• 4:29
  SPEAKER_00: I got up every single morning and put one foot in front of the other because that's my gritty nature, and because people were relying on me.
• 4:37
  SPEAKER_00: Four children, clients waiting for me in a studio.
• 4:40
  SPEAKER_00: There's no version of that where you get to stop.
• 4:42
  SPEAKER_00: So you soldier on, even when you don't want to, and even when it feels nearly impossible.
• 4:48
  SPEAKER_00: But I want to name what that costs because nobody ever does.
• 4:52
  SPEAKER_00: Life carries on, just with most of the joy taken out of it.
• 4:56
  SPEAKER_00: The pleasure quietly drains out of the things you used to love.
• 5:00
  SPEAKER_00: The simplest tasks start to feel like a chore.
• 5:03
  SPEAKER_00: From the outside, you look like you're managing perfectly well, and on the inside you're running on grit alone.
• 5:09
  SPEAKER_00: And the thing that goes first for me is the future.
• 5:13
  SPEAKER_00: You get through the day, sure, but I want to be clear that getting through it is not the same as it being easy.
• 5:20
  SPEAKER_00: Most days felt really long.
• 5:22
  SPEAKER_00: There were a lot of days I just wanted it to be over, counting down to bedtime, hoping that tomorrow might bring something different.
• 5:30
  SPEAKER_00: And then you do that again the next day, and the next day, and the day after that.
• 5:35
  SPEAKER_00: So when every ounce of what you've got is going on simply getting to the end of the day, sitting down and planning something bright is almost impossible.
• 5:44
  SPEAKER_00: Dreaming up something good for next year, having something to look forward to, building towards something, that takes a kind of fuel you simply haven't got.
• 5:53
  SPEAKER_00: And that's the loss nobody sees, because from the outside, nothing looks wrong at all.
• 5:59
  SPEAKER_00: And I can say if you're at a point where you can't push through, where soldiering on isn't available to you at the moment, please don't hear any of that as a standard you're failing to meet.
• 6:09
  SPEAKER_00: It isn't grit that's missing.
• 6:11
  SPEAKER_00: It's a sign of how heavy this has become, and it's worth getting proper help for it.
• 6:15
  SPEAKER_00: We'll come to that.
• 6:16
  SPEAKER_00: I've spent nearly 30 years in health and fitness.
• 6:19
  SPEAKER_00: I've raised four children.
• 6:21
  SPEAKER_00: The twins arrived when I was 40.
• 6:23
  SPEAKER_00: I ran a business, a household, a family.
• 6:26
  SPEAKER_00: I was the woman with all the balls in the air, and I was pretty good at it.
• 6:30
  SPEAKER_00: And I went from that to waking up most days feeling like I was about to drop every single one of them.
• 6:36
  SPEAKER_00: And here's one that still gets me because of what I do for a living.
• 6:40
  SPEAKER_00: I'm a personal trainer.
• 6:41
  SPEAKER_00: I've loved exercise my entire life.
• 6:43
  SPEAKER_00: It's my job, it's my joy, and it's one of the biggest things that makes me me.
• 6:48
  SPEAKER_00: And there were months where I didn't want to do any of it, not one bit.
• 6:53
  SPEAKER_00: I'd force myself every time because 30 years of knowing bodies means I knew I'd feel better afterwards, and I usually did, but the wanting was gone.
• 7:03
  SPEAKER_00: I'll tell you something honestly, I still exercise far more for my head now than I do for my body.
• 7:09
  SPEAKER_00: The physical aspect is obviously super important, but the need to exercise for my mental health has become top priority.
• 7:17
  SPEAKER_00: And through all of it, the question that ran underneath everything was the one that kept me up, the one that made it so heavy.
• 7:25
  SPEAKER_00: It wasn't what is wrong with me, it was how long?
• 7:28
  SPEAKER_00: How long until somebody helps me get on top of this?
• 7:31
  SPEAKER_00: How long until I feel like myself again?
• 7:34
  SPEAKER_00: Is there a light at the end of this?
• 7:36
  SPEAKER_00: And if there is, when do I get to see it?
• 7:39
  SPEAKER_00: Not knowing that, that was the hardest part.
• 7:42
  SPEAKER_00: And I went looking for years.
• 7:44
  SPEAKER_00: If you've heard episode one, you know some of this.
• 7:47
  SPEAKER_00: I've sat in more doctors' rooms than I can count.
• 7:50
  SPEAKER_00: GPs, doctors advertising themselves as women's hormone experts, some of whom it turned out had done a one-day seminar.
• 7:58
  SPEAKER_00: Rheumatologists, pain doctors, functional medicine practitioners, physios, chiros, naturopaths, thousands and thousands of dollars.
• 8:08
  SPEAKER_00: Every single one of them told me something different.
• 8:10
  SPEAKER_00: A few things helped a little, some made me worse.
• 8:14
  SPEAKER_00: I've been told I was too young.
• 8:16
  SPEAKER_00: I've been told that because I still had periods at the time, I couldn't possibly be in perimenopause, which is simply not correct.
• 8:23
  SPEAKER_00: I've been handed HRT with almost no information and a free license to adjust the dose myself, with no monitoring and no blood work.
• 8:32
  SPEAKER_00: And then when I reacted badly to it, I was told my body's response was very unusual and they'd never seen it before.
• 8:40
  SPEAKER_00: I've sat in a chair and described the sadness and the anxiety and the not feeling like myself, and been told it was depression or stress and often an antidepressant, with not one question asked about my hormones, not one.
• 8:55
  SPEAKER_00: And it wasn't that they didn't have the information.
• 8:58
  SPEAKER_00: I told them I wasn't sleeping.
• 9:00
  SPEAKER_00: I told them my history.
• 9:01
  SPEAKER_00: I sat there and handed it over.
• 9:04
  SPEAKER_00: Nobody joined it up, and nobody said the word perimenopause.
• 9:08
  SPEAKER_00: And that wasn't even the first time.
• 9:10
  SPEAKER_00: Earlier on in all of this, when my sleep was in ruins, I was prescribed an antidepressant that works on the sleep pathways, given to me specifically to help with sleep.
• 9:20
  SPEAKER_00: And again, not once did that doctor look at my hormones.
• 9:23
  SPEAKER_00: Not once was perimenopause raised.
• 9:26
  SPEAKER_00: Nobody suggested we look at progesterone, which, as we talked about back in episode five, is the calming sleep-promoting hormone.
• 9:34
  SPEAKER_00: It's very often the first one to drop away in perimenopause, and there's research behind using it for exactly that.
• 9:41
  SPEAKER_00: And it goes further back than that.
• 9:43
  SPEAKER_00: Years before any of that, my periods were extremely heavy.
• 9:47
  SPEAKER_00: The pain, the bloating, the water retention, the clotting.
• 9:51
  SPEAKER_00: It went on for years and it got worse, not better.
• 9:54
  SPEAKER_00: And I raise it for one reason only.
• 9:56
  SPEAKER_00: A change in your periods is one of the recognized signs of perimenopause.
• 10:01
  SPEAKER_00: Not just when they stop, when they change.
• 10:04
  SPEAKER_00: Heavier, closer together, more painful, clotting.
• 10:08
  SPEAKER_00: It's on every symptom list there is, and the Australian Menopause Society says plainly that bleeding should be investigated when it's very heavy or prolonged.
• 10:17
  SPEAKER_00: So there I was, a woman in my 40s whose periods had changed dramatically, and it was treated as a bleeding problem to be managed.
• 10:25
  SPEAKER_00: Which, fair enough, it also was.
• 10:27
  SPEAKER_00: But not once did anyone ask whether my hormones were behind it.
• 10:30
  SPEAKER_00: Not once did anyone say the word perimenopause.
• 10:34
  SPEAKER_00: And that's the pattern over and over across years and across more doctors and more specialists than I can count.
• 10:40
  SPEAKER_00: The question never came up.
• 10:42
  SPEAKER_00: And this is not just my story.
• 10:44
  SPEAKER_00: In 2024, the Australian Senate ran an inquiry into menopause and perimenopause.
• 10:50
  SPEAKER_00: And in its report, this is our own parliament, on the record, the committee said it learned of the experiences of women seeking care through the health system, often being prescribed antidepressants as a first-line therapy for a range of different perimenopausal symptoms, rather than further investigation being undertaken.
• 11:10
  SPEAKER_00: Read that last bit again, because it's the whole thing, rather than further investigation being undertaken.
• 11:16
  SPEAKER_00: The same report describes women being misdiagnosed, women being told they were too young, and one woman whose GP told her that all he'd learnt at medical school was that menopausal women were either mad or sad.
• 11:30
  SPEAKER_00: Now, I want to be fair here because I'm not interested in a Dr.
• 11:33
  SPEAKER_00: Bashing episode.
• 11:34
  SPEAKER_00: Antidepressants are a genuinely important treatment, and for a great many women they are exactly the right answer.
• 11:40
  SPEAKER_00: And if you're on one, please don't go changing anything because of a podcast.
• 11:45
  SPEAKER_00: I'd also say this in your GP's defence.
• 11:48
  SPEAKER_00: They've been working without an Australian menopause guideline at all.
• 11:52
  SPEAKER_00: We actually don't have one.
• 11:53
  SPEAKER_00: The first national guideline is only being written right now in 2026.
• 11:58
  SPEAKER_00: That's a system problem, not a 15-minute appointment problem.
• 12:02
  SPEAKER_00: But I'm not going to pretend nothing went wrong either, because that wouldn't be honest.
• 12:07
  SPEAKER_00: I was a woman in her 40s with almost every classic sign of perimenopause written across her, asking for help over and over.
• 12:16
  SPEAKER_00: And the question that would have changed everything, could this be hormonal, never got asked.
• 12:21
  SPEAKER_00: It took me about three years to work it out myself.
• 12:24
  SPEAKER_00: Three years of assuming the problem was me, my resilience, my personality, my ability to cope with a life that from the outside looked completely fine.
• 12:34
  SPEAKER_00: And I want to be really clear that finding the answer didn't flip a switch.
• 12:38
  SPEAKER_00: It didn't.
• 12:39
  SPEAKER_00: Even four or five months ago, I was in a bad enough place that I genuinely thought I was going to have to give up work, that I simply could not keep doing what I do.
• 12:48
  SPEAKER_00: That's how recent it was.
• 12:50
  SPEAKER_00: But I'm going to tell you the good part because you need to hear it from someone who's actually in it.
• 12:55
  SPEAKER_00: I'm on a protocol now that is helping.
• 12:58
  SPEAKER_00: The fog is lifting.
• 12:59
  SPEAKER_00: The weight of it is lifting.
• 13:01
  SPEAKER_00: There is light at the end of this.
• 13:02
  SPEAKER_00: I can see it now.
• 13:04
  SPEAKER_00: I'm not out the other side, and I'm not going to pretend that I am.
• 13:07
  SPEAKER_00: But I have dug myself out of the hole, and there are good days now, real ones.
• 13:13
  SPEAKER_00: And I'll say this too, because last week matters here.
• 13:16
  SPEAKER_00: We spent a whole episode on brain fog, and I told you how frightening that got.
• 13:20
  SPEAKER_00: But if you asked me which was worse, the fog or what happened to my mental health, I wouldn't have to think about it.
• 13:26
  SPEAKER_00: This was worse, absolutely worse.
• 13:29
  SPEAKER_00: The fog stole my sharpness, but this stole me.
• 13:33
  SPEAKER_00: Because for those of us who it comes for hard, perimenopause doesn't just change how you think.
• 13:39
  SPEAKER_00: It changes how you feel, what you enjoy, what you can tolerate, how much room you have for the people you love.
• 13:46
  SPEAKER_00: And it does it quietly without announcing itself.
• 13:49
  SPEAKER_00: So you don't experience it as a symptom.
• 13:51
  SPEAKER_00: You experience it as a personality change, as a character failure, as proof you've become someone smaller and harder and less kind than the woman you were.
• 14:01
  SPEAKER_00: So if you're sitting there wondering when you turned into this, wondering why you can't get a grip, hear me.
• 14:08
  SPEAKER_00: It is very unlikely to be a character flaw.
• 14:10
  SPEAKER_00: It is very likely to be, in large part, chemistry.
• 14:14
  SPEAKER_00: And chemistry is workable.
• 14:16
  SPEAKER_00: So today, what perimenopause does to your mood and why?
• 14:21
  SPEAKER_00: The load you've been carrying and why it suddenly feels unbearable.
• 14:24
  SPEAKER_00: How to tell hormonal mood changes from clinical depression.
• 14:28
  SPEAKER_00: Exactly what to ask for so you don't lose three years the way I did.
• 14:33
  SPEAKER_00: Real practical help.
• 14:35
  SPEAKER_00: And, because I promise you this matters, what women say about the other side.
• 14:40
  SPEAKER_00: I'm not standing on the far side of this telling you how it was.
• 14:43
  SPEAKER_00: I'm still in it.
• 14:44
  SPEAKER_00: So let's take this one gently and let's get into it.
• 14:48
  SPEAKER_00: Welcome back to What the Perry.
• 14:50
  SPEAKER_00: I'm Kirsten Cook.
• 14:51
  SPEAKER_00: Before we go any further, one piece of housekeeping that matters more today than any other week.
• 14:56
  SPEAKER_00: This episode talks openly about depression and how dark this can get for some women.
• 15:01
  SPEAKER_00: If that's a hard listen for you right now, please look after yourself.
• 15:05
  SPEAKER_00: Pause it, come back to it another day, or listen with someone.
• 15:10
  SPEAKER_00: And if at any point today or any other day you're struggling, Lifeline is there on 1311 24 hours a day and beyond blue on 1-300-224636.
• 15:24
  SPEAKER_00: You can also text Lifeline on 0477-131114 or chat online.
• 15:31
  SPEAKER_00: Those numbers are in the show notes, and I'll say them again at the end.
• 15:36
  SPEAKER_00: Last week I said that if that episode was about your mind, this one would be about your heart.
• 15:41
  SPEAKER_00: And here we are.
• 15:42
  SPEAKER_00: Brain fog is a huge part of not feeling like yourself, but it isn't the whole of it, and honestly, it isn't the worst of it either.
• 15:49
  SPEAKER_00: For a lot of the women I speak to, the emotional side is the part that does the real damage to their confidence, to their relationships, to their sense of who they are.
• 15:59
  SPEAKER_00: And one thing before we start, because it matters, and I don't want anyone hearing the wrong message today.
• 16:05
  SPEAKER_00: Perimenopause is not the same experience for every woman.
• 16:09
  SPEAKER_00: Some women genuinely sowl through it.
• 16:12
  SPEAKER_00: A few mild symptoms, nothing that derails them, and they come out the other side wondering what all the fuss was about.
• 16:18
  SPEAKER_00: If that's you, that is wonderful.
• 16:20
  SPEAKER_00: I mean that sincerely.
• 16:22
  SPEAKER_00: This transition is not a sentence, and I'm not here to tell you it's coming for you.
• 16:27
  SPEAKER_00: But for those of us who do get hit, and there are a great many of us, it can be brutal, debilitating honestly.
• 16:35
  SPEAKER_00: That's been my experience, and it's the experience of most of the women who come to me.
• 16:40
  SPEAKER_00: So today I'm speaking to her, the woman who's been flattened by this.
• 16:44
  SPEAKER_00: If that's not you, stay anyway.
• 16:46
  SPEAKER_00: You'll almost certainly recognise someone you love in it.
• 16:50
  SPEAKER_00: So here's what I want to get done today.
• 16:52
  SPEAKER_00: I want you to understand what's actually happening chemically so that you can stop blaming your character for something your biology is doing.
• 16:59
  SPEAKER_00: I want to talk properly about the load you've been carrying because I don't think anyone has ever named that for you.
• 17:06
  SPEAKER_00: I want you to be able to tell the difference between a hormonal mood swing and something that needs proper treatment.
• 17:12
  SPEAKER_00: I want you walking into your next appointment knowing exactly what to ask.
• 17:17
  SPEAKER_00: I want to give you real specific ways to shift some of the weight off your shoulders.
• 17:22
  SPEAKER_00: And I want to finish by telling you what's waiting on the other side of this, because nobody told me and it would have helped enormously.
• 17:30
  SPEAKER_00: This one's a bit longer than usual, but it's earned it, and I think it's necessary.
• 17:35
  SPEAKER_00: Let's begin with what it actually feels like, because I don't think anyone has ever named this properly for you.
• 17:41
  SPEAKER_00: Let me describe the shapes this takes, because it doesn't look the same in every woman, and a lot of you are going to hear yourselves in one of these and not the others.
• 17:51
  SPEAKER_00: The rage.
• 17:52
  SPEAKER_00: This is the one nobody warns you about and the one women are most ashamed of.
• 17:56
  SPEAKER_00: It's not ordinary irritation, it's a hot, immediate, totally out-of-proportion fury that arrives before you've had a chance to decide anything about it.
• 18:06
  SPEAKER_00: Someone leaves a cupboard door open, someone asks you what's for dinner, or someone chews too loudly, and something inside you goes off like a firework, and the size of it shocks you as much as it shocks them.
• 18:17
  SPEAKER_00: I still have this.
• 18:19
  SPEAKER_00: I want to be honest about that.
• 18:21
  SPEAKER_00: This isn't a story about how I fixed it and now I'm all chilled.
• 18:24
  SPEAKER_00: I have a shorter fuse with my kids that I did not used to have, and it's ongoing, and I hate it.
• 18:30
  SPEAKER_00: I've got four children, and the twins are eight, and eight-year-olds are eight-year-olds.
• 18:34
  SPEAKER_00: And there are days when the noise and the questions and the being needed constantly is so overstimulating, and it hits something in me that just detonates.
• 18:44
  SPEAKER_00: And then comes the part that's actually worse than the anger, the guilt.
• 18:48
  SPEAKER_00: That specific, sour, late-at-night guilt where you replay how you spoke to your child when you wish you had led with kindness, and you think, what's wrong with me?
• 18:58
  SPEAKER_00: Nothing is wrong with you.
• 19:00
  SPEAKER_00: Your threshold has moved.
• 19:02
  SPEAKER_00: That's a different thing entirely, and we'll get to why.
• 19:05
  SPEAKER_00: The anxiety.
• 19:07
  SPEAKER_00: And this one catches women completely off guard because there are many of us who have never been truly anxious a day in our lives.
• 19:14
  SPEAKER_00: It's a low hum that won't switch off.
• 19:16
  SPEAKER_00: It's a dread with no object.
• 19:19
  SPEAKER_00: Nothing's happened, nothing is wrong, and yet you feel like something is coming.
• 19:23
  SPEAKER_00: And I want to draw a line under something here because I don't want to muddle what I told you in the sleep episode.
• 19:29
  SPEAKER_00: Remember, I said that waking at three in the morning wired with your heart pounding is not anxiety you've invented, it's a physiological alarm going off.
• 19:38
  SPEAKER_00: Cortisol doing something it shouldn't be doing at that hour.
• 19:42
  SPEAKER_00: That still stands.
• 19:43
  SPEAKER_00: What I'm describing today is different.
• 19:45
  SPEAKER_00: This is the daytime version.
• 19:47
  SPEAKER_00: The hum that's there when you wake up and still there at four in the afternoon, with nothing setting it off at all.
• 19:53
  SPEAKER_00: It's suddenly finding a phone call hard, suddenly finding a party unbearable, suddenly not wanting to drive somewhere new.
• 20:01
  SPEAKER_00: Women who have run businesses and raised families and handled genuine crises without flinching, now sitting in a car park, working up to walking into a shopping centre.
• 20:12
  SPEAKER_00: And there's a really interesting thing in the research here that I think is enormously validating, and it's this.
• 20:18
  SPEAKER_00: The women most affected are often the ones who were never anxious before.
• 20:22
  SPEAKER_00: If you're sitting there thinking, but I've never been an anxious person, that's not evidence against you.
• 20:28
  SPEAKER_00: In the research, that's almost the pattern.
• 20:31
  SPEAKER_00: But the flatness, this is the quietest one, and I think the cruelest.
• 20:36
  SPEAKER_00: It's not sadness.
• 20:38
  SPEAKER_00: Sadness would almost be easier because at least sadness is a feeling.
• 20:42
  SPEAKER_00: This is the absence of feeling.
• 20:44
  SPEAKER_00: The things you used to love just don't land anymore.
• 20:47
  SPEAKER_00: Music doesn't move you, the beach doesn't lift you.
• 20:51
  SPEAKER_00: You go to do the thing you've been looking forward to, and you stand there thinking, I should be enjoying this.
• 20:56
  SPEAKER_00: You're not miserable, you're not anything.
• 20:59
  SPEAKER_00: Somebody turned the colour down.
• 21:01
  SPEAKER_00: And this one has a proper name, which I only learned relatively recently and found oddly comforting, because a thing with a name is a thing that's real.
• 21:10
  SPEAKER_00: It's called anodonia.
• 21:12
  SPEAKER_00: It means the pleasure just doesn't arrive.
• 21:14
  SPEAKER_00: You do the thing you've always loved and you feel nothing.
• 21:18
  SPEAKER_00: Two things about it worth knowing.
• 21:20
  SPEAKER_00: The first is that it isn't some obscure term I've gone digging for.
• 21:24
  SPEAKER_00: Loss of interest in most things sits on the standard checklist doctors use to assess menopausal symptoms right alongside irritability.
• 21:33
  SPEAKER_00: It belongs to this transition, and there is research to show that giving perimenopausal women estrogen can reduce it.
• 21:41
  SPEAKER_00: The second is the one I really want you to have.
• 21:44
  SPEAKER_00: When doctors assess for depression, there are two symptoms that act as the front door.
• 21:48
  SPEAKER_00: You need at least one of them.
• 21:50
  SPEAKER_00: One is feeling persistently sad.
• 21:53
  SPEAKER_00: The other is anidonia, the loss of interest and pleasure, which means you can be genuinely clinically.
• 22:00
  SPEAKER_00: Depressed without ever feeling sad a single day.
• 22:03
  SPEAKER_00: And that is exactly why so many women in this stage get told, well, you don't seem depressed, by their families, by their doctors, and by themselves.
• 22:12
  SPEAKER_00: If you've been dismissing what's happening to you because you're not crying, please stop.
• 22:17
  SPEAKER_00: Not feeling is a symptom too.
• 22:19
  SPEAKER_00: And the one almost nobody says out loud, so I'm going to say it.
• 22:23
  SPEAKER_00: For some women, the pull towards the people close to them goes quiet.
• 22:28
  SPEAKER_00: Not the love.
• 22:29
  SPEAKER_00: The love is absolutely still there.
• 22:31
  SPEAKER_00: You know intellectually that you love them.
• 22:34
  SPEAKER_00: You would still do anything for them.
• 22:36
  SPEAKER_00: But you don't want to be around them.
• 22:38
  SPEAKER_00: You want everyone to stop needing something from you for just five minutes.
• 22:42
  SPEAKER_00: You want to break from your own family, and you want it badly, and you feel horrendous about wanting it.
• 22:48
  SPEAKER_00: And then you carry that around like the most shameful secret you ever had.
• 22:52
  SPEAKER_00: Absolutely certain you're the only woman on earth who's ever felt that way about her own family.
• 22:57
  SPEAKER_00: You are not.
• 22:58
  SPEAKER_00: It is common, and it's chemistry as much as it is character.
• 23:02
  SPEAKER_00: I'll come back to why, and it does ease.
• 23:06
  SPEAKER_00: And underneath all of it, the invasion.
• 23:09
  SPEAKER_00: That's the word I keep coming back to.
• 23:11
  SPEAKER_00: Last week I said the fog felt like someone else had invaded my body and my brain.
• 23:17
  SPEAKER_00: This is that, but it feels like it's in your heart.
• 23:20
  SPEAKER_00: It's not that you feel unwell, it's that you feel occupied, like someone got in and started moving the furniture, changing what you like, changing what you can bear, changing the temperature of you, and you're standing in the middle of your own life watching yourself react to things in ways that don't belong to you, thinking, I don't know who this is.
• 23:40
  SPEAKER_00: If you felt any of that, the rage, the dread, the flatness, the numbness towards the people you love, the sense of being occupied, you are not broken and you are very, very far from alone.
• 23:54
  SPEAKER_00: But there's something sitting underneath all of that I don't think gets talked about nearly enough, and I want to give it proper time because for a lot of women it's the real story.
• 24:04
  SPEAKER_00: Let me describe a day, not a hard day, an ordinary one.
• 24:09
  SPEAKER_00: You know one of them has been quiet for three days and you need to find a moment to ask why, properly without making it a thing.
• 24:16
  SPEAKER_00: You know the dentist is overdue and the referral expires.
• 24:19
  SPEAKER_00: You know the boots don't fit anymore and training is on Tuesday.
• 24:23
  SPEAKER_00: You know which one of them has gone off the sandwiches they ate happily for two years.
• 24:27
  SPEAKER_00: You know the library book is under the couch, you know whose birthday it is in eleven days, what she'd actually like for a present, whether it clashes with the other party, and that you'll be the one buying the present, wrapping the present, writing the card, and remembering to put it in the car.
• 24:42
  SPEAKER_00: You know the milk situation, you know which uniform is clean, you know the car's due for a service, and the power bill lands this week, and there's nothing defrosted for tonight.
• 24:52
  SPEAKER_00: Nobody handed you that list.
• 24:54
  SPEAKER_00: Nobody asked whether you wanted it.
• 24:56
  SPEAKER_00: It simply arrived one item at a time over years, and somewhere along the way it became yours, and it became invisible because you were so good at carrying it that nobody ever had to notice it was being carried.
• 25:10
  SPEAKER_00: And this is why you can't sleep.
• 25:12
  SPEAKER_00: I want to connect that properly because we spent a whole episode on sleep, and this is the piece I didn't say.
• 25:17
  SPEAKER_00: It's eleven o'clock at night, you're exhausted to your bones, and your brain will not switch off.
• 25:22
  SPEAKER_00: Because it's running the audit.
• 25:24
  SPEAKER_00: What did I forget today?
• 25:26
  SPEAKER_00: What's due tomorrow?
• 25:27
  SPEAKER_00: Did I reply to that?
• 25:28
  SPEAKER_00: Is she alright?
• 25:29
  SPEAKER_00: The list doesn't stop when you lie down.
• 25:32
  SPEAKER_00: It's the only time all day it has your undivided attention.
• 25:36
  SPEAKER_00: And here's the thing about that load.
• 25:38
  SPEAKER_00: It isn't the doing.
• 25:39
  SPEAKER_00: Anyone can do a load of washing.
• 25:41
  SPEAKER_00: It's the holding.
• 25:42
  SPEAKER_00: It's being the only person in the house who has the whole picture in her head at all times, and knowing that if you put it down for a week, things would simply stop happening.
• 25:53
  SPEAKER_00: Women do this for years, often for decades.
• 25:57
  SPEAKER_00: Now, before I go on, let me be fair, because I know not every household looks the same.
• 26:02
  SPEAKER_00: There are homes where this genuinely is shared, where two people both hold the picture and where nobody is carrying it alone.
• 26:09
  SPEAKER_00: If that's yours, that is wonderful and I'm glad.
• 26:12
  SPEAKER_00: And then there are women listening who are doing most of it, or every bit of this on their own, with nobody to share it with at all, which is its own particular kind of hard.
• 26:23
  SPEAKER_00: But I'm going to speak to what I actually see, and in the vast majority of women who come to me struggling in perimenopause, this load is sitting overwhelmingly on her.
• 26:34
  SPEAKER_00: There's Australian data on it, and I'll come back to that later, but honestly, I didn't need the data.
• 26:39
  SPEAKER_00: I have the conversations.
• 26:41
  SPEAKER_00: And then the hormones change.
• 26:43
  SPEAKER_00: Here's what I want you to understand, and it's the heart of today for me.
• 26:47
  SPEAKER_00: For your entire adult life, you have had chemistry helping you to do that.
• 26:52
  SPEAKER_00: And what I want to be clear about is this, because I think it gets softened for women far too often.
• 26:58
  SPEAKER_00: The urge to nurture is not simply a personality trait or a virtue or something you decided to be.
• 27:04
  SPEAKER_00: There is real biology underneath it.
• 27:07
  SPEAKER_00: Estrogen isn't only a reproductive hormone, it's threaded right through the brain systems that run mood, pleasure, and connection, including the ones involving oxytocin, the hormone most of us associate with bonding.
• 27:21
  SPEAKER_00: Estrogen actually helps your body make oxytocin and it helps your brain listen to it.
• 27:26
  SPEAKER_00: So when your estrogen starts surging and crashing and then dropping away, it's entirely plausible that some of that pull towards looking after everybody else gets turned down along with it.
• 27:38
  SPEAKER_00: Now I'll be straight with you, as I always am.
• 27:41
  SPEAKER_00: Nobody has run the study that proves that exact chain in perimenopausal women.
• 27:46
  SPEAKER_00: The research hasn't been done, which tells you something in itself.
• 27:50
  SPEAKER_00: But the biology is real, the direction makes sense, and the experience of I just don't want to be the one holding everyone anymore is something I hear from woman after woman.
• 28:01
  SPEAKER_00: It is chemistry as much as it is character.
• 28:05
  SPEAKER_00: And for a lot of us in perimenopause, that capacity goes.
• 28:09
  SPEAKER_00: I've come to think of it as the hormonal veil lifting.
• 28:12
  SPEAKER_00: Because that's what it feels like.
• 28:14
  SPEAKER_00: Something you didn't know was there is suddenly gone, and you're seeing your own life without it clearly and for the first time, and you find yourself standing in the kitchen at half past six thinking, why is this mine?
• 28:27
  SPEAKER_00: Why has it always been mine?
• 28:29
  SPEAKER_00: Does anyone in this house have any idea what I hold?
• 28:33
  SPEAKER_00: And I'll level with you.
• 28:34
  SPEAKER_00: It isn't as tidy as one hormone switching off your ability to care.
• 28:38
  SPEAKER_00: It isn't.
• 28:39
  SPEAKER_00: But the effect is real and the timing is not a coincidence.
• 28:43
  SPEAKER_00: At the exact moment your energy is gone, your sleep is wrecked, your mood is all over the place, and your brain is full of fog, the thing that let you absorb all of this without complaint stops absorbing.
• 28:56
  SPEAKER_00: And so you start to question everything.
• 28:58
  SPEAKER_00: And for a great many women, this is the first time in their entire adult life that they have questioned any of it.
• 29:06
  SPEAKER_00: Not just the load, everything.
• 29:08
  SPEAKER_00: Am I happy?
• 29:09
  SPEAKER_00: Have I been happy?
• 29:11
  SPEAKER_00: What have I actually done with the last 20 years?
• 29:14
  SPEAKER_00: Is this it?
• 29:14
  SPEAKER_00: Do I still love my partner?
• 29:16
  SPEAKER_00: Or have I just been too busy and too tired to check?
• 29:19
  SPEAKER_00: Is any of what I do even noticed?
• 29:23
  SPEAKER_00: And what comes up is not one feeling, it's all of them in waves and in no sensible order.
• 29:29
  SPEAKER_00: Rage, then a terrible sadness, then frustration, then that specific hollow ache of feeling take it for granted, of realizing you cannot remember the last time anyone said thank you for something they didn't even know that you did.
• 29:44
  SPEAKER_00: Then despair, and then sometimes nothing at all.
• 29:48
  SPEAKER_00: Just flat grey apathy, which unsettles a lot of women more than the rage does.
• 29:54
  SPEAKER_00: And running underneath all of it?
• 29:57
  SPEAKER_00: This is unfair.
• 29:58
  SPEAKER_00: It just is.
• 29:59
  SPEAKER_00: It feels like an injustice, and I'm not going to talk you out of that because I don't think you're wrong.
• 30:04
  SPEAKER_00: Now let me talk about the part that breaks women's hearts, because this is the bit I hear most often, and almost never outside a private conversation.
• 30:13
  SPEAKER_00: You ask for help proper.
• 30:15
  SPEAKER_00: You sit them down and you try to explain that you're not yourself, that something is happening in your body, that you're drowning and you need things to change.
• 30:24
  SPEAKER_00: It's a hard conversation, and you've probably rehearsed it.
• 30:27
  SPEAKER_00: And maybe for a few days it works.
• 30:30
  SPEAKER_00: Everyone steps up, someone unstacks the dishwasher without being asked, and you feel a flicker of relief.
• 30:36
  SPEAKER_00: And then it goes back.
• 30:38
  SPEAKER_00: None of it out of malice.
• 30:40
  SPEAKER_00: That's the maddening part.
• 30:41
  SPEAKER_00: Nobody decides to stop.
• 30:43
  SPEAKER_00: It just quietly reverts to how it's been for 15 years, because that's the shape the household has always been, and you're the only person for whom the arrangement is unbearable.
• 30:54
  SPEAKER_00: So you ask again, and maybe it works again for a bit, and then it reverts again.
• 30:59
  SPEAKER_00: And every single time that happens, something in you gets a little quieter, because it stops being about the dishwasher, it starts being about what that means.
• 31:08
  SPEAKER_00: You told them you were drowning, it wasn't enough to make anything change, that you are not important enough to anyone for them to hold a new habit for more than a fortnight.
• 31:19
  SPEAKER_00: More unseen, more unheard, more taken for granted, and more heartbroken.
• 31:25
  SPEAKER_00: And then you do the math, you look at all of it, the list, the holding, the asking, the reverting, and you think, am I supposed to do this for another 20 years?
• 31:35
  SPEAKER_00: That thought on a bad day in a body with no energy and no sleep and no buffer left is one of the bleakest thoughts a woman can have.
• 31:45
  SPEAKER_00: So let me say the thing I think you need to hear.
• 31:48
  SPEAKER_00: That reckoning is not you being ungrateful, and it's not you turning into a bitter person.
• 31:54
  SPEAKER_00: It is a genuinely capable woman finally seeing the size of what she's been carrying.
• 31:59
  SPEAKER_00: At the precise moment she no longer has the chemistry to carry it quietly.
• 32:04
  SPEAKER_00: Both halves of that are real.
• 32:06
  SPEAKER_00: The load was always unfair, and your ability to absorb it has changed.
• 32:11
  SPEAKER_00: You're not imagining either one.
• 32:13
  SPEAKER_00: And that's where relationships come into it.
• 32:16
  SPEAKER_00: I understand, I really do, why so many women arrive at this point and start to think quite seriously that they would be better off on their own.
• 32:24
  SPEAKER_00: When you've asked over and over and nothing has permanently changed, being alone can start to look less lonely than being in the room with someone who doesn't see you.
• 32:34
  SPEAKER_00: And for some women, managing a partner starts to feel like one more item on the list, another person to be organized, another set of needs to anticipate.
• 32:44
  SPEAKER_00: And resentment grows in that soil very fast.
• 32:47
  SPEAKER_00: I'm not going to tell you what to do with that.
• 32:49
  SPEAKER_00: It's your life and you're the one living it.
• 32:52
  SPEAKER_00: But I will say two things.
• 32:54
  SPEAKER_00: First, please say the hard part out loud to your partner, in plain words, on a good day, not in the middle of a crash at 11 at night.
• 33:03
  SPEAKER_00: And not I need more help.
• 33:05
  SPEAKER_00: Something closer to, I am not okay.
• 33:08
  SPEAKER_00: This is hormonal, and I need you to take three things off my list permanently and never hand them back.
• 33:15
  SPEAKER_00: Whole jobs, start to finish, not tasks done when asked, because being asked is the load.
• 33:21
  SPEAKER_00: I'll give you a proper way to do this later in the episode because try communicating better is useless advice, and I'm not going to leave you with it.
• 33:30
  SPEAKER_00: Some partners genuinely have no idea.
• 33:32
  SPEAKER_00: They just don't see what we see, and information can be the bridge.
• 33:37
  SPEAKER_00: The second, and I say this gently, before you make an enormous permanent decision, get the hormonal side of this looked at.
• 33:45
  SPEAKER_00: Not because your feelings aren't real, they are, and the unfairness is real, whatever your estrogen is doing.
• 33:52
  SPEAKER_00: But because it is worth knowing what you actually think about your life when your chemistry isn't shouting over the top of it.
• 33:59
  SPEAKER_00: Some women look again from steadier ground and make exactly the same decision.
• 34:04
  SPEAKER_00: I just want you to make it as you, not in the middle of the worst week of a hormonal crash.
• 34:10
  SPEAKER_00: Now let me show you what's happening underneath all of this because the mechanism is genuinely reassuring.
• 34:16
  SPEAKER_00: Right, let me explain the chemistry because this is the part that took some of the overwhelm out of it for me.
• 34:22
  SPEAKER_00: Back in episode two, we talked about what estrogen actually does, and the headline was that it was not just a reproductive hormone, it has jobs all over your body.
• 34:32
  SPEAKER_00: Well, one of its biggest jobs is in your brain and specifically in the systems that run your mood.
• 34:38
  SPEAKER_00: Your brain talks to itself using messenger chemicals.
• 34:41
  SPEAKER_00: Three of them matter enormously here.
• 34:44
  SPEAKER_00: Serotonin, think of it as your steadiness, your evenness, your ability to let something go.
• 34:50
  SPEAKER_00: Dopamine, that's your drive, your motivation, your capacity to look forward to something and enjoy it when it arrives.
• 34:57
  SPEAKER_00: And noroadrenaline, that's your alertness and your alarm system.
• 35:02
  SPEAKER_00: Now back in episode two, I told you estrogen supports your brain by influencing serotonin and dopamine.
• 35:09
  SPEAKER_00: Today I want to show you what that actually means for how you feel, because it's the difference between a fact and an explanation.
• 35:16
  SPEAKER_00: Estrogen helps your brain make serotonin and it helps serotonin work properly once it's made.
• 35:23
  SPEAKER_00: It has a generally encouraging effect on your dopamine system too.
• 35:27
  SPEAKER_00: So estrogen in your brain is a bit like the person who keeps the lights on and the music playing.
• 35:33
  SPEAKER_00: And in perimenopause, that person starts flicking the switches on and off at random.
• 35:38
  SPEAKER_00: And here's where I want to take something you've heard me say before and finally show you why it matters so much.
• 35:44
  SPEAKER_00: I've told you from episode one that in perimenopause your hormones don't decline in a tidy line.
• 35:50
  SPEAKER_00: They surge and crash.
• 35:52
  SPEAKER_00: Well, here's the payoff.
• 35:54
  SPEAKER_00: For your mood, it is not the low estrogen alone that does the damage.
• 35:58
  SPEAKER_00: It's the swinging.
• 35:59
  SPEAKER_00: Your brain is remarkably good at adjusting to a new level.
• 36:03
  SPEAKER_00: What it can't cope with is a supply that surges and crashes with no warning and no pattern.
• 36:09
  SPEAKER_00: That's why post-menopausal women, women whose estrogen is lower but steady, often feel emotionally more settled than perimenopausal women whose levels are still surging all over the place.
• 36:21
  SPEAKER_00: Low and steady your brain can work with.
• 36:24
  SPEAKER_00: High, low, high, low, crash, bang.
• 36:27
  SPEAKER_00: That's the bit that takes you apart.
• 36:29
  SPEAKER_00: And this is where it leaks straight back to something we've talked about before.
• 36:33
  SPEAKER_00: Remember what I've called a hormonal crash where the fog and the headaches and the fatigue and the low mood and the broken sleep all pile in together with no pattern.
• 36:43
  SPEAKER_00: And it still happens even on HRT as it does to me.
• 36:47
  SPEAKER_00: This is the same phenomenon seen from the mood side.
• 36:50
  SPEAKER_00: That crash isn't you failing to cope.
• 36:53
  SPEAKER_00: That's a chemical drop and your mood is riding it.
• 36:56
  SPEAKER_00: There's a second piece, and this one I find really helpful.
• 37:00
  SPEAKER_00: Your brain doesn't just make those feel-good messenger chemicals, it also clears them away again once they've done their job.
• 37:06
  SPEAKER_00: Think of it like a tap and a drain.
• 37:09
  SPEAKER_00: Estrogen keeps the tap running nicely and it also keeps the drain at a sensible size.
• 37:15
  SPEAKER_00: When estrogen drops away, two things happen at once.
• 37:18
  SPEAKER_00: The tap slows down, so you're making less, and the brain scans of perimenopausal women show the drain opens wider.
• 37:26
  SPEAKER_00: So what you do get gets cleared away faster than what it used to.
• 37:30
  SPEAKER_00: So we have less coming in, more going out, and that's why the good feelings don't seem to stick around the way they used to.
• 37:37
  SPEAKER_00: And then there's progesterone, which we don't talk about nearly enough on the mood side.
• 37:42
  SPEAKER_00: Progesterone breaks down into a compound that works on your brain's own calming system, the same system that anti-anxiety medications target.
• 37:51
  SPEAKER_00: It's your natural brake pedal.
• 37:53
  SPEAKER_00: In perimenopause, progesterone typically drops away earlier and harder than estrogen, so the brake pedal gets soft right at the moment you need it most.
• 38:02
  SPEAKER_00: I'll be honest that the research on this specific piece is still developing rather than settled, but it fits what most Mimen describe precisely.
• 38:11
  SPEAKER_00: That feeling of having lost your buffer, of everything getting to you.
• 38:15
  SPEAKER_00: That I think it's worth understanding.
• 38:18
  SPEAKER_00: Now, one more layer, and it's an important one.
• 38:21
  SPEAKER_00: Some of what you're feeling isn't a direct chemical effect at all.
• 38:24
  SPEAKER_00: It's the sheer accumulative cost of everything perimenopause is doing to you.
• 38:29
  SPEAKER_00: You're not sleeping, you're being woken by night sweats, you're foggy at work, your body's changing in ways you don't recognize, your periods have gone haywire.
• 38:39
  SPEAKER_00: Of course your mood is on the floor.
• 38:41
  SPEAKER_00: And there's good research on both sides of that.
• 38:44
  SPEAKER_00: Evidence that broken sleep and nighttime flushes genuinely do drag your mood down, and equally good evidence that even when you account for all of that, the hormonal effect on mood is still there underneath.
• 38:57
  SPEAKER_00: So it's not one or the other, it's both, and they're stacked, which is actually good news because it means there are more places to intervene.
• 39:05
  SPEAKER_00: Now let's do the bit that really matters practically because this is where women get stuck and where I got stuck for over three years.
• 39:13
  SPEAKER_00: How do you tell the difference between perimenopausal mood changes and clinical depression?
• 39:19
  SPEAKER_00: And my first answer is going to be an honest one.
• 39:22
  SPEAKER_00: Sometimes you can't, and sometimes it's both at once.
• 39:25
  SPEAKER_00: But here are the things that point one way or the other and they're genuinely useful.
• 39:30
  SPEAKER_00: Signs it might be hormonal.
• 39:33
  SPEAKER_00: It fluctuates.
• 39:34
  SPEAKER_00: You get good days and good weeks, not just an unbroken grey.
• 39:38
  SPEAKER_00: If you still have a cycle, it often tracks with it, and it's frequently worse in the week or so beforehand.
• 39:44
  SPEAKER_00: And if you don't have a cycle to track for whatever reason, you won't have that signpost, so you're looking for the fluctuation itself instead.
• 39:53
  SPEAKER_00: Good stretches and bad stretches with no real life reason attached.
• 39:58
  SPEAKER_00: It arrives with the rest of her peri friends, the hot flushes, the broken sleep, the fog, the joint aches.
• 40:05
  SPEAKER_00: It's often more rage and anxiety than classic sadness, and there's usually no obvious life reason for it.
• 40:12
  SPEAKER_00: Nothing's gone wrong, which is exactly what makes it so disorientating.
• 40:17
  SPEAKER_00: Signs it's leading towards clinical depression is that it's more persistent rather than fluctuating.
• 40:24
  SPEAKER_00: Two weeks and more of most days, all day without real relief.
• 40:30
  SPEAKER_00: The flatness and hopelessness are constant.
• 40:33
  SPEAKER_00: It's gone deep into your functioning.
• 40:35
  SPEAKER_00: You're not eating properly, or you're eating everything, you can't get out of bed, you've withdrawn from everyone, you feel worthless, not just tired, and you're finding no pleasure in anything at all for weeks on end.
• 40:49
  SPEAKER_00: And here's the honest headline because I don't want to oversimplify this.
• 40:53
  SPEAKER_00: Perimenopause genuinely does raise your risk of depression.
• 40:56
  SPEAKER_00: That's well established and in good research, and I've linked it in the show notes.
• 41:01
  SPEAKER_00: It's a meaningful increase and it is real, but I want to be careful because you'll see some enormous scary numbers thrown around online.
• 41:08
  SPEAKER_00: And when you actually pull all the good long-term studies together, the increase is more modest than the internet would have you believe.
• 41:16
  SPEAKER_00: It is a real, meaningful, raised risk, but it's not a certainty and it's not a catastrophe.
• 41:22
  SPEAKER_00: And two things are worth knowing about that risk.
• 41:25
  SPEAKER_00: First, and I mentioned this right back in episode one, it applies to women with no prior history of depression at all.
• 41:33
  SPEAKER_00: This can be your first ever episode in your late 40s, out of nowhere.
• 41:37
  SPEAKER_00: That's not a sign you were always fragile and it's finally showing.
• 41:41
  SPEAKER_00: Second, and hold on to this, the elevated risk is concentrated in the transition.
• 41:47
  SPEAKER_00: Once you're through the other side, things settle.
• 41:50
  SPEAKER_00: It comes down again.
• 41:52
  SPEAKER_00: This is a passage, it's not a permanent state.
• 41:55
  SPEAKER_00: Now I'm a coach, a personal trainer, a Pilates instructor, a health coach.
• 42:00
  SPEAKER_00: I'm not a doctor and I'm absolutely not a psychologist.
• 42:03
  SPEAKER_00: So let me be very clear about where my job ends.
• 42:06
  SPEAKER_00: If what you're living with sounds like that second list, please don't spend six months trying to sort it out with better sleep and a walk.
• 42:14
  SPEAKER_00: Go and get proper help.
• 42:16
  SPEAKER_00: Both things can be true.
• 42:17
  SPEAKER_00: It can be hormonally driven and it can need real treatment.
• 42:22
  SPEAKER_00: Getting help doesn't mean you've conceded it's all in your head.
• 42:25
  SPEAKER_00: It means you're treating something that's genuinely hard.
• 42:29
  SPEAKER_00: So let's talk about what to actually do with this because I lost over three years and I would very much like you not to.
• 42:36
  SPEAKER_00: There were things that went wrong in my story.
• 42:39
  SPEAKER_00: I was offered the wrong treatments and the wrong protocols over and over, and underneath that a whole conversation never happened.
• 42:47
  SPEAKER_00: And this happens constantly.
• 42:48
  SPEAKER_00: A woman in her 40s presents with low mood and anxiety and irritability, and because those are mental health symptoms, they're treated as a mental health problem, full stop.
• 42:59
  SPEAKER_00: The hormonal question never gets raised.
• 43:01
  SPEAKER_00: And the maddening thing is that in perimenopause, mood changes are very often the first thing to show up, before the flushes, sometimes years before anything obvious happens to your cycle.
• 43:13
  SPEAKER_00: So here's what I want you to walk in with, and I'd write it down before you go because it's very easy to lose your train of thought once you're in the room.
• 43:21
  SPEAKER_00: One, put your symptoms together, not separately.
• 43:24
  SPEAKER_00: Don't lead with the mood alone.
• 43:26
  SPEAKER_00: Lead with the whole picture.
• 43:28
  SPEAKER_00: My mood has changed, and so has my sleep and my periods and my memory and my body temperature.
• 43:35
  SPEAKER_00: When you present it as a cluster, it looks like what it is.
• 43:38
  SPEAKER_00: When you present the mood on its own, it looks like a mood disorder.
• 43:42
  SPEAKER_00: 2.
• 43:43
  SPEAKER_00: Bring your diary.
• 43:45
  SPEAKER_00: Back in episode 1, I asked you to keep a symptom diary.
• 43:48
  SPEAKER_00: This is exactly what that's for.
• 43:50
  SPEAKER_00: Track your mood alongside your cycle for two or three months.
• 43:54
  SPEAKER_00: If your worst days sit in the same place every month, that's powerful information and it makes the conversation.
• 44:00
  SPEAKER_00: Far shorter.
• 44:02
  SPEAKER_00: 3.
• 44:02
  SPEAKER_00: Ask the question directly, in those words, could this be perimenopause?
• 44:07
  SPEAKER_00: Can we look at that as well?
• 44:09
  SPEAKER_00: You're allowed to ask that.
• 44:10
  SPEAKER_00: You're not being difficult and you're not diagnosing yourself.
• 44:14
  SPEAKER_00: You're asking for something to be considered.
• 44:16
  SPEAKER_00: And as well matters, not instead of as well.
• 44:21
  SPEAKER_00: And if a prescription is offered for your mood or for your sleep, one more question asked kindly.
• 44:27
  SPEAKER_00: Before we start this, can we look at whether my hormones are part of it?
• 44:31
  SPEAKER_00: That's not refusing treatment.
• 44:33
  SPEAKER_00: You might well walk out with the same prescription, and that might be exactly right for you.
• 44:38
  SPEAKER_00: You're just making sure the assessment happens first.
• 44:41
  SPEAKER_00: That is the single thing that was missing from my story for quite some time and from a great many stories in that Senate report.
• 44:50
  SPEAKER_00: I'll add one specific thing for the sleep conversation because it's the one I lost the most years to.
• 44:56
  SPEAKER_00: If insomnia is your main problem, it's worth knowing that Australia's own sleep and GP bodies say the first-line treatment for insomnia isn't medication at all.
• 45:06
  SPEAKER_00: It's a structured program called CBT for insomnia, which we covered properly in episode 5.
• 45:12
  SPEAKER_00: Same position statement says sedating antidepressants are not recommended for insomnia.
• 45:18
  SPEAKER_00: That's not my opinion.
• 45:20
  SPEAKER_00: That's the Royal Australian College of General Practitioners' own signature on a document.
• 45:25
  SPEAKER_00: So if you're offered a tablet for sleep, it is entirely reasonable to ask what else is on the table, including whether progesterone is worth a conversation.
• 45:34
  SPEAKER_00: 4.
• 45:35
  SPEAKER_00: Ask for the basics to be checked.
• 45:37
  SPEAKER_00: Your thyroid, your iron, your ferritin, your B12.
• 45:40
  SPEAKER_00: And I told you last week that low iron in particular will flatten you, and it's extremely common in perimenopause when your periods have gone heavy.
• 45:48
  SPEAKER_00: Five, if you're not getting anywhere, find someone who works in this area.
• 45:54
  SPEAKER_00: Not a fancier doctor, a doctor who's done the training in menopause.
• 45:58
  SPEAKER_00: And as I've already mentioned, the Australasian Menopause Society keeps a public list of practitioners on their website, and it's a very good place to start.
• 46:06
  SPEAKER_00: It is entirely reasonable to seek a second opinion.
• 46:10
  SPEAKER_00: And on hormones and mood, briefly because this is a conversation for you and a knowledgeable practitioner, not a recommendation from me.
• 46:18
  SPEAKER_00: There is genuine evidence that estrogen has an antidepressant effect specifically in perimenopausal women, and the Australasian Menopause Society says so plainly in their own materials.
• 46:30
  SPEAKER_00: Interestingly, the same doesn't appear to hold once women are well past menopause, which fits everything we said about fluctuation being the problem.
• 46:39
  SPEAKER_00: What I want you to take from it is simply this.
• 46:42
  SPEAKER_00: Hormone therapy is a legitimate thing to raise when your mood has changed in perimenopause.
• 46:47
  SPEAKER_00: Not a fringe request, a reasonable question.
• 46:50
  SPEAKER_00: We covered HRT properly in episode three.
• 46:53
  SPEAKER_00: If you want the background before you go.
• 46:56
  SPEAKER_00: And I'll tell you plainly that for me, this is exactly what it turned out to be.
• 47:00
  SPEAKER_00: I want to be careful here because I'm not a doctor and what worked for me may not be what works for you, but it would be dishonest of me to leave it out.
• 47:08
  SPEAKER_00: It took a long time and it took some getting wrong along the way, but eventually I was prescribed a form of estrogen that I could actually tolerate, one that didn't make me feel worse, which had absolutely been my experience before that.
• 47:21
  SPEAKER_00: And then, slowly it started to lift.
• 47:25
  SPEAKER_00: Not overnight.
• 47:26
  SPEAKER_00: I want to be really clear about that because I think women are sold overnight far too often.
• 47:31
  SPEAKER_00: This was over months.
• 47:32
  SPEAKER_00: The fog started to clear a little, my mood started to come up a bit, and then I began getting glimmers, glimmers of feeling like my old self, glimmers of actual joy, little windows where I'd think, oh, there she is.
• 47:47
  SPEAKER_00: That's what it looked like for me.
• 47:49
  SPEAKER_00: Slow and uneven and absolutely worth it.
• 47:52
  SPEAKER_00: And it's why I'll always tell you that the hormonal conversation is worth having and worth pushing for.
• 47:58
  SPEAKER_00: It took me years just to get to the point of having it properly, and then it took nearly another two years of adjusting to get the protocol, the dose, and the delivery right.
• 48:07
  SPEAKER_00: So if you're in that middle bit right now where it's been raised but it isn't working yet, that's not failure.
• 48:14
  SPEAKER_00: That's the process, and it's worth staying with.
• 48:17
  SPEAKER_00: I want to spend a few minutes at the harder end of this carefully because I think you deserve honesty, and I'd rather you heard it from someone who'll put it in proper context.
• 48:27
  SPEAKER_00: For some women, this doesn't stay at low mood.
• 48:30
  SPEAKER_00: It gets to a place where you don't want to be here, where you find yourself thinking that everyone else would be better off or that you just want it all to stop.
• 48:39
  SPEAKER_00: If that's where you are right now, please stop and make a call.
• 48:43
  SPEAKER_00: Lifeline 131114 24 hours a day every day.
• 48:47
  SPEAKER_00: You can text them on 0477 13114 or chat online at lifeline.org.au.
• 48:55
  SPEAKER_00: Beyond blue is 1-300-224636.
• 48:59
  SPEAKER_00: If you're Aboriginal or Torres Strait Islander woman, 13 yarn is 1392 76.
• 49:07
  SPEAKER_00: And in an emergency, it's always triple zero.
• 49:10
  SPEAKER_00: Those are all in the show notes.
• 49:12
  SPEAKER_00: I talked back in episode one about some of the numbers around this stage of life, and I want to touch on them again briefly, carefully, and as a correlation, not a cause.
• 49:23
  SPEAKER_00: In Australia, women in their late 40s and early 50s have had amongst the highest suicide rates of any female age group in recent years.
• 49:31
  SPEAKER_00: And the median age at which Australian women divorce is 44.
• 49:35
  SPEAKER_00: Both of those sit right in the middle of the perimenopausal years.
• 49:39
  SPEAKER_00: Now I'm not going to stand here and tell you menopause causes either of those things, because nobody has proven that.
• 49:46
  SPEAKER_00: Those statistics record a woman's age, they record nothing at all about her hormones.
• 49:51
  SPEAKER_00: Not one national data set in this country connects the two, which tells you plenty on its own about how seriously this has been taken.
• 50:00
  SPEAKER_00: But the timing is worth noticing, and what I do know from the women who I work with in my practice is that this is often the hardest decade of a woman's life, and that a great many of them are going through it with symptoms nobody has explained to them, on top of teenagers, aging parents, a demanding career, and a marriage that's been running 20 years.
• 50:21
  SPEAKER_00: Perimenopause rarely builds the cracks, but it will absolutely show you where they are.
• 50:27
  SPEAKER_00: So here's where I land.
• 50:28
  SPEAKER_00: Suicide is never one thing.
• 50:30
  SPEAKER_00: It's never caused by a single symptom or a single season of life.
• 50:34
  SPEAKER_00: And I don't think a statistic has ever helped anybody at two in the morning anyway.
• 50:39
  SPEAKER_00: But what I will say is this: if perimenopause has taken you somewhere dark, that is not weakness, and it is not you being dramatic.
• 50:48
  SPEAKER_00: It's a signal that you need proper support, and proper support exists, and this is treatable.
• 50:53
  SPEAKER_00: Please make the call or tell one person.
• 50:56
  SPEAKER_00: Not because a number says you're at risk, because you deserve help and because this passes and you need to still be here on the other side of it to find out.
• 51:05
  SPEAKER_00: Someone will pick up.
• 51:07
  SPEAKER_00: That's the entire reason those lines exist.
• 51:10
  SPEAKER_00: And please, before you make an enormous permanent decision in the middle of the very worst of this, get the hormonal side looked at properly.
• 51:18
  SPEAKER_00: Not because your feelings aren't real, they absolutely are, but because it's worth knowing that what you actually think about your life isn't just chemistry shouting over the top of it.
• 51:29
  SPEAKER_00: I'm not going to leave you in the hard place because that's not where this ends.
• 51:33
  SPEAKER_00: And this is the part I want most of you to hear today.
• 51:36
  SPEAKER_00: So if you've been half listening while you fold the washing or try and tick off one of the many things on your never-ending list for today, come back to me for two minutes.
• 51:45
  SPEAKER_00: Perimenopause is a transition.
• 51:47
  SPEAKER_00: It is a passage from one place to another.
• 51:50
  SPEAKER_00: It's not a destination, and it's not who you are now permanently.
• 51:54
  SPEAKER_00: That word transition is not a soft word.
• 51:58
  SPEAKER_00: It's the entire point.
• 51:59
  SPEAKER_00: You're actually going somewhere.
• 52:01
  SPEAKER_00: And here's what women say who've come out the other side over and over, and it genuinely changed how I think about this whole stage of life.
• 52:09
  SPEAKER_00: They don't describe themselves as a diminished version of who they were.
• 52:14
  SPEAKER_00: They describe themselves as a different one.
• 52:16
  SPEAKER_00: And a great many of them will tell you without hesitation that she's better.
• 52:21
  SPEAKER_00: Because think about what actually happened.
• 52:24
  SPEAKER_00: For years, something in you was quietly making it easy to put everybody else first.
• 52:30
  SPEAKER_00: And then that veil lifted, and for the first time in your adult life, you looked at your own life clearly and asked what was actually working, what you're prepared to still carry, and what you're done carrying, what you'd tolerate and what you now don't.
• 52:45
  SPEAKER_00: That process is brutal while you're in it.
• 52:48
  SPEAKER_00: It feels like everything is falling apart.
• 52:50
  SPEAKER_00: But look at what it is.
• 52:52
  SPEAKER_00: It's a woman stripping out everything that stopped making sense.
• 52:56
  SPEAKER_00: The obligations she'd outgrown, the friendships that only ever ran one way, the apologizing, the making herself smaller, the saying yes when every part of her meant no.
• 53:07
  SPEAKER_00: And what's left on the other side is a woman who knows exactly what she wants, who's worked out what her standards are, and who's stopped auditioning for anyone's approval.
• 53:16
  SPEAKER_00: Women describe a confidence in their 50s and 60s that they never had at 30, a clarity about who they want in their life, a directness, a sort of hard-won ease in their own skin.
• 53:29
  SPEAKER_00: Some women describe it as a metamorphosis, and I don't think that's too dramatic a word.
• 53:34
  SPEAKER_00: Something goes into that dark, disorientating, wrapped-up stage, and something comes out the other end that can actually move through the world with confidence and purpose and with a sense of her own worth that maybe she never had before.
• 53:49
  SPEAKER_00: I want to be honest that this isn't automatic and it isn't tidy and nobody hands it to you on the day your period stop.
• 53:56
  SPEAKER_00: Some of it is work and some of it is treatment, and the women who fare best are generally the ones who got support rather than white knuckling it alone, which is the whole reason I do this podcast.
• 54:07
  SPEAKER_00: But it is real and it's worth naming because when you're in the thick of it, nobody tells you there's an after.
• 54:13
  SPEAKER_00: You just get told this is your life now.
• 54:16
  SPEAKER_00: But it isn't.
• 54:17
  SPEAKER_00: Everything you're feeling right now, the questioning, the reckoning, the fury at what's unfair, the grief for who you used to be, that's not the end of you.
• 54:26
  SPEAKER_00: That's the middle of something.
• 54:28
  SPEAKER_00: And I say that as someone who is right in the middle of it too, only recently able to see any light at all, and choosing to believe what the women ahead of me are telling me.
• 54:39
  SPEAKER_00: She's coming.
• 54:40
  SPEAKER_00: Give her time.
• 54:42
  SPEAKER_00: Right.
• 54:42
  SPEAKER_00: Practical.
• 54:43
  SPEAKER_00: And I want to say up front that none of this is instead of getting proper help.
• 54:47
  SPEAKER_00: It's what you're doing alongside it.
• 54:50
  SPEAKER_00: Movement.
• 54:50
  SPEAKER_00: And I'm going to be specific because the specifics matter here.
• 54:54
  SPEAKER_00: I want to be really clear about something first, because I'm not here to talk anybody out of medication.
• 54:59
  SPEAKER_00: Antidepressants save lives.
• 55:01
  SPEAKER_00: If you need them, take them, and there's no shame in that ever.
• 55:05
  SPEAKER_00: But I also don't want you walking out of an appointment with a script and nothing else.
• 55:10
  SPEAKER_00: Because that's not what the guidelines actually say should happen.
• 55:13
  SPEAKER_00: Here's what they say: the Royal Australian and New Zealand College of Psychiatrics, our own psychiatrist, not a wellness website, describe attending to lifestyle, and they name sleep, diet, exercise, and alcohol as a necessary first step in the management of major depression.
• 55:32
  SPEAKER_00: A first step.
• 55:33
  SPEAKER_00: Their framework is actions first, lifestyle and psychological support, and then medication if that hasn't got you there.
• 55:41
  SPEAKER_00: The UK's national guidelines go further and say it outright.
• 55:45
  SPEAKER_00: For less severe depression, do not routinely offer antidepressants as the first-line treatment unless that's what the person actually wants.
• 55:53
  SPEAKER_00: And the Canadian guidelines list supervised exercise as a first-line treatment on its own for mild depression at their highest level of evidence.
• 56:02
  SPEAKER_00: And here's the one that's about us specifically.
• 56:05
  SPEAKER_00: The UK menopause guideline states that there is no clear evidence that SSRIs or SNRIs ease low mood in menopause or women who haven't been diagnosed with depression.
• 56:17
  SPEAKER_00: So for our particular symptoms, the evidence isn't there.
• 56:21
  SPEAKER_00: So when a woman turns up at 46, exhausted, flat, not sleeping, and walks out 10 minutes later with a prescription and no other conversation, that isn't best practice.
• 56:32
  SPEAKER_00: That's assistant running on six-minute appointments.
• 56:36
  SPEAKER_00: I'm not telling you to refuse anything.
• 56:38
  SPEAKER_00: I'm telling you the floor is supposed to be laid first, and most of us were never offered it.
• 56:43
  SPEAKER_00: And the one caveat I will never skip.
• 56:46
  SPEAKER_00: If you are severely depressed, if you can't function, if you're not safe, that is a different situation, and you get proper help today.
• 56:55
  SPEAKER_00: Exercise is not the answer to that, and I'd never pretend it was.
• 56:59
  SPEAKER_00: Now, two findings in the exercise research that I think are enormously relevant to us.
• 57:05
  SPEAKER_00: The first is that strength training in particular came out better for women than for men in that research.
• 57:11
  SPEAKER_00: The second is that resistance training has its own separate evidence for anxiety, and that one was done in a group that was two-thirds women around our age.
• 57:20
  SPEAKER_00: So when I tell you to lift weights, this is not me being a personal trainer who's a one-trick pony.
• 57:25
  SPEAKER_00: This is one of the best evidence things you can do for your mood, and it's the one most likely to work for us specifically.
• 57:33
  SPEAKER_00: I'll be honest about the quality because I always will be.
• 57:37
  SPEAKER_00: Many of the individual studies behind this aren't the highest grade of research, so treat the exact numbers loosely, but the direction is consistent and it lines up with what I see in real women.
• 57:48
  SPEAKER_00: Two or three proper sessions a week, challenging, not the little pink dumbbells.
• 57:53
  SPEAKER_00: And walking, plain ordinary walking came out strongly too, and it caused nothing and it needs no equipment.
• 58:00
  SPEAKER_00: Here's the thing I most want to say about all of it though.
• 58:03
  SPEAKER_00: On the days you feel like this, exercise is the last thing on earth you want to do, and the motivation is exactly what's been taken from you.
• 58:11
  SPEAKER_00: So don't wait to feel like it.
• 58:13
  SPEAKER_00: That feeling is not coming.
• 58:15
  SPEAKER_00: Make it small and make it non-negotiable.
• 58:18
  SPEAKER_00: Ten minutes out the front door.
• 58:20
  SPEAKER_00: The mood follows the movement, not the other way around.
• 58:24
  SPEAKER_00: Morning light, this one is free, takes 10 minutes, and I think it's badly underrated.
• 58:30
  SPEAKER_00: There's solid research showing that people with more morning daylight exposure have lower rates of depression, and more convincingly, that bright light used properly is an effective treatment for depression that has nothing to do with the seasons.
• 58:44
  SPEAKER_00: Get outside within an hour of waking.
• 58:47
  SPEAKER_00: 15 or 20 minutes, no sunglasses, doesn't need to be sunny.
• 58:51
  SPEAKER_00: It steadies your body clock, which helps your sleep, which helps your mood.
• 58:55
  SPEAKER_00: Three birds, one stone.
• 58:59
  SPEAKER_00: Talking therapy and specifically CBT.
• 59:03
  SPEAKER_00: Cognitive behavioural therapy is practical, structured, and secular.
• 59:07
  SPEAKER_00: It's not lying on a couch discussing your childhood.
• 59:10
  SPEAKER_00: It's learning to catch and challenge thoughts and change what you actually do.
• 59:15
  SPEAKER_00: The UK's national clinical guidelines say, word for word, to consider CBT for low mood or anxiety arising from menopause.
• 59:24
  SPEAKER_00: That's an official recommendation, not a wellness suggestion.
• 59:28
  SPEAKER_00: Two Australian routes.
• 59:30
  SPEAKER_00: Your GP can write you a mental health treatment plan which gives you up to 10 Medicare subsidised psychology sessions per calendar year.
• 59:38
  SPEAKER_00: And there's This Way Up, an online CBT program run by St.
• 59:42
  SPEAKER_00: Vincent Hospital and the University of New South Wales.
• 59:45
  SPEAKER_00: So it's clinical and it's proper.
• 59:47
  SPEAKER_00: The courses are around$59 or free if your GP or psychologist prescribes it.
• 59:54
  SPEAKER_00: Ask for the depression or the mixed depression and anxiety course.
• 59:57
  SPEAKER_00: It's all in the show notes.
• 1:00:00
  SPEAKER_00: Sleep.
• 1:00:01
  SPEAKER_00: I'm not doing the whole episode again.
• 1:00:03
  SPEAKER_00: Go back to episode five, but I have to say it because sleep and mood are a loop that runs in both directions.
• 1:00:10
  SPEAKER_00: Bad sleep flattens your mood, low mood wrecks your sleep, and round and round it goes.
• 1:00:15
  SPEAKER_00: If one thing in your life is broken and you can only fix one, fix this one.
• 1:00:21
  SPEAKER_00: Alcohol, and I'm sorry, I know the wine at six o'clock is holding a lot of women together right now, but here's what it's actually doing: it gets you to sleep faster, which is why it feels like it helps, and then it takes the second half of your night apart, which is the exact half perimenopause is already coming for.
• 1:00:39
  SPEAKER_00: And there's good evidence that relationship with low mood runs the way you'd least like it to.
• 1:00:44
  SPEAKER_00: Heavy drinking makes depression worse, not the other way around.
• 1:00:49
  SPEAKER_00: And I'm not going to give you a number because I don't think a number helps here, and I'm not about to sit here as a health coach telling you what you're allowed.
• 1:00:56
  SPEAKER_00: What I would give you is the Australian Guidelines own line because it's the useful part.
• 1:01:01
  SPEAKER_00: The document is literally titled Guidelines to Reduce Health Risks from Drinking Alcohol.
• 1:01:06
  SPEAKER_00: And what it says is this the less you drink, the lower your risk of harm.
• 1:01:11
  SPEAKER_00: And on your brain specifically, there's a study of nearly 37,000 people with actual brain scans, and the difference in brain volume shows up in people drinking just one or two drinks a day.
• 1:01:24
  SPEAKER_00: Going from one day to two was associated with roughly two years' worth of brain aging.
• 1:01:29
  SPEAKER_00: Now that's an association and not proof, and it's scans rather than symptoms, but it's a lot of people, and there's no point on that line where it goes flat.
• 1:01:39
  SPEAKER_00: I'm not telling you to be a saint.
• 1:01:41
  SPEAKER_00: I'm telling you that if you're anxious and not sleeping, that this is one of the fastest changes you'll ever feel.
• 1:01:48
  SPEAKER_00: Food, briefly, because we did this properly last week, and it's the same answer.
• 1:01:53
  SPEAKER_00: Protein at every meal, plenty of plants, oily fish, lots of fibre, and stop riding the blood sugar roller coaster.
• 1:02:01
  SPEAKER_00: A brain on spikes and crashes is not a brain with an even temper.
• 1:02:06
  SPEAKER_00: Other people.
• 1:02:07
  SPEAKER_00: And this one is quietly the most important thing I'm going to say today.
• 1:02:11
  SPEAKER_00: When you feel like this, you withdraw, you cancel, you go quiet on the group chat, you stop putting your hand up, and it makes complete sense.
• 1:02:20
  SPEAKER_00: You don't feel like yourself and you haven't got the energy to perform being fine.
• 1:02:25
  SPEAKER_00: But loneliness is not just a consequence of low mood.
• 1:02:29
  SPEAKER_00: There is very solid research showing that being persistently lonely roughly doubles your risk of developing depression.
• 1:02:36
  SPEAKER_00: It's a cause, not only a symptom.
• 1:02:38
  SPEAKER_00: So the withdrawal that feels like self-protection is quietly making it worse.
• 1:02:43
  SPEAKER_00: I'm not asking you to be social.
• 1:02:45
  SPEAKER_00: I'm asking you to keep one thread, one friend, one walk a week with someone who knows.
• 1:02:51
  SPEAKER_00: And if you can, tell one person the truth.
• 1:02:54
  SPEAKER_00: Not the, oh, I'm fine, but tired and wired version.
• 1:02:58
  SPEAKER_00: The real one.
• 1:02:59
  SPEAKER_00: Saying it out loud takes an extraordinary amount of weight off, and it's usually the moment you find out she's been going through the same thing and hasn't said it either.
• 1:03:08
  SPEAKER_00: And now the big one, actually shifting the load.
• 1:03:12
  SPEAKER_00: I promised you I'd come back to this because telling a drowning woman to communicate better is not help.
• 1:03:18
  SPEAKER_00: First, so you know you're not imagining the imbalance, these are the government's own numbers, not somebody's campaign.
• 1:03:26
  SPEAKER_00: An Australian woman in a couple with a child under 15 does 47 hours a week of unpaid work and care.
• 1:03:33
  SPEAKER_00: 47.
• 1:03:35
  SPEAKER_00: That's a full-time job, and then some, sitting on top of whatever paid work she's already doing.
• 1:03:40
  SPEAKER_00: And when the census asked everyone directly, three and a half times as many women as men reported doing 30 hours or more of unpaid domestic work every week.
• 1:03:50
  SPEAKER_00: That's not an average anyone has massaged.
• 1:03:53
  SPEAKER_00: That's a headcount.
• 1:03:54
  SPEAKER_00: Then there's the one that names the invisible part.
• 1:03:57
  SPEAKER_00: Women usually or always coordinate the children's activities 78% of the time.
• 1:04:04
  SPEAKER_00: Coordinating isn't doing.
• 1:04:06
  SPEAKER_00: That's the mental load sitting in a government statistic.
• 1:04:10
  SPEAKER_00: Now, four things that actually work, and I've picked these because there's something real behind each one.
• 1:04:16
  SPEAKER_00: One, stop asking for help with tasks.
• 1:04:19
  SPEAKER_00: Hand over whole territories.
• 1:04:21
  SPEAKER_00: There's a framework called Fair Play by a woman named Eve Rodsky.
• 1:04:26
  SPEAKER_00: It's a book and a deck of about a hundred cards, and the cards are awesome.
• 1:04:30
  SPEAKER_00: Every household responsibility is on a card, and whoever holds the card owns all three parts of it.
• 1:04:36
  SPEAKER_00: Noticing it needs doing, working out how, and actually doing it.
• 1:04:41
  SPEAKER_00: Not put the bins out, the whole domain.
• 1:04:45
  SPEAKER_00: Rubbish and recycling, which bin, which week, buying the bags, dealing with the council.
• 1:04:51
  SPEAKER_00: In Rodsky's own example, her husband took over the kids' sport, the entire thing.
• 1:04:57
  SPEAKER_00: The registrations, the forms, snacks, carpels, and it gave her back eight hours a week.
• 1:05:03
  SPEAKER_00: Here's the test, and I want you to hold on to it.
• 1:05:06
  SPEAKER_00: If you still have to remember it, you still own it.
• 1:05:10
  SPEAKER_00: You don't need to buy anything to do this.
• 1:05:12
  SPEAKER_00: Sticky notes and a kitchen table works great.
• 1:05:15
  SPEAKER_00: Write every recurring responsibility on its own note, and please include the invisible ones.
• 1:05:20
  SPEAKER_00: The birthdays, the appointments, the school emails, the gifts, when the car's due, then lay them all out where both of you can see.
• 1:05:29
  SPEAKER_00: For a lot of couples, that moment is the entire intervention.
• 1:05:33
  SPEAKER_00: They may genuinely have not seen the size of it before.
• 1:05:37
  SPEAKER_00: If you'd rather have the actual cards, they're about$30 in Australia and easy to get.
• 1:05:42
  SPEAKER_00: One warning though, search Eve Rodsky Fairplay because the Fairplay app brings up gambling sites, and there's an unrelated Netflix film by the same name that is very much not what you're after.
• 1:05:55
  SPEAKER_00: And I'll be straight with you about it.
• 1:05:56
  SPEAKER_00: As always, the fair play method has only been formerly.
• 1:06:00
  SPEAKER_00: Evaluated once and around three-quarters of the couples who signed up to try it didn't see it through.
• 1:06:06
  SPEAKER_00: I'm telling you that because it's the actual lesson here.
• 1:06:09
  SPEAKER_00: What defeats these systems usually isn't a partner who disagrees with them.
• 1:06:14
  SPEAKER_00: It's everyone quietly stopping or giving up.
• 1:06:17
  SPEAKER_00: Two, agree what done looks like before it changes hands.
• 1:06:22
  SPEAKER_00: This is the piece everyone skips and it's why handovers collapse.
• 1:06:26
  SPEAKER_00: Both of you agree up front what finished looks like and why it matters.
• 1:06:31
  SPEAKER_00: Then, and this is the hard bit, you stop checking.
• 1:06:34
  SPEAKER_00: Because if you hand it over and then hover, you haven't handed anything over.
• 1:06:39
  SPEAKER_00: You've just added supervising to your list.
• 1:06:42
  SPEAKER_00: Negotiate the standard at the start so you're not enforcing it forever.
• 1:06:46
  SPEAKER_00: Three, get it out of your mouth and onto paper.
• 1:06:50
  SPEAKER_00: A conversation is not a system.
• 1:06:52
  SPEAKER_00: There's very solid research showing that a vague intention, like I'll do more around the house, achieves close to nothing, while a specific plan naming who, what, and when has a substantial effect.
• 1:07:06
  SPEAKER_00: So, you own school lunches every weeknight, including buying the food, written down, on the fridge or in a shared app or on the cards.
• 1:07:15
  SPEAKER_00: The medium doesn't matter, but it needs to be visible and specific.
• 1:07:20
  SPEAKER_00: And here's why this matters more than it sounds.
• 1:07:23
  SPEAKER_00: The old arrangement wasn't just laziness, it was a system that ran without anyone having to think.
• 1:07:29
  SPEAKER_00: If you remove it and don't put a new system in place, the moment life gets stressful, the household will snap straight back to the default.
• 1:07:37
  SPEAKER_00: That's exactly why the change never sticks.
• 1:07:40
  SPEAKER_00: Four, book the review before you need it.
• 1:07:43
  SPEAKER_00: Fifteen minutes, a family meeting or a meeting just you and your partner, same time every week, in the calendar, and not a Sunday night, and not when anybody's angry.
• 1:07:54
  SPEAKER_00: This is the highest value habit in the whole list because it catches the slow slide back while the slips are still small enough to mention it without a fight.
• 1:08:02
  SPEAKER_00: Because that's how it reverts, by the way, and I found this genuinely clarifying.
• 1:08:07
  SPEAKER_00: There's sociology on it.
• 1:08:09
  SPEAKER_00: Couples don't argue their way back to old patterns, they reason their way back, one perfectly sensible exception at a time.
• 1:08:16
  SPEAKER_00: Work's busy this month, the kids had a thing.
• 1:08:19
  SPEAKER_00: Nobody's lying, and nobody decided anything.
• 1:08:23
  SPEAKER_00: That default just quietly reforms.
• 1:08:25
  SPEAKER_00: A short weekly check-in is what catches that.
• 1:08:29
  SPEAKER_00: Two more things.
• 1:08:30
  SPEAKER_00: If your partner won't engage with any of this, the answer isn't a better card system.
• 1:08:35
  SPEAKER_00: It's Relationships Australia.
• 1:08:37
  SPEAKER_00: They're government funded, and here in Queensland, it's around$75 a session or$35 concession.
• 1:08:43
  SPEAKER_00: That's a fraction of private costs.
• 1:08:46
  SPEAKER_00: The number's 1-300-364-2777, and it's in the show notes.
• 1:08:51
  SPEAKER_00: And if you're doing this all on your own, either solo or with a partner who isn't going to change, then redistributing isn't available to you, and I'm not going to pretend otherwise.
• 1:09:02
  SPEAKER_00: What helps there is lowering the bar without shame, and there's a very good, very kind book by a counsellor called KC Davis called How to Keep House While Drowning, written for people who are already underwater.
• 1:09:15
  SPEAKER_00: Also in the show notes.
• 1:09:17
  SPEAKER_00: So four things to do this week.
• 1:09:20
  SPEAKER_00: One, name it out loud to one person.
• 1:09:23
  SPEAKER_00: Whoever's safest, your partner, your sister, your closest friend, your GP.
• 1:09:28
  SPEAKER_00: Say the true version.
• 1:09:29
  SPEAKER_00: If you can't say it, send it in a message.
• 1:09:32
  SPEAKER_00: Getting it out of your head is where this starts.
• 1:09:35
  SPEAKER_00: Two, move and get outside doing it.
• 1:09:38
  SPEAKER_00: Ten minutes of daylight in the morning and two sessions this week where you make your muscles work.
• 1:09:44
  SPEAKER_00: Not to change your body, to change your chemistry.
• 1:09:47
  SPEAKER_00: 3.
• 1:09:48
  SPEAKER_00: Book the appointment and go in with the whole picture.
• 1:09:51
  SPEAKER_00: Mood, sleep, cycle, memory, temperature, and the question, could this be perimenopause as well?
• 1:09:58
  SPEAKER_00: Take your diary, ask your thyroid and iron and ferritin and B12 to be checked.
• 1:10:03
  SPEAKER_00: And ask about your options, including hormones, with someone who understands menopause.
• 1:10:08
  SPEAKER_00: 4.
• 1:10:09
  SPEAKER_00: Do the sticky notes.
• 1:10:11
  SPEAKER_00: 20 minutes, a pad of notes, and a kitchen table.
• 1:10:14
  SPEAKER_00: Every recurring responsibility in your house on its own note, including all the invisible ones.
• 1:10:20
  SPEAKER_00: Lay them out where someone else can see them.
• 1:10:22
  SPEAKER_00: You don't have to solve it this week.
• 1:10:24
  SPEAKER_00: Just make it visible because you cannot renegotiate something that nobody can see.
• 1:10:29
  SPEAKER_00: And if you're somewhere heavier than all of that, please make it one call instead.
• 1:10:34
  SPEAKER_00: Lifeline 131114.
• 1:10:37
  SPEAKER_00: Everything I've talked about today is backed by research, and I've linked it all in the show notes.
• 1:10:42
  SPEAKER_00: So if you want to read it yourself or take it to your doctor, it's right there.
• 1:10:46
  SPEAKER_00: Here's where I want to leave you today.
• 1:10:48
  SPEAKER_00: If you've spent months or years quietly believing you've become a worse person, angrier, colder, smaller, less able to cope than the woman you used to be, I want you to consider seriously that you might just be a woman whose chemistry has changed underneath without anyone telling her it would.
• 1:11:07
  SPEAKER_00: You have not lost your warmth.
• 1:11:09
  SPEAKER_00: You have not lost your patience.
• 1:11:11
  SPEAKER_00: You have not stopped loving your family.
• 1:11:14
  SPEAKER_00: Those things are all still in there, and I say that as someone who is still right in the middle of it, still crushing, still apologizing to my kids some nights.
• 1:11:23
  SPEAKER_00: It's not a straight line out, but it does move.
• 1:11:26
  SPEAKER_00: I know that now because mine has started to.
• 1:11:29
  SPEAKER_00: And if I could go back and tell myself one thing, it would be this.
• 1:11:33
  SPEAKER_00: Ask the hormonal question.
• 1:11:35
  SPEAKER_00: Ask it early, ask it loud, and ask it again and again if nobody answers you.
• 1:11:41
  SPEAKER_00: Not instead of mental health treatment, alongside it.
• 1:11:45
  SPEAKER_00: You may need both, and there's no shame in either.
• 1:11:48
  SPEAKER_00: And then hold on to the thing that I told you about the other side.
• 1:11:52
  SPEAKER_00: You are not at the end of yourself.
• 1:11:54
  SPEAKER_00: You're a woman in the middle of a transition, and there is a version of you waiting past it who knows exactly what she wants and has stopped apologizing for it.
• 1:12:03
  SPEAKER_00: I haven't met mine yet either, but I've decided to believe the woman who tells me she's well worth the wait.
• 1:12:09
  SPEAKER_00: Please be gentle with yourself this week.
• 1:12:12
  SPEAKER_00: You're managing something invisible with no time off and mostly without anyone noticing.
• 1:12:17
  SPEAKER_00: And that deserves some kindness from you, of all people.
• 1:12:21
  SPEAKER_00: Next week we're changing gear completely.
• 1:12:24
  SPEAKER_00: We're going to talk about weight, the belly fat that arrived out of nowhere, why eating and exercise that worked for your whole life suddenly stopped working, and what actually shifts it now.
• 1:12:34
  SPEAKER_00: That is squarely my wheelhouse after nearly 30 years in the industry, and there's a great deal of nonsense out there I'm looking forward to clearing up.
• 1:12:41
  SPEAKER_00: If today's episode spoke to you, please share it.
• 1:12:45
  SPEAKER_00: Send it to the woman you know who's been quiet lately, or the one who's been apologizing for her temper.
• 1:12:50
  SPEAKER_00: She might need to hear that it isn't her fault.
• 1:12:53
  SPEAKER_00: And please subscribe and leave a review.
• 1:12:55
  SPEAKER_00: For a show like What the Perry, it's the single best way to reach the women who need it.
• 1:13:00
  SPEAKER_00: I'm so glad you're here.
• 1:13:02
  SPEAKER_00: Look after yourself, and I'll see you next week.
• 1:13:09
  SPEAKER_00: Everything I've mentioned today is referenced in the show notes along with all the links.
• 1:13:14
  SPEAKER_00: And you can find me at Kirstencookcoaching.com.
• 1:13:18
  SPEAKER_00: Just a reminder, though, this is education, not medical advice.
• 1:13:22
  SPEAKER_00: So take these conversations to a practitioner who will actually listen to you.
• 1:13:27
  SPEAKER_00: Thank you so much for being here and for listening to the What the Perry podcast.
• 1:13:32
  SPEAKER_00: The change you didn't the conversations you need.