Anxiety is one of the most common symptoms of Pre-Menstrual Syndrome (PMS), post-childbirth, and perimenopause (the period of time before the onset of menopause). It may take the form of panic attacks, nervousness, sweating, intense fear, anxiety combined with depression, or other overwhelming symptoms. 

Here are several periods of hormonal change that can intensify or trigger anxiety in women. 

Puberty — Developing girls experience hormonal changes as they prepare to begin their reproductive years. 

Monthly menstrual cycle — Often girls and women experience PMS the week before their period. 

Following childbirth — The severe drop in certain hormones following childbirth can cause dramatic physical symptoms and a temporary feeling of depression or anxiety; in some women, it is prolonged.

Perimenopause — Perimenopause is the period of time when the body is approaching menopause. It may last from two to ten years. During this time the menstrual cycle becomes irregular as the hormone levels keep fluctuating, causing some women to experience PMS-like symptoms.

Although many of us may use the term “going through menopause” to describe this period of time, it is actually called perimenopause. Many women experience panic attacks for the first time during perimenopause. Other symptoms such as insomnia, hot flashes, rapid heartbeat, and sweating are also common. 

With surgical menopause (hysterectomy), you’ll likely experience perimenopausal symptoms after the surgery, even if you did not experience symptoms prior to surgery. Symptoms can be prolonged and are due to the dramatic and sudden decrease of certain hormones as a result of the hysterectomy.  

In non-surgical circumstances, menopause occurs after a woman has no periods for twelve consecutive months. It lasts only one day. Many women report feeling better than ever mentally and physically after menopause, due to the fact that hormone levels stabilize.

Hormonal Change Triggers the Fight Or Flight Response

Due to the fact that hormonal change causes physical and psychological stress, it triggers our “fight or flight” response. The fight or flight response is the body’s inborn, self-protective response to perceived danger. 

When we perceive that we are under stress, our bodies send out a rush of cortisol, adrenaline, and other brain chemicals to prepare us to “fight” or “flee” the danger. 

The fight or flight response triggers the physiological changes that we associate with anxiety, such as rapid heartbeat, increased blood pressure, sweating, muscle tension, narrowed mental focus, heightened emotion, and many other symptoms. 

These are the same physical sensations that many women experience when their hormone levels fluctuate. In other words, most of the symptoms women experience during times of hormonal change are really fight or flight reactions. While these physical sensations are not dangerous, they can be very intense and overwhelming.

Our fight or flight response mechanism can become “hypersensitive” with the various hormonal changes in our bodies that take place from puberty to menopause. Many of us are in a constant state of stress due to our lifestyle and thought patterns, which also causes hypersensitivity.

In other words, our bodies may be stuck in the “on” switch of fight or flight. What normally wouldn’t trigger symptoms, now initiates symptoms and perpetuates an ongoing cycle. 

Fight or flight reactions in and of themselves are harmless. However, when our thoughts convince our rational minds that these symptoms are scary and dangerous, we create an anxiety cycle.

Anxiety consists of more than fight or flight reactions acting by themselves. Unproductive thoughts play a critical role in creating and perpetuating the anxiety we experience.

Our thoughts convert fight or flight reactions into anxiety, and a self-perpetuating cycle begins. Soon we find ourselves limiting our behaviors because of anxiety as well, which further entrenches the vicious cycle.

When a person is under stress, unresolved emotions and issues commonly come to the forefront. Because hormonal change is a major stressor, it can bring up internal conflicts and self-doubt in many areas of our lives. All of a sudden, we may find that the negative self-talk that we successfully pushed to the background of our lives during less stressful times is now playing center stage. 

During periods of hormonal change, we may also feel uncertain about our changing roles (e.g. maturing from girl to woman, becoming a mother, becoming a mature woman past childbearing years), which can add to our internal conflict. 

When we fail to successfully resolve internal conflicts and the unhelpful thought patterns that contribute to them, we create a breeding ground for anxiety. Combined with fight or flight symptoms, it’s no wonder that these unproductive thoughts create and perpetuate the anxiety cycle! 

What can you do if hormone-related anxiety affects you?

Here’s some great news! The same tools that you can use to overcome anxiety due to other reasons can help you to conquer anxiety related to hormonal changes too.

Research shows that cognitive-behavioral techniques that help you change unhelpful thoughts and behaviors, lifestyle changes, relaxation techniques, and nutritional strategies (all found in our Conquer Anxiety Success Program) can help women dealing with hormonal changes.

These types of strategies not only help women regain a sense of control over their lives, but actually achieve improved physical and emotional well being! Here are a few tips to get you started:

– Focus on reducing preventable stress in your life that triggers the fight or flight response — stop the yo-yo dieting; increase sleep to eight or nine hours a night; exercise regularly; don’t skip meals; cut back on your frantic schedule; and decrease stimulants, such as caffeine. 

The body isn’t designed for constant stress. When we are bombarded with stress, our ability to cope can become overwhelmed because the elevation in stress hormones makes the fight or flight switch remain “on.”

– Learn how to train your body to respond differently to stress so that you can automatically turn the false alarm “off” when the fight or flight response is triggered. Relaxation techniques such as deep breathing, yoga, meditation, and progressive muscle relaxation can help you achieve this goal.  

– Most importantly, learn how to change how you think. Our thoughts are what convert the harmless fight or flight response into a vicious cycle of anxiety. Remember, just as our thoughts hold the key to creating anxiety, they also hold the key to eliminating it!

Who experiences social anxiety symptoms? Is it only people who have some deeply repressed unconscious psychological trauma? NO! Is it only people who are shy or people who have low self-esteem? NO! Is it due to some sort of failure to develop good social skills? NO! People who have social anxiety that reaches the point that it is interfering with their enjoyment of life are simply those among us who have a very powerful ability to practice what is called mind-sight, combined with a self-perpetuating process of avoidance and anxiety. The ultimate cause of both of these underlying mental processes is genetics. You didn’t do anything wrong. It’s not your fault, and yes, you CAN improve your lot in life by focusing on tactics that recognize the true underlying cause of social anxiety.

Who else recognizes the following patterns?

1. More anxiety about someone noticing your anxiety than about having the anxiety in the first place.

2. Dread of situations in which you could not easily disappear from the spot light if you needed to.

3. People thinking you are, “quiet,” when that’s not the real you.

4. Being afraid that someone will notice that your voice is shaking, your hand is sweating, your face is blushing, or some other physical sign of anxiety.

5. Wanting to speak up and show people how interesting and smart you can be, only to find that the thought of speaking up is enough to start your heart pounding or your breath to feel like it’s been sucked out of you.

These patterns are complex, but the cause of social anxiety disorder is caused by your genetically inherited personality traits more than anything else. Over time, what happens is that your hypersensitivity to the way others are perceiving you leads to situations that are very uncomfortable or embarrassing (though to someone else it would seem like a normal life experience). Normal life experiences like blushing in front of others and having someone point this out and laugh can lead someone with a social anxiety disorder trait to become hyper vigilant to the normal experience of blushing. As you mind begins to label blushing as a threat, you may begin to become super tuned-in to the slightest inkling of blushing, which then causes you to feel embarrassed at the thought that you might blush…and BAM…you are blushing out of nowhere and you look at the floor instead of making eye contact, and before you know it, you’ve been labeled, “quiet.” This is just one tiny example of the many variations that social anxiety disorder can take. Yours will be unique.

The mind-sight issue is at the root of all of the symptoms. Mind-sight is the process by which you mentally project yourself into the other person’s perspective and then look back at yourself through their eyes. This gives you a great social advantage (unless it takes over as in social anxiety disorder). You are able to self-monitor to present yourself in a positive light to others. People who are low on this ability are the are at a great disadvantage in relationships and business ( Think of someone you have known who seems clueless about how they talk on and on without checking to see if the listener is still interested. Or think of someone who doesn’t seem to realize that other people brush their hair and don’t start personal conversations in the grocery store line). Mind-sight allows you to predict what others are thinking about you. If the mind-sight ability is genetically wired into you to a very strong degree, all it takes is one or two situations that cause you anxiety about how others are perceiving you, and then the process of feeling anxious about a recurrence of those situations sets in. Once you begin to consciously or unconsciously anticipate a certain kind of situation with fear, you will become more aware of the first signs that the situation is approaching.

Trying to “not feel anxious” doesn’t work. In fact, to stick with the example from above, trying to not feel anxious can lead a person who fears blushing to become more likely to blush out of anxiety that they might be approaching a situation that would be embarrassing if they blushed. Translate this to a more general “feeling of anxiety” in social situations and you get a sensation of increasing quiet feelings that seem to take over and suppress your natural spontaneity even before you arrive at the destination where you begin to anxiously anticipate that you might get that “quiet feeling” with all the unwanted judgements of others about seeming shy and quiet. Avoiding the sensation you don’t want ends up creating it. And for a person who wants to know the cause of social anxiety disorder, that’s the crucial point to understand beyond genetics. It’s this point that allows people with social anxiety disorder to make a change in the way their mind and body reacts, and that’s what the site, www.anxiety-counselor.com is all about. See that page: the cause of social anxiety disorder for more information on how to put these ideas to practical use in reversing the effects of social anxiety on your life.

Counseling

  The first thing to do is to find a good counselor.  Good counseling can be a hard find, and it can also be expensive.  To find a good counselor, one simply needs to find a personality type with which he or she can work well.  Some counselors are in-your-face and confrontational, while others are very laid-back, perhaps even more anxious than the client at the first meeting.  Sometimes, a person will find that a particular counselor just is not working well with him or her for whatever reason; at this point it is important to remember that the client is the boss of the counselor.  If the client wants, he or she can fire the counselor and see another one – just make sure that the counselor is being fired for an inability to work effectively with the client, and not because of a silly superficial reason like the client disliking the way the counselor asks questions. 

 Keep in mind that the term here used is “counselor,” and that it is used for a very specific reason.  Many other professionals can treat anxiety; these include therapists, psychiatrists, and psychologists.  The reason I recommend a counselor is because a counselor typically takes in the “big picture.”  As noted earlier, those of us with anxiety struggles in our lives often have many other stressful situations co-occuring which serve to increase our anxiety level.  Therapists and psychiatrists will focus on reducing only the anxiety, while possibly psychologists, and definitely counselors, will look at the other stressful situations such as difficult parents, bad significant others, or substance dependency which may be playing an important role in increasing the client’s anxiety level.

 Finally, counseling can be expensive, but it can be made affordable.  Typically, counseling will run somewhere from $75-$125 per hour, which is way outside the range of affordability for those of us without insurance.  One thing to check into is “sliding-scale” counseling, which is where a counselor will lower his or her fee based on the client’s income.  Simply placing a call to the local NAMI (National Alliance for the Mentally Ill), looking in the phone book for counseling agencies (Counselors are more than happy to help.  Feel free to call ANY agency and they will know someone at their organization or someone else’s who can provide sliding-scale services), or asking friends and relatives who are comfortable with this topic will eventually turn up something affordable.

 Counseling is incredibly beneficial, and it does not last a lifetime-only until the counselor and the client are comfortable the client can operate on his or her own.  It helped me to completely turn my life around in a matter of months! There is no shame in it.  Everybody has problems, but most do not seek help.  It takes great courage and strength to admit one has problems and ask for help, but it can be the best decision one makes in life.

Exercise

 The next most important thing to add to one’s life, if it does not exist already, is regular exercise that increases one’s heart rate to 80% of its maximum for twenty minutes three times per week.  Exercise helps to increase one’s confidence and general feelings of well being, while simultaneously adding energy (exercise is like a natural caffeine) and enhancing the quality of one’s sleep, and most important to this article, it reduces anxiety!  Exercise is great in every way for a person’s health.  For more details on exercise’s relationship to anxiety, read ASN’s article entitled Anxiety and Exercise.

Medication

 Medication is a very controversial topic in our society, and it is very wise for each person to carefully consider the advantages and disadvantages of taking medication.  One thing to remember about medication is that different people respond to the same medication in different ways.  I take a low dosage of Lexapro (10 mg), and that works really well for me.  But, another person may try it and receive no benefit whatsoever, or even worse, that person may experience increased anxiety and other symptoms while receiving no benefit at all.  The best thing to do is to keep a brief journal of how one is thinking and feeling in the days after taking the medication.  Give the medication a couple of months to take full effect, and to allow the body to adjust to this new substance.  If things are not going quite right, either switch the medication or go off of it entirely.

 Another point to consider when thinking about medication is how the client would like the medication to work in his or her life.  The Lexapro that I am on is intended to be a medication that I take daily and that is working all the time.  Some people may experience low anxiety most of the time, but extreme anxiety in certain situations.  Medications exist which only have an effect for a few hours at a time, and in my opinion, the less medication that is running through the body, the better. 

 The technical aspects of medication are not my area of expertise; I know only the generalities of medication.  But, what I have given is solid advice.  The bottom line is for clients to realize that they are the expects on themselves, and if something is not working right or is causing more bad than good, it is perfectly okay to change things up or stop medication entirely.

 Finally, medication is not a requirement for recovery from anxiety, but it certainly can be helpful.  It is most effective when used in combination with counseling, diet, exercise, and supportive friends.  For additional details, read ASN’s article Medication – Don’t Believe the Hype!

Biofeedback

 Biofeedback can be another very helpful option in helping anxiety-sufferers to relax.  If a client is seeing a counselor, be sure to ask about it.  Many counselors keep simple biofeedback devices ready and available, or know where to get them for a reasonable price.  The university that I attend has a counseling center that allows students to check out the devices and use them for free, so this can be a viable option for persons in that age range.  Otherwise, I have been told that biofeedback devices that hook up to any household computer can run only about $125 or so.

 Different types of biofeedback devices exist, and the only one I know about is one that has little “caps,” for lack of a better term, that connect to the middle, index, and ring fingers.  These caps are then connected to another device that is attached to a computer.  The caps measure the electrical resistance across a person’s skin.  In this particular biofeedback system, a game, called the Wild Divine, is played that helps to teach the anxious person how to relax.  For myself, I found it moderately beneficial, and I do not have the time to do it these days.  However, it was helpful, and different things can work for different people, so if one is able to try out biofeedback and one finds it useful, use it!

Taking Risks

 The next, and probably scariest part of recovering from anxiety is taking risks.  One can read all the information that exists, go to counseling, or engage in biofeedback all one wants, however, one eventually must take the real risks and begin to approach situations that are terrifying. 

 Probably the best way to do this is to discuss the terrifying situation with a counselor or supportive friend.  People who are outside of the situation can see it more realistically and can help a person to identify his or her anxious thoughts that are not very realistic.  After actually taking the risk, report the happenings to the trusted friend or counselor, and again they will help the client or friend interpret the situation in a realistic sense.  This is the best way to help one realize that the anxious beliefs and thoughts are simply not true. 

 If a person ends up failing and not taking the risk, there is no problem!  Simply regroup, take a break, and get ready to get back at it because limitless opportunities exist for taking risks!

Supportive Social Network

 Another major key to one’s recovery is having a supportive social network.  Many of us live in families where personal problems are not to be discussed.  These persons may claim that mental conditions such as social anxiety do not exist (this is an extreme point of view), or they may simply belittle or mock the problems that other people face (as an aside, other people do this usually because they are trying to avoid problems in their own lives and want to make themselves feel better about their situation). 

 Having a supportive social network means that we can go somewhere to talk to people who have experience with anxiety.  Not only this, but a supportive social network will be made of people who will listen and try to understand what one is experiencing, and perhaps offer some useful advice or sympathy for the situation.  If a friend or family member seems resistant to understanding difficulties present in other person’s lives, one can continue to attempt to help that person understand, but ultimately, it is best to seek out other people who have common experience with anxiety, as it is impossible to force someone to understand something.

 All humans need some sort of social network and place to vent their problems; it is a requirement of a happy life.  Places that offer supportive social networks can include the Anxiety Support Network’s forum, NAMI (National Alliance for the Mentally Ill) meetings (these typically only exist in larger cities), and anxiety groups that can be run in many different places such as the local library or a local counseling agency.

Regrouping During Burnout

  Finally, one thing that is inevitable for all of us is that we will all hit a point where we feel burned out from all the anxiety we have been facing.  This happened to me many times over the years, and I believe that it will happen again; the reason I continue to want to recover from anxiety is that the burnout becomes less frequent and less intense over the years.  In the past, it may have happened every couple weeks or so, but now it may only happen once or twice per year, and only under very stressful conditions.

 It is important to remember at this point that what we need to do is to take care of ourselves.  The temptation is to get upset about where we are in our life; that we are not making enough progress and that will always be stuck in this endless cycle of terrifying anxiety.  However, as I have noted from my own personal experience, there is an end.  At this point, the best thing that we can do for ourselves is to take a break, relax, and do something very nice to ourselves that will bring healthy enjoyment to our lives.  This can be very different for many people, but some things that some of us choose would include spending all day watching movies, taking a hot bath with scented candles, getting a massage, eating a favorite meal, playing videogames, or any other activity that brings joy to one’s life. 

 While life is challenging and difficult at times, it is a wise idea to do the things we love in order to keep our sanity.  Those people who do nothing that brings them joy find themselves to be very miserable persons.

 It may take a few hours or a few days to regroup from burnout.  During this period, it is also important to be talking to friends, and also to take a break from challenging anxiety.  So what if one is not taking anxiety-provoking risks for a few days!  Everyone needs a break at some time and it is perfectly okay to do so once in a while.  I still do it at times myself.

 The final point to keep in mind is to congratulate one’s self for any progress made, no matter how small.  Was a conversation, though full of stuttering and stammering, started with a stranger?  If so, and if this is something one could not do in the past, but now one can do it, then this is progress and a job well done!  Was one able to leave the house and just enter the local gym and just be around other people, but not actually exercise?  If so, this is progress.  This is good enough for now, and eventually, if a person sticks to it, that person will be able to start conversations with strangers without having to think about it, or that person will be able to go to the gym and exercise without worrying about what other people are thinking of him or her.

To Wrap It Up

This guide was meant as a comprehensive guide to treating anxiety.  It does not go into great detail in each section, but it gives enough of an idea so that a person can make reasonable steps towards defeating anxiety and living a happier life.  Treating anxiety can be infinitely complex, but if one follows the basic steps in this article, one will be heading in the right direction, and before one knows it, one will be living a happier life and be doing the things that he or she always dreamed of doing!