Keeping Our Spark: Perimenopause, Mental Health, & Creativity
For those of you that are wondering, I turned 45 years old this year. My friends, family, colleagues, and clients alike know that I can be quite existential. In fact, it is my draw to meaning-making that surely drew me to become a creative arts therapist and mental health counselor. As an avid creator and devotee of the arts, I have always looked to my creativity and the creations of others for hope and inspiration: to keep my spark going.
Over the past few years, as our world is going through so much change and turmoil; so much conflict, violence, polarization, and collective trauma; I have noticed existential themes arising more, and more in the breath of my work with clients and colleagues; along with my own questions and concerns about who we are becoming as a society.
As I confront uncertain times together with my clients, I am simultaneously becoming aware of the changes that come both physically and mentally with age. I have also noticed this distinct alchemy happening for many of the women that I work with, many of which are mothers like me. So many of us are feeling the weight of the world and our children’s futures on our shoulders; whilst our bodies and minds are going through monumental shifts. As a result, I have been reflecting on how I can fuel the “spark” for myself, and for others in my life going through similar transformations.
While I imagine that those that have chosen to read on are likely women that are having a personal connection with this topic; my hope is that partners, loved ones, colleagues, clinicians, and other community members will also find value in this offering; and maybe even find a spark for themselves to propel them through tumultuous times.
So let’s start first with the basics…
What is Perimenopause?
Perimenopause is a 7–10-year phase that occurs prior to menopause beginning between the ages of 35-45 years old. While menopause is defined as the time that a woman’s period has stopped, perimenopause refers to the changes that occur to the body leading up to this time. While I have chosen to specifically focus on perimenopause in this discussion, it is important to note that there is an overlap in what women might experience and need through both phases.
Most notably, perimenopause is characterized by inconsistencies in the production of hormones such as estrogen and progesterone. Estrogen levels, for example, impact every system in the body, including one’s neurological health which is tied to mental health.
On the Mel Robbins podcast, 55-year-old obstetrician-gynecologist, Dr. Mary Claire Haver shares that in perimenopause, “all of a sudden, you can’t put your finger on it, but something has changed”. Reflecting on her own experience, 56-year-old-host Mel Robbins shared, “I’m doing the same stuff I’ve always done…my pants are not fitting, I’m grouchy, suddenly I feel like I have ADHD, or brain fog, or dementia; I don’t feel like myself in my body”. To this Dr. Haver responded, “you are every single patient that comes to my office”.
Dr. Haver goes on to explain that the loss and “chaotic” ups and downs of estrogen production in the body impact every bodily system therefore contributing to a range of physical and psychological symptoms that are often misdiagnosed, or worse, dismissed by doctors or mental health providers.
Focusing here on the psychological impact, Dr. Haver notes the effect that estrogen levels have on our serotonin and norepinephrine efficiency. As a result, some going through perimenopause might become more depressed and anxious; and for some, she says, their “executive functioning tanks”. Dr. Haver also notes that those with known ADHD may experience a worsening of symptoms; and that some women who didn’t meet the criteria for this disorder previously do so as they go through this transition.
Furthermore, on the Inside Mental Health Podcast 46-year-old psychiatrist Dr. Crystal Clark refers to perimenopause as a “biological transition”. She estimates that 20-40 percent of women will experience depression due to perimenopause. In addition, she identifies anxiety, sharing that both disorders can arise as a new disorder for women not diagnosed previously; can arise again for those in remission; or exacerbate symptoms for those presently being treated.
It is also important to note the correlations between perimenopause and sleep disturbances. The sleep disruption that perimenopause can incite has an undeniable impact on women’s mental health and well-being.
In addition to the effect that perimenopause has on mental health, some of the physical symptoms include menstrual migraines, bloating, swelling, “frozen shoulder”, joint pain, loss of libido, asthma flares, new autoimmune disease, vaginal dryness, irregular periods, and hot flashes. Physical symptoms also contribute to women enduring adjustment related depression and anxiety. For some women, perimenopause’s negative effect on mental health is due to the natural discomfort and even distress that our experience of these bodily changes can produce.
According to Dr. Clark and Dr. Haver, there are many areas to consider when treating perimenopause (and menopause) symptoms including hormone replacement therapy, nutritional & supplemental interventions, exercise & weight training, psychopharmalogical support, and psychotherapy. Dr. Haver specifically notes that taking progesterone (which she said is generally safe for women in perimenopause) can be of support for sleep issues in addition to working on other sleep hygiene skills. Dr. Clark also notes the value of psychotherapy sharing that for women in this stage, “psychotherapy is often about processing emotions” and “learning coping skills”.
Creativity through Change
As both a licensed mental health counselor and creative arts therapist I find it important to look at the role that creativity can play in therapy through different phases of our lives; whether it be living through perimenopause or societal discord. Keeping both in mind, one of my favorite assertions is “art is the insistence of existence”. During times of existential strife, art and creativity affirm our value as human beings. Creativity dips into our inner wells echoing our deeper voices and reflections; some of which may not have words.
When we are in our own creative flow or connect with what is expressed through another’s we can exhale a sigh of relief in being known to ourselves and to others. In those moments we are not alone, our existence is irrefutable.
Furthermore, art and creativity are resiliency resources that every single one of us has access to regardless of cognitive or creative skill. The benefits of both creating and witnessing creative works are paramount to both individual and collective health.
For women going through perimenopause and beyond, creativity can be a space of connection; a safe haven where we can explore and revisit who we are and who we are becoming; and a space that combats the invisibility that can come with age. Through creativity we can explore and express our feelings about the impact of aging; fostering a place where are experiences are seen and heard.
Furthermore, through creative practices such as writing, watercolor, collaging, and singing (some of my favorites) we can also reflect and appreciate the hard-earned wisdom we have gathered with age and experience; and envision how we would like to share it in our personal and professional worlds. As Dr. Haver says, “what I love about (peri)menopause is women find this power to put themselves first for the first time in their lives."
In this vain, art-making can be a container of radical self-care. For as writer & activist Audre Lorde wrote in her 50’s "Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare".
For me personally, creativity is a conduit of hope in uncertain times that keeps my spark going and reminds me that:
…Whoever you are, no matter how lonely,
the world offers itself to your imagination,
calls to you like the wild geese, harsh and exciting—
over and over announcing your place
in the family of things.
(From Wild Geese written by Mary Oliver at age 51yo)
In thinking about this topic, I experimented with ink on one piece of watercolor paper, watching my image change and transform whilst photo recording its iterations. I then put the pieces together to create this digital photo collage. Through my creative process I notice uncertainty, lack of control, muddiness, power, delight, joy, frustration, flow, energy, cloudiness, blossoming, rising, and falling...My piece reminds me to be flexible, bold, courageous, open to change, present with the tides of feeling…to go where the flow takes me…
References
Haver, M.C. (2024). The New Menopause: Navigating Your Path Through Hormonal Change with Purpose, Power, and Facts.
Howard, G. (Host). (2025, July 24). Perimenopause and depression: when horomones hijack your mental health (No. ) [Audio podcast episode]. Inside Mental Health Podcast. https://open.spotify.com/episode/5HcJJ3Y5BoEcMWfm0v3hrp?si=f-t8R3YMT66vSr-ZCRMMSw
Robins, Mel. (Host). (2024, March 21). The #1 Menopause doctor: how to lose belly fat, sleep better, & stop suffering now (No. ) [Audio podcast episode]. The Mel RobbinsPodcast.https://open.spotify.com/episode/5H5JHSy9E0q9FeoMWbNJUN?si=S5IttUu1QrWx6XDIcBwuKA&context=spotify%3Ashow%3A7vz4RYsD5MulTCrcH478t1
The Menopause Society: https://portal.menopause.org/
Women Have Been Mislead About Menopause: https://www.nytimes.com/2023/02/01/magazine/menopause-hot-flashes-hormone-therapy.html
Wild Geese, By Mary Oliver
A Burst of Light by Audre Lorde
