How do I cope with grief during menopause?

If you’re mourning the loss of a loved one, you may feel overwhelmed. Psychotherapist Julia Samuel offers her advice

• Navigating emotions during hormonal changes and grief
• Why processing grief is so important
• Approaches to dealing with grief and accessing support

Perimenopause and menopause can be a challenging time in your life but if you’re also grieving, it can be particularly tough. You might feel you need to be strong for your family or feel so floored by your emotions and your menopausal symptoms, you’re not able to see the wood for the trees.

Leading psychotherapist Julia Samuel MBE, author of Grief Works, says: ‘Perimenopause and menopause are times of transition, where you’ll need to psychologically adjust to a new phase of your life. If a significant person in your life dies at this time, it can rock an already wobbly system. You are grieving while experiencing a living loss. This is an important context, because often women feel they are “doing it wrong”, but acknowledging the level of loss you are facing is an important factor in supporting yourself.’

Julia says it is important to take your physical and mental needs seriously. ‘The support you receive at the time of the death and following the death is the single most important factor in your capacity to grieve effectively. This means you need to give yourself permission to support yourself, and not pour all your energy into supporting everyone else.’ 

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How do I know if how I’m feeling is due to grief or menopause?

Grief cannot be fixed. However, perimenopausal and menopausal symptoms can be managed and improved with individualised treatment. Seeing a healthcare professional can help with this.

Some women find it difficult to pinpoint if their feelings – of sadness, hopelessness, anger, numbness, etc – are due to grief or menopause. Psychological symptoms are common during menopause common – in a Newson Health survey of 5,744 women, 95 per cent of respondents said they’d experienced a negative change in their mood and emotions [1]. There is also a significant increase – approximately three times higher – in the likelihood of depressed mood during the perimenopause and menopause than in other life stages [2]. 

If you’re overwhelmed by your emotions but unsure of the cause, consider if you’ve had similar symptoms in the past? How did you used to feel before your periods, or when you were pregnant, in times of hormonal fluctuations? Alongside your emotional symptoms, do you have physical symptoms, such as hot flushes, dry skin, palpitations, genitourinary symptoms? These don’t usually occur due to depression or grief.

However, it is possible to be menopausal and grieving, and you can have a bodily reaction to your grief. This is why it’s important to track symptoms and share this with your healthcare practitioner. Sometimes grief can lead to clinical depression but there are subtle differences between low mood due to menopause and clinical depression. In general, women who experience hormonal low mood, know how they are feeling isn’t right – they have insight and want to feel better. With clinical depression people tend not to have that insight nor care about how they feel. Your healthcare professional will be able to help you explore your emotions and possible diagnoses.

RELATED: Am I depressed or menopausal?

How can I handle my grief?

Julia stresses that grief is not something to fight and there is no one single approach to coping with grief. Here are some of Julia’s suggested strategies to consider:

Get support

‘We need to allow grief to process through us, and it is often experienced as waves of pain crashing through us. In order to withstand those waves, you need to access support. Support will look different for different people but it needs to include time to focus on your grief. You need time to feel the pain and face the reality of the person’s death. This could be with a friend, a family member, a therapist, or with the Grief Works app. Or all of them. It helps to create structure around it, so perhaps block out time to walk and talk to a friend. Or create a habit of journalling after exercise in the morning. If you can only manage small bites of support, connect with people who love you. When the person you love dies, it is the love of others that enables you to survive.’

RELATED: Families, relationships and the power of connection with Julia Samuel

Regulate your body

‘Choose to do things that help regulate your nervous system, because grief often feels like fear. This includes taking regular exercise (by this I mean moving your body, not running a marathon!) and remembering that whatever you do, who you see, what you watch, what you eat, what you drink, how much you sleep, all has an impact on your capacity to regulatory effect. And get outside for a walk, run, bicycle.’

Feel the pain

‘Grief is a tidy word that describes a complex and messy process. The task of mourning is to face the reality of the death, to let yourself know that the person has died, that their death is irreversible. Unfortunately, the mechanism for that is allowing yourself to feel the pain – pain is the agent of change. The model that is helpful to think about is the dual process: loss orientation where we, cry, emote, express our pain and then oscillating to restoration orientation where we have a break from the pain, do tasks, allow ourselves to be distracted, get on with life. Recognising the movement between the two orientations is helpful. Allow time for both.’ 

Accommodate your loss

‘Whilst culturally people often think of grief as something to ‘get over’, what we understand now is that we don’t get over someone’s death. Instead we learn to live with it, to accommodate the loss into our life. Which means we build our life around the loss. The intensity of the pain changes, grief is naturally adaptive so we have the capacity to live and love again, but we may find a wave of grief wash over us many decades after the loss.’ 

Create touchstones

‘The other important understanding is that the person we love has died, and we need to adjust to their physical absence. But our love for them never dies. Our love continues, and we have touchstones to memory that keep the person connected to us. These touchstones may be writing to the person, wearing something of theirs or cooking their favourite recipe. Creating a playlist in memory of your person can be helpful, or lighting a candle in their memory. I find that people instinctively know what to do once they have the idea of continuing bonds, and touchstones to their memory.’ 

Find hope 

‘My final thought is that hope is the alchemy that turns a life around. Hope isn’t just a feeling, it is a plan A and a plan B, and the belief we can make it happen. Picturing how you want to live your life now, whilst accommodating the person’s loss, will help you get there.’ 

RELATED: How friends can ease your menopause

Julia Samuel is a leading psychotherapist and author of Grief Works: Stories of Life, Death and Surviving. Her app, Grief Works, was created to help navigate grief after the death of a loved one.

References

1. Experiences of the perimenopause and menopause, December 2022
2. Freeman EW. Associations of depression with the transition to menopause. Menopause. 2010;17(4):823-827. doi: 10.1097/gme.0b013e3181db9f8b