Getting back to self-care, writing in my journal and embracing positive thoughts | how I'm dealing with a period of (menopause) depression

It's been a whole year since I travelled up to Tintern in Wales to join a women's only retreat, Awaken the Creatrix - Walk and Write Retreat.  I was so inspired, so energised, hopeful that the challenges of a pandemic were behind us and better days were ahead.  I remember being so determined to embrace positive thoughts, up my self-care, journal and walk in nature.  And yet many of you following my blog and my social media will have noticed that despite my determination to look after myself better, this last year has turned out to be one of my most challenging yet.  The lockdowns of 2020 and 2021 seem like a walk in the park (literally) compared to the difficulties that came with 2022 and 2023.  I will admit that sitting down to write this, I am exhausted BUT optimistic that I can turn this around and get back to being me again.  And something I have always done is write stuff down, especially since I've had my blog, and share my own struggles especially as so many of you can relate to the menopause element.  

If I commit my thoughts to paper (or blog) then the goals seem far more achievable.  Although I admit I am not sure where to start but I am hoping that as I work through what has been going on for me, I can start to see where I need to make changes!

October 2022, Portishead Beach

Understanding menopause depression

Starting with hormones and antidepressants ... when I began my HRT journey properly in 2018, I was only 52 and looking back probably still had some of my own oestrogen circulating.  So despite a few changes in type of HRT and dose, plus the difficulties with progesterone, the oestrogen (Estrogel) and testosterone (Androfemme) was working for me.  I was also still taking a low dose antidepressant medication.  But over the last 3-4 years I have had several dips and symptoms returning and each blood test has confirmed a much lower oestrogen level that is optimal.  Every woman is different and some of you will cope with lower oestrogen but I can't!  Recently I have been using 5 pumps of Estrogel and still my oestrogen is only 211 and I know I feel rubbish!  I listened to Dr Louise Newson explaining about oestrogen absorption and doses on the Liz Earle podcast recently, it is worth a listen and really backed up what my own thoughts, GP and consultant have been saying to me.

I also decided back in the summer to come off my antidepressants, I felt that they were probably masking my ability to understand how effective HRT is for me.  Ideally I wanted the HRT to do it's job rather than need antidepressants as well.  Looking back I do wonder if I was prescribed antidepressants back in my mid-40s when actually I should have started on HRT much earlier.  There are side-effects from antidepressants and I'd rather not need them.  But with hindsight, maybe it was still too soon to manage without them.  I stopped altogether in early September and have felt even worse since!  But I know I need to get my oestrogen sorted before I resort to going back on them.  This blog post explains a bit more about my anxiety and phobia and why I chose to take antidepressants.

I made an appointment to see my private menopause specialist and I chatted to my GP too, she organised a blood test which showed that despite the 5 pumps of gel my oestrogen was only 211 (it has been as low as 47 so I suppose I should be pleased)!

But talking to the private specialist, we concluded that even on 5 pumps I am clearly not absorbing the gel (a lot of women don't - again listen to Dr Louise Newson linked above).  Together we made the decision for me to have the oestrogen implant (and testosterone).  However, this is not available on the NHS so will cost me £600 every time I need it.  It will last between 5-6 months hopefully but until we monitor it properly we won't know for sure.  I am hopeful I can manage on two implants a year.  I feel very fortunate I can afford to go private for this, not everyone can, and I appreciate how lucky I am.  But it is still a big financial commitment and as I want to stay on HRT indefinitely that cost will remain!

I am now just over four weeks post-implant insertion and at the time of writing, I am still waiting to feel better but it could take 6 weeks or even 3 months.  I don't want to reconsider antidepressants until I know whether the HRT is going to manage my symptoms.  Another excellent podcast on this subject Dr Louise Newson - Menopause and Depression.

And a note on progesterone, I am intolerant to it, but we are managing this by using a low dose and by closely monitoring for any endometrial thickening with regular pelvic scans.  

Journalling really helps focus my thoughts

What my depression looks light right now

What are my symptoms ... well I've had a year of emotional turmoil, worries, disappointments and challenges.  It's all been a bit of a whirlwind of overwhelm to be honest.  And the result is I am a bit of an emotional mess, there are highs but there are a lot of lows too.  And I feel like I've crashed. 

I've been supporting my children through some difficult times, I was reminded recently 'you are only as happy as your unhappiest child' and I certainly absorb their emotions, I'd do anything to wave a magic wand and help them feel better. 

My parents are elderly, my dad needs a bit more help and my mum has dementia.  My husbands business ticked over nicely during Covid but post-pandemic has been very very difficult.  I do my best to manage home life, I also have to run the admin for our business as our office manager left last January, sometimes my house feels like Piccadilly Circus with so many bodies passing through and every one of them needing me in some form or another - queue more overwhelm.  I can no longer multi task and brain fog is real. 

I don't sleep very well, I know I am not eating as well as I should, I have used alcohol as an all too easy stress reliever and I am utterly useless at saying no!

Yes I have recurring low mood, yes I have had a phobia in the past, I've had insomnia on and off for years but it all comes and goes and when I feel good I feel amazing!  I am confident, happy, capable and can solve any of life's problems that come my way.  But right now, I can't see anything clearly, I feel hopeless and everything that needs doing seems impossible.  I have sad days, I feel guilty and I head into a black hole or put on a mask and do my best to carry on for everyone else.

When it lifts I vow to never put the mask back on!  And yet here I am back to feeling utterly bereft of joy.  If only I could turn the clock back to 2019!

I'd like to say I am learning but I am not sure I am, the problem is that when I feel so rubbish, I let all my carefully controlled support mechanisms slack and we all know that HRT and even antidepressants are amazing BUT lifestyle factors are essential too.  

I used to hide my mental health struggles but having had my blog and realised that by sharing my story I help others but also mental health is no longer the taboo subject it used to be, like menopause and menopause with mental health symptoms, we are now prepared to talk about it, thank goodness!

Being able to write freely here in my own space, helps me process my thoughts and what I need to do to feel better.  It's like writing a letter to a best friend.

I am not an expert but I hope that my story inspires others and reassures that you are never alone, I share resources that might help, signposting to things that have helped me.

Write down what you are grateful for!

My self-care action plan

What am I going to do to feel better?  Lots I hope, maybe it is a sign that the implant is slowly helping that I am even prepared to sit down and come up with an action plan!  Or maybe it is just that unusually the house is empty and I feel like I have a bit of space to think.

Journal - writing it all down helps so I am trying to get back into a habit of offloading and journalling what I am grateful for.

Counselling and holistic treatments - I am not sure exactly what I will do yet but so far I have made an appointment for a massage (time out) and also to see a Shamanic Healer for a Medicine Stone Massage "It is a beautiful gift to give yourself if your feeling stressed, anxious or just a little tired from life's journey. The effects are instant. You will leave feeling lighter, calmer and in a more peaceful state. This is extremely beneficial if you are in constant "flight of fight" mode".  Sounds like me!

Alcohol - oh the fun of lockdown wine o'clock especially as the sun was shining and an hour or two in the garden felt amazing!  But now drinking at home has become a habit I need to let go of.  There are so many benefits to being alcohol free including better sleep,  improved energy levels, reduced stress and weight loss.  I am not sure if I will go completely alcohol free but certainly not drinking at home might be a good place to start.

Sleep - not sure what the answer is here but having had chronic insomnia in the past, and having noticed poor sleep creeping back in I know something needs to change (read benefits of being alcohol free above) but also I need to cut down on blue light and social media scrolling at bedtime!

Hydration - I am rubbish at drinking water, my lovely PT keeps reminding me how important hydration is for mood regulation, a quick google search tells me "Even mild dehydration (around 4 cups or less per day) is associated with reduced cognitive function characterized by increased fatigue, sleepiness, worse mood, and attention."

More free time - my diary has got ridiculous recently, I need a quiter, slower life, I need to prioritise me! I am not someone that can be out two days or two nights in a row!  Plus I've accepted too many gifted Instagram collaborations and they really stress me.  My blog is my happy place to be!

Nutrition - I know what to eat, I know I've allowed myself to get into a rut of bad habits, but I hope starting with alcohol reduction, I can get back to a better balance (and weight loss, yes it has crept on recently).
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Nature - I feel at peace in nature and I especially love being by the sea but I don't make enough effort to get outside.  I live in the woods so nature is right on my doorstep but I hate the mud, hate rain and cold and the resulting frizzy hair!

Escape days - I so miss my escape days, I love time just for me, a wander in London, a walk in nature, a trip to the sea.  Time to breathe.

Retreat day - I'm looking forward to a retreat day in early December being organised by my lovely friend Chloe Leibowitz with Pilates expert Laura from Zenergy Active and local healthy chef Jo from Time to Nourish.
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​Any tips or tricks you can share or if you just need some comfort yourself, please do leave a comment below or get in touch via email.

Love from
Michelle xx

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