Mental Health at Menopause - Tips for staying sane!

This month saw Mental Health Awareness week and Wake up to the Menopause week on BBC Breakfast. As both subjects are passions of mine, I couldn’t decide which to write about. So I’m combining the two!

Around the time of the menopause one of the most common symptoms is increased anxiety. It is also true that if you have suffered from trauma and it is as yet unresolved, you are likely to find it rearing its ugly head at menopause.

I’ve mentioned the benefit of Ashwaghanda before but this adaptogenic herb is a wonder. An adaptogen is a herb that supports your body acclimate to stress. Stress is the root cause of anxiety so anything you can do to prevent or manage stress will also help.

Often at the transitional time of menopause, women are at their most busy; running a business or working long hours, managing family life, coping with elderly parents; all of which is stressful. Making time for yourself is the most important thing you can do. Women are notoriously bad at this. We feel guilty if we step away from our family. We feel that we SHOULD be there for everybody else, but this is stressful and you run the risk of compassion fatigue. Yes, it’s a thing!

Doing something that is relaxing, allows you to switch off mentally and that calms your nervous system will benefit. Literally step away from technology for a time.

Research shows that spending time in nature is fabulous for your mental well-being, so why not go for a brisk walk in the park or the countryside. Spending time with others, especially if they are understanding of what you are going through is extremely supportive. After all, a problem shared is a problem halved as they say. Find your tribe and regularly spend time with them.

If you are suffering from depression and finding it difficult to function, there are many things you can do. Rhodiola is another adaptogenic herb that can help with stress, anxiety and depression.

If you are taking ANY other medication, it is always worth speaking with your GP to make sure it is safe to take supplements. However, you might consider speaking with your GP anyway as according to Dr. Rosemary Leonard, author of Menopause - the Answers, anti-depressants can also suppress other menopausal symptoms.

Diet is important. What you eat can effect your mental health. Speak to a nutritional therapist if you need to but the two most important things to cut down on are alcohol and sugar. Alcohol may be your go to when you are stressed but the high you receive from the release of GABA is short lived. You go for another drink and another and soon find that you only feel that same high after a bottle.

Sweets, chocolate and carbohydrates are another choice when stressed but will spike your blood sugar levels and maybe even give you a high, but you will crash down very soon after and feel hungry again. At menopause we tend to gain weight around the middle which usually heightens your risk of cardiovascular disease. Plus the weight gain doesn’t help your self esteem if you are already suffering mentally.

From a yogic perspective, practicing daily will support your mental, physical and physiological well-being. Observe your energy levels and mental state and consider whether to practice some grounding techniques, strong poses or gentle stretches. There is something for every mood and even a breathing technique that cools your hot flushes. Pranayama is magical for mental well-being, as is chanting and meditation. Ten minutes of practice a day is better than one hour a week. If you come to a class, try and practice at home too. You are welcome to photograph my lesson plan to remind you of what you enjoyed.

Cardiovascular exercise really benefits you physically and mentally. I know it can be difficult to fit it in but ask your family to help. Perhaps they can cook for themselves once a week so that you can go to a class . You might take a ten minute walk before eating your lunch. Little and often is better than nothing at all and really boosts your mood.

The most important thing is NOT to suffer in silence. You are not alone. I am a great believer in choice so do your research, never dismiss advice, try something and if it doesn’t work, try something else; whether that is homeopathy, herbs, medication, yoga, meditation or counseling. What works for your best friend might not work for you, so keep an open mind.

Community, support and exercise will greatly benefit. Reach out to me or anyone else who might be able to help. If women are ill informed about menopause, men are going to be less so. TELL your partner and family what you need; it might be the only way you get your needs met.

Talk about the menopause. The more you do, the better educated future generations will be and the easier the transition will be for our daughters.

Go well . Namaste.

Anneliese

Stress - Begin Where You Are.

It only has to take one event to trigger a complete change in your breathing habit. You might always have breathed in your belly (although you were probably not aware of this), then one day you were traumatised by a major stressor. This could be anything that put you into an immediate stress response, from a traumatic event to being yelled at. How your body responds is what is important here.

Commonly with the stress response, your breath shifts from belly to chest. You want to pull air into your lungs so that oxygen can be sent to your heart rapidly, enabling you to fight or flee from the threat. In a healthy system, once the threat is over, the stress response is switched off and breathing returns to the belly.

In modern society where we are constantly under threat on a psychological and physiological basis, the stress response can be triggered again and again in a single day. So what happens? The breath gets stuck in your chest and whether you feel stressed or not, your body thinks you are and keeps you in the stress response.

With so much threat around us, how do we know that we are stuck in the stress response? There are too many signs to list, but here are some things to look out for:

• Being easily startled.

• Constant doing - restlessness.

• Eyes darting around.

• Constant chatter.

• Rushing.

• Low pain tolerance.

• Consistent tension in the back of the skull, jaw, neck or shoulders.

• Feeling regularly overwhelmed.

• Sensory overload - sensitivity to light and sound in particular.

• Over-thinking and spending too much time in the head.

• Consistent chest breathing and pulling of the breath.

• Mouth breathing.

• Difficulty with concentration and focus.

• Listlessness, exhaustion or fatigue.

Sound familiar? Whatever you do, DON’T carry on as you are! Stress is not your friend. The stress hormones that are constantly rampaging around your body can do serious damage to your health. Now is the time to implement self care.

If you find that your mind is busy, busy, busy, you might need to begin with movement. A simple routine like the cat sequence I frequently teach can be a good place to begin. Don’t worry about the breathing but do notice the contact your body has with the floor.

If you are overwhelmed, begin at your feet. Notice them, feel them on the ground and if that is difficult, massage them so that you really feel the sensations in your feet. Squeezing the arms and legs can be useful if you feel disconnected from yourself.

If you can cope with stillness, concentrate on your breath. Sound is the easiest way of making the shift from chest breathing to belly breathing. It doesn’t matter what it is but you could try, sss, fff, ahh, brr. Sound that can loosen a tense jaw is brilliant!

Practice breathing through your nose as often as possible. It took a single event to alter your breath; it is possible to change it back within 24 hours. It just takes practice. Mouth breathing or shallow breathing reduces the amount of Carbon Dioxide (CO2) you take in. CO2 is necessary for vaso-dilation (dilating your blood vessels) which allows for oxygen uptake. Without this, blood vessels constrict which means the flow of blood is slowed leading to potential complications. Red blood cells hang on to oxygen when CO2 is low, therefore the body’s cells are not receiving enough oxygen to thrive.

If after reading this you start to panic, STOP! This is life and you are not alone. Stuff gets in the way of self care. But now you understand the importance of taking time for yourself and addressing the issue, begin where you are.

If you need support on your journey, do get in touch.

Look after your Adrenal Glands and they'll take care of you!

The adrenal glands sit on top of each of your kidneys. They play a vital role in your body, secreting hormones that are essential for life, stress hormones that also act as neurotransmitters, sending messages to your nervous system and sex hormones.

Here are just a few examples of hormones produced by the adrenal glands:

Aldosterone is responsible for maintaining the body’s salt and water levels which in turn regulates blood pressure.
Cortisol responds to illness and and helps regulate body metabolism. Cortisol stimulates glucose production and has significant anti-inflammatory effects.
Adrenaline, noradrenaline and small amounts of dopamine are responsible for all the physiological characteristics
of the stress response, the so called 'fight or flight' response.
Testosterone plays an important role in sexual arousal, sexual response, libido, bone strength, cardiovascular health, cognitive performance, energy levels and well-being in women. 

In a stress response, adrenaline increases your heart rate, elevates your blood pressure and increases energy supplies. Cortisol dampens all non-essential functions in a fight and flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system and growth processes. Natures alarm system communicates with regions of your brain that control mood, motivation and fear.

Once a perceived threat has passed, hormone levels return to normal. But in the case of chronic perceived stress, the adrenal glands persistently secrete hormones and become fatigued resulting in a potentially dangerous situation. Initially you may experience some of the following:

• Depression

• Anxiety

• Digestive problems

• Headaches

• Sleep problems

• Weight gain

• Memory and concentration impairment

During peri-menopause the adrenal glands produce a hormone that mimics oestrogen. With already diminishing oestrogen levels, exhausted adrenal glands cannot produce adequate amounts adding to the already ageing affects of low oestrogen levels. Long term adrenal fatigue can also result in lower levels of testosterone; lowering libido, thinning bones, damaging cardiovascular health, causing cognitive impairment and low evergy levels.

More serious conditions of adrenal fatigue are overproduction of aldosterone causing treatment resistant high blood pressure. The adrenals may become overactive resulting in Cushing’s Syndrome. Underactive adrenals may result in Addison’s disease. You can do your own research into these diseases if you want to. But I want to highlight that stress should be treated seriously rather than being ignored or dismissed as something to deal with later.

Lifestyle changes may be required; even a change of career! I’m sure you know the score by now, but just in case:

• Deal with any unresolved trauma through counseling.

• Get regular exercise (overexercising is stressful on the body so take it easy).

• Eat a healthy diet.

• Practice relaxation techniques or take up yoga.

• Take time for hobbies.

• Spend time in nature.

• Make time for friends.

• Take action to improve quality of sleep.

Stay well.

Finding Space in a Frantic World - Part 2

Following on from last month’s post when you were invited to practice the 3 step breathing space as a way of ‘checking in’ to your sense of self, we are going to continue by looking at further areas where self awareness can make a big difference to our sense of space.

Posture. When life gets on top of you, physical tension builds up in the body. Most commonly, the shoulders protract in an effort to protect your heart; your emotional centre.

Over time, the more protracted you get, the more the body has to compensate in order to be able to look straight ahead. You are likely to develop tension in your neck that may cause headaches. I often see a permanent crease in the neck after years of compensation. Alternatively, the head is pushed forwards and the curves of the spine become exaggerated. These physical changes result in a decrease in lung capacity as you are literally restricting their ability to expand. The breath becomes shallow, often in the chest, which sends a message to the autonomic nervous system (ANS) that you are stressed. The pattern of lacking mental, emotional and now physical space perpetuates. Shoulder protraction may begin with poor posture which still sends a message of stress and even depression to the brain and body, culminating in actually feeling that way even if you were not before.

So what can you do about it? When sitting, raise your hips slightly higher than your knees. This allows the hip flexor muscles (at the top of your thighs) to switch off and enables your pelvis to sit in ‘neutral’ so that the natural curves of your spine are supported by gravity. It helps to support the lumbar curve so that this part of your back can rest and you can maintain length throughout your spine without creating tension. Any deviation to this and you have to compensate as you can see in the first two images above.

Whatever table or desk you are sitting at, it is important to make sure that your chair is at the correct height so that you don’t have to hunch your shoulders to use your keyboard or write or even eat. Make sure your computer monitor is at eye level. It might be a good idea to purchase a separate keyboard if you use a lap top for hours every day. The worst thing of all for posture, is to sit side on to your desk. Do what you can to be able to face your monitor squarely. If you regularly have to turn, turn your whole body not just your neck or spine, otherwise you risk developing a scoliosis by only ever rotating in one direction. Sitting with the legs crossed will in time create an imbalance in your pelvis which will carry on up the spine, so uncross your legs and sit with your heels under your knees instead.

Try this exercise daily to maintain mobility in the shoulders and relieve tightness across the chest.

Emotions You are probably aware that negative thoughts such as worry and doubt cause the sensation of anxiety in the body; butterflies in the tummy or the literal feeling of adrenaline surging through you. Negative thinking therefore, causes stress. The brain and nervous system only understand stress as threat and will essentially do what is natural to support you in escaping the threat. You will be forced to take shallow breaths into the chest in preparation to run or fight. So in order to relax the nervous system we need to move the breathing into the belly so informing the brain that you are in fact in a state of rest. Thoughts are not facts. So write positive affirmations and post them around you! ‘I am confident’. ‘Overcoming challenges builds strength’. Or as I saw on the final of The Great British Bake Off; ‘I have won’ (the great British bake off). Making affirmations in the present tense, as if they have already happened, helps us to think more positively.

Breath Lying on your back with your knees bent, or sitting upright with your lumbar spine supported, breathe into your belly as if you were inflating a balloon both upwards and width-ways. This may feel alien to begin with, especially if you are used to chest breathing. You may have to imagine your rib cage expanding first and then bring the breath down to the belly.

With practice this action will inform your ANS that you are relaxed. If you are familiar with Ujjayi breathing, this pranayama will slow your breath down and help you to relax more. You should aim to breathe out for twice as long as you breathe in. Initially however, you may need to keep the ratio equal and gradually lengthen the out breath. This is particularly important if you are depressed and/or suffer from lethargy, as lengthening the out breath makes us more relaxed and as a result, for some at least, a little sleepy.

I like to start my day with this breathing practice while still lying in bed. It is also a helpful practice to lull you to sleep and to give you mental space at the end of your working day.

Do you ever get home with the feeling that the last thing you are ready for is your family pouncing on you and demanding your attention? One of the biggest gifts you can give your family is time to yourself first. After all, I’m sure they would rather enjoy your company when you are relaxed and jovial, than when grouchy and snappy! Let it be known that before you spend time with them, you need 5 minutes to lie down somewhere quiet and focus on your breathing.

In addition to the breathing practice, you can use the out breaths to visualise your back, neck and shoulder muscles relaxing; melting like butter into the ground beneath you. Stay for as long as you need to so that you relieve some of the tension of the day.

If this sounds like your life, you might find the Stress Busting Yoga on the first Sunday of each month a helpful lesson to take. During the two hours from 10.00 - 12.00, we practice some strong asana to rid the body of stress hormones and include some restorative poses, deep breathing and relaxation or meditation to help you feel restored.

5 Ways to Well-being - Wisdom from Sussex Oakleaf

Ever since completing my training in Yoga Therapy for the Mind with The Minded Institute, I have considered myself to be cured of mental illness. But lately I have had to accept that I will never be fully cured of my particular mental illness. It is triggered by stress and even though I advocate that yoga and mindfulness practices are life-long when managing mental illness, stress has a way of blocking them out for me and like every human, I get overwhelmed by the stress and put those practices at the back of the list of jobs to be done. Because in my head, if I tick off all the other jobs that I believe to be causing the stress, I will cope better. But this is rarely the case.

Taking a week off afforded me the time to rest, recuperate and regroup; to prioritise my practices again and therefore my well-being. Consequently I found the space I required to set up strategies that should keep me on the straight and narrow.

I found wisdom from the young that week. The coordinator of the Sussex Oakleaf Youth Mental Health group that I volunteer for 'BeOk', constructed a list of 5 ways to well-being. These are:

Connecting. Learning.  Being Active. Noticing. Giving.

Connecting with family, friends, colleagues and community satisfies a human need of feeling valued and close to others. Connection can also be felt for some through religion, spirituality and nature. In the group we drew mind-maps of things that cultivated connection for us. Other than those mentioned above, examples were communication, reliance, sharing, trust, honesty, love, safety, grounding etc...

This was only the first step on our journey to exploring the 5 ways of well-being together. I find the intelligence, honesty and wisdom of these young men and women incredibly humbling.

Next on the list is Learning. During the BeOk sessions, we have discussed in the past how exams put too much pressure on those of us whose memories have been affected by mental health. But there is always something to learn that can be done just for the fun or fascination of it such as a new skill. Continued learning enhances self esteem and encourages social interaction. Setting goals can be a great way to achieve a sense of well-being.

Being Active is vital for health in general. Regular activity is associated with lower levels of stress, anxiety and depression and is essential for slowing age-related cognitive decline.

Noticing the things around you comes under the umbrella of mindfulness; simply being more present and attentive to whatever you are doing or whoever you are speaking to. Savoring the moment; eating lunch without looking at your phone for example, hearing the words another is saying are ways to help you appreciate the important things in life and in turn, to make positive choices based on your own values.

Giving time to others is incredibly rewarding and helps to create connections. Acts of kindness to a friend, neighbor, community group or charity are more likely to make you feel happy!

I have found that the best strategy for me to cultivate well-being is to be organised. I used to be more organic in the way my days evolved but I found it was too easy to be lazy. So I set myself daily goals, ticking off at least two of five ways to well-being. And it feels good!