Why Perimenopause Feels Like Losing Yourself

And why you’re not broken.

There’s a specific kind of disorientation women describe in perimenopause:

“I don’t feel like myself.”

“My emotions don’t match my life.”

“I’m reactive in ways I’ve never been.”

“I can’t think clearly.”“

It feels like my body is running the show—and I’m just trying to keep up.”

If that’s you, you’re not imagining it. And you’re not failing at life. Perimenopause can genuinely change how you feel, how you function, and how you experience your own identity—because it’s not just a reproductive transition. It’s a nervous system and brain transition, too. ACOG+2PMC+2

Perimenopause is a Window of Vulnerability (and that’s research-backed)

Large studies and reviews consistently show that depressive symptoms and first-time depression risk increase during the menopause transition, especially in perimenopause. A 2024 meta-analysis found perimenopausal women had a significantly higher risk of depressive symptoms/diagnosis compared with premenopausal women.

This doesn’t mean hormones “cause” every emotional struggle. It means the body is going through a shift that can amplify stress sensitivity, destabilize mood, and bring old vulnerabilities to the surface. PMC+1

The Core Reason It Feels Like You Aren't You

Hormones influence the brain, not just your cycle. During perimenopause, estrogen and progesterone don’t simply decline smoothly—they often fluctuate unpredictably. Those swings matter because estrogen receptors are active in brain regions involved in mood and emotional regulation. Researchers describe perimenopause as a time when shifting reproductive hormones can interact with stress biology and brain systems involved in mood—helping explain why some women experience emotional dysregulation, anxiety, or depression even if they’ve never had it before.

The Nervous System Piece That Often Isn't Talked About:

Perimenopause often comes with:

• sleep disruption (which directly worsens mood and emotional regulation),

• stress physiology shifts (more sensitivity to stress),

• and symptoms like hot flashes/night sweats that fragment rest and recovery.

So a woman can feel “emotionally unstable” when what’s really happening is her nervous system is losing its usual buffering capacity. When your system is stuck closer to fight/flight—or drops into shutdown—your emotions feel bigger, your tolerance gets smaller, and your sense of self can feel harder to access. This is not weakness. It’s physiology.

Why It Triggers Confusion

This phase isn’t only about symptoms. It often hits at the same time as:

• caregiving demands,

• career strain,

• relationship shifts,

• loss, grief, or major transitions,

• and the quiet realization that “the old way I ran my life isn’t working anymore.”

That combination can feel like you’re losing your old identity—when in reality you may be outgrowing a version of yourself that was built for a different season.

In other words: perimenopause can be a rite of passage, but it becomes brutal when we’re expected to navigate it with zero support and a “just deal with it” mindset.

Who is More Likely to Struggle (Important, and Not Your Fault)

Not everyone experiences severe mood disruption—but research suggests higher vulnerability in women with:

• a history of depression/anxiety,

• high chronic stress,

• sleep disruption,

• and significant past adversity or trauma.

One study found adverse childhood experiences were associated with increased risk of first-episode depression during the menopause transition. This matters because it reframes the story. You’re not “too sensitive.” Your nervous system has carried a lot—and this transition can unmask what you’ve been managing for years.

What Helps (a Grounded, Evidence-Informed Starting Point)

Perimenopause isn’t meant to be white-knuckled.. If symptoms are interfering with your life, support is appropriate.

A few evidence-aligned directions to explore with a qualified clinician:

• Screening and support for mood symptoms (especially if depression/anxiety are new or worsening). Stanford Medicine+1

• Sleep support (because fragmented sleep can be gasoline on emotional symptoms). ACOG+1

• Menopause-informed care (you deserve a provider who understands this transition and doesn’t dismiss you). The Menopause Society’s patient education resources are a good place to start. The Menopause Society+1

And from an embodied perspective: supporting regulation through the body—breath, movement, nervous system work—can help rebuild steadiness and self-trust as your biology shifts. (This doesn’t replace medical care; it complements it.)

When to get more support right away

Please seek prompt professional support if you have:

• persistent depression, hopelessness, or panic,

• thoughts of self-harm,

• inability to function at work/home,

• severe insomnia for weeks,

• or symptoms that feel extreme or frightening.

This is not a personal failure—this is a signal to widen support.

Grounding Support During Perimenopause

(Simple tools that help the nervous system and hormones stabilize)

When perimenopause feels destabilizing, the goal is not to “fix” everything at once. It’s to restore a sense of safety, rhythm, and steadiness in the body. These tools are gentle, accessible, and supportive for many women navigating this transition.

1. Regulate Before You Analyze

Emotional reactivity and brain fog are often signs that the nervous system is overloaded.

Try this:Once or twice a day, place one hand on your chest and one on your lower belly. Slow your exhale slightly longer than your inhale for 2–3 minutes. This simple practice can help shift the nervous system out of fight-or-flight and improve emotional regulation.

The goal isn’t calm — it’s enough safety for your system to settle.

2. Gentle, Rhythmic Movement (Not Exercise)

During hormonal transitions, intense workouts can worsen fatigue, anxiety, and weight resistance.

Supportive options include:

• Slow, flowing movement (Qigong, Tai Chi–inspired practices)

• Gentle somatic movement focused on sensation rather than performance

• Walking with awareness of breath and posture

Rhythmic movement helps regulate stress hormones, improve circulation, and support emotional steadiness without overwhelming the system.

3. Support the Liver–Nervous System Axis

Hormonal fluctuations increase the demand on the liver and detox pathways, which can influence mood, sleep, and inflammation.

Gentle herbal allies often used during this phase include:

• Lemon balm – calming to the nervous system, supportive for mood and sleep

• Chamomile – supports digestion and emotional steadiness

• Milk thistle – gentle liver support during hormonal shifts

Herbs work best when chosen thoughtfully and used consistently, not aggressively.

4. Nourish Blood Sugar and Minerals

Blood sugar instability can amplify mood swings, anxiety, and fatigue during perimenopause.

Simple supports include:

• Eating regularly (especially protein earlier in the day)

• Including healthy fats and mineral-rich foods

• Avoiding long periods of fasting if you’re already depleted or anxious

Stabilizing blood sugar often improves emotional resilience more than people expect.

5. Rebuild Rhythm, Not Willpower

Many women feel like they’re “losing discipline” during perimenopause. In reality, the body is asking for different pacing.

Supportive rhythms include:

• Earlier bedtimes when possible

• Reduced evening stimulation

• Morning light exposure

• Consistent daily routines, even if they’re simple

The body responds better to rhythm than force during this stage.

A Reframe That Matters

Perimenopause is not a sign that your body is failing you. It’s a period of increased sensitivity that asks for regulation, nourishment, and respect. When the nervous system and hormones are supported together, many of the symptoms that feel overwhelming begin to soften.

You are not broken.

Resources:

• ACOG (American College of Obstetricians and Gynecologists): Mood changes during perimenopause and what to know ACOG

• The Menopause Society (formerly NAMS): Mental health and menopause education The Menopause Society

• Cleveland Clinic: Perimenopause symptoms overview Cleveland Clinic

• JAMA Psychiatry (Freeman, 2014): evidence of increased depression risk around the menopause transition JAMA Network

• Peer-reviewed review (Bromberger, 2018): depression during and after perimenopause PMC

• 2024 meta-analysis (Journal of Affective Disorders): elevated depression risk specifically in perimenopause sciencedirect.com