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How Are You Holding Up?

On May third, in the Women’s Wisdom Village, we discussed the effects of long-term Covid-19 stress on our bodies, minds, and spirits. For women who are already navigating perimenopause, midlife, and menopause, daily life during a pandemic can amplify the stress that we are already managing. For example, based on my 2019 research survey, 40% of women respondents were experiencing sleeplessness and increased anxiety, 25% suffered from depression, and 11% were contending with mood swings—before the pandemic.

Compounding the stress of midlife with social isolation and mortal danger can intensify stress levels for women. While the combined stressors may make it difficult to separate the chicken from the egg as to the cause of the stress outcomes in our lives— is it menopause or Covid-19?—it's important to consider that living in mortal danger also affects the body and brain over long periods.

When we are in mortal fear for our lives, an instinctual survival response is triggered in our brains; Flight, Fight or Freeze. Evolution taught us that when a sabretooth tiger comes after us, we run, when attacked in battle, we fight, and when startled and caught unaware, we freeze. This deeply instinctual response comes from the part of our brain called the amygdala. It releases an instant flood of epinephrine, so we can outrun a predator, stand and fight, or hide and freeze. But we can’t run from Covid-19, there is nowhere to go, there is no physical enemy to do battle with, and we can’t hide. Living in fear for our lives and for our loved ones triggers this response over and over, and there is no resolution. All of that epinephrine coursing through our bodies has no outlet.

Our brains don't differentiate between an actual physical threat in front of us and the frightening images we see on TV or the web. Nor does our brain differentiate between a physical threat and the strong emotions that result from learning about horrible Covid-19 deaths. They all trigger the triple F response, again and again. The anxiety caused by the epinephrine coursing through our bodies doesn't respond to logic or rationalism as a calming agent. The constant uncertainty, loss of jobs, income, and personal safety all play a part in keeping the anxiety response active.

We have been living amid danger and uncertainty from day to day, week to week, and month to month. This causes literal physical and mental burn out.

Our brains are exhausted from processing constant mortal danger.

The parts of our brain that activate the F, F, or F response and the natural biochemical recovery from it are tapped out. Cortisol, one of the recovery hormones constantly responding to the epinephrine, can cause us to store fat and have food cravings at night when out of balance.

As a result, our bodies, minds, and psyches are drained, bone dry. The imbalance and stresses of these processes affect our concentration, cognition, emotions, and more. This is why the days meld into one another, why it’s so hard to focus and concentrate, and why our moods are a child on a park swing, flipping from high to low in an instant.

It can be challenging to be going through perimenopause, midlife, and menopause, and we now have Covid -19 to deal with at the same time. Some of the results of the stresses may overlap or some may be new to you. Since the beginning of the stay at home orders you may be feeling exhausted, yet be unable to sleep. You may have foggy-brain, the inability to concentrate, poor short-term memory, and shifting feelings that come and go in waves, such as anxiety, depression, anger, frustration, hopelessness, and sadness.

One minute we can feel "ok," the next we fear for ourselves and those we love. People who’ve lost their jobs and have no income may be living in fear of hunger and homelessness for themselves and their families. Thoughts creep in when we can't sleep at night about our own mortality and the death of those we love. We're mourning our former lives; we've come to realize that life may never go back to the way it was. There is now a dividing line in our lives, pre-Covid-19 and post Covid-19.

Many effects of pandemic stress on brain biochemistry and on our thinking and information processing, are similar to those experienced by women in perimenopause, midlife, and menopause. For women in Regency (ages 45-70), what is most important is how we manage our state of mind and our stress, no matter what the combined causes are. Despite all of this, we are not powerless to help ourselves. You can make choices that can help reduce your stress response and give yourself some much needed mental and physical recovery time.

First, I want to remind you not to spend too much time listening to the news or reading about it on social media. One hour a day, or less, will likely keep you up to date on everything you need to know about the ongoing changes in your home state. Instead, use social media to stay in touch with friends and family and to keep current on what is important to you in your life. If you are isolating in your home alone, please reach out to your friends and family daily. Stay in touch with the people you care about. As one day merges into another, we can lose track of time, so talk on the phone or video chat with someone each day. Hearing love, compassion, and empathy in the voice of another person is transformative. It actually releases a hormone that helps to calm you. You can’t hear the nuance of someone’s voice in a text. Reach out, folks will be glad to hear from you. It will help you both.

Second, if you are isolating with one or more adults, remember to be kind and compassionate with them and with yourself. Living in uncertainty and fear can bring out the worst in us. All of our faults and weaknesses can take center stage. Apologies for missteps and empathy for everyone’s anxiety can go a long way to keeping the stress levels down.

Third, get outside. Get out in the sunshine and get some exercise, any exercise, safely with social distancing. Only 30 minutes of activity like walking, yoga, or bike riding helps to relieve anxiety and releases feel-good brain chemicals. Being outside will also help to boost your vitamin D production.

Fourth, create a daily schedule that you can follow. Go to bed and get up at the same time every day. Eat healthy foods, get some exercise, and find something you really enjoy doing and schedule it into your days, such as reading, art projects, or gardening. Make time to play. Reach out to friends and loved ones often and make time to practice relaxation techniques, such a meditation, mindfulness, or breathing exercises.

This will not last forever, though some days it feels like it may. Let’s set our schedules, take gentle control of what we can, be kind, and creative as we journey forward together to create a new world.

Please take care of yourself.

All my best to you and your loved ones,

Dr. A.

If you have any questions or if I can help you, please reach out to me at or leave a comment below.

I invite you to join us for these conversations each week in the Women's Wisdom Village, on zoom. You can find the schedule here.

Credits: Photo header Sara Ritcher

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