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I have issues with perimenopausal anxiety a couple of weeks per month and don’t want to turn to SSRIs.

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My challenges with anxiety have been hormonal. I’ve had issues with both postpartum anxiety and now perimenopausal anxiety a couple of weeks per month as I’m approaching menopause. I don’t want to turn to SSRIs but some days are pretty miserable and most other days I feel fine. Any info you have to share regarding this topic or any natural solutions would be of great interest.

When I’m working with a client who reports symptoms like this we start with serotonin and GABA support; determine if they have low zinc, low vitamin B6 and low iron. I also always ask the question: are you on the birth control pill (now or in even in the past).

I’ve blogged about much of this in the past so I’m going to share snippets and blogs for further reading.

Serotonin support with tryptophan for immediate worry-type anxiety relief

In a study published in 1999, A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, tryptophan was found to reduce symptoms of PMS when used in the luteal phase or second half of the cycle (i.e. after ovulation).

This is very typical when I’m working with someone with both PMS (premenstrual syndrome) and perimenopausal anxiety, depression, irritability and mood swings. It typically takes 2 to 3 cycles for an amino acid like tryptophan to have an impact on the cyclical nature of your perimenopausal symptoms.

However, tryptophan does typically start to work right away on the less severe anxiety and mood symptoms assuming you find the ideal dose for your needs. I use the trial method to help my clients figure this out.

When you boost serotonin you also reduce the worry-in-your-head and ruminating type of anxiety, and end to panic attacks and phobias, a boost of confidence, no more depression and negativity, imposter syndrome that is no more, an end to your anger issues and irritability, an improvement in sleep and no more afternoon/evening cravings for something sweet.

You can read more about tryptophan here: Tryptophan for the worry-in-your-head and ruminating type of anxiety

GABA support for relief from tension-type anxiety

During perimenopause progesterone is often low and when it is low, we can expect GABA to be low too. Research confirms low GABA and high glutamate-glutamine in premenstrual dysphoric disorder (PMDD) and that shifting hormones may lead to dysregulation of GABA which contributes to HPA axis dysfunction. The HPA (hypothalamic pituitary adrenal) axis is your stress response system and when it’s not functioning well you are more susceptible to the effects of stress and more likely to feel depressed and anxious.

If your GABA levels are low you will feel increased physical tension and insomnia. The amino acid GABA, opened on to the tongue, can provide calming results within minutes.

Dee likes the instant calm and compares how it worked as well as Xanax had worked for her in the past:

I have taken Xanax in the past for panic attacks. My functional medicine doctor suggested this product as I wanted a natural product. I was amazed how it works just like the Xanax did – instant calm feeling within 10 mins of taking 2 capsules. I use them as needed when I am having heightened stress and anxiety.

Low zinc, low vitamin B6 and/or low iron?

Low iron/ferritin is common if you’re still having a period and it’s one of the important -cofactors for making serotonin, thyroid hormones and the sex hormones. Low iron, together with low vitamin B6 plays a role in anxiety and panic attacks. In one study premenopausal women who had been admitted to the emergency room with panic attacks were found to have both low iron and low vitamin B6. I have an entire blog post on this topic here

The other key co-factor for making serotonin is zinc. You’ll want to look into and address pyroluria if you feel more anxious in social situations like family gatherings, going to church events or community picnics, or even while doing business networking or in work meetings. The key nutrients for pyroluria are zinc and vitamin B6 and both help with PMS and perimenopausal anxiety, and hormone balance.

Are you on the birth control pill?

I recently reviewed Beyond the Pill A 30-Day Program to Balance Your Hormones, Reclaim Your Body, and Reverse the Dangerous Side Effects of the Birth Control Pill by Dr. Jolene Brighten.

If you currently on the pill or have been in the recent past read the above review and get the book to give you an excellent understanding of what may be going on with your body.

Dr. Jolene shares that mood disruption is common and mentions a study in the Journal of the American Medical Association which reports the following:

women who began the pill were more likely to be prescribed an antidepressant – which means it contributes to a bit more than moodiness

She writes in great detail about Post–birth control syndrome (PBCS) which is “is a constellation of symptoms women experience when they discontinue hormonal birth control.” She has found the symptoms of PBCS typically occur in the first 4-6 months after stopping the pill. As well as mood swings and anxiety, you may also experience heavy bleeding or no period, acne, headaches, infertility, pill-induced PCOS (polycystic ovarian syndrome), hypothyroidism, gut issues and even autoimmune symptoms.

You also want to reduce your stress levels. Here are some ideas for you:

All the above is a great starting point. You also want to consider adrenal support if needed; and support liver health, together with dietary changes, addressing gut health and thyroid health, getting toxins out of your life and figuring out whatever your own root causes may be.

Here is the link to the amino acids and pyroluria supplements I use with my clients.

Have you found that any of the above has helped you with your PMS or perimenopausal anxiety?

Do you have any stress-relief tips to share with other women who find themselves so stressed out at this age?

Feel free to post questions here too.

Bouldering envisioned as new treatment for depression and anxiety

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Climbing was my main sport for 15 years and I absolutely loved it. Bouldering, a type of climbing where you don’t use ropes, is really fun and exciting, as well as a great form of exercise. So you can imagine my delight when I read about new research that suggests it may also be used to effectively treat symptoms of depression and anxiety. I’ve added anxiety because we see similar underlying causes and solutions, and many individuals with depression also suffer from anxiety.

Here are the details from the University of Arizona (UA) press release

A growing body of research suggests that bouldering, a form of rock climbing, can help build muscle and endurance while reducing stress — and a new study co-led by a University of Arizona doctoral student of psychology suggests that the activity also may be used to effectively treat symptoms of depression.

UA researcher Eva-Maria Stelzer and Katharina Luttenberger of the University of Erlangen-Nuremberg led a team that involved more than 100 individuals in a bouldering intervention in Germany, where some hospitals have begun to use climbing as a therapeutic treatment.

The participants were randomly split into two groups. One immediately began the intervention, while the other group had to wait to start bouldering, which involves climbing rocks or walls to a moderate height without ropes or a harness. Each participant bouldered for three hours a week over the course of eight weeks.

Depression symptoms improved from moderate depression to mild depression over 8 weeks:

The team’s major finding was that, during the therapy, the immediate intervention group’s Beck’s Depression scores improved by 6.27 points, but for the same time period the group that was initially wait-listed improved by only 1.4 points. This drop in score reflects an improvement of one severity grade from moderate to mild depression levels.

“Bouldering, in many ways, is a positive physical activity,” said Stelzer, who began researching the benefits of bouldering while completing her master’s in psychology at the University of Erlangen-Nuremberg in Germany and is now completing her doctorate at the UA. “There are different routes for your physical activity level, and there’s a social aspect along with the feeling of an immediate accomplishment when bouldering.”

Stelzer presented the study and findings during the 29th annual Association for Psychological Science Convention, recently held in Boston.

Like me, the study authors, Stelzer, Luttenberger and Schopper have experienced bouldering first hand:

Invested in improving interventions to aid with such conditions, Stelzer, Luttenberger and Schopper, who have offered bouldering sessions for patients at a care center in Germany, drew on their own experiences as avid rock climbers and boulderers to investigate the benefits the sport could provide to those dealing with anxiety, depression, social isolation and self-esteem issues.

This is how I describe bouldering: you feel like a kid all over again, it’s a joy to be out in nature, sometimes it’s quite the adventure getting to the crag and finding the routes, and the sense of accomplishment when you succeed at a difficult route is quite amazing. It’s very meditative and your focus has to be spot on. There is also problem-solving involved as you figure out the moves.

The social aspect is also great – encouraging and supporting your fellow-climbers/friends and then being encouraged by them when it’s your turn. There is also a big trust aspect as you “spot” each other, making sure you each land safely on the bouldering mat should you fall off the climb or decide to jump off because it’s too challenging.

There is of course the exercise aspect too. After the hike in to the rocks or crags, bouldering builds strength and stamina, and improved balance and flexibility.

Here are some pictures of us bouldering in the UK with friends Marc and Cath a few years ago.

Hiking in to the crags in an almost “fairy-glen-like” setting. The big blue thing I am carrying is a bouldering mat for helping with a soft and safe landing.
Marc “spots” me as a I climb a fun and easy route. The left is me at the start of the bouldering route and the right is me topping out.
Brad “spots” Marc on a more difficult bouldering route (notice the bouldering mat below)

I highly recommend bouldering if you ever get the opportunity. There are also indoor climbing gyms with bouldering walls if you don’t have a rock-climbing area near where you live, or if you’d like to give it a go there first before venturing out to the crags.

Luttenberger’s message is the same one I have for my clients:

I’d always encourage patients to do the sport they like — may it be climbing or something else — as sport is a wonderful possibility to prevent all possible sorts of illnesses, mental and physical.

Given the positive results, the team believes that bouldering may be used to complement traditional care for clinical depression:

Team members are now working to develop a manual that could be adopted for an eight-week program integrating bouldering and psychotherapeutic interventions for groups.

I really look forward to recommending a program like this for my clients, in conjunction with dietary changes and supportive nutrients!

Have you tried climbing or bouldering? Would you be open to an 8-week recommended supervised bouldering program?

If you haven’t tried climbing or bouldering and this isn’t your thing I’d love to hear what exercise you love to do in nature?