E30 - Am I Going Crazy

Listen to E30  Am I Going Crazy here - https://bit.ly/4bvO4zs

Hey there friend, it is Dr. Tiffany and this is the Integrative Mental Health Therapy Podcast with Dr. Tiffany.  I want to welcome you to episode 30, which I cannot believe we're on episode 30 of the public podcast, which means I've done a total  of  66 podcasts. So  that's incredible to me  because I actually did a bunch of private podcasts as well. at some point we're going to systematically open those up to the public. But anyway, I digress. This is episode 30 of Integrative Mental Health Therapy with Dr. Tiffany. Am I going crazy? A love note to women in their forties. That is today's podcast. And as I sit here drinking my tea, I'm thinking about all of the women that I work with who  are  noticing that their brain is changing just like their body has changed in their mid to late  40s  and early  50s. And I did a previous podcast, I think it was maybe episode 22 even, and I would encourage you to go back.  No, yes, episode 22, perimenopause and ADHD. And then, I did a podcast, I think next, shortly thereafter was Your Inner Critic. That was episode 24 and people pleasing. And then I did episode 28, I reported Dear Parentified Daughters. And it has been me dropping into this particular age group. This is a big part of my practice. My practice has shifted over the years as I have really just dialed things in a bit really focused on working with women because that is where my heart is and young women. So women 20 to 24 years old, like I am a rock star with that group. I don't know what it is, but I love working with them and they love working with me. And women and they're in the 45 to 55 range.

And in that age range of 45 to 55, there is a pattern of things occurring that is similar but very different to what was going on at 20 to 24, 25 years old. If you are my listener, you were definitely in that later age group and you're noticing that your brain has changed, your mood has changed, your desires are changing. And at times you can feel,like you don't like anyone, you don't like your spouse, you need a new job, you need new friends, you don't have any hobbies, you need to deal with the fact that something's happening with your hormones that is terribly disrupting your sleep, your appetite, your cravings, your muscle tone. It feels like you are losing your mind. I'm gonna take a sip of tea here.

And  you aren't losing your mind, but your brain is very much changing. Your brain is remodeling in a very similar way to the way it remodeled when your menstrual cycle first started. And then it changed again around 25. For women in particular, our  big moments are when we start menstruating,  when our brain myelinates, that's around 25 and as we're facing menopause. All of these things start with M, that just happens to be a coincidence.  And what is happening for us,  because  I just celebrated my 47th birthday and I am  so intrigued,  it has been so surreal to be in this place  of hormonal shifting. what that means for energy and sleep, but also,  oh, just like things I'm interested in and things that my clients are interested in  and,  um,  dealing with that inner people pleaser and that inner critic and how,  um,  my attitude towards their demands is parts of my system has so dramatically changed. And I know that this is  a part of this phase of life. So I know you're not going crazy,  but not just because I can relate to your experience.  So  let me just frame this. In the Paraminopause and ADHD podcast, I talked about what is happening during perimenopause and menopause? So just to be clear menopause requires that you have gone 12 months without a menstrual cycle Perimenopause is the decade leading up to that glorious moment where you've gone 12 months without a menstrual cycle  There is a lot happening as we wait for these cycles to stop okay  I am in that phase where I there is no indication that I'm stopping anytime soon. But things have gotten really weird.  so  if this is where you are too where it's like I am very different But some things are very much still the same  as you're monitoring your blood work you're gonna notice that your Progesterone your progesterone has started to shift it is on the decline You may be more anxious more irritable. You may not sleep as well. You may  Notice that during the menstrual cycles, have premenstrual syndrome  or  your cycle is shorter.  Your hair may have started to thin a bit. Your nails may have changed. You may notice that you need to be more intentional with maintaining  muscle tone and your workouts.  really where what I noticed as a naturopathic doctor and neuropsychotherapist, where I sit in this intersection of brain, body, and mind is women feel like all of the things they used to care about, they don't care about anymore. They feel like they're ready to start a fight with someone or they're ready to get a divorce  or leave a relationship or quit a job. And that is because  as women, we are biologically wired to be caretakers. Now, is that a spectrum?

Is that on a continuum? Yes. Some of us,  I have a whole career where I just care about other people's problems and other people's struggles and other people's relationships and other people's families. So some of us are wired to be, you know,  high level caretakers, right?  Some of us express that  with having children and express caretaking with having children. Some of us express caretaking and, ways of like caring for our communities or caring for our  elders.  Um, but I just did an interview with the warrior parent podcast, and we just talked about how women are caretakers and we are biologically wired to, to care for other human beings. And we have the hormones to do so. And guess what? I swear God, mother nature, all of the above have a sense of humor. because menopause marks the end of caring.  Okay?  And I just think it is absolutely fascinating that menopause, when you are no longer really supposed to be, from a biological reproductive perspective, capable of creating a child,  where it all ends, and you really, at that age, Mother Nature had intended for you to have kind of moved into a different phase of  mothering and parenting, you don't care  as much about all the things that you used to care about because  literally you do not have the levels of estrogen or progesterone and you have much higher levels of cortisol and testosterone than you ever have in your life. So no, you're not going crazy. You are preparing for this phase of life where you're less engaged with  everybody else's issues and struggles and desires for you and needs for you, and you are more willing to step away from those and  listen to what your own interests  are, your own desires, your own needs, and you're paying a lot more attention to whether the people in your life care about those or if you  really chose individuals and friends  and cultivated relationships where your needs weren't important if you have chosen jobs that  and hobbies that are not nurturing to that and you are opting to find people and spaces and places  and careers that feed you that love you back.

So no, you're not going crazy. And so what I have to do when I'm working with women  and couples, you know,  in my practice, because I oftentimes will work with neurodivergent  mixed couples  in the practice,  is really work with women to understand that this is what's happening. And then in a perimenopausal ADHD female brain, there are receptors in the brain for hormones. And as those hormones are dropping  out,  the perimenopausal brain, ADHD brain may be more trigger happy to  end a thing or change a thing or find a new something because the hormones have dropped out so dramatically.  Serotonin levels may be lower and dopamine levels are  absolutely lower.

So  I find myself leaning into a blended approach  of, you know, like ADHD relationship therapy, as well as some of the more traditional kind of  therapy models for relationships, because this time of life is hard for all brains going through perimenopause, but especially ADHD brains or glitchy brains or anxious brains.

You're not going crazy, but I need you to take a beat  and give your partner an opportunity to learn what your needs are, to learn to meet them. And I need you to honor the fact that you have spent anywhere from 20 years to 30 years in a relationship, know,  or 10, wherever you are,  but really cultivating relationship where you didn't prioritize your needs, you were engaging in a lot of people pleasing and you didn't teach the people around you how to care for you. And they may need  six to nine to twelve months to really learn how to do that before you give up on the relationship because you are now showing up differently than you ever have. Okay, but no, you're not going crazy. Your brain is remodeling, it's rewiring, it's remapping as your hormones are,  and you're figuring out a new way of doing life. And it is an exciting time. It is an adventurous time.  And you very much can take the partner that you chose along on that path with you  with a little bit of effort on both your parts. I hope this was helpful. I hope this  is an episode that you can share with someone that you care about. And until next time. Be well.