CBT for Perimenopause and Menopause
Cognitive behavior therapy (CBT) is an evidence-based form of psychotherapy that can help manage perimenopause and menopause symptoms such as changes in mood and sleep difficulty. CBT focuses on the relationship between thoughts, emotions, and behaviors and teaches skills for how to change unhelpful thoughts or behaviors that may be contributing to, or worsening menopause symptoms. For example, hot flashes and night sweats are two common vasomotor symptoms of menopause. When experiencing a hot flash, you may think, “This is horrible. I can’t stand this!” which may increase your stress and anxiety and intensify the severity of the hot flash.
How To Manage Symptoms
By changing your initial thought to be more balanced and helpful – for example, “This is unpleasant and it will pass” – you can lower your stress and better manage symptoms. Also, we live in a go-go-go world and it is common to downplay symptoms and focus on charging ahead with various tasks. However, downplaying or ignoring symptoms may increase stress over time and an important component of therapy can be learning to acknowledge and normalize your symptoms while enhancing helpful coping skills.
The often unpredictable nature of menopause symptoms can lead to anxiety as you are not sure when symptoms may hit, how intense they will be, and the impact they may have on your day. Given this, you may have the urge to avoid certain activities or social situations. Further, we live in a society that is focused on youth and it is natural to feel a sense of embarrassment or stigma related to aging and menopause. Stigma can lower self-esteem and create or strengthen unhelpful beliefs about menopause. CBT can assist in challenging unhelpful beliefs, creating more helpful beliefs, and taking steps to engage in enjoyable and meaningful activities.
Further, it is common to resist unpleasant physical symptoms and experiences. You may feel a sense of battling with symptoms such as hot flashes, desperately wanting them to go away, and the more you fight against them, the stronger they seem to become. CBT and related therapeutic approaches can help you cultivate a sense of acceptance and willingness toward your symptoms. You don’t have to like them, yet by “dropping the rope” in the ongoing game of tug-of-war with your symptoms, you can free up energy to focus on meaningful pursuits and not exacerbate the intensity of symptoms. Also, the more you practice accepting the moment as it is, you create a sense of calm and set yourself up to have a greater ability to implement additional helpful behaviors.
Sleep and Menopause
Night sweats can disrupt sleep and poor quality sleep can lower mood, energy, and quality of life. CBT for insomnia (CBT-I) is an effective treatment for sleep difficulty and can assist you in practicing helpful sleep behaviors and improving sleep within the context of perimenopause or menopause. For example, maintaining a consistent wake time, getting out of bed if not sleeping, and changing how you respond to anxious thoughts about sleep. Click here for an overview article on CBT-I. CBT also involves learning relaxation exercises such as slow, deep breathing which decreases nervous system activation and allows you to feel more relaxed and grounded.
Please contact us at CBT Denver to learn more about evidence-based therapy approaches for perimenopause and menopause.