Is Catastrophising a Menopausal Symptom

Most of us were raised on the Old Woman who Swallowed a Fly (or the House that Jack Built, or the one about the kingdom being lost for want of a horse shoe nail!) Those tales of escalation are compelling - and amusing - unless they're playing inside your head and won't go away.

And sometimes it can feel like you only have to see a fly before you're choking on a horse. It can happen so fast that we go straight to visions of cars flying off hillsides, of cats under fallen cupboards, or pitiless exile in foreign lands before we've noticed that the thought process is even happening.

There can be an advantage to thinking of worst case scenarios. The cupboard is now drilled into the wall, so it's not going to fall on cats or anything else. But catastrophising goes far beyond this. Worse case scenarios become intrusive and it's exhausting and distressing.

It is, strictly speaking, a thinking habit not a physical symptom. But it's thinking habit that many of us never experienced before perimenopause - or which has worsened. I suspect it's to do with the amygdala - the fight or flight centre of our brain - which is affected by changing hormone levels. While many theories work on the basis that it is our thoughts that cause anxiety, for many of us anxiety is a feeling before it's a a thought - and that feeling could well be generated in the amygdala.

So what can we do to help ourselves?

Go upstream

We probably catastrophise more when all is not well with our lives. This is a habit that seems to come and find me when there's something in my life that's already a bit out of whack. Not enough alone time. Not enough people time. Not enough down time. Not enough up time. Not enough exercise. Not enough rest. Not enough time outside. One of the tricks of surviving menopause is to figure out the elements that need to be balanced to keep our lives working healthily.

Good sleep and a healthy diet are probably going to help to. And meditation and mindfulness are always worth a shot. And many people find that HRT deals with the underlying anxiety - although some more prefer other medical options.

Spot it happening

It isn't easy. It can happen rapidly, and once it's there we can be so involved in it, we don't notice it. It's just our reality in that moment.

But when you are in that state you may notice certain things happening in your body - whether it's shortness of breath, agitated movements, sweating or heart thudding. They're things you can look out for.

Other people's reactions may also give you a clue that something is happening. If they are people you trust, you may wish to let them know how they can gently let you know you've started catastrophising.

And we do get better at noticing it the more we practice.

I've got a small pebble that's often in my pocket, with the word 'stop' written on it. When I start catastrophising, I often start fidgeting and happen on the pebble, which acts as a reminder of what's happening.

Stop it happening

Some people find it works just to tell themselves to stop - or to visualise a big stop sign. Sometimes it takes more than that.

Distracting ourselves can be really useful. That can be through mindfulness activities. The simplest one for me is: take three deep breaths; list three things you notice; wiggle three parts of the body. There are many others you can try.

Or sometimes you need to do something. I know many people who like to knit or sew to distract themselves but that's not always available.

If you've someone with you, try setting up a conversation about something else. Or get them to tell you a joke.

When it's at night

Our worst fears plague us in the very early hours of the morning, when the brain has so few stimuli. So I give it a few extra! I put fragrance on my pillow. You can get all sorts of sleepband and pillow sleepers. I have a Snoozeband which I love - alongside Radio 3s Night Tracks.

I also have a mental repository of nice things to think about when I wake at night. The holidays I've been on. The people I love. The best birthdays ever. The cutest baby animals I've ever seen.

Remind yourself just how much you have coped with

The irony of this is that we're really good copers. When the you know what has hit the fan, we've always sorted it. Believing in your own resilience can bring you a lot of comfort when this nonsense starts happening.


I think it's fair to say, though, that stopping the thinking pattern is hard, particularly when it's become ingrained - our brain is going to keep jumping back on its old track and bringing up those images of disaster. We may be able to stop ourselves escalating but pulling it back completely may take a great deal of practice.

Likewise stopping the thinking might not stop the underlying feeling of anxiety of that's hormonally driven. It might just be a case of stopping it getting worse and breathing through the anxious feeling until it passes.