I see you out there. You spent much of your late 20s and 30s working through wounding and trauma that you knew was interfering with your relationship with yourself and others. You read the books, did the workshops, went to therapy – you did “the work.”

And you felt so much better for it. But now, here you are in your midlife chapter and somehow the memories and feelings are resurfacing. You find yourself thinking about experiences you had long since worked through – childhood memories are returning, body image or disordered eating has re-emerged, old relationship wounds feel raw, or you’re having emotional reactions (triggers) that surprise you.

Believe it or not, you’re not alone in this. Many midlife women experience the resurfacing of old emotional experiences they thought they had already worked through. Let’s dive into why.

Where to begin with this one? The anger and irritability are real. Some women even call it rage.

Things that once rolled off your back now make you furious. You're snapping at your partner, feeling irritated with coworkers, and can’t quite pin point why.

You might be wondering: What’s going on here? I don’t feel like myself.

If you're in your in midlife, perimenopause may be playing a role. But there's often more to the story than just the hormonal fluctuations at hand. In this post, let’s talk about the anger and irritability that commonly surface in perimenopause and how to work with it.

So there you are, my high-achieving friend, moving along with your life – navigating (likely) a mix of hormonal flux, career demands, caregiver obligations and, you know, life. You had been doing pretty well the past few weeks – feeling on top of things and getting it done like you usually do. The systems, rituals and routines were working and you were working them. That’s such a good feeling, right?

But then something happened. Life got life-y as it tends to do.

… You got derailed and the anxiety has officially crept in. Now you’re feeling overwhelmed and in a downward spiral, and you don’t know how to get back on track. Meanwhile, your inner critic has grabbed the closest megaphone and is yammering on about how you’ll never meet your goals and there’s really no point in trying. Maybe they’re going on about how “this is what always happens” and that “overwhelm is just an excuse for laziness” ….

Therapists aren’t really supposed to play favorites, but I’ll be honest - I adore working with women with ADHD. They are amongst some of the most interesting, creative and thoughtful clients I have and yet, ADHD gets SUCH a bad rap in our culture. The mere labeling of “disorder” is problematic and arguably inaccurate.

As if our brains are the problem and not the cultural expectations and norms ….

If you’re tuned into the midlife corner of the internet, you know the space has gotten noisy AF.

Hormone Replacement Therapy (HRT) is being talked about and then talked about some more, often touted as a panacea for the perimenopause and midlife transition.

In some ways, the former is huge progress and falls into the category of it’s about time. For much too long, HRT had been villainized, leaving women with little to no treatment options for difficult symptoms of vacillating, chaotic estrogen and progesterone levels in perimenopause.

But the current conversation is lacking nuance about HRT and neglects completely a very important part of midlife – the felt experience.

As a therapist who specializes in working with midlife women, I hear time and time again questions of spirituality and belief systems parallel questions about identity, purpose and creating a meaningful life.

That’s not by accident. At this stage in life, at this period in history, women are seeking more depth in the way they understand themselves and their place in the world. Spiritually-integrated therapy is a way to explore that level of seeking.

I see you out there, quietly wondering who you’ve become now that you’ve hit midlife.

Sometimes that very question arrives in a series of small whispers. We wonder about our changing likes and dislikes, our personal style, the types of relationships we want. Sometimes, though, the question of identity shows up in the urgency of a rebel yell – like, okay: Who have I become and do I even want to be this person? What’s my purpose?

No matter how these questions surface for you, it’s normal to wonder. It’s common. It’s healthy. Midlife is a natural time to pause (literally) and take inventory …

Does any of this sound familiar?

You wake up with a tightness in your chest or a strange lightheaded sensation, and you panic, which only makes it worse.

You forget a word you’ve used a thousand times, or maybe even why you walked into a room.

You find yourself, for the first time, really considering your family health history and wondering if you’re destined to repeat patterns.

And then the mental spiral begins.

So you consult Dr. Google or his assistants ChatGPT or Claude, and maybe you get some temporary reprieve from the worry, only to find yourself feeling the same way the next day. You can’t shake the feeling something must be wrong …

In addition to the identity shifts, hormonal flux, and existential crunch of midlife, Sarah and so many women like her are now feeling shame for even wanting, needing, or craving support.

These days, we’re not supposed to call our midlife stress a crisis, even though that may be our truth.

Midlife has had a rebrand—which, in a lot of ways, has been a step forward. I’ve written about it as well.

For years, women were told to fear midlife, as though it marked the beginning of decline. Thankfully, we’re beginning to rewrite that story.

But somewhere along the way, we’ve created a new impossible standard, and midlife has become subject to toxic positivity …

Midlife irritability is extremely common, but that doesn’t mean you need to white-knuckle through it. Let’s jump in to what this all means and how you can access support …

I won’t romanticize perimenopause … because it’s A LOT.

Many women are caught off guard by the intensity of what surfaces during this time: anxiety that feels unfamiliar, mood swings that seem disproportionate, grief that comes out of nowhere, or a persistent sense of “not feeling like myself.”

Caring for ourselves and receiving care become non-negotiable. Here are five grounded, compassionate ways to do that. Let’s dive in.

A deeper look at midlife changes, identity shifts, and the role of perimenopause

Many women I work with reach a point where a persistent thought begins to surface: I want a different life.

It may start as a soft whisper and grow, or it may arrive as an all out scream. Traditionally, this is the trope of the midlife crisis, but I like to call it the Midlife Invitation.

As a psychotherapist who specializes in working with women in perimenopause and midlife, I hear the same questions again and again. These aren’t surface-level concerns. At all. They’re deeply felt experiences about mood, identity, relationships, and what it means to move through this transition with clarity and self-trust.

Ya’ll, there’s been plenty of conversation lately about increased anxiety in perimenopause, but we’re not giving as much airtime to anxiety’s cruel cousin: depression. And we really need to.

Truly, the omission of depression from the conversation is not much of a surprise. Anxiety is much more socially acceptable as far as mental health concerns go. In fact, I could write a whole blog about that topic, but I’ll say here that folks typically think of anxiety as related to productivity. It’s work stress. I’m stressed about caring for ___. I lay awake thinking about ___. And in our culture, there’s a martyrdom that happens at this intersection.

Depression, meanwhile, has been framed as the opposite, and it’s more stigmatized. Even more, depression can be hard to recognize. It shows up for women in many different ways and hinders their wellbeing accordingly. That’s even more reason we need to normalize and tend to depression in perimenopause early, because it’s much more common than you’d think.

There is a steady and persistent message running through our culture: women are most valuable when they look young.

This article, written by Jessika Fruchter LMFT, explores the impact of toxic youth culture and beauty industry marketing on midlife women and identifies strategies for safeguarding our mental health.

For many of our generations, the topic of perimenopause/menopause was never discussed, and if it was, it was hush-hush, referred to cryptically or as fodder for jokes. Talking about perimenopause openly in the context of women’s health is a new development. And long over due.

This is the first of a series of blog posts that will explore cultivating wellness during perimenopause and reclaiming a rite of passage that has been minimized and/or over-medicalized.

Ya’ll, here we are. I’m not going to sugar coat anything. It’s a new year with the same dumpster-fire political climate. It’s overwhelming.

But let me pause here for a moment because if you don’t know me, you may be wondering why a psychotherapist is writing about the political climate. My ‘why’ is pretty clear. Feminist Psychology, the approach from which my work is based, does not separate individual wellness from collective systems. This is to say: the political is always personal.

If this isn’t for you, I don’t take it personally. But for so many of you, I see you out there trying to balance staying informed with keeping your mental health intact and struggling in the process. As the year picks up momentum, I’m reminded that to be awake, really awake and sentient, requires a particular kind of courage and strategy. The choice is also a privilege, which I bring up as an acknowledgment, not a source of guilt.

The courage that we need in this case is not the loud, performative kind. Not the grit-your-teeth, push-through kind either. It’s the quieter courage of staying present, of feeling what is actually here, of resisting the many ways we are encouraged to numb out …

The 12 Days of Yule span the time between the solstice and the New Year (or a day before/after). This marks a liminal corridor between what has ended and what has not yet begun.

What I love about this framework is that it mirrors something I see again and again in midlife and perimenopause:
the need for integration rather than reinvention.

Each day carries its own subtle theme of ancestry, stillness, shadow, intuition, creativity, commitment. But none of them ask us to hustle toward clarity. Instead, they invite us to listen. To tend the hearth. To rest. To let something slowly take shape beneath the surface.

This feels especially important in a culture that treats January 1st like a starting gun.

For better or worse the holidays shine a light on all that's there and all that's not.

Anger, irritability, sadness, grief and anxiety are all common (and understandable) feelings. We’re inundated with the Hollywood version of what the holidays are meant to feel and look like, and the bar is just too dang high ….

When women in their 40s and 50s say things like “I feel like my brain is broken” or “I used to juggle it all, and now I can’t keep up,” they’re not being dramatic or hyperbolic.

The overwhelm is a very real, very common experience. In fact around 80% of the women I work with share these concerns.

Gen X and Elder millennial women are knee deep in midlife and realizing the struggles they’ve carried for decades - difficulty staying organized, easily fatigued, sensory sensitivity, rejection sensitivity, trouble with motivation, and generally on top of things - may have a name: ADHD.