Well+Being Holistic Mental Health
Emotional Health & Wellness Tips From The Therapy Couch And Other Places
Gaslit by the System: How Perimenopausal & Menopausal Women With Mental Health Changes Are Dismissed by Doctors and Therapists
Perimenopause is a profound biological transition that marks the beginning of the end of a woman’s reproductive years. While many associate this phase with hot flashes and irregular periods, far less attention is given to the complex emotional and mental health changes that can arise as the many body-wide systems are impacted by hormone depletion. Typically high-functioning, already overwhelmed New York City women are caught off guard. For many, perimenopause is not just a hormonal shift but a neurological and psychological one, capable of reshaping how they think, feel, and relate to themselves and others.
My mental health is tanking—what’s happening to me?
So many women have no idea what is happening to them during perimenopause. They feel emotionally off-balance, disconnected, or unlike themselves—and often, they’re met with confusion or dismissal. Their doctors may be undereducated about the emotional and neurological dimensions of hormonal changes, or tell them they’re "too young" for hormone therapy. Many are left feeling brushed aside or undersupported. Compounding this is the reality that most mental health professionals receive little to no formal training on how hormonal transitions impact emotional well-being. This lack of awareness can leave women misdiagnosed, misunderstood, and unsure where to turn. In my Manhattan-based boutique psychotherapy practice, I regularly hear from high-functioning, high-achieving women who have been struggling in silence, unaware that their mental health challenges are rooted in hormonal change. Therapy that integrates an understanding of these transitions can be a game-changer—offering validation, regulation, and real tools for relief.
What’s on Your Not-To-Do List? How Letting Go May Be the Key to Feeling Better
While reading a thoughtful article on Lifehacks, I was reminded of just how much pride we take in our daily to-do lists—and how deeply modern culture, particularly here in New York City, worships at the altar of productivity. We’re a society of movers and shakers. Our calendars are full, our inboxes overflowing, and we often measure self-worth by what we’ve accomplished by the end of the day.
But here’s a gentle reframe worth considering:
What if feeling better—more grounded, more content, even happier—wasn’t about doing more, but about doing less?
This article introduced a refreshing concept: the Not-To-Do List. Instead of optimizing every moment for efficiency, this list invites us to look inward and ask:
What am I doing—mentally, emotionally, behaviorally—that’s contributing to my unhappiness?
It’s a powerful question. And one that brings many people to therapy.
Why Therapy Often Begins With Unlearning
As a therapist working with high-functioning individuals, I often hear a version of this:
“I just want to feel better.”
But feeling better isn’t just about goals or action steps—it’s often about identifying the hidden habits and mental scripts that are making life harder than it needs to be.
We rarely pause to take inventory of the things we do automatically—judgmental self-talk, perfectionism, emotional avoidance, people-pleasing, numbing behaviors—that, over time, chip away at our capacity for joy, peace, and connection.
The Lifehacks article suggests something radical: Start your emotional healing by creating a personal list of habits that generate misery. Then, ask yourself honestly:
How are these behaviors serving me—and what might it feel like to gently let them go?