Perimenopause, often referred to as the “menopausal transition,” marks the period when a woman’s body begins to shift from its reproductive years toward menopause. While menopause is officially defined as the point when a woman has not had a menstrual period for 12 consecutive months, perimenopause can begin years earlier—sometimes as early as a woman’s late 30s or early 40s. This transition is not only physical but can also have profound effects on mental health, often catching women and even healthcare providers off guard.
Recognizing Early Perimenopausal Symptoms: The early stage of perimenopause is characterized by subtle hormonal changes, most notably fluctuations in estrogen and progesterone. These changes can trigger a variety of symptoms, including:

• Irregular periods: Cycles may become shorter or longer, and flow can vary.
• Hot flashes and night sweats: Sudden feelings of warmth, often accompanied by sweating, can disrupt daily life and sleep.
• Sleep disturbances: Trouble falling asleep, staying asleep, or waking up feeling unrested.
• Mood swings: Increased irritability, anxiety, or depressive symptoms.
• Cognitive changes: Difficulty concentrating, forgetfulness, or “brain fog.”
• Physical changes: Breast tenderness, headaches, and changes in libido.

It’s important to note that these symptoms can be mistaken for stress, aging, or other health issues, making perimenopause a frequently overlooked diagnosis.
The Mental Health Connection: The hormonal fluctuations of perimenopause don’t just affect the body—they can profoundly impact mental health. According to Dr. Jen Gunter, author of The Menopause Manifesto, many women experience increased rates of anxiety and depression during perimenopause, even if they have no prior history of mental health disorders. This is due in part to the direct effects of estrogen on neurotransmitters like serotonin, which regulate mood, as well as the indirect impact of physical symptoms such as insomnia and fatigue.
A recent New York Times article, “Women Have Been Misled About Menopause,” highlighted that many women feel unprepared for the emotional rollercoaster of perimenopause. The article points to a lack of education and open discussion about the mental health aspects of perimenopause, which can lead to feelings of isolation and confusion.
Common Mental Health Symptoms in Early Perimenopause

• Anxiety: Sudden onset, often without clear triggers.
• Depression: Persistent sadness, loss of interest in activities, or feelings of hopelessness.
• Irritability: Increased sensitivity to stress or frustration.
• Mood instability: Rapid changes in mood, sometimes described as “emotional whiplash.”

The Science Behind the Symptoms: Estrogen plays a critical role in brain health, influencing everything from mood to memory. During perimenopause, estrogen levels can fluctuate dramatically, affecting the balance of neurotransmitters and leading to symptoms like anxiety and depression. Additionally, sleep disturbances commonly seen in perimenopause can further exacerbate mental health issues, creating a vicious cycle.
Dr. Lisa Mosconi, neuroscientist and author of The XX Brain, discusses how hormonal changes during perimenopause can impact cognitive function and emotional regulation. She notes that women may experience “brain fog” and memory lapses, which are often temporary but can be distressing.
Strategies for Managing Symptoms: Navigating early perimenopausal symptoms—especially those affecting mental health—requires a multifaceted approach. Here are some evidence-based strategies:
1. Education and Awareness Understanding that perimenopause can affect mental health is the first step. Listening to podcasts like The Menopause Podcast by Dr. Louise Newson can provide valuable insights and practical advice.
2. Lifestyle Changes

• Regular exercise: Physical activity can boost mood and improve sleep.
• Balanced diet: Focus on whole foods, healthy fats, and plenty of fruits and vegetables.
• Stress management: Mindfulness, yoga, and meditation can help regulate mood.

3. Sleep Hygiene 
Prioritize good sleep habits, such as maintaining a regular schedule, creating a calming bedtime routine, and limiting screen time before bed.
4. Medical Support 
Consult with a healthcare provider about symptoms. Hormone therapy may be appropriate for some women, while others may benefit from antidepressants or counseling.
5. Social Support 
Connecting with other women experiencing perimenopause can reduce feelings of isolation. Online communities and support groups can be invaluable.
Breaking the Silence: Despite the prevalence of perimenopausal symptoms, many women still feel uncomfortable discussing their experiences. The stigma surrounding menopause and mental health can prevent women from seeking help. As highlighted in the New York Times article, open conversations and accurate information are key to empowering women during this transition.
Podcasts like The Menopause Podcast and books such as The Menopause Manifesto and The XX Brain are helping to change the narrative, providing reliable information and fostering supportive communities.
When to Seek Help: If mental health symptoms become overwhelming or interfere with daily life, it’s important to seek professional help. Perimenopause is a normal life stage, but no one should have to suffer in silence. Healthcare providers can offer a range of treatments, from medication to therapy, tailored to individual needs.
Conclusion: Early perimenopausal symptoms can be confusing, especially when they affect mental health. By increasing awareness, seeking support, and utilizing available resources, women can better navigate this transition and maintain their well-being. Remember: you are not alone, and help is available. Contact Debra Eng, MSW, LCSW for integrative health and mental health counseling to address perimenopausal symptoms. 
References:

1. Gunter, Jen. The Menopause Manifesto: Own Your Health with Facts and Feminism. Citadel Press, 2021.
2. Mosconi, Lisa. The XX Brain: The Groundbreaking Science Empowering Women to Maximize Cognitive Health and Prevent Alzheimer's Disease. Avery, 2020.
3. “Women Have Been Misled About Menopause.” The New York Times, 2023. Link
4. The Menopause Podcast by Dr. Louise Newson. Link

#Perimenopause #MentalHealth #WomenHealth #MenopauseAwareness #Hormones #Wellbeing #MenopauseMatters #BrainFog #MoodSwings #TheMenopauseManifesto #XXBrain  #DebraEngLCSW

The nervous system is the command center of our bodies, responsible for everything from movement and sensation to thought and emotion. Proper nervous system regulation is essential for optimal health, cognitive function, and emotional well-being. While genetics and lifestyle play major roles in nervous system health, nutrition is a powerful, often overlooked factor. Certain foods contain nutrients that support neurotransmitter production, protect nerves, and promote healthy brain and nerve function. In this blog, we’ll explore five foods scientifically shown to support nervous system regulation, and share resources for further learning.

1. Fatty Fish
Why it helps:
Fatty fish such as salmon, mackerel, sardines, and trout are rich in omega-3 fatty acids, especially EPA and DHA. These healthy fats are crucial components of neuronal cell membranes and play a vital role in neurotransmission and anti-inflammatory processes. Omega-3s help regulate mood, improve cognitive function, and protect against neurodegenerative diseases.
Scientific support:
A meta-analysis published in the Journal of Clinical Psychiatry found that omega-3 supplementation can reduce symptoms of depression and improve overall brain health (Grosso et al., 2014). Omega-3s are also linked to improved memory, learning, and reduced risk of Alzheimer's disease.
How to include:
Aim for two servings per week of fatty fish, or consider a high-quality fish oil supplement if dietary intake is insufficient.

2. Leafy Green Vegetables
Why it helps:
Leafy greens such as spinach, kale, Swiss chard, and collard greens are packed with magnesium, folate, and antioxidants. Magnesium is essential for nerve transmission and muscle contraction, while folate supports methylation—a process critical for neurotransmitter synthesis and nervous system repair.
Scientific support:
A study in Frontiers in Aging Neuroscience showed that higher intake of leafy greens is associated with slower cognitive decline and better nervous system function (Morris et al., 2018). Antioxidants in greens help protect nerves from oxidative damage.
How to include:
Add a handful of spinach to smoothies, sauté kale as a side dish, or toss Swiss chard into soups and stews.

3. Nuts and Seeds
Why it helps:
Almonds, walnuts, flaxseeds, chia seeds, and pumpkin seeds are rich in vitamin E, B vitamins, zinc, and healthy fats. Vitamin E is a powerful antioxidant that protects nerve cells from damage, while B vitamins (especially B6, B12, and folate) are crucial for neurotransmitter synthesis and myelin formation.
Scientific support:
Research published in Nutrients highlights the neuroprotective effects of nuts and seeds, with studies showing improved memory, reduced inflammation, and better nerve function in those who regularly consume these foods (O'Brien et al., 2020).
How to include:
Sprinkle seeds on oatmeal or salads, snack on a handful of nuts, or blend nut butter into smoothies.

4. Fermented Foods
Why it helps:
Fermented foods like yogurt, kefir, kimchi, sauerkraut, and miso contain probiotics—beneficial bacteria that support gut health. The gut-brain axis is a bidirectional communication system between the gut and nervous system. A healthy gut microbiome can positively influence neurotransmitter production, stress response, and overall nervous system regulation.
Scientific support:
A review in Frontiers in Psychiatry discusses how probiotics from fermented foods can reduce anxiety, improve mood, and regulate nervous system function by modulating the gut-brain axis (Sarkar et al., 2016).
How to include:
Enjoy a cup of yogurt with fruit, add sauerkraut to sandwiches, or sip on kefir as a refreshing beverage.

5. Dark Chocolate
Why it helps:
Dark chocolate (at least 70% cocoa) is rich in flavonoids, magnesium, and theobromine. Flavonoids have neuroprotective properties, improving blood flow to the brain and supporting cognitive function. Magnesium helps regulate nerve impulses, and theobromine acts as a mild stimulant, enhancing mood and alertness.
Scientific support:
A study in the Journal of Nutrition found that regular consumption of dark chocolate is associated with improved cognitive performance and better nervous system function due to its high flavonoid content (Socci et al., 2017).
How to include:
Enjoy a square or two of dark chocolate as a treat, add cocoa powder to smoothies, or use it in homemade energy bites.

Putting It All Together
Supporting your nervous system through nutrition doesn’t require drastic changes—small, consistent choices make a big difference. Try incorporating these five foods into your weekly routine, and notice the positive effects on your mood, focus, and overall well-being.
Additional Resources
Podcast:

• The Huberman Lab Podcast: Nutrition and Brain Health
  Neuroscientist Dr. Andrew Huberman explores how nutrition influences brain and nervous system function, with practical tips and explanations.

Journal Article:

• Grosso, G., Galvano, F., Marventano, S., Malaguarnera, M., Bucolo, C., Drago, F., & Caraci, F. (2014). Omega-3 fatty acids and depression: Scientific evidence and biological mechanisms. Journal of Clinical Psychiatry, 75(11), e1325–e1337. Link

Book:

• Eat to Beat Disease: The New Science of How Your Body Can Heal Itself by Dr. William Li
  This book explores how specific foods can activate the body’s natural defense systems, including the nervous system.

Conclusion
Nourishing your nervous system is about more than just avoiding junk food—it’s about purposefully choosing foods that provide the nutrients your nerves and brain need to thrive. Whether it’s the omega-3s in fatty fish, the magnesium in leafy greens, or the probiotics in fermented foods, each bite can make a difference. Explore, experiment, and enjoy the journey to better nervous system health.

#NervousSystem #BrainHealth #Nutrition #HealthyEating #Neuroscience #MentalWellness #EatToBeatDisease #GutBrainAxis #Omega3 #Superfoods #DebraEngLCSW

Chronic pain can feel like an endless loop—frustrating, exhausting, and sometimes confusing. If you’re living with persistent pain that doesn’t seem to have a clear physical cause, you’re not alone. Recent research has uncovered that the brain and nervous system play a much bigger role in pain than we once thought. This is called neuroplastic pain, and understanding it can open new doors to recovery.
What is Neuroplastic Pain?
Neuroplastic pain refers to pain that arises due to changes in the brain and nervous system, rather than from ongoing tissue injury or disease. The term “neuroplasticity” means that the brain is capable of changing and adapting—sometimes in helpful ways, sometimes in ways that cause problems.
When pain becomes chronic, the brain can “learn” pain pathways, making it easier for pain signals to fire even if there is no longer a physical injury. This is similar to how we develop habits: the more we repeat something, the stronger the connection becomes. In neuroplastic pain, the brain’s pain circuits become overactive.
How Does Neuroplastic Pain Develop?
Neuroplastic pain often begins with an injury, illness, or stressful event. Normally, pain fades as the body heals. But sometimes, pain persists. Factors that can contribute include:

• Stress and emotional distress
• History of trauma
• Anxiety about symptoms
• Repeated focus on pain

Over time, the nervous system becomes sensitized, and pain can continue even after the original cause has resolved.
Common Conditions Linked to Neuroplastic Pain
Many chronic pain conditions are now understood to have a strong neuroplastic component. These include:

• Back pain
• Neck pain
• Fibromyalgia
• Tension headaches
• Irritable bowel syndrome (IBS)
• Temporomandibular joint disorder (TMJ)

If you’ve had medical tests that don’t show clear tissue damage, or treatments haven’t helped, neuroplastic pain may be part of the picture.
Why Is This Important?
Understanding neuroplastic pain can be empowering. It tells us that pain is real—but it’s not necessarily a sign of ongoing injury. The good news is that because the brain learned these pain pathways, it can also “unlearn” them. This opens the door to new treatments that focus on retraining the brain and nervous system.
How Can Neuroplastic Pain Be Treated?
You might be wondering: “If my pain is coming from my brain, does that mean it’s all in my head?” Absolutely not. Neuroplastic pain is real, and it’s caused by physical changes in the nervous system. The difference is that treatment focuses on the brain and behavior, not just the body.
Here are some approaches that have been shown to help:
1. Pain Reprocessing Therapy (PRT) PRT is a new therapeutic approach that helps people reinterpret pain signals as non-dangerous. By changing how you respond to pain, you can help your brain “rewire” and reduce pain over time. A landmark study published in JAMA Psychiatry found that PRT led to significant pain reductions in people with chronic back pain (Ashar et al., 2021).
2. Mindfulness and Meditation Mindfulness helps you observe sensations without judgment or fear. This can calm the nervous system and reduce pain sensitivity. Practices like guided meditation, breathing exercises, and body scans are often used.
3. Education and Cognitive Behavioral Therapy (CBT) Learning about neuroplastic pain can reduce fear and anxiety, which are known to amplify pain. CBT helps you change unhelpful thoughts and behaviors related to pain, making it easier to break the pain cycle.
4. Gradual Movement and Activity Gentle movement, such as walking, stretching, or yoga, can help reassure your brain that your body is safe. Over time, this can decrease pain and increase confidence.
What Can You Do Today?
If you suspect you have neuroplastic pain, here are some steps you can take:

1. Learn about pain science. Understanding how pain works can be a powerful first step.
2. Notice patterns. Does your pain change with stress, mood, or attention? This can be a clue.
3. Try self-compassion. Be kind to yourself. Chronic pain is tough, and you’re doing your best.
4. Seek support. Consider working with a therapist or pain specialist trained in neuroplastic pain approaches.

Resources for Your Healing Journey

1. Book: The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain by Alan Gordon and Alon Ziv. This book explains neuroplastic pain and guides you through Pain Reprocessing Therapy.
2. Website: Tame the Beast – A free resource with videos and articles explaining the science of pain and practical strategies for recovery.
3. Podcast: Tell Me About Your Pain – Hosted by Alan Gordon and Alon Ziv, this podcast features stories from people who have overcome neuroplastic pain and interviews with experts.

Conclusion
Chronic pain can be isolating, but you’re not alone. The discovery of neuroplastic pain offers hope to millions of people. By understanding that pain is a product of the brain’s protective mechanisms—and that these mechanisms can be changed—you can take steps toward healing and reclaiming your life.
If you’re struggling, reach out for help. Recovery is possible, and every step you take is a victory. Debra is certified in Pain Reprocessing Therapy and can assist you in your healing journey. 

References

• Ashar, Y. K., Gordon, A., et al. (2021). Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial. JAMA Psychiatry, 78(8), 808–817. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2780913
• Moseley, G. L., & Butler, D. S. (2017). Explain Pain Supercharged. Noigroup Publications.
• Gordon, A., & Ziv, A. (2021). The Way Out: A Revolutionary, Scientifically Proven Approach to Healing Chronic Pain. Avery.

#NeuroplasticPain #ChronicPain #PainReprocessing #BrainHealth #PainScience  #MindBodyMedicine #PainAwareness #MentalHealth #RecoveryIsPossible #DebraEngLCSW

Life’s journey is often marked by periods of uncertainty, stress, and turbulence. Whether we are facing personal challenges, societal upheaval, or global crises, these moments can feel overwhelming and all-consuming. Yet, even in the midst of adversity, it is possible—and profoundly important—to cultivate joy. Joyful moments can act as anchors, helping us maintain resilience, hope, and a sense of connection to ourselves and others. This blog post explores practical strategies for creating joyful moments during turbulent times and provides three valuable resources to support your journey.

Why Joy Matters in Difficult Times
Joy is more than fleeting happiness. It is a deep sense of well-being, contentment, and connection. During difficult periods, joy can:

• Reduce stress: Positive emotions help counteract the physical and emotional toll of stress.
• Boost resilience: Joyful experiences remind us of our strengths and capacity to cope.
• Enhance relationships: Shared joy strengthens bonds with family, friends, and community.
• Support mental health: Moments of joy can buffer against anxiety and depression.

Cultivating joy does not mean ignoring pain or pretending everything is fine. Instead, it is about finding light in the darkness, however small, and allowing it to grow.

1. Practice Mindful Awareness
Mindfulness is the practice of being present in the moment, observing thoughts and feelings without judgment. When life feels chaotic, mindfulness can help us notice and savor small moments of joy we might otherwise overlook. This could be as simple as appreciating the warmth of sunlight, the taste of your morning coffee, or the sound of laughter.
How to try it:

• Start your day by noticing three things you are grateful for.
• Pause during stressful moments to take three deep breaths and observe your surroundings.
• Engage your senses: notice colors, smells, and textures as you move through your day.

Mindfulness creates space for joy by helping us tune into the present, rather than becoming lost in worry about the past or future.

2. Connect with Others
Human connection is a powerful source of joy. During turbulent times, it is easy to become isolated, but reaching out can make a significant difference. Connection does not have to be grand—it can be a text message, a phone call, or a shared meal.
Ways to connect:

• Schedule regular check-ins with loved ones, even if brief.
• Share a favorite song, recipe, or memory with a friend.
• Volunteer or offer support to someone in need; helping others boosts our own sense of purpose and joy.

If you are struggling to connect, consider joining online communities or support groups where you can share experiences and find encouragement.

3. Engage in Joyful Activities
Joyful moments often arise when we engage in activities that bring us pleasure and fulfillment. These activities might look different for everyone—art, music, movement, nature, or play.
Ideas to spark joy:

• Take a walk in nature and notice the beauty around you.
• Listen to uplifting music or dance in your living room.
• Create something: draw, write, cook, or garden.
• Spend time with pets or children, who often model pure joy.

The key is to give yourself permission to enjoy these moments, even when things feel tough. Remember, joy is not frivolous—it is essential.

4. Celebrate Small Wins
During turbulent times, it can be hard to see progress or feel accomplished. Celebrating small wins helps shift our focus from what is wrong to what is going well, however minor.
How to celebrate:

• Keep a journal of daily victories, no matter how small.
• Treat yourself when you complete a challenging task.
• Share your successes with someone who will celebrate with you.

Acknowledging small wins builds confidence and reinforces the belief that we can navigate challenges.

5. Find Meaning and Purpose
​Joy is deeply connected to meaning. Even in hardship, reflecting on what matters most can help us find purpose and fulfillment. This might involve spiritual practices, personal values, or contributing to causes you care about.
Ways to find meaning:

• Spend time reflecting on your values and what brings you purpose.
• Engage in activities that align with your beliefs.
• Support others or advocate for change in your community.

Finding meaning transforms adversity into an opportunity for growth and deeper joy.

Resources 
Here are three resources designed to help you cultivate joy and resilience during turbulent times:

1. Greater Good Science Center: Practices for Cultivating Joy
   Greater Good Science Center offers free articles, guided meditations, and research-based practices for building joy, gratitude, and resilience. Their “Happiness Practices” section is especially helpful for daily inspiration.
2. Ten Percent Happier App
   Ten Percent Happier is a mindfulness app offering practical meditation guidance for real life. It includes courses on finding joy, coping with anxiety, and building resilience. The app is suitable for beginners and experienced meditators alike.
3. The Happiness Lab with Dr. Laurie Santos
   Website: https://www.happinesslab.fm/

Conclusion
​Turbulent times are an inevitable part of life, but they do not have to be devoid of joy. By practicing mindful awareness, connecting with others, engaging in joyful activities, celebrating small wins, and finding meaning, we can create moments of light that sustain us through darkness. Remember, joy is not just a luxury—it is a necessity for well-being and resilience.
If you are struggling, reach out for support. You are not alone, and with intention and care, joyful moments can be found—even now.
May you discover and nurture joyful moments, wherever you are on your journey.
#CultivateJoy #Resilience #MindfulLiving #FindJoy #MentalHealthMatters #Connection  #PurposefulLiving #Happiness #Wellbeing #StressRelief #JoyfulMoments #SelfCare #Gratitude #TurbulentTimes #GrowthMindset #EmotionalWellness #YouAreNotAlone #DebraEngLCSW

Feeling stuck in political worry—mind racing, tears rising, hope dimming—is not uncommon these days. Political stress isn’t imaginary. Science confirms its impact, and that means there’s room to act on it.

Political Stress Is Real—and Measurable
Researchers have observed that politics isn’t just a headline—it affects our bodies and minds. A 2022 study found that political engagement between 2017 and 2020 became a chronic stressor that “exacted significant health costs for large numbers of American adults” (Smith, 2022). Another large-scale survey documented how polarization and media exposure amplified anxiety, depression, and stress symptoms in those closely following political events (APA, 2017; Pappa et al., 2022).

Why Rumination Follows Political Overload
Constant news cycles fuel rumination—the brain’s spin cycle. That repetition increases anxiety, disrupts rest, and can slide into hopelessness. While rumination is a well-established risk factor for depression, newer research highlights how political stress specifically intensifies that loop (Watkins, 2016).

Strategies That Ground, Guide, and Restore
​1. Regulate Through Grounding

• Deep breaths, sensory check-ins, or short mindfulness sessions can calm the nervous system.
• Step away from constant news—replace endless scrolling with set “check-in” times.
• Try progressive muscle relaxation or guided imagery as quick resets.

2. Reframe Control and Embrace Agency

• Focus on what you can influence: local community work, volunteering, voting.
• Set boundaries around draining conversations.
• Remember: choosing joy, play, and rest is also an act of resilience.

3. Reshape Thought Patterns

• Notice repeated themes in your worries (fear, loss, injustice).
• Use CBT strategies: challenge assumptions and generate more balanced perspectives.
• Try ACT-style reflection: anchor actions in personal values, even when uncertainty lingers.

4. Cultivate Support and Balance

• Talk with trusted friends, join community groups, or connect in therapy.
• Balance political engagement with restorative activities: nature, creativity, physical activity.

5. Additional Coping Skills

• Limit screen time before bed for better sleep.
• Keep a daily routine for stability.
• Carry grounding objects (a stone, bracelet, or photo) as reminders to re-center.
• Practice gratitude journaling—list three things you value daily.

Final Thought
Politics can erode hope—but your response doesn’t have to follow the same script. Find footing in your body, your values, and your small acts of resilience. These are quiet revolutions worth noticing.

References

• American Psychological Association. (2017). Stress in America: Coping with Change.
• Pappa, S., Ntella, V., Giannakas, T., & Katsaounou, P. (2022). Political stress and mental health: A systematic review. Journal of Psychiatric Research, 146, 211–220.
• Smith, K. B. (2022). Politics is making us sick: The negative impact of political engagement on public health during the Trump administration. PLOS ONE.
• Watkins, E. R. (2016). Rumination-focused cognitive-behavioral therapy for depression. Journal of Clinical Psychology, 72(6), 479–491.
• Election Anxiety: Navigating and Easing the Stress. Psych Central Podcast, Sept 30, 2024.