Is It Perimenopause, Or Am I Just Not Coping?

Over the past few years, I’ve heard a similar question from many women in their late 30s and 40s:

"Is this perimenopause… or am I just not coping very well anymore?"

You might notice anxiety where you never had it before.
Your mood feels less predictable.
You’re more irritable, more emotional, or more overwhelmed than you used to be.

And alongside that comes a quiet self-criticism:

I should be able to handle this.

You may have spent most of your adult life being capable — managing work, relationships, parenting, responsibilities — and suddenly something feels… different.

It can be unsettling.

What perimenopause can actually feel like

When we think about perimenopause, we often hear about hot flushes or irregular periods.

But many women experience something much more subtle and confusing.

It might look like:

• anxiety that feels unfamiliar

• brain fog or difficulty concentrating

• sudden dips in confidence

• emotional sensitivity

• irritability or low mood

• a feeling of being unlike yourself

For some women, these changes come on gradually. For others, they seem to appear almost overnight.

And because these symptoms don’t always get talked about openly, many women assume the problem must be them.

Why so many women blame themselves

The women I work with are often thoughtful, capable and used to coping.

So when something shifts internally, the first response is rarely curiosity.

It’s usually self-judgement.

You might think:

• I should be stronger than this.

• Other women seem fine.

• Maybe I’m just not managing well anymore.

But perimenopause doesn’t happen in isolation.

This stage of life often overlaps with a lot of change.

Children may be growing up.
Careers may feel different.
Relationships evolve.
Parents begin to need support.

You may find yourself questioning things that once felt certain.

So when anxiety or emotional shifts appear, it’s rarely just hormones — and it’s rarely just you.

It’s often a combination of biological change, life transition, and the slow realisation that you’re not quite the same person you used to be.

This stage of life is often about evolution

One of the most helpful shifts I see in therapy is when women move from asking:

"What’s wrong with me?"

to asking:

"What might be changing here?"

Perimenopause can be destabilising, yes — but it can also be a time of deeper self-understanding.

You might begin to notice:

• what you’ve been tolerating for years

• where you’ve been minimising yourself

• what no longer fits in your life

• what you actually need now

This isn’t always comfortable.

But it can be meaningful.

How therapy can help during perimenopause

Therapy during this stage of life isn’t about fixing you or explaining everything away with hormones.

It’s about creating space to:

• understand what’s changing internally

• reconnect with who you are now

• explore what you want your life to look like going forward

For many women, therapy becomes the first place they can pause long enough to listen to themselves again.

Not the version of themselves that existed ten years ago.

The version of themselves that’s emerging now.

If this resonates

If you’re experiencing anxiety, emotional shifts, or a sense of unfamiliarity with yourself during perimenopause, you’re not alone.

Something in you may simply be asking for attention.

Therapy can be a place to reconnect, understand what’s happening, and explore what comes next.

If you’re based in London Bridge, or looking for online therapy you’re welcome to get in touch.