WEBVTT
00:00:02.640 --> 00:00:05.599
Thanks for joining me on Menopause Unscripted.
00:00:05.759 --> 00:00:09.039
Remember, the change is just another beginning.
00:00:11.839 --> 00:00:14.000
Welcome back to another week of Menopause Unscripted.
00:00:14.080 --> 00:00:14.400
I'm Dr.
00:00:14.480 --> 00:00:17.199
Heidi and I'm joined this week by my friend Naomi Zellen.
00:00:17.600 --> 00:00:23.120
She is a therapist and she deals a lot with midlife women's uh mental health, which is what we're here to discuss today.
00:00:23.280 --> 00:00:24.399
Thank you so much for joining me.
00:00:24.640 --> 00:00:25.280
You're so welcome.
00:00:25.359 --> 00:00:26.239
I'm so happy to be here.
00:00:26.480 --> 00:00:29.760
Can you tell us a little bit about your background, who you typically treat, all the things?
00:00:30.160 --> 00:00:30.719
Absolutely.
00:00:30.960 --> 00:00:36.399
So I think my my desire to work with women started a really long time ago.
00:00:36.560 --> 00:00:42.320
I was on some of the pioneering research back in the early aughts with um animal studies.
00:00:42.479 --> 00:00:50.079
And so I did a lot of the newest animal studies at the time, back in like 2008, um, researching female rats.
00:00:50.240 --> 00:00:50.399
Okay.
00:00:50.640 --> 00:00:53.039
Um and that kind of midlife health and female rats.
00:00:54.000 --> 00:00:54.479
Yeah.
00:00:54.799 --> 00:01:00.000
So I started fe uh researching endochronology of the female brain.
00:01:00.159 --> 00:01:00.479
Okay.
00:01:00.880 --> 00:01:06.000
And specifically looking at kind of the HP axis of stress, anxiety, and depression.
00:01:06.400 --> 00:01:09.920
And so that's where all of my like excitement for women's health really started.
00:01:10.719 --> 00:01:15.599
Um female rats, um, which was great at the time, right?
00:01:15.680 --> 00:01:21.920
Because that was so new, and now we're just talking about it, and it's like incredible that back then it was absolutely not happening.
00:01:22.079 --> 00:01:34.400
Um, and so since then I've really been interested in you know brain health, women's health in particular, because female brains are different than male brains, and most of the medical research we've done in the past has always been on male brains.
00:01:34.480 --> 00:01:45.680
Um now we're kind of here at the point of talking about menopause and perimenopause and midlife and how that impacts female brains, so much like significantly different than men, right?
00:01:45.920 --> 00:01:50.159
Um I have a background in uh clinical mental health.
00:01:50.239 --> 00:01:57.920
I'm a somatic experiencing practitioner, I am a sex therapist, um, and I work with men, women, and all other genders.
00:01:58.079 --> 00:02:07.519
Um, and I got to the point of thinking about this period of time because I think we're just so people don't think about women.
00:02:07.760 --> 00:02:11.199
No, and like you said, the research really did not include us for a long time.
00:02:11.360 --> 00:02:13.199
It didn't differentiate between genders.
00:02:13.280 --> 00:02:18.879
So for a long time we had to extrapolate male data to female brains, which we now know doesn't really translate very well.
00:02:19.199 --> 00:02:20.080
It does not translate, yeah.
00:02:20.240 --> 00:02:20.560
Yeah.
00:02:20.719 --> 00:02:27.360
Um, and especially because we know that women experience anxiety and depression like at almost like uh double the rate that men do.
00:02:27.599 --> 00:02:43.360
And so when we get to this state of time in life when women's kind of brain chemistry is really being impacted by the uh decreasing estrogen and progesterone, there are a lot of kind of behavioral and cognitive implications of that.
00:02:43.680 --> 00:02:45.039
Can we just talk about that for a minute?
00:02:45.199 --> 00:02:49.840
Like what estrogen does to the brain versus what progesterone does in your mental state?
00:02:50.159 --> 00:02:58.240
Yeah, I think estrogen is the one that I'm like most focused on because I think it is really important for two things that I that I'm like fascinated by.
00:02:58.479 --> 00:03:03.120
One, estrogen supports the um kind of the creation of dopamine.
00:03:03.360 --> 00:03:15.680
And in particular, when we talk about folks or women who are neurodivergent, they're already lacking dopamine, and that makes things like focusing hard, memory hard, initiating tasks hard.
00:03:16.000 --> 00:03:16.400
Yeah.
00:03:16.639 --> 00:03:25.439
And so when estrogen starts to drop, or when it's even like kind of going up and down like this, um, it makes everyday challenges sometimes more hard.
00:03:25.599 --> 00:03:28.960
And women often feel like I just don't feel like myself.
00:03:29.280 --> 00:03:31.439
And clinical sign of menopause or parametapa.
00:03:32.000 --> 00:03:33.520
Yes, a hundred percent.
00:03:33.759 --> 00:03:48.800
Um, and so why that is so important is when estrogen falls and dopamine falls, women just get into this like I'm depressed, I can't do anything, I have brain fog, I just don't feel like myself.
00:03:49.360 --> 00:04:00.080
Oh, that is the thing you hear over and over and over in clinic, is like they don't people won't really think that I'm in perimenopause and I'm in this zone of hormonal chaos, but they just don't feel like themselves.
00:04:00.319 --> 00:04:10.000
And I don't know about you, but I find that a lot of women in here almost are in like menopause brain, right there.
00:04:10.240 --> 00:04:13.360
Um, they're basically in denial that they're in perimenopause.
00:04:13.439 --> 00:04:16.079
I think they think maybe I'm not old enough for this.
00:04:16.319 --> 00:04:19.199
I just had a child, I can't be there, I just had a baby.
00:04:19.680 --> 00:04:19.920
Yeah, yeah.
00:04:20.160 --> 00:04:32.000
It's just denial, and I've seen them for oftentimes orthopedic symptoms of this, but we have this conversation about perhaps we should start talking about these things, and women just don't want to go there.
00:04:32.240 --> 00:04:32.800
Right, yeah.
00:04:32.879 --> 00:04:38.959
I think historically the conversation around perimenopause or menopause is like, oh, that's women in you know their 50s.
00:04:39.120 --> 00:04:39.199
Right.
00:04:39.439 --> 00:04:40.240
That's that's not me.
00:04:40.319 --> 00:04:41.920
I can't that can't possibly be me.
00:04:42.079 --> 00:04:52.000
But what we know is that perimenopause starts as early as 35, and for women who are neurodivergent, that actually some of the newer research is coming out that they might experience it even sooner.
00:04:52.319 --> 00:04:53.199
Why is that?
00:04:53.519 --> 00:04:56.079
Um, I think it's just the way that their brains are.
00:04:56.240 --> 00:05:00.959
I think there isn't enough research to give a like a specific, like this is the thing that's pointing to it.
00:05:01.040 --> 00:05:15.839
But if I were to take an educated guess, I think because women's brains who are neurodivergent because of the already lower dopamine, when it even starts to creep down just a whisper, it just is going to start the cascade of all of the things that impact their health, right?
00:05:15.920 --> 00:05:20.399
And I think what you mentioned is so important, is that right, it's not just mental health that's impacted.
00:05:20.560 --> 00:05:26.480
There's bone health, there's pelvic floor health, there's cardiovascular health, and all of these things are impacted.
00:05:26.639 --> 00:05:34.560
And it's kind of that slow burn, which is why I think sometimes it's hard to even notice because it happens so discreetly, and then it's like bam.
00:05:35.040 --> 00:05:39.600
And so I think that's why so many women are like, no, it can't be that, and it's like, yeah, it is.
00:05:39.839 --> 00:05:41.680
But really, that's what we've got going on.
00:05:41.839 --> 00:05:42.240
Exactly.
00:05:42.560 --> 00:05:48.000
So for just a moment, can we talk about what neurodivergency entails versus neurotypical?
00:05:48.399 --> 00:05:51.360
Because for someone who isn't a therapist, yeah, we hear these terms, right?
00:05:51.439 --> 00:05:52.240
Yeah, great question.
00:05:52.480 --> 00:05:55.519
We don't necessarily know what these things mean, and is that me?
00:05:55.839 --> 00:05:58.879
Because I think everyone wants to be neurotypical, right?
00:05:59.040 --> 00:06:01.040
Because they think that is normal.
00:06:01.279 --> 00:06:01.439
Yeah.
00:06:01.839 --> 00:06:03.680
Can you just kind of tell us a little bit about the liberally?
00:06:04.319 --> 00:06:20.319
So, folks who are neurodivergent, they mostly experience, not always, there are obviously an array of symptoms, but folks who experience neurodivergence, they have um parts of their brain, mostly in the forebrain, um, with uh executive functioning.
00:06:20.399 --> 00:06:24.560
Um, and that's really the main thing that impacts a lot of neurodivergence.
00:06:24.639 --> 00:06:37.519
And executive functioning is a part of your brain that helps you again with task completion, with following through with tasks, um, with being able to um just initiate and get motivated.
00:06:37.680 --> 00:06:44.240
And uh sometimes, you know, in young kids, I'm thinking right now just women, but in young kids we see that in a lot of hyperactivity, right?
00:06:44.319 --> 00:06:48.000
There's a hyperactivity piece to it because we can't regulate ourselves.
00:06:48.160 --> 00:06:52.720
Um, and then sometimes there's the inattentive piece where we can't focus enough.
00:06:52.879 --> 00:06:56.399
Um, and all of those kind of converge in the front of your brain.
00:06:56.560 --> 00:07:07.920
And what we know about folks who are neurodivergent too is that their brains and their executive functioning skills actually grow and develop at a much slower pace than neurotypicals.
00:07:08.000 --> 00:07:12.879
So, neurotypicals, if you see in the classroom the kids can sit down, you know, they pay attention.
00:07:13.040 --> 00:07:22.800
Um kids who often struggle with the neurodivergence can't meet that same expectation because their brains just don't have the chemicals inside to help them sit still.
00:07:22.959 --> 00:07:24.560
And they sound like ADHD.
00:07:24.639 --> 00:07:26.000
It's like what you described.
00:07:26.399 --> 00:07:27.360
Yes, yes, yeah.
00:07:27.600 --> 00:07:35.279
And you hear this a lot with women in midlife that like their ADHD feels worse or we're not able to focus or brain fog or exactly those things.
00:07:35.600 --> 00:07:38.800
Yeah, which is why, going back to what we were just talking about, right?
00:07:39.040 --> 00:07:51.360
If you already have less dopamine in your brain to be able to do tasks, and then all of a sudden the chemical that helps make dopamine estrogen starts to fall, you are not making as much dopamine as you ever were before.
00:07:51.519 --> 00:08:01.199
So, women in particular with ADHD or neurodivergence who experience and go through perimenopause and menopause are kind of getting a twofold in that experience because of that.
00:08:01.360 --> 00:08:02.560
So, great, great insight.
00:08:02.879 --> 00:08:16.480
So, you're talking about dopamine estrogen reduction, and this is making me think it's a little bit of a swing of topic, but of the drug addict, which I'm on, yeah, and how that helps with having more dopamine in the brain, which has to do with like the sexual functioning and call.
00:08:16.959 --> 00:08:18.959
Can we just go and swing there for a minute?
00:08:19.199 --> 00:08:19.600
Totally.
00:08:19.759 --> 00:08:22.560
So, what happens when you are taking a drug?
00:08:22.639 --> 00:08:38.559
And I will say, like right now, I'm a therapist, so you know, I'm not a doctor, so what I know of this is that when you take a certain drug that helps with functioning of dopamine, is that it often our brains work, or these little connections are called neurotransmitters.
00:08:38.639 --> 00:08:45.120
And in the center, in those middle of the neurotransmitters, is kind of this communication center where they're all talking to each other.
00:08:45.279 --> 00:08:50.879
Um, and what happens when you don't have enough dopamine is that there isn't enough dopamine to talk to each cell.
00:08:51.039 --> 00:08:59.679
And so, what those drugs are doing is actually allowing the dopamine to hang out in that center and talk for a little bit longer rather than getting sucked up.
00:08:59.840 --> 00:09:07.759
And so it allows your brain to actually experience dopamine inside of your head for a lot longer, and that's part of what's happening in that drug.
00:09:08.000 --> 00:09:11.840
And how does dopamine affect our sexual functioning versus our attention?
00:09:12.320 --> 00:09:12.960
Love that, yeah.
00:09:13.120 --> 00:09:13.600
Same thing.
00:09:13.759 --> 00:09:19.039
So we have a handful of chemicals in our brain that yes, they do a lot of things.
00:09:19.120 --> 00:09:26.320
So, one, we're talking about attention, but dopamine also in our sexual functioning is impacted by estrogen.
00:09:26.480 --> 00:09:28.559
And it's also impacted by oxytocin.
00:09:28.639 --> 00:09:34.639
So, oxytocin, as we know, is a chemical that makes us want to bond with people, makes us warm fuzzies.
00:09:34.799 --> 00:09:38.799
Yes, it's the warm fuzzies, it's the like, ooh, look me in the eye, I want to hug ya.
00:09:39.120 --> 00:09:44.879
And oxytocin is also something that estrogen helps create.
00:09:45.360 --> 00:09:51.919
And so when estrogen starts to drop, right, our desire, and it's all right, these kind of cascades all are happening at once.
00:09:52.080 --> 00:09:58.559
So as estrogen starts to drop and oxytocin starts to drop, we actually don't want to feel connected to people.
00:09:58.639 --> 00:10:03.600
That's kind of when people say, Oh, maybe I'm a little depressed or I'm not feeling like I really want to be around people.
00:10:04.080 --> 00:10:05.759
That's a part of that component, right?
00:10:05.919 --> 00:10:08.960
In particular when it comes to relationships, right?
00:10:09.039 --> 00:10:18.799
If you want to reach out to your partner and one, you're like already kind of moody and feeling not yourself, and your partner's reaching out to you, and the chemical that like tells you, hey, reach out to your partner, is also tanking.
00:10:18.879 --> 00:10:21.759
Yeah, you're kind of like, ugh, get away from me.
00:10:21.919 --> 00:10:22.879
They say, Don't touch me.
00:10:23.120 --> 00:10:24.000
Don't touch me.
00:10:24.240 --> 00:10:24.559
Yeah.
00:10:25.279 --> 00:10:32.559
Um, and I think that's really important because we see that in how relationships start to really be impacted in this stage of life.
00:10:32.799 --> 00:10:35.600
And it has nothing to do with the relationship itself most of the time.
00:10:35.679 --> 00:10:42.639
It's just more the fact that there's like these chemical changes and as we kind of know desire and stuff lives in the brain a lot of this.
00:10:43.200 --> 00:10:44.639
So yes, yeah.
00:10:45.120 --> 00:10:48.559
Do you see that in like sex therapy that you do in the sex like couples counseling?
00:10:49.279 --> 00:11:27.200
Yeah, I'd say, I mean, working with a lot of midlife couples, what we know about is, you know, what the research indicates is there's actually a lot of divorce that happens in that time because I think women are going through so many changes in their body, and I think this is why things like educating ourselves of what's actually happening is gonna be really important because I think often, yes, there are marriages that maybe we wanna end for good reasons, and maybe there are marriages that maybe have ended because women were going through something really challenging and maybe didn't know themselves or their partners didn't know, and they didn't actually have the support they needed to get through this life transition.
00:11:27.440 --> 00:11:28.480
That makes so much sense.
00:11:28.559 --> 00:11:31.039
I am rereading Come As You Are right now.
00:11:31.279 --> 00:11:45.519
And every like literally every chapter makes me wish that every single person knew these things about their relationships and about themselves, both men knowing it about women and understanding better, right, and women knowing what they're experiencing during this time.
00:11:45.840 --> 00:11:46.159
100%.
00:11:46.480 --> 00:11:59.279
Yeah, and I think if you kind of go with what um I think Emily Nagoski is an incredible sex researcher, um, you know, the biggest thing that came out of that book was the accelerators and the brakes that she talks about, right?
00:11:59.360 --> 00:12:03.519
What pushes on the gas for desire and what kind of slams on the brakes?
00:12:03.679 --> 00:12:15.200
And if we kind of bring it all together, right, if you have so many things slamming on your brakes, you're not feeling yourself, you're overwhelmed, your sleep is disrupted because of menopause, right?
00:12:15.360 --> 00:12:23.759
You're having a hard time connecting with your partner, your kids are driving you crazy, you're struggling at work because your brain feels fuzzy because you haven't been sleeping.
00:12:24.080 --> 00:12:29.679
And those are things that are constantly putting on the brakes of your desire.
00:12:29.919 --> 00:12:38.720
And so when people come and see me, kind of trying to figure out, well, wow, I just like don't want to have sex, I'm not connected, I just like feel so distant from them.
00:12:38.879 --> 00:12:42.080
We feel like roommates, it's like, oh man, you are working from empty.
00:12:42.159 --> 00:12:46.480
That you will slam down the brake, and there is just nothing hitting that gas pedal.
00:12:46.559 --> 00:12:52.480
And so we gotta learn what are the things that are putting on those brakes in your relationship, in your body, in your life, right?
00:12:52.559 --> 00:12:56.639
You have to kind of see it holistically, so that we can bring in more of the space.
00:12:56.799 --> 00:12:58.559
Be like, okay, what's on that accelerator?
00:12:58.639 --> 00:13:00.080
What real what's gonna turn you on?
00:13:00.159 --> 00:13:02.080
What's gonna allow you to be inside of your body?
00:13:02.240 --> 00:13:03.840
How do you want support to look?
00:13:04.000 --> 00:13:07.360
It's gonna look different in this time of life than it might have otherwise.
00:13:07.600 --> 00:13:11.600
It's fun, like your husband doing the dishes starts being real sexy and being a turn on, right?
00:13:11.840 --> 00:13:16.799
Yeah, cleaning the house, cleaning the dinner house, yes, taking care of the kids, do the thing for me.
00:13:16.960 --> 00:13:18.320
Like, I don't want to have to do it.
00:13:18.399 --> 00:13:18.720
Yes.
00:13:18.960 --> 00:13:19.200
Absolutely.
00:13:19.519 --> 00:13:19.679
Yes.
00:13:20.000 --> 00:13:22.240
This was actually the chapter I was just listening to in my drive-in.
00:13:22.399 --> 00:13:26.000
Oh my god, amazing! Like, I just listened to this about two hours ago.
00:13:26.240 --> 00:13:26.480
Uh-huh.
00:13:26.639 --> 00:13:26.879
Uh-huh.
00:13:27.120 --> 00:13:27.519
Yeah.
00:13:27.759 --> 00:13:29.200
And I think that's so important.
00:13:29.360 --> 00:13:34.000
How how support in this time is is just so pivotal.
00:13:34.320 --> 00:13:34.799
Definitely.
00:13:34.960 --> 00:13:35.200
Yeah.
00:13:35.600 --> 00:13:36.799
So let's go back to the brain.
00:13:36.960 --> 00:13:39.360
We talked about dopamine and we talked about estrogen.
00:13:39.440 --> 00:13:43.360
Let's pop over to progesterone and what that does.
00:13:43.840 --> 00:13:47.200
Not as I I will be honest, I'm not as familiar with progesterone.
00:13:47.279 --> 00:13:47.519
No problem.
00:13:47.759 --> 00:13:50.879
I have taken most of my dive into estrogen and oxytose, and I will say.
00:13:51.120 --> 00:13:56.320
But we don't know that like when estrogen drops, oftentimes at the same time, the progesterone starts dropping off, also.
00:13:56.480 --> 00:13:56.720
Correct.
00:13:56.960 --> 00:13:58.639
And that can affect our mental health and mood.
00:13:58.960 --> 00:13:59.840
So, but that's okay.
00:13:59.919 --> 00:14:01.039
We can kind of skip over that.
00:14:01.200 --> 00:14:02.159
That's totally fine.
00:14:02.480 --> 00:14:08.159
So let's go back over to like the ADHD and other mental health disorders that can happen during midlife.
00:14:08.320 --> 00:14:13.519
And there's kind of this predisposition to if you have this, this kind of can heighten and worsen it.
00:14:13.919 --> 00:14:16.320
What about other types of mental health problems?
00:14:16.480 --> 00:14:18.000
Anxiety, depression.
00:14:18.240 --> 00:14:21.360
I'd asked you earlier about this concept of unmasking.
00:14:21.519 --> 00:14:22.399
Can we talk about that?
00:14:23.039 --> 00:14:23.600
Yeah.
00:14:23.919 --> 00:14:31.279
Um so going to, you know, if women are experiencing depression and anxiety in general, right?
00:14:31.360 --> 00:14:44.480
I think what happens is when we look at a lifespan, if you've come into midlife without any history of anxiety or depression, um, you might experience it for the first time.
00:14:44.720 --> 00:14:51.200
But I think what you're saying is if I've already experienced anxiety depression, how is that impacted when I get to this point?
00:14:51.440 --> 00:14:54.480
And when we get to that point, it's really similar to ADHD, right?
00:14:54.559 --> 00:15:04.080
And neurodivergence in particular is that anxiety levels will often increase because our ability to tolerate stress is at an all-time low.
00:15:04.240 --> 00:15:06.639
Because we're often not feeling like ourselves.
00:15:06.799 --> 00:15:14.879
Um, and so anxiety tends to spike because the stresses of life feel even more overwhelming than they did before.
00:15:15.039 --> 00:15:24.399
Um, our ability, our ability to be resilient in this time of the stage of life for women is has been really disrupted because of all of the hormone changes going on.
00:15:24.480 --> 00:15:26.480
And so anxiety often increases.
00:15:26.639 --> 00:15:30.720
And with that, depression can oft also often increase as well.
00:15:30.879 --> 00:15:35.120
So that can look like um just struggling to get tasks done.
00:15:35.200 --> 00:15:48.879
And you know, mental health, there's a lot of similar uh symptomology, and so with depression in particular, it can look similar to symptoms of ADHD that women experience, having a hard time struggling, getting things done, having a hard time getting tasks completed.
00:15:49.039 --> 00:15:54.639
Um, and they do all get uh more uh what's the word I'm looking for?
00:15:54.799 --> 00:15:58.159
They get um um impacted at the same time.
00:15:58.399 --> 00:15:58.879
Yeah.
00:15:59.120 --> 00:16:05.679
One of the interesting things I see in here is this intersect with mental health and pelvic health and sexual functioning here and also orthopedics.
00:16:06.080 --> 00:16:13.519
So doing orthopedic PT and doing pelvic chlorine PT are these women who have had reduced resiliency because of reduction hormones.
00:16:13.759 --> 00:16:19.840
They're getting injured or having injured injuries that were happened previously, kind of seem like they're cropping back up.
00:16:20.559 --> 00:16:22.559
Then we start trying to do PT.
00:16:23.200 --> 00:16:27.840
And it's like the ADHD kicks in, which then amplifies anxiety.
00:16:28.399 --> 00:16:32.320
And oftentimes what I hear is women just beating themselves up.
00:16:32.480 --> 00:16:32.799
Oh, yeah.
00:16:33.039 --> 00:16:35.840
Because I'm not doing my PT, I'm embarrassed to come tell you.
00:16:36.000 --> 00:16:40.879
Yeah they're not making progress because they just can't get on the task.
00:16:41.279 --> 00:16:55.600
But then we have this like nasty cycle back into the mental health, and so oftentimes I'm trying to co-work somebody with a therapist like yourself at the same time because we have to attack this from both sides, both the physical and the mental, because I am not a mental therapist.
00:16:55.840 --> 00:16:59.759
So as much as I can try to coach someone through that, that is not my job.
00:16:59.919 --> 00:17:07.359
Yeah, and this is something that I see on repeat week after week, and it's interesting because I never seen the men doing this.
00:17:07.599 --> 00:17:09.599
You know, I never seen the men doing this.
00:17:09.680 --> 00:17:12.559
They just come in and they're like, Yeah, I didn't do my homework, or I did.
00:17:13.200 --> 00:17:15.359
But the women, it's like this beating up.
00:17:15.839 --> 00:17:26.880
And how from a therapeutic aspect can you help somebody with with that and like that feeling of just I mean, these women like just literally, it's like they just are beating themselves up.
00:17:27.200 --> 00:17:29.839
How can you help with women doing these things?
00:17:30.319 --> 00:17:49.119
Wow, you're touching on such a bit, there's such a big point, and what women feel every day is the way of the world of needing to be perfect and to do it all and to show up, um, and to you know, the fear of not of not being the person that she knows she can be, right?
00:17:49.200 --> 00:17:51.440
I think that's what I was before, exactly.
00:17:51.519 --> 00:17:52.559
And I think that's the hard part.
00:17:52.640 --> 00:17:56.960
It's like I used to be able to do all of these things, and now I can't, I don't recognize myself.
00:17:57.200 --> 00:18:26.240
Um, I think to really slow it down and parse out what are the things that are at the root of all of the stress, where is the thing that's causing the biggest um issues, and then really similarly to you know, executive functioning skills are really concrete, so it's really helpful because as overwhelming as the stage can be, if we look at it from an executive functioning um kind of lacking a skill there, that we can do things really quickly.
00:18:26.480 --> 00:18:32.640
So um getting a really clear timeline, how do we organize our schedules?
00:18:32.799 --> 00:18:35.039
How do we chunk out certain areas of time?
00:18:35.200 --> 00:18:41.920
How do we track our energy levels throughout the day, which are impacted by our like cascading hormones throughout the day, right?
00:18:42.000 --> 00:18:48.160
It's also impacted um by food and diet, which we also know impacts um this time of life.
00:18:48.319 --> 00:18:55.119
And so being able to track kind of like when am I gonna be the most energetic to do the most difficult tasks?
00:18:55.279 --> 00:19:01.359
When am I gonna be kind of tired, but I can knock out things that don't take as much mental energy?
00:19:01.440 --> 00:19:14.240
And being able to track that, and I think where the somatic piece for me comes in is that often people feel something in their body and they feel like they have to go into that feeling.
00:19:14.319 --> 00:19:21.920
And what I mean by that is, oh, I'm really tired, so I'm gonna continue to be tired until I feel rested enough.
00:19:22.240 --> 00:19:27.279
When sometimes we don't need to do that, sometimes ourselves out of it's falling into it.
00:19:27.599 --> 00:19:27.920
Exactly.
00:19:28.160 --> 00:19:28.400
Cool.
00:19:28.559 --> 00:19:31.839
Can I give myself five, 20, 15 minutes of rest?
00:19:32.079 --> 00:19:34.160
And that allows me to know I've rested.
00:19:34.240 --> 00:19:35.279
Do I feel rested?
00:19:35.680 --> 00:19:41.039
Maybe not a hundred percent, but maybe just do one or two tasks to see if I can get something done.
00:19:41.279 --> 00:19:46.000
Oftentimes we can start getting things done once we just do one little thing.
00:19:46.079 --> 00:19:47.599
But we gotta go for the low-hanging fruit.
00:19:47.680 --> 00:19:48.559
That's what I always like to tell people.
00:19:48.640 --> 00:19:51.839
I was like, don't do the hard thing, don't try hard, try easy.
00:19:52.000 --> 00:19:59.519
It's like just do the one dish or just strip the bed, don't even do the laundry, just get it all done and then just see how you feel, and then kind of take it one step at a time.
00:19:59.680 --> 00:20:04.319
I think we just often see it too much of a big picture and just little baby steps.
00:20:04.480 --> 00:20:06.160
Okay, get that energy back up.
00:20:06.319 --> 00:20:06.799
Exactly.
00:20:06.960 --> 00:20:08.400
Take up take a rest, it's okay.
00:20:08.559 --> 00:20:10.640
It's also women, like we can't take rests.
00:20:10.799 --> 00:20:12.400
That's also given permission, right?
00:20:12.720 --> 00:20:15.759
I am the worst the absolute worst of it.
00:20:16.079 --> 00:20:16.480
It's okay.
00:20:16.799 --> 00:20:18.960
Yeah, someone telling you that you it's okay.
00:20:19.200 --> 00:20:21.200
It's okay because we don't do that to ourselves.
00:20:21.440 --> 00:20:21.759
Yeah.
00:20:22.160 --> 00:20:26.400
But with the somatic therapy, can you tell me the difference a little bit between that and CBT?
00:20:26.480 --> 00:20:29.119
Because we hear a lot about CBT for women's midlife health.
00:20:29.440 --> 00:20:32.720
Can we talk a little bit about what somatic therapy can do for us that's a little different?
00:20:32.960 --> 00:20:33.279
Yeah.
00:20:33.599 --> 00:20:43.440
CBT is great, um, I think in particular with uh depression and anxiety, um, where CBT stands for cognitive behavioral therapy.
00:20:43.519 --> 00:20:47.119
So what you look at is what are my cognitions, what are things I'm thinking?
00:20:47.279 --> 00:20:49.920
Um, how does that influence my behavior?
00:20:50.160 --> 00:20:54.000
Um, and then how you know what is the next step?
00:20:54.160 --> 00:21:01.839
And so often our the the way they the way cognitive behavioral therapy is kind of taught is that your thoughts influence your behavior.
00:21:01.920 --> 00:21:07.359
So if you change your thoughts, you can change your behaviors, um, which is great up until a point.
00:21:08.000 --> 00:21:12.960
Um, because what we also know is that our brains and our bodies aren't disconnected, right?
00:21:13.119 --> 00:21:15.519
This this also is a part of this.
00:21:15.680 --> 00:21:22.960
And so somatic therapy actually at the root of it is working with the nervous system, which is uh really working with your five senses.
00:21:23.039 --> 00:21:30.400
So not just your thoughts, but you're also working with emotions, um, physical sensations, I call that proprioception.
00:21:30.480 --> 00:21:31.920
So, like, what does it feel like inside?
00:21:32.079 --> 00:21:34.480
And I'm sure you hear people in your clinic, oh, pain.
00:21:34.559 --> 00:21:37.759
Okay, pain is a is a kind of a messenger of proprioception.
00:21:37.839 --> 00:21:43.440
So sometimes we can feel energetics, we can feel things swirly, tingling, almost like when your foot falls asleep, right?
00:21:43.680 --> 00:21:47.680
There's constant kind of messages inside internally that we want to track.
00:21:47.839 --> 00:21:52.640
Um, it can be sight, it can be smell, it can be, you know, uh uh vision, something like that.
00:21:52.799 --> 00:21:59.359
And so somatic therapy takes cognitive behavior behavior behavioral therapy and kind of just expands it, right?
00:21:59.440 --> 00:22:00.880
We are Expanding, okay.
00:22:00.960 --> 00:22:05.839
Well, when you think about that thing, what does that feel like in your body?
00:22:06.000 --> 00:22:07.759
Where do you feel that in your body?
00:22:08.000 --> 00:22:11.200
Okay, when you feel that in your body, what are the emotions tied to it?
00:22:11.359 --> 00:22:22.079
So we're really expanding all of that and noticing kind of what the whole body is communicating to us, and then with that awareness, it's the mindfulness piece.
00:22:22.319 --> 00:22:24.160
What is the next step that we want to do?
00:22:24.319 --> 00:22:25.759
What is the behavior we want to do?
00:22:25.920 --> 00:22:28.079
So they're similar in certain ways but different.
00:22:28.160 --> 00:22:33.440
Um, and they kind of do, you know, stack on top of each other.
00:22:33.759 --> 00:22:37.920
So you mentioned pain earlier, which is something I work with people with every day.
00:22:38.480 --> 00:22:42.720
And one of the things I do here is I try to get people to differentiate between sensations.
00:22:43.279 --> 00:22:46.960
Is it really pain that you're feeling or is it discomfort?
00:22:47.519 --> 00:22:48.720
Or is it something else?
00:22:49.279 --> 00:22:52.319
How do you work with people without from a somatic therapy point of view?
00:22:52.480 --> 00:22:57.359
Because that's something I deal with all the time, where people are so rooted in that my body hurts.
00:22:57.519 --> 00:22:57.680
Yeah.
00:22:57.759 --> 00:22:59.680
I'm like, but does it hurt and when does it hurt?
00:23:00.000 --> 00:23:05.599
And do I like and working with am I anxious about my condition and does that amplify my pain?
00:23:05.920 --> 00:23:06.799
Is it really pain?
00:23:07.039 --> 00:23:07.359
Yes.
00:23:07.599 --> 00:23:08.319
Is it something else?
00:23:08.640 --> 00:23:12.880
Because so many times every single thing has become pain by the time they come to see me.
00:23:13.200 --> 00:23:14.400
And it's not really pain.
00:23:14.480 --> 00:23:17.279
And so we use a lot of different words like discomfort.
00:23:17.359 --> 00:23:18.559
Is it therapeutic discomfort?
00:23:18.640 --> 00:23:19.680
Are you feeling a stretch?
00:23:20.000 --> 00:23:21.279
Are you feeling the muscle work?
00:23:21.519 --> 00:23:25.599
Because sometimes just making the muscle work, people think that is pain.
00:23:25.759 --> 00:23:26.000
Right.
00:23:26.160 --> 00:23:27.440
And they can't get that separated.
00:23:27.599 --> 00:23:29.200
So, how can you work with that on your end?
00:23:29.440 --> 00:23:30.160
Great question.
00:23:30.319 --> 00:23:41.119
What we know about chronic pain is that there's often a point of it, and because the way the body works, the our bodies intuitively want to help us.
00:23:41.359 --> 00:23:45.519
And so when there's pain, we often clamp around the pain to kind of protect it.
00:23:45.599 --> 00:23:48.160
That's what the body does, which often increases inflammation.
00:23:48.240 --> 00:23:57.440
And so it's not just that small pain point, it's now the muscles and the tissue around it are clamping down, creating more um inflammation and more pain.
00:23:57.680 --> 00:24:13.279
And the way I like to work with pain is uh I like to use like a it's uh I use a bullseye model, and so I often like to help people see, okay, if we were to go to the center of where that pain is, how do you notice where there is less pain?
00:24:13.519 --> 00:24:15.440
And so coming out from the center.
00:24:15.839 --> 00:24:16.000
Okay.
00:24:16.640 --> 00:24:17.279
I like this visual.
00:24:17.519 --> 00:24:18.000
Yeah, yeah, yeah.
00:24:18.079 --> 00:24:18.799
It's a great visual.
00:24:18.880 --> 00:24:19.599
People love it.
00:24:19.680 --> 00:24:23.519
Um, and so what happens is people say, well, the pain is everywhere, it's everywhere, it's everywhere.
00:24:23.599 --> 00:24:26.880
It's like, and it's generally in a very localized spot.
00:24:27.039 --> 00:24:30.319
So often I like to have people say, Okay, where is it the most intense?
00:24:30.480 --> 00:24:35.839
And then can we go out a f a few rings and see, okay, where is it the least painful?
00:24:36.079 --> 00:24:38.720
Where do you not feel any pain around that center?
00:24:38.880 --> 00:24:41.839
And can we focus on where there is no pain?
00:24:42.160 --> 00:24:46.160
And that often allows people to spread their awareness, right?
00:24:46.240 --> 00:24:58.799
What happens when um when you're working with the nervous system is people kind of get like very tunnel-visioned, and when we kind of focus somewhere outside of that tunnel, we actually expand the nervous system's ability to take in.
00:24:58.880 --> 00:25:00.000
Oh, what else is happening here?
00:25:00.240 --> 00:25:00.559
I love that.
00:25:00.720 --> 00:25:03.200
And you never heard this, and it's great unless you feel it.
00:25:04.240 --> 00:25:05.119
Yeah, please.
00:25:06.160 --> 00:25:07.200
And that's how you work with it.
00:25:07.440 --> 00:25:08.640
So, okay, what's the outside?
00:25:08.720 --> 00:25:10.559
And then okay, can we go in and in?
00:25:10.640 --> 00:25:14.000
So eventually the person can be in that just one area of pain.
00:25:14.240 --> 00:25:14.720
Interesting.
00:25:14.880 --> 00:25:16.000
Yeah, I love this.
00:25:16.160 --> 00:25:16.640
Yeah.
00:25:16.880 --> 00:25:18.079
All right, I'm gonna jump topic.
00:25:18.480 --> 00:25:20.079
Yeah, there's so many different things I want to talk about.
00:25:20.240 --> 00:25:22.400
Yeah, so we kind of talked about pain a little bit.
00:25:22.559 --> 00:25:23.200
Now let's go.
00:25:23.279 --> 00:25:27.039
I want to go back to the mental health and talk about the concept of unmasking.
00:25:27.200 --> 00:25:27.440
Yes.
00:25:27.599 --> 00:25:28.720
So can you tell me what this is?
00:25:28.799 --> 00:25:30.160
Because I feel like this is me.
00:25:30.240 --> 00:25:33.519
And I have been telling my boyfriend, I think that all of a sudden I have Tourette's.
00:25:33.759 --> 00:25:34.079
Yeah.
00:25:34.400 --> 00:25:38.400
And I don't mean to, but all of a sudden I'm just swearing and dropping F-bombs all the time.
00:25:38.480 --> 00:25:38.640
Yeah.
00:25:38.799 --> 00:25:41.920
And he calls me out on it because I don't even know I'm doing it.
00:25:42.640 --> 00:25:46.559
And I honestly, it's sometimes I think that like my filter has just been taken off.
00:25:46.960 --> 00:25:51.920
And I try really hard to put it back on, but I feel like I'm then putting back on the mask, like on the damper.
00:25:52.079 --> 00:25:52.319
Yes.
00:25:52.480 --> 00:25:55.599
And I feel like lately my damper has just been removed.
00:25:55.920 --> 00:25:57.839
And it's hard to put it back on.
00:25:58.160 --> 00:25:59.039
Can we talk about that?
00:25:59.200 --> 00:26:00.000
Absolutely, yeah.
00:26:00.160 --> 00:26:07.519
So another key feature in neurodivergence, and I think what shows up in perimenopause and menopause is impulse control, right?
00:26:08.240 --> 00:26:22.960
And that's a big thing with masking, is that um when we are masking, we are that we have the ability to kind of have a certain level of impulse control to like keep ourselves in a state of you know what is socially appropriate in different areas.
00:26:23.119 --> 00:26:33.759
Um, and when our impulse control kind of goes down, we have a lack of uh our filter, if you will, to be able to kind of hold ourselves together in a socially acceptable way, right?
00:26:34.640 --> 00:26:45.200
And so when people are mad, it takes a and I will say, it is a lot of energy to to kind of keep yourself all rigid and like, okay, I'm gonna just like be a normal human person today.
00:26:45.279 --> 00:26:47.519
I'm gonna go out in the world and like do my thing.
00:26:47.759 --> 00:26:51.119
And I think you see this, I think see this with like you know, kids when they come back from school.
00:26:51.200 --> 00:26:57.279
It's like they, especially if they're neodivergent, they like work so hard to like do the thing at school and then they just like flop.
00:26:57.599 --> 00:26:58.880
Does this feel like you have to clinic?
00:26:58.960 --> 00:26:59.519
Because this feels like me.
00:26:59.599 --> 00:27:00.559
It's like all day at clinics.
00:27:00.799 --> 00:27:02.720
I'm like, this is like my clinic persona.
00:27:02.880 --> 00:27:07.839
Yes, I have to be the therapist and the healer and I have to keep it together and keep all my emotions inside.
00:27:08.079 --> 00:27:10.079
Yes, I don't put them onto the patient, right?
00:27:10.240 --> 00:27:11.039
Exactly.
00:27:11.279 --> 00:27:15.279
I feel like I lose I leave work and like that just I can't do it.
00:27:15.599 --> 00:27:16.160
I can't anymore.
00:27:16.480 --> 00:27:17.200
Yes, yeah.
00:27:17.519 --> 00:27:29.279
Because of that ability to hold in, and so when we kind of have used up the the the tank of our impulse control or ability to kind of tolerate being in that state, it just kind of goes out the window.
00:27:29.519 --> 00:27:41.599
And so often we'll hold it in for you know the people outside, but the people that are around us that are closest sometimes are impacted the most out of us not having a filter, and you're like, man, I just like I can't, I just don't want to like deal with you anymore.
00:27:41.920 --> 00:27:43.920
And I'm really sorry, but yeah, exactly.
00:27:44.000 --> 00:27:46.160
Like, I'm just gonna be a little bit kooky right now.
00:27:46.480 --> 00:27:48.400
Yeah, he gets the weirdo side first.
00:27:48.799 --> 00:27:49.119
Exactly.
00:27:49.279 --> 00:27:51.839
Yeah, like I just can't, I just can't be, I can't do it.
00:27:52.000 --> 00:27:54.319
I only have a couple patients I'm willing to see at 6 p.m.
00:27:54.720 --> 00:27:55.920
And I think that they get it also.
00:27:56.000 --> 00:27:56.799
Yeah, yeah, yeah, yeah.
00:27:56.960 --> 00:28:00.880
It's like they have to be able to deal with more of the non-clinic meetings, exactly.
00:28:01.200 --> 00:28:08.000
So like schedule a youth at this time if like we can be slightly in that gray zone because we can't do it.
00:28:09.119 --> 00:28:10.319
Exactly, exactly.
00:28:10.480 --> 00:28:16.559
Yeah, it takes, you know, because there is so much that energy that it takes to really hold ourselves together.
00:28:17.039 --> 00:28:18.880
It's exhausting, it's exhausting, yes.
00:28:19.200 --> 00:28:25.519
So is this why you hear about like a lot of women just like literally, it's like they just kind of have that like I don't care anymore?
00:28:25.680 --> 00:28:27.599
Like, is that kind of why you see this around midlife?
00:28:27.759 --> 00:28:31.920
Because you know, there's that really popular count that we don't we do not care club, right?
00:28:32.160 --> 00:28:37.200
And she's so cute, she's at multiple pair of glasses and eye masks and everything, but it's like a thing, right?
00:28:37.279 --> 00:28:39.519
That we all identify with this at midlife.
00:28:39.680 --> 00:28:40.480
Is this part of it?
00:28:40.640 --> 00:28:41.519
Yes, absolutely.
00:28:41.759 --> 00:28:52.240
I just can't, it's it's holding it all together, and because your resiliency going back to that, and like what you can tolerate is at an all-time low, you have to pick and choose.
00:28:52.319 --> 00:29:10.000
You get to a choice point of like what are the most important things that like I'm going to focus my time and attention on if I have so little, and if it's gonna be like I just don't care anymore about X, Y, and Z, and I cared about that, it's like okay, that's going out the window because I only have so much and there are so many competing needs, yeah, so much bandwidth and not enough bandwidth.
00:29:10.240 --> 00:29:10.799
Exactly.
00:29:11.119 --> 00:29:19.920
Another mental health thing that I was reading about before you came in is autism, and I don't have a lot of experience with it, but how does this all impact autism?
00:29:20.160 --> 00:29:32.000
Because I was reading that there's a lot of people who were never diagnosed with autism, and then they get to midlife, and then all of a sudden they come up with this new diagnosis, and it's not new, it's just that they finally were diagnosed in midlife.
00:29:32.319 --> 00:29:34.000
How does that tie into all of this as well?
00:29:34.240 --> 00:29:36.480
Yeah, I think that's such an important call out.
00:29:36.799 --> 00:29:38.559
I think it's happening more often than not.
00:29:38.640 --> 00:29:54.000
I think both uh women who are getting diagnosed as autistic later in life and with ADHD or other neurodiversities is that in in childhood, I think I mentioned it a little bit before, ADHD is often associated with like hyperactivity.
00:29:54.480 --> 00:30:01.759
And so in childhood, boys are often diagnosed more uh more often because of that symptom.
00:30:01.839 --> 00:30:03.039
It's just like more obvious.
00:30:03.200 --> 00:30:03.519
Okay.
00:30:03.839 --> 00:30:18.400
Where women mostly often have the inattentive ADHD or autism where it's like, uh, they can get through and they're not very hyperactive, they can sit down, they can do this thing, and they're often missed because of that.
00:30:18.640 --> 00:30:24.559
And so they get missed because the symptoms just aren't as loud in childhood.
00:30:24.720 --> 00:30:32.799
And so they kind of have the ability to get through and get by, but then in midlife, it's like, wait a second, it's just not working.
00:30:33.039 --> 00:30:51.440
It's just not working because the symptomology just looks so much different in in boys and girls, and then gals get to this phase, and with all the chemical cascading that's happening, and because so much of it uh mirrors executive functioning, which is really what impacts people with uh ADHD and autism, is that it just explodes.
00:30:51.519 --> 00:30:55.279
It's just like, oh my god, this is so much worse than it ever has been before.
00:30:56.000 --> 00:30:59.200
Yeah, and that was exactly what I was reading about was like this explosion.
00:30:59.839 --> 00:31:04.000
And like that just sounded really intense for people, and yeah.
00:31:04.400 --> 00:31:11.279
So yeah, I think it it really impacts, I think you see it the most with women who are in the workplace.
00:31:11.519 --> 00:31:11.839
Okay.
00:31:12.000 --> 00:31:27.759
Um, because I think that can be a bit more of it, you can see it in family dynamics, and I think people will come in with it, but I think where it can get particularly uncomfortable because more people write on the outside when we're trying to mask on the outside, but it's not working anymore.
00:31:27.920 --> 00:31:40.559
And women who are in the workplace are struggling with um relationship dynamics, are struggling to get tasks done, are struggling to um write sleep is impacted, so their memory is impacted, word recall is impacted.
00:31:40.720 --> 00:31:51.839
And so you really can see it in like work performance, in particular with women with ADHD and autism, because I mean you spend so much time at work, um, especially if you are in an office and sitting down.
00:31:52.000 --> 00:31:59.359
Um and I think that really is often the trigger for a lot of people to start coming in to get therapy because they see it in the workplace, yeah.
00:31:59.599 --> 00:32:09.519
And we hear that all the time like that women just they feel like their work performance is for um is maybe impacted the fact that they are leaving the workforce early or their productivity has gone down.
00:32:09.680 --> 00:32:20.559
And do you have certain things that you and this it might be really too general, but do you have certain things that you would broadly tell women that these are things that they could be doing to help that in the workplace?
00:32:20.720 --> 00:32:26.559
Like certain skills or tools, like are there a few that you broadly could say might be good for people to try?
00:32:26.799 --> 00:32:42.079
Yeah, I think it's similar, you know, with executive and functioning, I think the biggest thing that I always try to tell my clients is, and I like to talk, I talk in business talk with my clients who are in uh corporate too, where it's like, what are your standard operating procedures?
00:32:42.160 --> 00:32:42.720
Yeah, right?
00:32:42.880 --> 00:32:44.880
Like, what are your personal SOPs?
00:32:44.960 --> 00:32:46.000
You have to have that down.
00:32:46.160 --> 00:32:54.240
I think it goes back to how do you create a schedule and a way of living that your brain can operate in?
00:32:54.400 --> 00:33:07.839
And so if you're going into the workplace and you're struggling with meetings at a certain time, you're struggling with emails at a certain time, you're struggling with certain related like coworker dynamics, figuring out when you feel your best self, right?
00:33:08.000 --> 00:33:13.440
And figuring out what you are going to need to be able to operate in whatever daily schedule you create.
00:33:13.519 --> 00:33:14.880
So is that working out?
00:33:15.039 --> 00:33:23.200
Is that that you're gonna need a certain coffee or a drink or uh neurodivergent brains love a stimulant, right?
00:33:23.359 --> 00:33:26.240
And so, yeah, take a coffee, they're great.
00:33:26.400 --> 00:33:40.400
Um, so really optimizing like for your brain, because everyone's brain is different, everyone's way of living is going to be different, so you really have to be kind of a little bit of a researcher in your own right and say, okay, well, what is the thing that actually really works for me?
00:33:40.799 --> 00:33:41.759
And then implement that.
00:33:42.000 --> 00:33:43.279
And then implement that when.
00:33:43.599 --> 00:33:43.920
When.
00:33:44.160 --> 00:33:46.880
Yeah, and I always like to say this is another analogy.
00:33:46.960 --> 00:33:47.759
I love analogies.
00:33:47.920 --> 00:33:48.799
I'm a therapist.
00:33:48.960 --> 00:33:59.519
Um, but I tell my clients when they are starting new things or new behaviors, including, you know, creating schedules or tasks, is not to judge the first one.
00:33:59.599 --> 00:34:02.720
So I always like to say the first pancake is never a good pancake.
00:34:02.960 --> 00:34:03.119
Never.
00:34:03.440 --> 00:34:04.799
And it's never a good pancake.
00:34:05.039 --> 00:34:07.519
Sometimes the second one, never a good pancake.
00:34:07.759 --> 00:34:10.000
So you have to keep trying, right?
00:34:10.079 --> 00:34:18.159
Don't give up just because the first, second, or third time um didn't work with this new skill or this new thing that you're trying to implement.
00:34:18.400 --> 00:34:23.840
And so, yeah, that's my favorite thing so many times because that's really it.
00:34:23.920 --> 00:34:28.880
And I talk to people all the time about when you can try to do your PT and when you can do your exercise.
00:34:28.960 --> 00:34:30.960
And for me, I have to have it scheduled in.
00:34:31.280 --> 00:34:32.400
I'm an appointments girl.
00:34:32.719 --> 00:34:34.880
If I don't have appointments, I will waste an entire day.
00:34:35.119 --> 00:34:35.440
Exactly.
00:34:35.760 --> 00:34:36.559
Absolutely nothing done.
00:34:36.800 --> 00:34:36.960
Yes.
00:34:37.199 --> 00:34:40.800
But it's like if I have it scheduled and I make an appointment with myself, then I'll go.
00:34:41.039 --> 00:34:42.480
That is something everyone struggles with.
00:34:42.559 --> 00:34:46.559
And it's like I tell them if it doesn't work for you that you did it this time, try a different time.
00:34:46.880 --> 00:34:48.159
And again, start with a little bit.
00:34:48.320 --> 00:34:50.880
My favorite motto is something's better than nothing.
00:34:51.360 --> 00:34:54.239
Because we get so hard on ourselves we have to try to get it all done.
00:34:54.559 --> 00:34:54.800
Yes.
00:34:54.960 --> 00:34:59.199
And I try really hard to give people maybe only three or four things.
00:34:59.519 --> 00:35:11.039
Because my younger self was like, I'm gonna give someone 20 exercises, yes, and no one ever did it because you know this younger person feels like you have to impress the person with how much you know and do all of these things.
00:35:11.360 --> 00:35:13.199
But no one does it, not right.
00:35:13.280 --> 00:35:14.880
I can't do it if you throw 20 things at me.
00:35:15.199 --> 00:35:16.880
It's like three, maybe four tasks.
00:35:16.960 --> 00:35:20.079
Yeah, do that for a week or two, gain mastery over that level.
00:35:20.320 --> 00:35:20.960
Yes, yes.
00:35:21.119 --> 00:35:22.719
But also, when am I gonna do it?
00:35:22.800 --> 00:35:26.960
And back to the pelvic floor ladies, a lot of them wait until right before bed.
00:35:27.519 --> 00:35:29.599
I'm like, you are too tired then.
00:35:29.920 --> 00:35:32.239
It's just and they're like, Well, that's when I'm in my bedroom by myself.
00:35:32.400 --> 00:35:34.480
I'm like, you gotta figure out another time.
00:35:34.639 --> 00:35:37.440
And I try it's like five minutes three times a week, you know.
00:35:37.599 --> 00:35:44.960
So I try to keep it really small, and that's something that I find is more helpful.
00:35:45.119 --> 00:35:45.440
Yeah.
00:35:45.599 --> 00:35:55.760
But again, like the first time never works, the second time might not work, and so oftentimes people give up before they actually even figure out yes, yep, yep, yep, yeah.
00:35:56.079 --> 00:35:56.480
Interesting.
00:35:56.800 --> 00:35:58.320
Yeah, failure tolerance.
00:35:58.719 --> 00:36:00.800
What failure tolerance, right?
00:36:00.880 --> 00:36:07.840
We have to learn how to tolerate and be able to be okay with when we don't do it a hundred percent successfully.
00:36:08.159 --> 00:36:24.400
Think learning how to tolerate the discomfort of not doing it right or well, and going back to what we're talking about, women are just expected to like do everything perfectly and amazing, and then if we don't do it, it's like, oh my god, there's shame and self-doubt that kind of pulls in.
00:36:24.719 --> 00:36:28.880
And can we tolerate the discomfort of what failure feels like?
00:36:29.199 --> 00:36:33.679
This is what I love to call say about like just be a kook, like it's okay, it's okay, you can totally be a kooky.
00:36:33.840 --> 00:36:34.159
It's okay.
00:36:34.559 --> 00:36:36.400
Like, oh, it's the kookiness, it has a name.
00:36:36.480 --> 00:36:36.559
Yeah.
00:36:36.880 --> 00:36:37.599
Failure tolerance.
00:36:37.840 --> 00:36:38.559
Failure tolerance.
00:36:38.800 --> 00:36:38.960
Yeah.
00:36:39.199 --> 00:36:40.320
But we're not taught that.
00:36:40.480 --> 00:36:41.039
No, we're not.
00:36:41.280 --> 00:36:46.320
We're not taught taught that we have to do it perfectly right away or we are somehow not worthy.
00:36:46.559 --> 00:36:46.880
Yes.
00:36:47.039 --> 00:36:47.440
Yes.
00:36:47.840 --> 00:36:53.920
What are some other things, other tips that you give broadly to a lot of your people for this midlife women's health?
00:36:54.000 --> 00:36:55.840
Like, I feel all of these feels.
00:36:56.239 --> 00:37:00.079
Are there other just broad general strokes that you like to give people?
00:37:00.400 --> 00:37:13.760
Yeah, I think going back to kind of the the um chemicals in our brains, the the things in our brains that are happening are often drawing us away from relationship, right?
00:37:14.000 --> 00:37:15.599
Away from people.
00:37:16.000 --> 00:37:18.320
Um, and we are animals at heart, right?
00:37:18.400 --> 00:37:27.280
We are social creatures, and it's really important for people in general, this is just very broadly speaking, to have great relationships and to have a support system.
00:37:27.360 --> 00:37:32.000
But I think in particular in this time of life, relationships are so important.
00:37:32.159 --> 00:37:35.199
They're so vital to our health in so many ways.
00:37:35.519 --> 00:37:54.800
And I say if there's anything that I would broadly say is creating relationships and leaning on other women who are experiencing this, friends, like siblings, cousins, you know, community, um, spirituality, whatever it is that draws you into a community, I think is one of the best protecting factors.
00:37:54.960 --> 00:37:56.079
Um, there's a lot of other things.
00:37:56.159 --> 00:38:01.360
There are medical things we can do, like you can do HRT, you can have really comprehensive multidisciplinary care.
00:38:01.519 --> 00:38:06.719
But I think for what I like to guide people to is how can you just connect with people?
00:38:06.880 --> 00:38:08.719
Don't feel alone in this experience.
00:38:08.880 --> 00:38:15.440
Women that have suffered like kind of alone in this for so long and not anymore.
00:38:15.599 --> 00:38:16.159
I love that.
00:38:16.320 --> 00:38:17.119
Friends, friends.
00:38:17.840 --> 00:38:26.880
Friendship is so important for midlife women, and oftentimes that's a struggling time because the women or the women, the kids, if you have them, are out the door, you know, you might lose that.
00:38:27.039 --> 00:38:29.119
Maybe we're leaving work, right?
00:38:29.280 --> 00:38:31.920
Hopefully, we're finding other ways to be socially connected.
00:38:32.159 --> 00:38:32.400
Yes.
00:38:32.880 --> 00:38:38.480
So yeah, you hear a lot about that, like why friendship in this time is so yes, and some of the hardest times to find.
00:38:38.639 --> 00:38:44.079
So really making it an effort with that noise, yeah.
00:38:44.320 --> 00:38:45.440
You have to do it.
00:38:45.679 --> 00:38:48.559
I feel like that is a great place for us to wrap this up.
00:38:48.800 --> 00:38:52.079
I hope thank you so much again for being here.
00:38:52.559 --> 00:38:58.880
And we will put all of the places that people can find you, both um in person and online, in the show notes.
00:38:59.119 --> 00:38:59.440
Perfect.
00:38:59.599 --> 00:39:01.599
So thank you again for sharing your wisdom with us.
00:39:02.000 --> 00:39:03.280
Wait, you didn't do your health negotiation.
00:39:03.519 --> 00:39:04.400
No, I'm not here yet.
00:39:04.559 --> 00:39:04.880
Oh.
00:39:07.519 --> 00:39:09.440
Well, let's let's start that over.
00:39:10.559 --> 00:39:12.719
I feel like this is a really great place to wrap this up.
00:39:12.800 --> 00:39:15.360
So thank you so much for this conversation of being here today.
00:39:15.599 --> 00:39:16.400
You're so welcome.
00:39:16.559 --> 00:39:20.480
We will put everywhere that we can find you, both in person and online, in the show notes.
00:39:20.559 --> 00:39:23.920
So everyone who wants to learn more about you or maybe work with you, it'll be in there.
00:39:24.079 --> 00:39:24.639
Incredible.
00:39:24.880 --> 00:39:25.840
Well, thank you again.
00:39:25.920 --> 00:39:28.800
And thank you all for being here for another week of menopause unscripted.
00:39:28.880 --> 00:39:33.840
If you like today's episode with Naomi, please like, follow, and subscribe everywhere you find your favorite podcasts.
00:39:34.079 --> 00:39:37.039
With that being said, can we just ask one more question?
00:39:37.280 --> 00:39:37.679
Absolutely.
00:39:37.840 --> 00:39:39.920
I say we as in like I have only personalities.
00:39:40.079 --> 00:39:40.639
Maybe I do.
00:39:40.880 --> 00:39:41.199
Yeah.
00:39:41.599 --> 00:39:42.719
All your parts are showing up.
00:39:42.800 --> 00:39:45.039
All your parts want to be like all the weeds.
00:39:45.280 --> 00:39:45.440
Yes.
00:39:45.679 --> 00:39:48.159
Like I try not to we it because I'm like, that's showing.
00:39:48.400 --> 00:39:48.559
Yeah.
00:39:48.719 --> 00:39:50.559
That's too much unmasking my weeds.
00:39:51.599 --> 00:39:55.519
But can you just tell us what is your one daily health non-negotiable?
00:39:55.920 --> 00:40:03.039
My one daily health non-negotiable that I actually recently started, I think within the last six months, is my nighttime routine.
00:40:03.199 --> 00:40:04.239
Ooh, tell us more.
00:40:04.400 --> 00:40:06.639
I really I never had a nighttime routine.
00:40:06.719 --> 00:40:15.360
I was really locked in with the morning routine, and now my nighttime routine, I think, is even more important because it sets you up for the next day because sleep is so important.
00:40:15.840 --> 00:40:22.880
Um I stopped having my phone in my room, so I actually take my phone out of my room at around 7 or 8 p.m.
00:40:22.960 --> 00:40:24.320
So I'm no longer looking at a screen.
00:40:24.480 --> 00:40:24.800
Okay.
00:40:25.039 --> 00:40:27.519
Um I know, it's really hard.
00:40:27.599 --> 00:40:28.159
It's so crazy.
00:40:28.239 --> 00:40:29.199
I've bookmarked my days.
00:40:29.280 --> 00:40:33.199
No screen time at the end of the day or the first hour to 90 minutes.
00:40:33.519 --> 00:40:39.920
Um I take magnesium, I allow my body to kind of settle and relax, and I read a book.
00:40:40.079 --> 00:40:43.519
Um, for me, my body had a lot of restless leg syndrome happening.
00:40:43.599 --> 00:40:52.480
So for me, getting my body slowly integrated and ready into like to slumber um has had a massive impact on my day-to-day.
00:40:52.559 --> 00:40:55.280
And so that is like a non-negotiable at this point.
00:40:55.599 --> 00:40:56.159
I love that.
00:40:56.239 --> 00:40:57.119
Thank you so much for sharing.
00:40:57.360 --> 00:40:58.159
You're so welcome.
00:40:58.400 --> 00:41:00.000
Well, I will see you very soon.
00:41:00.159 --> 00:41:00.480
Yeah.
00:41:00.719 --> 00:41:02.719
So we'll be do more conferencing together.
00:41:02.960 --> 00:41:03.280
Absolutely.
00:41:03.519 --> 00:41:04.079
Oh, thank you.
00:41:05.679 --> 00:41:07.679
Now I have to end with the boring stuff.
00:41:07.840 --> 00:41:10.960
While I am a doctor, I am not your doctor.
00:41:11.519 --> 00:41:16.159
This podcast is for entertainment and educational purposes only.
00:41:16.480 --> 00:41:24.079
If something in today's episode resonated with you, please bring this to your own healthcare team and self advocate.
00:41:24.320 --> 00:41:26.000
You always are promoting that.
00:41:26.239 --> 00:41:34.079
I cannot wait for you to join me on next week's episode of Metapause Unscripted for another hot topic.
00:00:02.640 --> 00:00:05.599
Thanks for joining me on Menopause Unscripted.
00:00:05.759 --> 00:00:09.039
Remember, the change is just another beginning.
00:00:11.839 --> 00:00:14.000
Welcome back to another week of Menopause Unscripted.
00:00:14.080 --> 00:00:14.400
I'm Dr.
00:00:14.480 --> 00:00:17.199
Heidi and I'm joined this week by my friend Naomi Zellen.
00:00:17.600 --> 00:00:23.120
She is a therapist and she deals a lot with midlife women's uh mental health, which is what we're here to discuss today.
00:00:23.280 --> 00:00:24.399
Thank you so much for joining me.
00:00:24.640 --> 00:00:25.280
You're so welcome.
00:00:25.359 --> 00:00:26.239
I'm so happy to be here.
00:00:26.480 --> 00:00:29.760
Can you tell us a little bit about your background, who you typically treat, all the things?
00:00:30.160 --> 00:00:30.719
Absolutely.
00:00:30.960 --> 00:00:36.399
So I think my my desire to work with women started a really long time ago.
00:00:36.560 --> 00:00:42.320
I was on some of the pioneering research back in the early aughts with um animal studies.
00:00:42.479 --> 00:00:50.079
And so I did a lot of the newest animal studies at the time, back in like 2008, um, researching female rats.
00:00:50.240 --> 00:00:50.399
Okay.
00:00:50.640 --> 00:00:53.039
Um and that kind of midlife health and female rats.
00:00:54.000 --> 00:00:54.479
Yeah.
00:00:54.799 --> 00:01:00.000
So I started fe uh researching endochronology of the female brain.
00:01:00.159 --> 00:01:00.479
Okay.
00:01:00.880 --> 00:01:06.000
And specifically looking at kind of the HP axis of stress, anxiety, and depression.
00:01:06.400 --> 00:01:09.920
And so that's where all of my like excitement for women's health really started.
00:01:10.719 --> 00:01:15.599
Um female rats, um, which was great at the time, right?
00:01:15.680 --> 00:01:21.920
Because that was so new, and now we're just talking about it, and it's like incredible that back then it was absolutely not happening.
00:01:22.079 --> 00:01:34.400
Um, and so since then I've really been interested in you know brain health, women's health in particular, because female brains are different than male brains, and most of the medical research we've done in the past has always been on male brains.
00:01:34.480 --> 00:01:45.680
Um now we're kind of here at the point of talking about menopause and perimenopause and midlife and how that impacts female brains, so much like significantly different than men, right?
00:01:45.920 --> 00:01:50.159
Um I have a background in uh clinical mental health.
00:01:50.239 --> 00:01:57.920
I'm a somatic experiencing practitioner, I am a sex therapist, um, and I work with men, women, and all other genders.
00:01:58.079 --> 00:02:07.519
Um, and I got to the point of thinking about this period of time because I think we're just so people don't think about women.
00:02:07.760 --> 00:02:11.199
No, and like you said, the research really did not include us for a long time.
00:02:11.360 --> 00:02:13.199
It didn't differentiate between genders.
00:02:13.280 --> 00:02:18.879
So for a long time we had to extrapolate male data to female brains, which we now know doesn't really translate very well.
00:02:19.199 --> 00:02:20.080
It does not translate, yeah.
00:02:20.240 --> 00:02:20.560
Yeah.
00:02:20.719 --> 00:02:27.360
Um, and especially because we know that women experience anxiety and depression like at almost like uh double the rate that men do.
00:02:27.599 --> 00:02:43.360
And so when we get to this state of time in life when women's kind of brain chemistry is really being impacted by the uh decreasing estrogen and progesterone, there are a lot of kind of behavioral and cognitive implications of that.
00:02:43.680 --> 00:02:45.039
Can we just talk about that for a minute?
00:02:45.199 --> 00:02:49.840
Like what estrogen does to the brain versus what progesterone does in your mental state?
00:02:50.159 --> 00:02:58.240
Yeah, I think estrogen is the one that I'm like most focused on because I think it is really important for two things that I that I'm like fascinated by.
00:02:58.479 --> 00:03:03.120
One, estrogen supports the um kind of the creation of dopamine.
00:03:03.360 --> 00:03:15.680
And in particular, when we talk about folks or women who are neurodivergent, they're already lacking dopamine, and that makes things like focusing hard, memory hard, initiating tasks hard.
00:03:16.000 --> 00:03:16.400
Yeah.
00:03:16.639 --> 00:03:25.439
And so when estrogen starts to drop, or when it's even like kind of going up and down like this, um, it makes everyday challenges sometimes more hard.
00:03:25.599 --> 00:03:28.960
And women often feel like I just don't feel like myself.
00:03:29.280 --> 00:03:31.439
And clinical sign of menopause or parametapa.
00:03:32.000 --> 00:03:33.520
Yes, a hundred percent.
00:03:33.759 --> 00:03:48.800
Um, and so why that is so important is when estrogen falls and dopamine falls, women just get into this like I'm depressed, I can't do anything, I have brain fog, I just don't feel like myself.
00:03:49.360 --> 00:04:00.080
Oh, that is the thing you hear over and over and over in clinic, is like they don't people won't really think that I'm in perimenopause and I'm in this zone of hormonal chaos, but they just don't feel like themselves.
00:04:00.319 --> 00:04:10.000
And I don't know about you, but I find that a lot of women in here almost are in like menopause brain, right there.
00:04:10.240 --> 00:04:13.360
Um, they're basically in denial that they're in perimenopause.
00:04:13.439 --> 00:04:16.079
I think they think maybe I'm not old enough for this.
00:04:16.319 --> 00:04:19.199
I just had a child, I can't be there, I just had a baby.
00:04:19.680 --> 00:04:19.920
Yeah, yeah.
00:04:20.160 --> 00:04:32.000
It's just denial, and I've seen them for oftentimes orthopedic symptoms of this, but we have this conversation about perhaps we should start talking about these things, and women just don't want to go there.
00:04:32.240 --> 00:04:32.800
Right, yeah.
00:04:32.879 --> 00:04:38.959
I think historically the conversation around perimenopause or menopause is like, oh, that's women in you know their 50s.
00:04:39.120 --> 00:04:39.199
Right.
00:04:39.439 --> 00:04:40.240
That's that's not me.
00:04:40.319 --> 00:04:41.920
I can't that can't possibly be me.
00:04:42.079 --> 00:04:52.000
But what we know is that perimenopause starts as early as 35, and for women who are neurodivergent, that actually some of the newer research is coming out that they might experience it even sooner.
00:04:52.319 --> 00:04:53.199
Why is that?
00:04:53.519 --> 00:04:56.079
Um, I think it's just the way that their brains are.
00:04:56.240 --> 00:05:00.959
I think there isn't enough research to give a like a specific, like this is the thing that's pointing to it.
00:05:01.040 --> 00:05:15.839
But if I were to take an educated guess, I think because women's brains who are neurodivergent because of the already lower dopamine, when it even starts to creep down just a whisper, it just is going to start the cascade of all of the things that impact their health, right?
00:05:15.920 --> 00:05:20.399
And I think what you mentioned is so important, is that right, it's not just mental health that's impacted.
00:05:20.560 --> 00:05:26.480
There's bone health, there's pelvic floor health, there's cardiovascular health, and all of these things are impacted.
00:05:26.639 --> 00:05:34.560
And it's kind of that slow burn, which is why I think sometimes it's hard to even notice because it happens so discreetly, and then it's like bam.
00:05:35.040 --> 00:05:39.600
And so I think that's why so many women are like, no, it can't be that, and it's like, yeah, it is.
00:05:39.839 --> 00:05:41.680
But really, that's what we've got going on.
00:05:41.839 --> 00:05:42.240
Exactly.
00:05:42.560 --> 00:05:48.000
So for just a moment, can we talk about what neurodivergency entails versus neurotypical?
00:05:48.399 --> 00:05:51.360
Because for someone who isn't a therapist, yeah, we hear these terms, right?
00:05:51.439 --> 00:05:52.240
Yeah, great question.
00:05:52.480 --> 00:05:55.519
We don't necessarily know what these things mean, and is that me?
00:05:55.839 --> 00:05:58.879
Because I think everyone wants to be neurotypical, right?
00:05:59.040 --> 00:06:01.040
Because they think that is normal.
00:06:01.279 --> 00:06:01.439
Yeah.
00:06:01.839 --> 00:06:03.680
Can you just kind of tell us a little bit about the liberally?
00:06:04.319 --> 00:06:20.319
So, folks who are neurodivergent, they mostly experience, not always, there are obviously an array of symptoms, but folks who experience neurodivergence, they have um parts of their brain, mostly in the forebrain, um, with uh executive functioning.
00:06:20.399 --> 00:06:24.560
Um, and that's really the main thing that impacts a lot of neurodivergence.
00:06:24.639 --> 00:06:37.519
And executive functioning is a part of your brain that helps you again with task completion, with following through with tasks, um, with being able to um just initiate and get motivated.
00:06:37.680 --> 00:06:44.240
And uh sometimes, you know, in young kids, I'm thinking right now just women, but in young kids we see that in a lot of hyperactivity, right?
00:06:44.319 --> 00:06:48.000
There's a hyperactivity piece to it because we can't regulate ourselves.
00:06:48.160 --> 00:06:52.720
Um, and then sometimes there's the inattentive piece where we can't focus enough.
00:06:52.879 --> 00:06:56.399
Um, and all of those kind of converge in the front of your brain.
00:06:56.560 --> 00:07:07.920
And what we know about folks who are neurodivergent too is that their brains and their executive functioning skills actually grow and develop at a much slower pace than neurotypicals.
00:07:08.000 --> 00:07:12.879
So, neurotypicals, if you see in the classroom the kids can sit down, you know, they pay attention.
00:07:13.040 --> 00:07:22.800
Um kids who often struggle with the neurodivergence can't meet that same expectation because their brains just don't have the chemicals inside to help them sit still.
00:07:22.959 --> 00:07:24.560
And they sound like ADHD.
00:07:24.639 --> 00:07:26.000
It's like what you described.
00:07:26.399 --> 00:07:27.360
Yes, yes, yeah.
00:07:27.600 --> 00:07:35.279
And you hear this a lot with women in midlife that like their ADHD feels worse or we're not able to focus or brain fog or exactly those things.
00:07:35.600 --> 00:07:38.800
Yeah, which is why, going back to what we were just talking about, right?
00:07:39.040 --> 00:07:51.360
If you already have less dopamine in your brain to be able to do tasks, and then all of a sudden the chemical that helps make dopamine estrogen starts to fall, you are not making as much dopamine as you ever were before.
00:07:51.519 --> 00:08:01.199
So, women in particular with ADHD or neurodivergence who experience and go through perimenopause and menopause are kind of getting a twofold in that experience because of that.
00:08:01.360 --> 00:08:02.560
So, great, great insight.
00:08:02.879 --> 00:08:16.480
So, you're talking about dopamine estrogen reduction, and this is making me think it's a little bit of a swing of topic, but of the drug addict, which I'm on, yeah, and how that helps with having more dopamine in the brain, which has to do with like the sexual functioning and call.
00:08:16.959 --> 00:08:18.959
Can we just go and swing there for a minute?
00:08:19.199 --> 00:08:19.600
Totally.
00:08:19.759 --> 00:08:22.560
So, what happens when you are taking a drug?
00:08:22.639 --> 00:08:38.559
And I will say, like right now, I'm a therapist, so you know, I'm not a doctor, so what I know of this is that when you take a certain drug that helps with functioning of dopamine, is that it often our brains work, or these little connections are called neurotransmitters.
00:08:38.639 --> 00:08:45.120
And in the center, in those middle of the neurotransmitters, is kind of this communication center where they're all talking to each other.
00:08:45.279 --> 00:08:50.879
Um, and what happens when you don't have enough dopamine is that there isn't enough dopamine to talk to each cell.
00:08:51.039 --> 00:08:59.679
And so, what those drugs are doing is actually allowing the dopamine to hang out in that center and talk for a little bit longer rather than getting sucked up.
00:08:59.840 --> 00:09:07.759
And so it allows your brain to actually experience dopamine inside of your head for a lot longer, and that's part of what's happening in that drug.
00:09:08.000 --> 00:09:11.840
And how does dopamine affect our sexual functioning versus our attention?
00:09:12.320 --> 00:09:12.960
Love that, yeah.
00:09:13.120 --> 00:09:13.600
Same thing.
00:09:13.759 --> 00:09:19.039
So we have a handful of chemicals in our brain that yes, they do a lot of things.
00:09:19.120 --> 00:09:26.320
So, one, we're talking about attention, but dopamine also in our sexual functioning is impacted by estrogen.
00:09:26.480 --> 00:09:28.559
And it's also impacted by oxytocin.
00:09:28.639 --> 00:09:34.639
So, oxytocin, as we know, is a chemical that makes us want to bond with people, makes us warm fuzzies.
00:09:34.799 --> 00:09:38.799
Yes, it's the warm fuzzies, it's the like, ooh, look me in the eye, I want to hug ya.
00:09:39.120 --> 00:09:44.879
And oxytocin is also something that estrogen helps create.
00:09:45.360 --> 00:09:51.919
And so when estrogen starts to drop, right, our desire, and it's all right, these kind of cascades all are happening at once.
00:09:52.080 --> 00:09:58.559
So as estrogen starts to drop and oxytocin starts to drop, we actually don't want to feel connected to people.
00:09:58.639 --> 00:10:03.600
That's kind of when people say, Oh, maybe I'm a little depressed or I'm not feeling like I really want to be around people.
00:10:04.080 --> 00:10:05.759
That's a part of that component, right?
00:10:05.919 --> 00:10:08.960
In particular when it comes to relationships, right?
00:10:09.039 --> 00:10:18.799
If you want to reach out to your partner and one, you're like already kind of moody and feeling not yourself, and your partner's reaching out to you, and the chemical that like tells you, hey, reach out to your partner, is also tanking.
00:10:18.879 --> 00:10:21.759
Yeah, you're kind of like, ugh, get away from me.
00:10:21.919 --> 00:10:22.879
They say, Don't touch me.
00:10:23.120 --> 00:10:24.000
Don't touch me.
00:10:24.240 --> 00:10:24.559
Yeah.
00:10:25.279 --> 00:10:32.559
Um, and I think that's really important because we see that in how relationships start to really be impacted in this stage of life.
00:10:32.799 --> 00:10:35.600
And it has nothing to do with the relationship itself most of the time.
00:10:35.679 --> 00:10:42.639
It's just more the fact that there's like these chemical changes and as we kind of know desire and stuff lives in the brain a lot of this.
00:10:43.200 --> 00:10:44.639
So yes, yeah.
00:10:45.120 --> 00:10:48.559
Do you see that in like sex therapy that you do in the sex like couples counseling?
00:10:49.279 --> 00:11:27.200
Yeah, I'd say, I mean, working with a lot of midlife couples, what we know about is, you know, what the research indicates is there's actually a lot of divorce that happens in that time because I think women are going through so many changes in their body, and I think this is why things like educating ourselves of what's actually happening is gonna be really important because I think often, yes, there are marriages that maybe we wanna end for good reasons, and maybe there are marriages that maybe have ended because women were going through something really challenging and maybe didn't know themselves or their partners didn't know, and they didn't actually have the support they needed to get through this life transition.
00:11:27.440 --> 00:11:28.480
That makes so much sense.
00:11:28.559 --> 00:11:31.039
I am rereading Come As You Are right now.
00:11:31.279 --> 00:11:45.519
And every like literally every chapter makes me wish that every single person knew these things about their relationships and about themselves, both men knowing it about women and understanding better, right, and women knowing what they're experiencing during this time.
00:11:45.840 --> 00:11:46.159
100%.
00:11:46.480 --> 00:11:59.279
Yeah, and I think if you kind of go with what um I think Emily Nagoski is an incredible sex researcher, um, you know, the biggest thing that came out of that book was the accelerators and the brakes that she talks about, right?
00:11:59.360 --> 00:12:03.519
What pushes on the gas for desire and what kind of slams on the brakes?
00:12:03.679 --> 00:12:15.200
And if we kind of bring it all together, right, if you have so many things slamming on your brakes, you're not feeling yourself, you're overwhelmed, your sleep is disrupted because of menopause, right?
00:12:15.360 --> 00:12:23.759
You're having a hard time connecting with your partner, your kids are driving you crazy, you're struggling at work because your brain feels fuzzy because you haven't been sleeping.
00:12:24.080 --> 00:12:29.679
And those are things that are constantly putting on the brakes of your desire.
00:12:29.919 --> 00:12:38.720
And so when people come and see me, kind of trying to figure out, well, wow, I just like don't want to have sex, I'm not connected, I just like feel so distant from them.
00:12:38.879 --> 00:12:42.080
We feel like roommates, it's like, oh man, you are working from empty.
00:12:42.159 --> 00:12:46.480
That you will slam down the brake, and there is just nothing hitting that gas pedal.
00:12:46.559 --> 00:12:52.480
And so we gotta learn what are the things that are putting on those brakes in your relationship, in your body, in your life, right?
00:12:52.559 --> 00:12:56.639
You have to kind of see it holistically, so that we can bring in more of the space.
00:12:56.799 --> 00:12:58.559
Be like, okay, what's on that accelerator?
00:12:58.639 --> 00:13:00.080
What real what's gonna turn you on?
00:13:00.159 --> 00:13:02.080
What's gonna allow you to be inside of your body?
00:13:02.240 --> 00:13:03.840
How do you want support to look?
00:13:04.000 --> 00:13:07.360
It's gonna look different in this time of life than it might have otherwise.
00:13:07.600 --> 00:13:11.600
It's fun, like your husband doing the dishes starts being real sexy and being a turn on, right?
00:13:11.840 --> 00:13:16.799
Yeah, cleaning the house, cleaning the dinner house, yes, taking care of the kids, do the thing for me.
00:13:16.960 --> 00:13:18.320
Like, I don't want to have to do it.
00:13:18.399 --> 00:13:18.720
Yes.
00:13:18.960 --> 00:13:19.200
Absolutely.
00:13:19.519 --> 00:13:19.679
Yes.
00:13:20.000 --> 00:13:22.240
This was actually the chapter I was just listening to in my drive-in.
00:13:22.399 --> 00:13:26.000
Oh my god, amazing! Like, I just listened to this about two hours ago.
00:13:26.240 --> 00:13:26.480
Uh-huh.
00:13:26.639 --> 00:13:26.879
Uh-huh.
00:13:27.120 --> 00:13:27.519
Yeah.
00:13:27.759 --> 00:13:29.200
And I think that's so important.
00:13:29.360 --> 00:13:34.000
How how support in this time is is just so pivotal.
00:13:34.320 --> 00:13:34.799
Definitely.
00:13:34.960 --> 00:13:35.200
Yeah.
00:13:35.600 --> 00:13:36.799
So let's go back to the brain.
00:13:36.960 --> 00:13:39.360
We talked about dopamine and we talked about estrogen.
00:13:39.440 --> 00:13:43.360
Let's pop over to progesterone and what that does.
00:13:43.840 --> 00:13:47.200
Not as I I will be honest, I'm not as familiar with progesterone.
00:13:47.279 --> 00:13:47.519
No problem.
00:13:47.759 --> 00:13:50.879
I have taken most of my dive into estrogen and oxytose, and I will say.
00:13:51.120 --> 00:13:56.320
But we don't know that like when estrogen drops, oftentimes at the same time, the progesterone starts dropping off, also.
00:13:56.480 --> 00:13:56.720
Correct.
00:13:56.960 --> 00:13:58.639
And that can affect our mental health and mood.
00:13:58.960 --> 00:13:59.840
So, but that's okay.
00:13:59.919 --> 00:14:01.039
We can kind of skip over that.
00:14:01.200 --> 00:14:02.159
That's totally fine.
00:14:02.480 --> 00:14:08.159
So let's go back over to like the ADHD and other mental health disorders that can happen during midlife.
00:14:08.320 --> 00:14:13.519
And there's kind of this predisposition to if you have this, this kind of can heighten and worsen it.
00:14:13.919 --> 00:14:16.320
What about other types of mental health problems?
00:14:16.480 --> 00:14:18.000
Anxiety, depression.
00:14:18.240 --> 00:14:21.360
I'd asked you earlier about this concept of unmasking.
00:14:21.519 --> 00:14:22.399
Can we talk about that?
00:14:23.039 --> 00:14:23.600
Yeah.
00:14:23.919 --> 00:14:31.279
Um so going to, you know, if women are experiencing depression and anxiety in general, right?
00:14:31.360 --> 00:14:44.480
I think what happens is when we look at a lifespan, if you've come into midlife without any history of anxiety or depression, um, you might experience it for the first time.
00:14:44.720 --> 00:14:51.200
But I think what you're saying is if I've already experienced anxiety depression, how is that impacted when I get to this point?
00:14:51.440 --> 00:14:54.480
And when we get to that point, it's really similar to ADHD, right?
00:14:54.559 --> 00:15:04.080
And neurodivergence in particular is that anxiety levels will often increase because our ability to tolerate stress is at an all-time low.
00:15:04.240 --> 00:15:06.639
Because we're often not feeling like ourselves.
00:15:06.799 --> 00:15:14.879
Um, and so anxiety tends to spike because the stresses of life feel even more overwhelming than they did before.
00:15:15.039 --> 00:15:24.399
Um, our ability, our ability to be resilient in this time of the stage of life for women is has been really disrupted because of all of the hormone changes going on.
00:15:24.480 --> 00:15:26.480
And so anxiety often increases.
00:15:26.639 --> 00:15:30.720
And with that, depression can oft also often increase as well.
00:15:30.879 --> 00:15:35.120
So that can look like um just struggling to get tasks done.
00:15:35.200 --> 00:15:48.879
And you know, mental health, there's a lot of similar uh symptomology, and so with depression in particular, it can look similar to symptoms of ADHD that women experience, having a hard time struggling, getting things done, having a hard time getting tasks completed.
00:15:49.039 --> 00:15:54.639
Um, and they do all get uh more uh what's the word I'm looking for?
00:15:54.799 --> 00:15:58.159
They get um um impacted at the same time.
00:15:58.399 --> 00:15:58.879
Yeah.
00:15:59.120 --> 00:16:05.679
One of the interesting things I see in here is this intersect with mental health and pelvic health and sexual functioning here and also orthopedics.
00:16:06.080 --> 00:16:13.519
So doing orthopedic PT and doing pelvic chlorine PT are these women who have had reduced resiliency because of reduction hormones.
00:16:13.759 --> 00:16:19.840
They're getting injured or having injured injuries that were happened previously, kind of seem like they're cropping back up.
00:16:20.559 --> 00:16:22.559
Then we start trying to do PT.
00:16:23.200 --> 00:16:27.840
And it's like the ADHD kicks in, which then amplifies anxiety.
00:16:28.399 --> 00:16:32.320
And oftentimes what I hear is women just beating themselves up.
00:16:32.480 --> 00:16:32.799
Oh, yeah.
00:16:33.039 --> 00:16:35.840
Because I'm not doing my PT, I'm embarrassed to come tell you.
00:16:36.000 --> 00:16:40.879
Yeah they're not making progress because they just can't get on the task.
00:16:41.279 --> 00:16:55.600
But then we have this like nasty cycle back into the mental health, and so oftentimes I'm trying to co-work somebody with a therapist like yourself at the same time because we have to attack this from both sides, both the physical and the mental, because I am not a mental therapist.
00:16:55.840 --> 00:16:59.759
So as much as I can try to coach someone through that, that is not my job.
00:16:59.919 --> 00:17:07.359
Yeah, and this is something that I see on repeat week after week, and it's interesting because I never seen the men doing this.
00:17:07.599 --> 00:17:09.599
You know, I never seen the men doing this.
00:17:09.680 --> 00:17:12.559
They just come in and they're like, Yeah, I didn't do my homework, or I did.
00:17:13.200 --> 00:17:15.359
But the women, it's like this beating up.
00:17:15.839 --> 00:17:26.880
And how from a therapeutic aspect can you help somebody with with that and like that feeling of just I mean, these women like just literally, it's like they just are beating themselves up.
00:17:27.200 --> 00:17:29.839
How can you help with women doing these things?
00:17:30.319 --> 00:17:49.119
Wow, you're touching on such a bit, there's such a big point, and what women feel every day is the way of the world of needing to be perfect and to do it all and to show up, um, and to you know, the fear of not of not being the person that she knows she can be, right?
00:17:49.200 --> 00:17:51.440
I think that's what I was before, exactly.
00:17:51.519 --> 00:17:52.559
And I think that's the hard part.
00:17:52.640 --> 00:17:56.960
It's like I used to be able to do all of these things, and now I can't, I don't recognize myself.
00:17:57.200 --> 00:18:26.240
Um, I think to really slow it down and parse out what are the things that are at the root of all of the stress, where is the thing that's causing the biggest um issues, and then really similarly to you know, executive functioning skills are really concrete, so it's really helpful because as overwhelming as the stage can be, if we look at it from an executive functioning um kind of lacking a skill there, that we can do things really quickly.
00:18:26.480 --> 00:18:32.640
So um getting a really clear timeline, how do we organize our schedules?
00:18:32.799 --> 00:18:35.039
How do we chunk out certain areas of time?
00:18:35.200 --> 00:18:41.920
How do we track our energy levels throughout the day, which are impacted by our like cascading hormones throughout the day, right?
00:18:42.000 --> 00:18:48.160
It's also impacted um by food and diet, which we also know impacts um this time of life.
00:18:48.319 --> 00:18:55.119
And so being able to track kind of like when am I gonna be the most energetic to do the most difficult tasks?
00:18:55.279 --> 00:19:01.359
When am I gonna be kind of tired, but I can knock out things that don't take as much mental energy?
00:19:01.440 --> 00:19:14.240
And being able to track that, and I think where the somatic piece for me comes in is that often people feel something in their body and they feel like they have to go into that feeling.
00:19:14.319 --> 00:19:21.920
And what I mean by that is, oh, I'm really tired, so I'm gonna continue to be tired until I feel rested enough.
00:19:22.240 --> 00:19:27.279
When sometimes we don't need to do that, sometimes ourselves out of it's falling into it.
00:19:27.599 --> 00:19:27.920
Exactly.
00:19:28.160 --> 00:19:28.400
Cool.
00:19:28.559 --> 00:19:31.839
Can I give myself five, 20, 15 minutes of rest?
00:19:32.079 --> 00:19:34.160
And that allows me to know I've rested.
00:19:34.240 --> 00:19:35.279
Do I feel rested?
00:19:35.680 --> 00:19:41.039
Maybe not a hundred percent, but maybe just do one or two tasks to see if I can get something done.
00:19:41.279 --> 00:19:46.000
Oftentimes we can start getting things done once we just do one little thing.
00:19:46.079 --> 00:19:47.599
But we gotta go for the low-hanging fruit.
00:19:47.680 --> 00:19:48.559
That's what I always like to tell people.
00:19:48.640 --> 00:19:51.839
I was like, don't do the hard thing, don't try hard, try easy.
00:19:52.000 --> 00:19:59.519
It's like just do the one dish or just strip the bed, don't even do the laundry, just get it all done and then just see how you feel, and then kind of take it one step at a time.
00:19:59.680 --> 00:20:04.319
I think we just often see it too much of a big picture and just little baby steps.
00:20:04.480 --> 00:20:06.160
Okay, get that energy back up.
00:20:06.319 --> 00:20:06.799
Exactly.
00:20:06.960 --> 00:20:08.400
Take up take a rest, it's okay.
00:20:08.559 --> 00:20:10.640
It's also women, like we can't take rests.
00:20:10.799 --> 00:20:12.400
That's also given permission, right?
00:20:12.720 --> 00:20:15.759
I am the worst the absolute worst of it.
00:20:16.079 --> 00:20:16.480
It's okay.
00:20:16.799 --> 00:20:18.960
Yeah, someone telling you that you it's okay.
00:20:19.200 --> 00:20:21.200
It's okay because we don't do that to ourselves.
00:20:21.440 --> 00:20:21.759
Yeah.
00:20:22.160 --> 00:20:26.400
But with the somatic therapy, can you tell me the difference a little bit between that and CBT?
00:20:26.480 --> 00:20:29.119
Because we hear a lot about CBT for women's midlife health.
00:20:29.440 --> 00:20:32.720
Can we talk a little bit about what somatic therapy can do for us that's a little different?
00:20:32.960 --> 00:20:33.279
Yeah.
00:20:33.599 --> 00:20:43.440
CBT is great, um, I think in particular with uh depression and anxiety, um, where CBT stands for cognitive behavioral therapy.
00:20:43.519 --> 00:20:47.119
So what you look at is what are my cognitions, what are things I'm thinking?
00:20:47.279 --> 00:20:49.920
Um, how does that influence my behavior?
00:20:50.160 --> 00:20:54.000
Um, and then how you know what is the next step?
00:20:54.160 --> 00:21:01.839
And so often our the the way they the way cognitive behavioral therapy is kind of taught is that your thoughts influence your behavior.
00:21:01.920 --> 00:21:07.359
So if you change your thoughts, you can change your behaviors, um, which is great up until a point.
00:21:08.000 --> 00:21:12.960
Um, because what we also know is that our brains and our bodies aren't disconnected, right?
00:21:13.119 --> 00:21:15.519
This this also is a part of this.
00:21:15.680 --> 00:21:22.960
And so somatic therapy actually at the root of it is working with the nervous system, which is uh really working with your five senses.
00:21:23.039 --> 00:21:30.400
So not just your thoughts, but you're also working with emotions, um, physical sensations, I call that proprioception.
00:21:30.480 --> 00:21:31.920
So, like, what does it feel like inside?
00:21:32.079 --> 00:21:34.480
And I'm sure you hear people in your clinic, oh, pain.
00:21:34.559 --> 00:21:37.759
Okay, pain is a is a kind of a messenger of proprioception.
00:21:37.839 --> 00:21:43.440
So sometimes we can feel energetics, we can feel things swirly, tingling, almost like when your foot falls asleep, right?
00:21:43.680 --> 00:21:47.680
There's constant kind of messages inside internally that we want to track.
00:21:47.839 --> 00:21:52.640
Um, it can be sight, it can be smell, it can be, you know, uh uh vision, something like that.
00:21:52.799 --> 00:21:59.359
And so somatic therapy takes cognitive behavior behavior behavioral therapy and kind of just expands it, right?
00:21:59.440 --> 00:22:00.880
We are Expanding, okay.
00:22:00.960 --> 00:22:05.839
Well, when you think about that thing, what does that feel like in your body?
00:22:06.000 --> 00:22:07.759
Where do you feel that in your body?
00:22:08.000 --> 00:22:11.200
Okay, when you feel that in your body, what are the emotions tied to it?
00:22:11.359 --> 00:22:22.079
So we're really expanding all of that and noticing kind of what the whole body is communicating to us, and then with that awareness, it's the mindfulness piece.
00:22:22.319 --> 00:22:24.160
What is the next step that we want to do?
00:22:24.319 --> 00:22:25.759
What is the behavior we want to do?
00:22:25.920 --> 00:22:28.079
So they're similar in certain ways but different.
00:22:28.160 --> 00:22:33.440
Um, and they kind of do, you know, stack on top of each other.
00:22:33.759 --> 00:22:37.920
So you mentioned pain earlier, which is something I work with people with every day.
00:22:38.480 --> 00:22:42.720
And one of the things I do here is I try to get people to differentiate between sensations.
00:22:43.279 --> 00:22:46.960
Is it really pain that you're feeling or is it discomfort?
00:22:47.519 --> 00:22:48.720
Or is it something else?
00:22:49.279 --> 00:22:52.319
How do you work with people without from a somatic therapy point of view?
00:22:52.480 --> 00:22:57.359
Because that's something I deal with all the time, where people are so rooted in that my body hurts.
00:22:57.519 --> 00:22:57.680
Yeah.
00:22:57.759 --> 00:22:59.680
I'm like, but does it hurt and when does it hurt?
00:23:00.000 --> 00:23:05.599
And do I like and working with am I anxious about my condition and does that amplify my pain?
00:23:05.920 --> 00:23:06.799
Is it really pain?
00:23:07.039 --> 00:23:07.359
Yes.
00:23:07.599 --> 00:23:08.319
Is it something else?
00:23:08.640 --> 00:23:12.880
Because so many times every single thing has become pain by the time they come to see me.
00:23:13.200 --> 00:23:14.400
And it's not really pain.
00:23:14.480 --> 00:23:17.279
And so we use a lot of different words like discomfort.
00:23:17.359 --> 00:23:18.559
Is it therapeutic discomfort?
00:23:18.640 --> 00:23:19.680
Are you feeling a stretch?
00:23:20.000 --> 00:23:21.279
Are you feeling the muscle work?
00:23:21.519 --> 00:23:25.599
Because sometimes just making the muscle work, people think that is pain.
00:23:25.759 --> 00:23:26.000
Right.
00:23:26.160 --> 00:23:27.440
And they can't get that separated.
00:23:27.599 --> 00:23:29.200
So, how can you work with that on your end?
00:23:29.440 --> 00:23:30.160
Great question.
00:23:30.319 --> 00:23:41.119
What we know about chronic pain is that there's often a point of it, and because the way the body works, the our bodies intuitively want to help us.
00:23:41.359 --> 00:23:45.519
And so when there's pain, we often clamp around the pain to kind of protect it.
00:23:45.599 --> 00:23:48.160
That's what the body does, which often increases inflammation.
00:23:48.240 --> 00:23:57.440
And so it's not just that small pain point, it's now the muscles and the tissue around it are clamping down, creating more um inflammation and more pain.
00:23:57.680 --> 00:24:13.279
And the way I like to work with pain is uh I like to use like a it's uh I use a bullseye model, and so I often like to help people see, okay, if we were to go to the center of where that pain is, how do you notice where there is less pain?
00:24:13.519 --> 00:24:15.440
And so coming out from the center.
00:24:15.839 --> 00:24:16.000
Okay.
00:24:16.640 --> 00:24:17.279
I like this visual.
00:24:17.519 --> 00:24:18.000
Yeah, yeah, yeah.
00:24:18.079 --> 00:24:18.799
It's a great visual.
00:24:18.880 --> 00:24:19.599
People love it.
00:24:19.680 --> 00:24:23.519
Um, and so what happens is people say, well, the pain is everywhere, it's everywhere, it's everywhere.
00:24:23.599 --> 00:24:26.880
It's like, and it's generally in a very localized spot.
00:24:27.039 --> 00:24:30.319
So often I like to have people say, Okay, where is it the most intense?
00:24:30.480 --> 00:24:35.839
And then can we go out a f a few rings and see, okay, where is it the least painful?
00:24:36.079 --> 00:24:38.720
Where do you not feel any pain around that center?
00:24:38.880 --> 00:24:41.839
And can we focus on where there is no pain?
00:24:42.160 --> 00:24:46.160
And that often allows people to spread their awareness, right?
00:24:46.240 --> 00:24:58.799
What happens when um when you're working with the nervous system is people kind of get like very tunnel-visioned, and when we kind of focus somewhere outside of that tunnel, we actually expand the nervous system's ability to take in.
00:24:58.880 --> 00:25:00.000
Oh, what else is happening here?
00:25:00.240 --> 00:25:00.559
I love that.
00:25:00.720 --> 00:25:03.200
And you never heard this, and it's great unless you feel it.
00:25:04.240 --> 00:25:05.119
Yeah, please.
00:25:06.160 --> 00:25:07.200
And that's how you work with it.
00:25:07.440 --> 00:25:08.640
So, okay, what's the outside?
00:25:08.720 --> 00:25:10.559
And then okay, can we go in and in?
00:25:10.640 --> 00:25:14.000
So eventually the person can be in that just one area of pain.
00:25:14.240 --> 00:25:14.720
Interesting.
00:25:14.880 --> 00:25:16.000
Yeah, I love this.
00:25:16.160 --> 00:25:16.640
Yeah.
00:25:16.880 --> 00:25:18.079
All right, I'm gonna jump topic.
00:25:18.480 --> 00:25:20.079
Yeah, there's so many different things I want to talk about.
00:25:20.240 --> 00:25:22.400
Yeah, so we kind of talked about pain a little bit.
00:25:22.559 --> 00:25:23.200
Now let's go.
00:25:23.279 --> 00:25:27.039
I want to go back to the mental health and talk about the concept of unmasking.
00:25:27.200 --> 00:25:27.440
Yes.
00:25:27.599 --> 00:25:28.720
So can you tell me what this is?
00:25:28.799 --> 00:25:30.160
Because I feel like this is me.
00:25:30.240 --> 00:25:33.519
And I have been telling my boyfriend, I think that all of a sudden I have Tourette's.
00:25:33.759 --> 00:25:34.079
Yeah.
00:25:34.400 --> 00:25:38.400
And I don't mean to, but all of a sudden I'm just swearing and dropping F-bombs all the time.
00:25:38.480 --> 00:25:38.640
Yeah.
00:25:38.799 --> 00:25:41.920
And he calls me out on it because I don't even know I'm doing it.
00:25:42.640 --> 00:25:46.559
And I honestly, it's sometimes I think that like my filter has just been taken off.
00:25:46.960 --> 00:25:51.920
And I try really hard to put it back on, but I feel like I'm then putting back on the mask, like on the damper.
00:25:52.079 --> 00:25:52.319
Yes.
00:25:52.480 --> 00:25:55.599
And I feel like lately my damper has just been removed.
00:25:55.920 --> 00:25:57.839
And it's hard to put it back on.
00:25:58.160 --> 00:25:59.039
Can we talk about that?
00:25:59.200 --> 00:26:00.000
Absolutely, yeah.
00:26:00.160 --> 00:26:07.519
So another key feature in neurodivergence, and I think what shows up in perimenopause and menopause is impulse control, right?
00:26:08.240 --> 00:26:22.960
And that's a big thing with masking, is that um when we are masking, we are that we have the ability to kind of have a certain level of impulse control to like keep ourselves in a state of you know what is socially appropriate in different areas.
00:26:23.119 --> 00:26:33.759
Um, and when our impulse control kind of goes down, we have a lack of uh our filter, if you will, to be able to kind of hold ourselves together in a socially acceptable way, right?
00:26:34.640 --> 00:26:45.200
And so when people are mad, it takes a and I will say, it is a lot of energy to to kind of keep yourself all rigid and like, okay, I'm gonna just like be a normal human person today.
00:26:45.279 --> 00:26:47.519
I'm gonna go out in the world and like do my thing.
00:26:47.759 --> 00:26:51.119
And I think you see this, I think see this with like you know, kids when they come back from school.
00:26:51.200 --> 00:26:57.279
It's like they, especially if they're neodivergent, they like work so hard to like do the thing at school and then they just like flop.
00:26:57.599 --> 00:26:58.880
Does this feel like you have to clinic?
00:26:58.960 --> 00:26:59.519
Because this feels like me.
00:26:59.599 --> 00:27:00.559
It's like all day at clinics.
00:27:00.799 --> 00:27:02.720
I'm like, this is like my clinic persona.
00:27:02.880 --> 00:27:07.839
Yes, I have to be the therapist and the healer and I have to keep it together and keep all my emotions inside.
00:27:08.079 --> 00:27:10.079
Yes, I don't put them onto the patient, right?
00:27:10.240 --> 00:27:11.039
Exactly.
00:27:11.279 --> 00:27:15.279
I feel like I lose I leave work and like that just I can't do it.
00:27:15.599 --> 00:27:16.160
I can't anymore.
00:27:16.480 --> 00:27:17.200
Yes, yeah.
00:27:17.519 --> 00:27:29.279
Because of that ability to hold in, and so when we kind of have used up the the the tank of our impulse control or ability to kind of tolerate being in that state, it just kind of goes out the window.
00:27:29.519 --> 00:27:41.599
And so often we'll hold it in for you know the people outside, but the people that are around us that are closest sometimes are impacted the most out of us not having a filter, and you're like, man, I just like I can't, I just don't want to like deal with you anymore.
00:27:41.920 --> 00:27:43.920
And I'm really sorry, but yeah, exactly.
00:27:44.000 --> 00:27:46.160
Like, I'm just gonna be a little bit kooky right now.
00:27:46.480 --> 00:27:48.400
Yeah, he gets the weirdo side first.
00:27:48.799 --> 00:27:49.119
Exactly.
00:27:49.279 --> 00:27:51.839
Yeah, like I just can't, I just can't be, I can't do it.
00:27:52.000 --> 00:27:54.319
I only have a couple patients I'm willing to see at 6 p.m.
00:27:54.720 --> 00:27:55.920
And I think that they get it also.
00:27:56.000 --> 00:27:56.799
Yeah, yeah, yeah, yeah.
00:27:56.960 --> 00:28:00.880
It's like they have to be able to deal with more of the non-clinic meetings, exactly.
00:28:01.200 --> 00:28:08.000
So like schedule a youth at this time if like we can be slightly in that gray zone because we can't do it.
00:28:09.119 --> 00:28:10.319
Exactly, exactly.
00:28:10.480 --> 00:28:16.559
Yeah, it takes, you know, because there is so much that energy that it takes to really hold ourselves together.
00:28:17.039 --> 00:28:18.880
It's exhausting, it's exhausting, yes.
00:28:19.200 --> 00:28:25.519
So is this why you hear about like a lot of women just like literally, it's like they just kind of have that like I don't care anymore?
00:28:25.680 --> 00:28:27.599
Like, is that kind of why you see this around midlife?
00:28:27.759 --> 00:28:31.920
Because you know, there's that really popular count that we don't we do not care club, right?
00:28:32.160 --> 00:28:37.200
And she's so cute, she's at multiple pair of glasses and eye masks and everything, but it's like a thing, right?
00:28:37.279 --> 00:28:39.519
That we all identify with this at midlife.
00:28:39.680 --> 00:28:40.480
Is this part of it?
00:28:40.640 --> 00:28:41.519
Yes, absolutely.
00:28:41.759 --> 00:28:52.240
I just can't, it's it's holding it all together, and because your resiliency going back to that, and like what you can tolerate is at an all-time low, you have to pick and choose.
00:28:52.319 --> 00:29:10.000
You get to a choice point of like what are the most important things that like I'm going to focus my time and attention on if I have so little, and if it's gonna be like I just don't care anymore about X, Y, and Z, and I cared about that, it's like okay, that's going out the window because I only have so much and there are so many competing needs, yeah, so much bandwidth and not enough bandwidth.
00:29:10.240 --> 00:29:10.799
Exactly.
00:29:11.119 --> 00:29:19.920
Another mental health thing that I was reading about before you came in is autism, and I don't have a lot of experience with it, but how does this all impact autism?
00:29:20.160 --> 00:29:32.000
Because I was reading that there's a lot of people who were never diagnosed with autism, and then they get to midlife, and then all of a sudden they come up with this new diagnosis, and it's not new, it's just that they finally were diagnosed in midlife.
00:29:32.319 --> 00:29:34.000
How does that tie into all of this as well?
00:29:34.240 --> 00:29:36.480
Yeah, I think that's such an important call out.
00:29:36.799 --> 00:29:38.559
I think it's happening more often than not.
00:29:38.640 --> 00:29:54.000
I think both uh women who are getting diagnosed as autistic later in life and with ADHD or other neurodiversities is that in in childhood, I think I mentioned it a little bit before, ADHD is often associated with like hyperactivity.
00:29:54.480 --> 00:30:01.759
And so in childhood, boys are often diagnosed more uh more often because of that symptom.
00:30:01.839 --> 00:30:03.039
It's just like more obvious.
00:30:03.200 --> 00:30:03.519
Okay.
00:30:03.839 --> 00:30:18.400
Where women mostly often have the inattentive ADHD or autism where it's like, uh, they can get through and they're not very hyperactive, they can sit down, they can do this thing, and they're often missed because of that.
00:30:18.640 --> 00:30:24.559
And so they get missed because the symptoms just aren't as loud in childhood.
00:30:24.720 --> 00:30:32.799
And so they kind of have the ability to get through and get by, but then in midlife, it's like, wait a second, it's just not working.
00:30:33.039 --> 00:30:51.440
It's just not working because the symptomology just looks so much different in in boys and girls, and then gals get to this phase, and with all the chemical cascading that's happening, and because so much of it uh mirrors executive functioning, which is really what impacts people with uh ADHD and autism, is that it just explodes.
00:30:51.519 --> 00:30:55.279
It's just like, oh my god, this is so much worse than it ever has been before.
00:30:56.000 --> 00:30:59.200
Yeah, and that was exactly what I was reading about was like this explosion.
00:30:59.839 --> 00:31:04.000
And like that just sounded really intense for people, and yeah.
00:31:04.400 --> 00:31:11.279
So yeah, I think it it really impacts, I think you see it the most with women who are in the workplace.
00:31:11.519 --> 00:31:11.839
Okay.
00:31:12.000 --> 00:31:27.759
Um, because I think that can be a bit more of it, you can see it in family dynamics, and I think people will come in with it, but I think where it can get particularly uncomfortable because more people write on the outside when we're trying to mask on the outside, but it's not working anymore.
00:31:27.920 --> 00:31:40.559
And women who are in the workplace are struggling with um relationship dynamics, are struggling to get tasks done, are struggling to um write sleep is impacted, so their memory is impacted, word recall is impacted.
00:31:40.720 --> 00:31:51.839
And so you really can see it in like work performance, in particular with women with ADHD and autism, because I mean you spend so much time at work, um, especially if you are in an office and sitting down.
00:31:52.000 --> 00:31:59.359
Um and I think that really is often the trigger for a lot of people to start coming in to get therapy because they see it in the workplace, yeah.
00:31:59.599 --> 00:32:09.519
And we hear that all the time like that women just they feel like their work performance is for um is maybe impacted the fact that they are leaving the workforce early or their productivity has gone down.
00:32:09.680 --> 00:32:20.559
And do you have certain things that you and this it might be really too general, but do you have certain things that you would broadly tell women that these are things that they could be doing to help that in the workplace?
00:32:20.720 --> 00:32:26.559
Like certain skills or tools, like are there a few that you broadly could say might be good for people to try?
00:32:26.799 --> 00:32:42.079
Yeah, I think it's similar, you know, with executive and functioning, I think the biggest thing that I always try to tell my clients is, and I like to talk, I talk in business talk with my clients who are in uh corporate too, where it's like, what are your standard operating procedures?
00:32:42.160 --> 00:32:42.720
Yeah, right?
00:32:42.880 --> 00:32:44.880
Like, what are your personal SOPs?
00:32:44.960 --> 00:32:46.000
You have to have that down.
00:32:46.160 --> 00:32:54.240
I think it goes back to how do you create a schedule and a way of living that your brain can operate in?
00:32:54.400 --> 00:33:07.839
And so if you're going into the workplace and you're struggling with meetings at a certain time, you're struggling with emails at a certain time, you're struggling with certain related like coworker dynamics, figuring out when you feel your best self, right?
00:33:08.000 --> 00:33:13.440
And figuring out what you are going to need to be able to operate in whatever daily schedule you create.
00:33:13.519 --> 00:33:14.880
So is that working out?
00:33:15.039 --> 00:33:23.200
Is that that you're gonna need a certain coffee or a drink or uh neurodivergent brains love a stimulant, right?
00:33:23.359 --> 00:33:26.240
And so, yeah, take a coffee, they're great.
00:33:26.400 --> 00:33:40.400
Um, so really optimizing like for your brain, because everyone's brain is different, everyone's way of living is going to be different, so you really have to be kind of a little bit of a researcher in your own right and say, okay, well, what is the thing that actually really works for me?
00:33:40.799 --> 00:33:41.759
And then implement that.
00:33:42.000 --> 00:33:43.279
And then implement that when.
00:33:43.599 --> 00:33:43.920
When.
00:33:44.160 --> 00:33:46.880
Yeah, and I always like to say this is another analogy.
00:33:46.960 --> 00:33:47.759
I love analogies.
00:33:47.920 --> 00:33:48.799
I'm a therapist.
00:33:48.960 --> 00:33:59.519
Um, but I tell my clients when they are starting new things or new behaviors, including, you know, creating schedules or tasks, is not to judge the first one.
00:33:59.599 --> 00:34:02.720
So I always like to say the first pancake is never a good pancake.
00:34:02.960 --> 00:34:03.119
Never.
00:34:03.440 --> 00:34:04.799
And it's never a good pancake.
00:34:05.039 --> 00:34:07.519
Sometimes the second one, never a good pancake.
00:34:07.759 --> 00:34:10.000
So you have to keep trying, right?
00:34:10.079 --> 00:34:18.159
Don't give up just because the first, second, or third time um didn't work with this new skill or this new thing that you're trying to implement.
00:34:18.400 --> 00:34:23.840
And so, yeah, that's my favorite thing so many times because that's really it.
00:34:23.920 --> 00:34:28.880
And I talk to people all the time about when you can try to do your PT and when you can do your exercise.
00:34:28.960 --> 00:34:30.960
And for me, I have to have it scheduled in.
00:34:31.280 --> 00:34:32.400
I'm an appointments girl.
00:34:32.719 --> 00:34:34.880
If I don't have appointments, I will waste an entire day.
00:34:35.119 --> 00:34:35.440
Exactly.
00:34:35.760 --> 00:34:36.559
Absolutely nothing done.
00:34:36.800 --> 00:34:36.960
Yes.
00:34:37.199 --> 00:34:40.800
But it's like if I have it scheduled and I make an appointment with myself, then I'll go.
00:34:41.039 --> 00:34:42.480
That is something everyone struggles with.
00:34:42.559 --> 00:34:46.559
And it's like I tell them if it doesn't work for you that you did it this time, try a different time.
00:34:46.880 --> 00:34:48.159
And again, start with a little bit.
00:34:48.320 --> 00:34:50.880
My favorite motto is something's better than nothing.
00:34:51.360 --> 00:34:54.239
Because we get so hard on ourselves we have to try to get it all done.
00:34:54.559 --> 00:34:54.800
Yes.
00:34:54.960 --> 00:34:59.199
And I try really hard to give people maybe only three or four things.
00:34:59.519 --> 00:35:11.039
Because my younger self was like, I'm gonna give someone 20 exercises, yes, and no one ever did it because you know this younger person feels like you have to impress the person with how much you know and do all of these things.
00:35:11.360 --> 00:35:13.199
But no one does it, not right.
00:35:13.280 --> 00:35:14.880
I can't do it if you throw 20 things at me.
00:35:15.199 --> 00:35:16.880
It's like three, maybe four tasks.
00:35:16.960 --> 00:35:20.079
Yeah, do that for a week or two, gain mastery over that level.
00:35:20.320 --> 00:35:20.960
Yes, yes.
00:35:21.119 --> 00:35:22.719
But also, when am I gonna do it?
00:35:22.800 --> 00:35:26.960
And back to the pelvic floor ladies, a lot of them wait until right before bed.
00:35:27.519 --> 00:35:29.599
I'm like, you are too tired then.
00:35:29.920 --> 00:35:32.239
It's just and they're like, Well, that's when I'm in my bedroom by myself.
00:35:32.400 --> 00:35:34.480
I'm like, you gotta figure out another time.
00:35:34.639 --> 00:35:37.440
And I try it's like five minutes three times a week, you know.
00:35:37.599 --> 00:35:44.960
So I try to keep it really small, and that's something that I find is more helpful.
00:35:45.119 --> 00:35:45.440
Yeah.
00:35:45.599 --> 00:35:55.760
But again, like the first time never works, the second time might not work, and so oftentimes people give up before they actually even figure out yes, yep, yep, yep, yeah.
00:35:56.079 --> 00:35:56.480
Interesting.
00:35:56.800 --> 00:35:58.320
Yeah, failure tolerance.
00:35:58.719 --> 00:36:00.800
What failure tolerance, right?
00:36:00.880 --> 00:36:07.840
We have to learn how to tolerate and be able to be okay with when we don't do it a hundred percent successfully.
00:36:08.159 --> 00:36:24.400
Think learning how to tolerate the discomfort of not doing it right or well, and going back to what we're talking about, women are just expected to like do everything perfectly and amazing, and then if we don't do it, it's like, oh my god, there's shame and self-doubt that kind of pulls in.
00:36:24.719 --> 00:36:28.880
And can we tolerate the discomfort of what failure feels like?
00:36:29.199 --> 00:36:33.679
This is what I love to call say about like just be a kook, like it's okay, it's okay, you can totally be a kooky.
00:36:33.840 --> 00:36:34.159
It's okay.
00:36:34.559 --> 00:36:36.400
Like, oh, it's the kookiness, it has a name.
00:36:36.480 --> 00:36:36.559
Yeah.
00:36:36.880 --> 00:36:37.599
Failure tolerance.
00:36:37.840 --> 00:36:38.559
Failure tolerance.
00:36:38.800 --> 00:36:38.960
Yeah.
00:36:39.199 --> 00:36:40.320
But we're not taught that.
00:36:40.480 --> 00:36:41.039
No, we're not.
00:36:41.280 --> 00:36:46.320
We're not taught taught that we have to do it perfectly right away or we are somehow not worthy.
00:36:46.559 --> 00:36:46.880
Yes.
00:36:47.039 --> 00:36:47.440
Yes.
00:36:47.840 --> 00:36:53.920
What are some other things, other tips that you give broadly to a lot of your people for this midlife women's health?
00:36:54.000 --> 00:36:55.840
Like, I feel all of these feels.
00:36:56.239 --> 00:37:00.079
Are there other just broad general strokes that you like to give people?
00:37:00.400 --> 00:37:13.760
Yeah, I think going back to kind of the the um chemicals in our brains, the the things in our brains that are happening are often drawing us away from relationship, right?
00:37:14.000 --> 00:37:15.599
Away from people.
00:37:16.000 --> 00:37:18.320
Um, and we are animals at heart, right?
00:37:18.400 --> 00:37:27.280
We are social creatures, and it's really important for people in general, this is just very broadly speaking, to have great relationships and to have a support system.
00:37:27.360 --> 00:37:32.000
But I think in particular in this time of life, relationships are so important.
00:37:32.159 --> 00:37:35.199
They're so vital to our health in so many ways.
00:37:35.519 --> 00:37:54.800
And I say if there's anything that I would broadly say is creating relationships and leaning on other women who are experiencing this, friends, like siblings, cousins, you know, community, um, spirituality, whatever it is that draws you into a community, I think is one of the best protecting factors.
00:37:54.960 --> 00:37:56.079
Um, there's a lot of other things.
00:37:56.159 --> 00:38:01.360
There are medical things we can do, like you can do HRT, you can have really comprehensive multidisciplinary care.
00:38:01.519 --> 00:38:06.719
But I think for what I like to guide people to is how can you just connect with people?
00:38:06.880 --> 00:38:08.719
Don't feel alone in this experience.
00:38:08.880 --> 00:38:15.440
Women that have suffered like kind of alone in this for so long and not anymore.
00:38:15.599 --> 00:38:16.159
I love that.
00:38:16.320 --> 00:38:17.119
Friends, friends.
00:38:17.840 --> 00:38:26.880
Friendship is so important for midlife women, and oftentimes that's a struggling time because the women or the women, the kids, if you have them, are out the door, you know, you might lose that.
00:38:27.039 --> 00:38:29.119
Maybe we're leaving work, right?
00:38:29.280 --> 00:38:31.920
Hopefully, we're finding other ways to be socially connected.
00:38:32.159 --> 00:38:32.400
Yes.
00:38:32.880 --> 00:38:38.480
So yeah, you hear a lot about that, like why friendship in this time is so yes, and some of the hardest times to find.
00:38:38.639 --> 00:38:44.079
So really making it an effort with that noise, yeah.
00:38:44.320 --> 00:38:45.440
You have to do it.
00:38:45.679 --> 00:38:48.559
I feel like that is a great place for us to wrap this up.
00:38:48.800 --> 00:38:52.079
I hope thank you so much again for being here.
00:38:52.559 --> 00:38:58.880
And we will put all of the places that people can find you, both um in person and online, in the show notes.
00:38:59.119 --> 00:38:59.440
Perfect.
00:38:59.599 --> 00:39:01.599
So thank you again for sharing your wisdom with us.
00:39:02.000 --> 00:39:03.280
Wait, you didn't do your health negotiation.
00:39:03.519 --> 00:39:04.400
No, I'm not here yet.
00:39:04.559 --> 00:39:04.880
Oh.
00:39:07.519 --> 00:39:09.440
Well, let's let's start that over.
00:39:10.559 --> 00:39:12.719
I feel like this is a really great place to wrap this up.
00:39:12.800 --> 00:39:15.360
So thank you so much for this conversation of being here today.
00:39:15.599 --> 00:39:16.400
You're so welcome.
00:39:16.559 --> 00:39:20.480
We will put everywhere that we can find you, both in person and online, in the show notes.
00:39:20.559 --> 00:39:23.920
So everyone who wants to learn more about you or maybe work with you, it'll be in there.
00:39:24.079 --> 00:39:24.639
Incredible.
00:39:24.880 --> 00:39:25.840
Well, thank you again.
00:39:25.920 --> 00:39:28.800
And thank you all for being here for another week of menopause unscripted.
00:39:28.880 --> 00:39:33.840
If you like today's episode with Naomi, please like, follow, and subscribe everywhere you find your favorite podcasts.
00:39:34.079 --> 00:39:37.039
With that being said, can we just ask one more question?
00:39:37.280 --> 00:39:37.679
Absolutely.
00:39:37.840 --> 00:39:39.920
I say we as in like I have only personalities.
00:39:40.079 --> 00:39:40.639
Maybe I do.
00:39:40.880 --> 00:39:41.199
Yeah.
00:39:41.599 --> 00:39:42.719
All your parts are showing up.
00:39:42.800 --> 00:39:45.039
All your parts want to be like all the weeds.
00:39:45.280 --> 00:39:45.440
Yes.
00:39:45.679 --> 00:39:48.159
Like I try not to we it because I'm like, that's showing.
00:39:48.400 --> 00:39:48.559
Yeah.
00:39:48.719 --> 00:39:50.559
That's too much unmasking my weeds.
00:39:51.599 --> 00:39:55.519
But can you just tell us what is your one daily health non-negotiable?
00:39:55.920 --> 00:40:03.039
My one daily health non-negotiable that I actually recently started, I think within the last six months, is my nighttime routine.
00:40:03.199 --> 00:40:04.239
Ooh, tell us more.
00:40:04.400 --> 00:40:06.639
I really I never had a nighttime routine.
00:40:06.719 --> 00:40:15.360
I was really locked in with the morning routine, and now my nighttime routine, I think, is even more important because it sets you up for the next day because sleep is so important.
00:40:15.840 --> 00:40:22.880
Um I stopped having my phone in my room, so I actually take my phone out of my room at around 7 or 8 p.m.
00:40:22.960 --> 00:40:24.320
So I'm no longer looking at a screen.
00:40:24.480 --> 00:40:24.800
Okay.
00:40:25.039 --> 00:40:27.519
Um I know, it's really hard.
00:40:27.599 --> 00:40:28.159
It's so crazy.
00:40:28.239 --> 00:40:29.199
I've bookmarked my days.
00:40:29.280 --> 00:40:33.199
No screen time at the end of the day or the first hour to 90 minutes.
00:40:33.519 --> 00:40:39.920
Um I take magnesium, I allow my body to kind of settle and relax, and I read a book.
00:40:40.079 --> 00:40:43.519
Um, for me, my body had a lot of restless leg syndrome happening.
00:40:43.599 --> 00:40:52.480
So for me, getting my body slowly integrated and ready into like to slumber um has had a massive impact on my day-to-day.
00:40:52.559 --> 00:40:55.280
And so that is like a non-negotiable at this point.
00:40:55.599 --> 00:40:56.159
I love that.
00:40:56.239 --> 00:40:57.119
Thank you so much for sharing.
00:40:57.360 --> 00:40:58.159
You're so welcome.
00:40:58.400 --> 00:41:00.000
Well, I will see you very soon.
00:41:00.159 --> 00:41:00.480
Yeah.
00:41:00.719 --> 00:41:02.719
So we'll be do more conferencing together.
00:41:02.960 --> 00:41:03.280
Absolutely.
00:41:03.519 --> 00:41:04.079
Oh, thank you.
00:41:05.679 --> 00:41:07.679
Now I have to end with the boring stuff.
00:41:07.840 --> 00:41:10.960
While I am a doctor, I am not your doctor.
00:41:11.519 --> 00:41:16.159
This podcast is for entertainment and educational purposes only.
00:41:16.480 --> 00:41:24.079
If something in today's episode resonated with you, please bring this to your own healthcare team and self advocate.
00:41:24.320 --> 00:41:26.000
You always are promoting that.
00:41:26.239 --> 00:41:34.079
I cannot wait for you to join me on next week's episode of Metapause Unscripted for another hot topic.
