When You Don’t Feel Like Yourself: Perimenopause, Mood, and the Distance It Can Create

“I just don’t feel like myself.”

If you have said these words, or quietly thought them, you are far from alone. For so many women in their forties and fifties, this is where it begins. It might be said with tears, or with frustration, or almost as an apology. Often it comes with a sense of being a little lost inside your own life, and not quite knowing why.

What many women don’t realize is that this feeling often has a biological starting point. Perimenopause, the years of hormonal change leading up to menopause, can shift your mood, your focus, your memory, and how much stress you can carry. And when you no longer recognize yourself, the people closest to you may struggle to recognize you too. Slowly, a distance can grow: first from yourself, and then from your partner, your children, and the people you work alongside.

For women in Dubai, many of whom are building careers and raising families far from the mothers, sisters, and old friends who might once have said “this happened to me too,” that distance can feel especially lonely. So let’s talk about it.

What’s Happening Beneath the Surface

It can help to know that what you are feeling is real, and that there are reasons for it. Perimenopause is recognized as a time of increased vulnerability to depression, particularly for women who have struggled with depression before, including after the birth of a child (Maki et al., 2018). Interestingly, research suggests it isn’t only lower hormone levels that matter, but the ups and downs themselves. As estradiol rises and falls unpredictably, some women are more sensitive to those shifts, and the body’s stress response can become more reactive along with them (Gordon et al., 2016). This may be part of why the years leading up to menopause can feel harder emotionally than the years after.

These changes don’t always look like sadness. You might notice more irritability, a new edge of anxiety, a shorter fuse, or feeling overwhelmed by things you used to handle with ease. In one survey of perimenopausal women, more than two-thirds described mood swings and brain fog, and nearly as many described difficulty concentrating (Harper et al., 2022).

That brain fog can touch the very skills so many women have relied on for years: planning, organizing, remembering, prioritizing, and juggling many things at once. Walking into a room and completely forgetting why, or reaching for a simple word that seems to have packed its bags and left without saying goodbye, can feel unsettling, especially if you have always been the one who keeps everything running. There is hopeful news here, though. Research following women through the transition found that these dips in learning and memory tend to be temporary, with performance rebounding after menopause (Greendale et al., 2009).

The Signs That Often Go Unnoticed

Most of us know about hot flashes. But perimenopause can show up in quieter ways that are easy to miss, or to explain away as stress, busyness, or simply “getting older.” Some of the signs women often don’t connect to perimenopause include:

• Anxiety that feels new, sometimes including panic, even if you have never been an anxious person
• A racing or pounding heart. In one large study, about half of women experienced palpitations at some point during the transition, often alongside stress, low mood, and poor sleep (Carpenter et al., 2023)
• Sleep that no longer restores you, such as waking in the early hours and lying awake. Sleep problems are among the most common perimenopausal symptoms and are closely linked with low mood (Chu et al., 2025)
• Aching joints, stiffness, or new aches and pains, now recognized as part of what some researchers call the musculoskeletal syndrome of menopause (Wright et al., 2024)
• Irritability or rage that feels out of proportion and out of character
• Losing interest in things that used to bring you joy, including intimacy
• Brain fog, forgetfulness, and difficulty finding words

On their own, each of these can seem small. Together, and on top of an already full life, they can quietly wear you down.

When You Don’t Recognize Yourself

When women describe not feeling like themselves, they are rarely describing just one thing. It is a feeling of being lost inside yourself. It can look like apathy, or a flatness where joy used to be: time with friends, a favorite hobby, even small moments with your children no longer bring the same lift. Sometimes it is watching yourself snap, or shut down, and wondering, “Where did that come from? That’s not me.”

This can be deeply disorienting. You may have spent decades knowing who you are and how you cope, and now the ground feels less steady. Many women carry a quiet grief here, and sometimes shame, as if they should be able to simply push through. Some find that they no longer recognize themselves or their partner, and a relationship that once felt secure suddenly feels confusing. If that is where you are, please know it makes sense, and it isn’t a sign that something is wrong with you.

How the Distance Grows at Home

There is a pattern many couples will recognize. She is struggling, and her partner is struggling to understand or to know how to help. She feels frustrated and unseen, and sometimes that frustration comes out as anger. Underneath, she feels more alone, so she pulls away. Her partner, confused by the change, becomes frustrated too, or withdraws. Neither person is doing anything wrong, yet each reaction feeds the other, and slowly the space between them widens.

Partners feel this as well. In a large survey of men whose partners were going through menopause, 63% said their partner’s symptoms affected them personally, and more than half felt it had strained the relationship, including less closeness and intimacy (Parish et al., 2019). Many partners know very little about perimenopause, and some may not understand why treatment such as hormone therapy could matter so much. Research on couples tells us that beneath these cycles there is usually not a lack of care, but a longing for connection and a fear of losing it that neither person can quite see in the other (Johnson, 2008).

And the strain rarely stays in one room. So many women hold it together at work all day, only to fall apart once they walk through the front door. Many are also parenting teenagers, which can mean a home where mom and her teens are both riding hormonal waves at the same time. It can feel a bit like two weather systems meeting over the kitchen table. Small disagreements can turn into big clashes, leaving everyone tired and feeling misunderstood.

Why So Many Women Miss It

One of the hardest parts of this season is that so many women simply don’t know it has begun. Perimenopause can start years before periods stop, and many women quietly struggle through those years before anyone names what is happening. In one survey, 90% of perimenopausal women said they had received no menopause education at school, and more than two-thirds only started looking for information once symptoms had already arrived (Harper et al., 2022). Across many cultures, menopause is still rarely spoken about openly, with partners, with doctors, or at work. And when something isn’t talked about, it is so easy to assume the problem must be you.

It is very common for a woman in her mid-forties to seek help for low mood or anxiety without perimenopause ever crossing her mind. When it is gently raised, the first response is often surprise, or a sense of “surely not yet,” as if admitting it means you’re one step away from reaching for a cane and reading glasses. (Rest assured, you are not.)

Here is the good news: recognizing perimenopause early is one of the kindest things you can do for your future self. For many women, hormone therapy started before age 60 or within ten years of menopause helps prevent bone loss and fractures, and may even support heart health (Faubion et al., 2022). Caring for your mood matters for the long run too, as depression is one of the modifiable risk factors for dementia identified in a major international report on brain health (Livingston et al., 2024). So getting the right support now isn’t a sign that you’re getting old. It’s an investment in the future you, who will one day reach for those reading glasses with strong bones, a steady heart, and a clear mind.

Caring for Your Body, Mind, and Relationships

Hormone therapy can absolutely help, and for women in perimenopause there is evidence that estrogen can ease depressive symptoms (Maki et al., 2018). It belongs within holistic care: caring for the body while also caring for the mind and the relationships that hold us. Talking with a physician who understands menopause is an important step.

And yet, hormones are rarely the whole story. Many women are also moving through a demanding season of life: career pressures at their peak, teenagers at home, aging parents (often in another country), and relationships that may have been under strain for a while. Perimenopause can arrive like one more suitcase piled onto a luggage trolley that was already wobbling. If you are still struggling after caring for the physical side, that isn’t a failure. It is simply a sign that you deserve more support.

The encouraging news is that support helps. A review of 30 trials found that psychological approaches such as cognitive behavioral therapy and mindfulness-based programs reduced depression and anxiety and improved quality of life for women in the menopause transition (Spector et al., 2024). A therapy program designed specifically for menopause also improved mood, sleep, and hot flashes (Green et al., 2019). Guidelines recognize therapy as an effective option for perimenopausal depression, on its own or alongside medical care (Maki et al., 2018). Whether it is individual therapy, couples therapy, a support group, or honest conversations with the people you love, you don’t have to carry this alone.

Finding Your Way Back to Yourself, and to Each Other

So often, healing begins with awareness. When you can connect what you are feeling to what your body is moving through, the self-blame often softens. “What is wrong with me?” can gently become “What is happening to me, and what do I need right now?”

Understanding matters for the people who love you, too. Sometimes the most helpful step is simply sharing information with your partner and family, so that irritability is no longer mistaken for rejection, and pulling away is no longer mistaken for not caring. When a partner can see the struggle beneath the reaction, they can move toward you rather than away. Many couples discover they can face this change side by side, rather than being pulled apart by it.

This season can feel lonely, but it doesn’t have to be. You deserve to feel understood, supported, and like yourself again. If this sounds familiar, or if perimenopause is creating distance in your relationships or at home, reach out to MapleTree Center, Dubai for a consultation. You don’t have to find your way through this alone.

References

Carpenter, J. S., Sheng, Y., Pike, C., Elomba, C. D., Alwine, J. S., Chen, C. X., & Thurston, R. C. (2023). Palpitations across the menopause transition in SWAN: Trajectories, characteristics, and associations with subclinical cardiovascular disease. Menopause, 30(1), 18–27. link

Chu, X., Zeng, W., Xu, J., Yang, Y., & Lv, M. (2025). Factors influencing sleep disorders in perimenopausal women: A systematic review and meta-analysis. Frontiers in Neurology, 16, 1460613. link

Faubion, S. S., Crandall, C. J., Davis, L., El Khoudary, S. R., Hodis, H. N., Lobo, R. A., ... & The 2022 Hormone Therapy Position Statement of The North American Menopause Society Advisory Panel. (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794. link

Gordon, J. L., Eisenlohr-Moul, T. A., Rubinow, D. R., Schrubbe, L., & Girdler, S. S. (2016). Naturally occurring changes in estradiol concentrations in the menopause transition predict morning cortisol and negative mood in perimenopausal depression. Clinical Psychological Science, 4(5), 919–935. link

Green, S. M., Donegan, E., Frey, B. N., Fedorkow, D. M., Key, B. L., Streiner, D. L., & McCabe, R. E. (2019). Cognitive behavior therapy for menopausal symptoms (CBT-Meno): A randomized controlled trial. Menopause, 26(9), 972–980. link

Greendale, G. A., Huang, M. H., Wight, R. G., Seeman, T., Luetters, C., Avis, N. E., Johnston, J., & Karlamangla, A. S. (2009). Effects of the menopause transition and hormone use on cognitive performance in midlife women. Neurology, 72(21), 1850–1857. link

Harper, J. C., Phillips, S., Biswakarma, R., Yasmin, E., Saridogan, E., Radhakrishnan, S., Davies, M. C., & Talaulikar, V. (2022). An online survey of perimenopausal women to determine their attitudes and knowledge of the menopause. Women's Health, 18, 17455057221106890. link

Johnson, S. M. (2008). Emotionally focused couple therapy. Clinical Handbook of Couple Therapy, 4, 107–137.

Livingston, G., Huntley, J., Liu, K. Y., Costafreda, S. G., Selbæk, G., Alladi, S., ... & Mukadam, N. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet, 404(10452), 572–628. link

Maki, P. M., Kornstein, S. G., Joffe, H., Bromberger, J. T., Freeman, E. W., Athappilly, G., Bobo, W. V., Rubin, L. H., Koleva, H. K., Cohen, L. S., & Soares, C. N. (2018). Guidelines for the evaluation and treatment of perimenopausal depression: Summary and recommendations. Menopause, 25(10), 1069–1085. link

Parish, S. J., Faubion, S. S., Weinberg, M., Bernick, B., & Mirkin, S. (2019). The MATE survey: Men's perceptions and attitudes towards menopause and their role in partners' menopausal transition. Menopause, 26(10), 1110–1116. link

Spector, A., Li, Z., He, L., Badawy, Y., & Desai, R. (2024). The effectiveness of psychosocial interventions on non-physiological symptoms of menopause: A systematic review and meta-analysis. Journal of Affective Disorders, 352, 460–472. link

Wright, V. J., Schwartzman, J. D., Itinoche, R., & Wittstein, J. (2024). The musculoskeletal syndrome of menopause. Climacteric, 27(5), 466–472. link