Annie thought perimenopause symptoms were keeping her awake. Alcohol was playing a role too | Diane Young

Hot flushes, anxiety, poor sleep and mood swings are common during perimenopause. But the very thing Annie was using to manage her symptoms had become an even bigger problem

• The modern mind is a column where experts discuss mental health issues they are seeing in their work

When Annie* started pacing around her house at 3am and struggling to find words during work meetings, she put it down to stress and perimenopause. She wasn’t entirely wrong. But it wasn’t the whole story.

At 43, she was juggling a full-time job as a hospitality HR manager, three teenage children and the endless demands of family life. Like many women in midlife, she felt stretched in every direction. “I was doing long hours at work, running around with kids’ activities and household chores. I wasn’t sleeping well. Then I’d get up feeling exhausted and spend the day dealing with headaches, mood swings, hot flushes and brain fog. I went around in circles for six months feeling like my world was imploding.”