Part 3 of a 3 part series: “The Menopause Series”
Episode 3: Menopause + Mental Health — Opal’s Nutrition Director and Co-Founder, Julie Church, RDN, speaks with therapist Katie McKenna, LMHC, about the connection between perimenopause, menopause, and mental health. Katie explores how hormonal changes can affect mood, anxiety, sleep, cognition, body image, and identity, while increasing vulnerability to eating disorder relapse or new onset.
Building on our previous conversations about the biological and workplace aspects of menopause, this episode focuses on the emotional and psychological dimensions of this transition. Julie and Katie discuss common misconceptions about menopause, the impact of cultural messages about aging, and invites listeners to approach menopause not only as a transition, but also a time of increased self-awareness, renewal and growth.
Connect with Katie:
McKenna Counseling — Integrative Psychotherapy and Nutrition
Connect with Opal:
Thank you to our team…
Editing by David Bazzi
Music by Aaron Davidson: https://soundcloud.com/diet75/
Sound engineering by Ayesha Ubayatilaka at Jack Straw Studios
Transcription provided by Rev.com
Julie Church (00:07):
Hello, and welcome to The Appetite, a podcast brought to you by Opal Food and Body Wisdom, an eating disorder treatment clinic in Seattle, Washington. Our podcast is about all things food, body, movement, and mental health. Today, I am your host, Julie Church. I’m one of the co-founders of Opal with Lexi and Kara, and I am nutrition director and director of People and Culture. I’m a dietician by training. And today I am getting to interview and introduce you, our listeners, to Katie McKenna, who is also here in Seattle, Washington, same place as Opal. And she is a local therapist and she in her practice, Katie McKenna, Integrative Counseling and Nutrition, offers that, nutrition and therapy. And I just so glad you’re here. And we had a mini conversation about this recently, and I said we need to have a conversation on the podcast about this. So Katie, what else do you want the listeners to know about you?
Katie McKenna (01:10):
Yeah, I’m a mental health therapist and a nutritionist, although I tell people frequently, I’m actually like 90% therapist. I work a lot with people’s relationship to food more than giving prescriptive diets and that kind of thing. And I really love the work that I do. I love taking talk therapy even deeper and including the body and things like EMDR. So I also work primarily with eating disorders, anxiety, and trauma.
Julie Church (01:37):
Wonderful. And
Katie McKenna (01:37):
These days, perimenopause.
Julie Church (01:39):
Exactly. That’s the conversation today, right? And are you doing your therapy virtually? And are you licensed outside of the state of Washington?
Katie McKenna (01:48):
I am licensed only in Washington and all therapy is telehealth.
Julie Church (01:52):
Okay, great. That’s great. For our listeners, and I will make sure to have Katie’s website and other ways to reach her and other things I referenced throughout this talk about what she’s doing in the world of menopause will be in the show notes for you listeners to get. Well, thanks Katie for being here. And yes, menopause is the topic and because Katie’s a therapist, it’s mostly going to focus around the mental health impact of perimenopause and menopause. So can you just share kind of how you got into this as a specialty in the midst of your journey and your career of mental health?
Katie McKenna (02:28):
Sure. I think it’s twofold. On one, I attended an education about people with eating disorders and how perimenopause is actually a time of high risk of either relapse or new onset in relationship to eating disorders. And that middle age for women ages 45 to 54 is actually their highest rate of suicide. And that really struck me that this is a really important time that many people feel, at least therapists, under-skilled and uninformed about how does perimenopause affect us? And then personally, I actually went through perimenopause rather early in life. So when I was seeking out support and help from doctors, I just experienced a lot of dismissal and frustration, and it took me a long time to get the help that I needed. And so now that I’m fully on the other side, these two things have combined to light a fire for me to want to talk about it and help educate people.
Julie Church (03:26):
That’s wonderful. Thank you. Yeah, I think each of us at the stage of life that we’re in, I’m noticing there’s so many more people around me at least that are talking about this topic and recognizing that those many people before us that are older than us, really, there was so much silence around this topic. And so I think we are, I guess, fortunate that there is at least a little bit more conversation and accessible education about the topic, but still you ran into lack of resources, right? So obviously it’s still important. I’m glad we’re having this conversation to have folks learn more. Can you do just maybe a mini teach on menopause? If this is the only podcast that somebody is listening to about menopause, would you be willing to do a little mini teach on what it is?
Katie McKenna (04:19):
Sure. Okay.
(04:21):
In short, perimenopause is the period of time. It’s typically like seven to 10 years time of fluctuating hormones where the body is going through a process of adjusting to having decreasing estrogen and progesterone and decreasing fertility. And with that comes quite a lot of different symptoms, hot flashes, sleep interruptions, mood swings, neurobiological changes. The brain actually is very impacted by estrogen, and so people can start to feel like foggy brain and things like that. So it typically starts in the 40s, although it can be in the late 30s, that’s not abnormal. And then menopause itself is the time when you’ve actually gone 12 months without having any bleeding. However, even once you’re at menopause and post-menopause, you might still have some symptoms. But the important note is that during this time of rising and falling hormones and symptoms, once things stabilize again, in so far as the estrogen, you get used to it staying low, the body adapts and things get better.
(05:29):
So it’s a transition phase. And I think that’s important to know that it does smooth out at some point.
Julie Church (05:35):
That actually, yeah, even as you were talking, it kind of pushed into a fear that I have of going, okay, wait, if this, since I am in perimenopause season of my life, what’s my baseline? Can I expect on the other side of this? Is it going to return to where I was before in terms of my mental health specifically and mood stability and things like that? Or am I going to be a changed person forever?
Katie McKenna (06:02):
And it’s a bit both. Things do get better and we come out on the other side changed.
Julie Church (06:08):
Yeah. Which is life, right? Especially if it’s a seven to 10 year span. I hope I’m changed. I hope I’m a different person then, right? So yeah, in the good ways. Okay, lovely. And then what would you say then in terms of the common mental health mood changes? What is the impact then of all those hormone fluctuations and changes in this transition?
Katie McKenna (06:33):
Sure. There’s a number of them. I mean, estrogen helps regulate a lot of our neurotransmitters, so like oxytocin and GABA and cortisol, dopamine. So when those start to change, we can experience new symptoms or mood swings with depression, with anxiety, with tearfulness. We can also go through, well, when the brain changes as far as feeling like a foggy mind or you have word finding difficulty, things like that can start to happen. To be honest, I think I forgot your question. Can you repeat it?
Julie Church (07:17):
I was just wanting to know the impact on our mental health from this whole season and the hormone fluctuation. So I think you’ve captured a lot of it, but what else did you miss?
Katie McKenna (07:26):
Yeah. Well, the overall impact, I think one of the things I would want to point out is that one of the primary things that starts to happen is that this is simplified, but estrogen’s considered a social bonding hormone. When it’s in our bodies in high amounts, it helps the person tend to want to prioritize others. So whether or not that’s prioritizing a child or family or community relationships. And when that starts to go down, there can be this rising awareness of a person’s own unmet needs. And because when we often prioritize other, we deprioritize self. So there can be this rise in resentment and anger when you start to realize maybe how much you’ve sacrificed. And so that’s a big piece of what might be going on. Along with during perimenopause, there’s a lot of physical changes to our bodies and that can be alarming, destabilizing.
(08:23):
It can impact people who are feeling already out of control with their bodies or maybe especially with an eating disorder past, might be re-triggered again to have these changes happen. And I think destabilizing is actually a great word because it feels sometimes like your body’s out of control. Mentally, emotionally, people feel like they don’t recognize themselves or they don’t feel like themself anymore.
Julie Church (08:47):
I love hearing you talk about all of this. It does feel so like you’re normalizing a lot of it. And then there’s just a lot of compassion I’m hearing coming through here of just that these are real things and they can have real impact. And the interpersonal, that is very insightful and kind of new for me to hear somebody talking about the link between menopause and that community pull. I mean, there’s so many, especially female identifying individuals that get to maybe midlife and some of those things are going to change. And to think that there’s actually a hormonal change, something biological that also is going to pull somebody to want to maybe prioritize their own needs above others is really powerful. And I don’t know that I ever learned that in my reading and such. So thanks for sharing that. And it’s so true that that can lead to anger, bitterness, resentment, regret, I think is a big one I hear in that.
(09:42):
So yeah, thanks for sharing all of that. And I’m sure that some listeners can identify with that. I think there’s so many folks that have gone through their own eating disorder recovery and journey and in that have needed to take more time for themselves and prioritize themselves and identify not being a people pleaser and not being somebody that’s constantly caretaking. And so I can see how maybe it’s a new season of that for those that maybe have that in their past or that even are in the midst of their recovery to kind of know that hormonally there’s even something that’s changing that might have them even be having these urges and desires more to care for themselves and prioritize themselves more than the past. It’s kind of cool to think about, not just something they want to do in their mind, but something biologically changing.
(10:32):
So it’s
Katie McKenna (10:33):
Cool. Exactly.
Julie Church (10:34):
It’s cool.
Katie McKenna (10:35):
Right. Well, and that’s part of what’s a little bit interesting about the psychology when we want to think about who am I and what’s my personality? And you start to realize as you go through hormonal changes, you feel different. And so the hormones really do impact our sense of self and sometimes how we see the world. Wow.
Julie Church (10:54):
I mean it’s big. It’s big. So when I think about the depression or anxiety as maybe two big buckets when I think of mood changes, I certainly have heard more individuals and peers of mine that are seeking therapy, seeking assistance through psychotropic medication and other means to be able to target some of that, those symptoms of depression and anxiety. Yeah, I suppose I’m just stating that, I guess, is there anything else you’d want to expand on in terms of maybe how depression might look differently in this time versus another experience of depression?
Katie McKenna (11:37):
Yeah, that’s actually a good question. And it’s something I speak to other therapists about. When somebody is going through perimenopause, it’s possible that if they’ve never had depression before, then some of these new depressive traits and symptoms might not necessarily be like a depression disorder. And I guess my point is how can we start to allow this natural process that bodies go through to not be pathologized, to not be looked at as a person or a body that is broken or diseased or that needs to be fixed? It needs to be supported. Now, if somebody has a prior diagnosis of depression or PMDD or things like that, that can actually mean that perimenopause might be, you might have more severe symptoms during that time. And so that’s worth talking about with your provider or if you’ve got a therapist. Sometimes if we also know that going into this time, a little bit what to expect, just some of that being proactive about it doesn’t mean it’s all going to happen, but it takes away some of the shock when you’re actually going through it.
(12:48):
There’s a couple other things too that impact not just the mood and the depression part, but estrogen itself is considering it helps buffer stress. So when estrogen starts to go down, your own experience of stress kind of changes. So you might feel more upset about things that used to be able to be like water off a duck’s back. And it can also influence cortisol spikes. So there’s a lot going on, again, with the hormones that just change your own reactions to the challenges that life presents.
Julie Church (13:20):
That’s a good way of saying it. And I do agree that getting ahead of it, having some learning about it prior to some of the actual changes do help somebody go through it and know they’re not alone or understand maybe what’s going on in their body. So yeah, I appreciate that so much. Yeah. Now the sort of common interventions or when you say the body needs support, what do you recommend? I guess from a mental health perspective, what do you see as all of the different tools that somebody could tap into to help with their mental health in this season?
Katie McKenna (13:55):
There’s actually so many. Certainly there’s the opportunity to seek out professional healthcare, and that’s through a doctor, medical doctor, a naturopathic doctor. Acupuncture is really well known for helping people through hormonal changes. There’s supplements out there and there’s also HRT. So those are all things that you can talk about with your provider to see what’s right for you. Because people really do have quite a variety of responses to perimenopause. So then of course their treatment plans are going to need to be different. But from a mental health perspective, and part of me likes to think about also what’s free and accessible. I think that’s some of my Midwest roots, but sometimes that’s a bit of getting back to the basics. So number one is working to protect and support sleep. When progesterone goes down, sleep itself can get more fragmented or lighter, meaning it’s easier to wake up, harder to go back to bed.
(14:52):
People with perimenopause often complain about waking up between two and four in the morning. And you can see how if that’s happening, that’s going to impact all the other things with mood and brain cognition and energy. So prioritizing sleep and your sleep routines and supporting your sleep is a number one thing to do. It seems simple and overlooked, but getting time outside, fresh air, sunshine. Also, our bodies, we are, we don’t like to think about it, but we are animals on this earth. And sunshine is almost like a nutrient. So sleep, sunshine, movement, physical activity. It’s also a time, this is a little bit loaded, but it’s a time when people start to realize there’s decades still ahead. Despite Western society acting like everything’s downhill, it’s most people
Julie Church (15:44):
Have – Over the hill.
Katie McKenna (15:46):
Right. Maybe 30 more years of living. And so it’s a time that if you’ve got the resources and the ability to really take care of your muscles and your bones, it’s a fine line to talk when we’re working with people who have eating disorders because if we say, “Hey, this is a good thing or it could benefit your body.” Some people can take it as pressure to do one more thing. Other people can take it as pressure to do it exactly right. And so it’s nuanced. There’s an art there to learning how does this body need to be cared for? But caring for your body through perimenopause, through physical activity does help stress. It helps mood. So it’s worth talking about the physical exercise and movement. One thing that is a great thing to mention is novelty. So as we approach midlife, we also start to realize that life is kind of no longer prescriptive.
(16:44):
Meaning when you’re young, you’re kind of told you have to grow up, you have to get a job, you have to go to school, you’re supposed to do these relational societal things. And then you arrive at midlife and a lot of that goes away. And so people have typically kind of led a structured life of doing what they’re supposed to do. And that also kind of puts a person into a block. And then we include ideas about youth and how people are supposed to be. And all of that starts to go into disarray in perimenopause. And so what we’re trying to do is help the mind understand that it can start to break the mold and ask these deeper questions about who am I? What are my values? What do I want? What matters to me now? What masks have I been wearing? What roles have I been doing that I no longer want to do?
(17:36):
And how that ties into novelty. Novelty is just part of forming new brain pathways. So you might not have answers to all these questions about what’s next in life, but you can start to do new things. And it’s like really small things count. And by small, I mean taking a different ride home from work, sitting at a different place at the dinner table, trying new recipes. I mean, I think this sounds silly, but parting your hair in a different place.
(18:06):
We’re trying to a little bit shake it up and help the brain start to be open to new things. And novelty also helps with dopamine. So that’s one of those neurotransmitters that sometimes feels low. And so doing new things, learning new things can be really helpful.
Julie Church (18:23):
Is that why I want to replace my closet all the time and get new clothes?
Katie McKenna (18:28):
Yeah.
Julie Church (18:29):
Now
Katie McKenna (18:29):
We know it’s prescriptive.
Julie Church (18:30):
Now I know that it’s rational. Okay, good. I can rationalize it now. That’s really great. I always heard that you should blow dry your hair with the other hand as you age. This is really random. I think my grandmother used to say it.
Katie McKenna (18:47):
Well, yeah, you could do the same thing with brushing your teeth. Part of what it is is we tend to favor one hand. So just forcing the brain to use your other hand to brush your teeth or blow dry your hair is part of neuroplasticity.
Julie Church (18:59):
Yeah. So good for the brain. Those are all such great insights. Thank you. There’s such a variety of ways to address it then too. I love that. It’s like the practical, some things might cost, some might not. Some might need another human in relationship to get their information and support, and some might just be totally independent. You did mention HRT, which I’m not sure all of our listeners would know what that is. Could you just explain what that is specifically since I think that comes more from the medical side of things?
Katie McKenna (19:31):
Sure. HRT, hormone replacement therapy. So I mean birth control counts as HRT, but also when people are going through perimenopause, one of the potential treatment options you have is to replace some of the hormones. So we talk about how estrogen and progesterone are starting to go down. And for some people, taking estrogen and progesterone can actually help mitigate some of the symptoms. Specifically, sometimes people seek it out. So hot flashes can be so problematic, especially if they’re interrupting sleep. And so taking estrogen and progesterone might decrease your hot flashes, which means you’re getting better sleep. 20 years ago, HRT, there was a lot of concern that there was a risk to cancer and stroke. And so that treatment option was kind of taken away. But with continued research these days in 2026, it’s now considered, there’s still a slight risk with it, but overall it’s considered that the benefits potentially outweigh the risk.
(20:28):
It’s a super individual decision because it depends on somebody’s own health history and whether or not they want that kind of support, but that’s what HRT is.
Julie Church (20:38):
Okay. And then do people tend to stay on that through into menopause or would they quit the HRT as they are actually in menopause on the other side of not having bleeding after a year?
Katie McKenna (20:50):
It seems to be variable. I’ve known a number of people who actually find that they feel so good on it, they want to keep it. In general, what I’ve read is that you’ll stay on it for a certain bit of time into menopause because it’s also considered that estrogen can be neuroprotective. It can be good for bones and brain. I think science is always changing. I mean, I’ve been now in healthcare for 23 years, and even in that time, I’ve seen a lot of changes. I’ve seen a lot of changes with nutrition. I’ve seen a lot of changes. And so my mind is always like, okay, we’ll see where it goes, where the science continues to go. I mean, in general, women’s health research is pretty lacking. So we’re learning as we go, I think. Yeah.
Julie Church (21:38):
Time will tell, I suppose, and each person will make the decision they need to make at that point. Yeah, you’ve shared so many good examples of ways that one can care for their body in this season. I am so aware that as I’ve heard more about it, and I then of course get all my Instagram messages and I feel as if I am a target of that and definitely am being marketed to in that regard. I’m curious if you want to name a few things that you feel are maybe getting too much airtime or aren’t really grounded in science. Any myth busting that you’re passionate about on this topic?
Katie McKenna (22:18):
Sure. Well, and it’s interesting that it’s been such a swing. We’ve gone from it being like this desert where nobody talks about it to now people are talking about it. And I think that’s so wonderful, but it’s almost like we’re inundated with so much information. We don’t always know what’s true or what’s accurate or what’s just an opinion. So there’s a lot of influencers popping up. And also, I don’t know if it’s fair to name names. I guess you can bleep it out later, but nitty health is a really common medical avenue that people can access that seems to be getting lukewarm results. And so I would suggest that people be, if you’ve got questions you need support, find a perimenopause-informed doctor so that you can get really somebody that’s going to pay attention to you and your needs. There is some popular authors out there that are also then selling a lot of products, which then makes it a little hard to know how much to trust what they’re saying versus what they’re selling.
(23:22):
Because right now what’s really popular is weighted vest and protein powders. And it’s almost, you can see the gang of folks who are all reading that information. And it’s true, a weighted vest might be good. And protein powders actually can be a really useful thing, but it’s the selling point that also can skew the information.
Julie Church (23:44):
Yeah. Right? Yeah. The reality that perhaps there’s a nugget of truth. I would say that’s true about so much nutrition science and information that comes out about nutrition is that, okay, there’s a nugget of truth. And then how it gets marketed or how it gets dispelled out to the world usually gets exaggerated or confusing or whatever it might be. So yeah. Yeah. And I think even though we get all of the. I guess we have to use our same critical lens through the season and how we might interpret things. And I just believe so strongly that we each are our own expert and we know our bodies and we’re going to discover what works for me and might be different than what works for you. So that is real and each person needs to sort of navigate it. And that’s why maybe bringing in professionals to try to sift through and try to make the best decisions for each person is why someone might seek a dietician or a therapist or a doctor that specializes in this for sure.
Katie McKenna (24:51):
Right. Well, and I love that you clearly stated everybody’s an expert of their own body because part of what happens when an individual is suffering, you tend to feel confused and you want to seek out help, but that can create this power differential where you’re just listening to somebody else, whether or not it’s a doctor or somebody on social media. And then we talk about these different treatment options too, that it can start to feel like there’s a right or a wrong out there. And so to know and to be reminded that you’re the expert of your own body and that your treatment options aren’t moral issues. I think that’s all really important and well said.
Julie Church (25:27):
Yeah. And when it comes to nutrition, so many of our listeners, if there have been food and eating disorders, food relationship difficulties, yeah, they are probably getting some of those messages about protein or it’s definitely sort of muscle mass and composition changes that happen within this season. And yeah, I guess I don’t feel like the expert on that either because I haven’t studied all the science out there in regards to it. But I am assuming that the message around protein is yes, be eating enough of it. Make sure your body’s getting enough. And I know that just total nutrition, total calories is a really important one to not get into some sort of under nourishment that can really negatively impact the body’s health in menopause or perimenopause. But I am curious what else you might want to speak to that is the nugget or the truth in the science around the protein piece that would be okay for our listeners to just know this is the fact in it versus maybe what all then gets created around it.
(26:36):
So I’m curious if that would be easy enough to do on this podcast or not. I don’t know.
Katie McKenna (26:42):
Well, I think we could at least touch on diet culture and how much it still influences so many people. And if we also think about most of the people who are going through perimenopause right now are about Gen X style. So that means they also were growing up in the 80s and the 90s with all the low fat crazes. And I mean, there’s always different fads through the years. But that diet culture, that conditioning can still be embedded. And generally what that means is either foods are good or bad or restriction. And so there are plenty of people in midlife who are trying to do it when doing air quotes, eat good, but they’re actually undereating. They’re not eating enough calories. They’re not eating enough nourishment. And the body really, it needs nourishment. And so a balance including protein and your carbs and your fats, I mean through the decades, it still comes back to finding balance with
Julie Church (27:40):
That. Okay. Yeah, I appreciate you saying that. I love the connection between thinking about the ’80s and ’90s and what things are deeply embedded in the way that we have thought about nutrition and food and how that then influences maybe exactly how we’re getting marketed to. That’s been talked about around a boardroom one time, I bet, in some marketing campaign brainstorm session. I so appreciate, especially you naming also the just total nourishment, total calorie need. And right now protein’s getting all the glitter and the glam, but I think we just need to be eating protein, fat and carbohydrates. It’s what our body has always needed and will always need. So definitely want for people to listen to what their needs are and feed themselves appropriately. So yeah.
Katie McKenna (28:32):
Part of something that’s happening right now, because perimenopause isn’t always being recognized in medical care. Well, I’m going to say two things. One thing related to perimenopause that happens is that people can experience this very normal fat redistribution in their body. So I’m not encouraging getting on the scale, but people might say like, “I weigh the same, but my clothes feel differently or my body looks different.” So adipose tissue, fat tissue can move on the body. It can tend to move more towards the belly. Insulin sensitivity changes. So there are changes happening in people’s bodies. And if somebody’s experiencing that plus let’s say mood swings or depression and then they go to their doctor, what may happen is a doctor recommends something like a Prozac and a GLP-1, which is very common. And again, I really do honestly believe in body autonomy and those are people’s choices as long as they’re being informed of those choices.
(29:28):
But if we also are able to take a step back and look holistically about maybe what’s this person going through, it might be possible and important to consider other treatment options. And so that’s also part of just where we’re at in the current view with medicine and what’s being offered to people besides the protein powders.
Julie Church (29:46):
Right. Yeah. And there’s a lot of that, just the ongoing sense of just believing the white coats, the people that are the doctors with the letters behind their names. And so how many people are in that vulnerable spot That then they’re going, “Okay, I am feeling different. I need somebody to tell me what’s going on.” And then if those providers also haven’t been getting the new information around how to screen for and assess and treat and help people in perimenopause and menopause, lots get missed there. I can hear that. And in my mind, I’m thinking, oh, there’s something that my mind went straight to thinking about pediatric care and how there’s a point there where many people, especially providers that are fearful of weight gain, see kiddos that are gaining weight and then they react with saying they need to lose weight or they need to be on a diet or talk to their parents about changing their eating habits or whatever.
(30:46):
And so I feel similarly like this is a similar vulnerable population for being missed in sort of what is truly going on and having weight bias and size discrimination, fear of fatness just creep in there and influence people to do things that might not align with their values and may not actually be health promoting, but they’re being told that it’s health promoting or this is what you do kind of thing. Here’s the bandaid. And GLP-1s, obviously, I guess I hadn’t thought. I guess I’m assuming that GLP-1s then would be prescribed in that moment for potentially with insulin resistance if that’s changing and then potentially weight if somebody’s complaining about weight. But is there any other mechanism that a medical provider would be saying, this is why we’d be recommending a GLP-1?
Katie McKenna (31:36):
Oh, I think that it’s primarily recommended because people come in asking for it or they say, I’m in distress about my body. What I used to do to take care of my body and maintain my body isn’t working anymore. That’s maybe something doctors hear.
Julie Church (31:51):
Yeah, absolutely. Yeah. Yeah. There’s so much for us all to be. I hope that there’s some more regulation coming around GLP-1s for sure. Yeah. I guess with that in mind, do you have, I guess, special advice or thoughts for those listeners that are either in this season or anticipating it that have had their eating disorder history or disordered eating concerns, kind of how to approach this season and both maybe internally, but also kind of with their providers?
Katie McKenna (32:30):
Sure. I think that being able to express some compassion for yourself if you’re feeling confused or out of control or like what’s working isn’t working anymore. That battle often is first to come up as like shame. And so to be able to have enough resources around to know like, wait, these things I’m going through is normal. These changes are normal. They might be hard, but that they’re normal. It doesn’t mean you’re doing anything wrong. So it’s an opportunity to practice compassion, mindfulness, acceptance. There’s actually, people find even relief from hot flashes with meditation. So bringing down that parasympathetic response and teaching yourself to be in this moment can be really helpful just against the fact that this body that you know is changing. And so how can you practice being in this present moment? And also getting to know the self, the person that you are today.
Julie Church (33:34):
Yeah. And that’s when I think about therapy modalities or sort of like when somebody might be seeking support for their mental health in the form of seeing a therapist, I kind of wonder, oh yeah, well, what modalities? What kind of treatment are they actually seeking in that? And so I’m wondering mindfulness and things like that, but I’m wondering what else comes to mind.
Katie McKenna (33:59):
Well, also the ability to kind of do some appraisals that go through about what do I believe about aging when I was younger? What did I think aging was going to be like? Who were my role models as a young person about aging? So you can start to look at your conditioning and your beliefs. Do you believe that it’s all downhill from here? I mean, that’s part of what segues into this idea that. So we’re talking about perimenopause and all of the symptoms that come with it, but it’s also during this time called midlife where Dr. Carl Young would talk about how at this point in life, you kind of start to realize that either you’ve hit the goals in life or you haven’t. Either way, you’re arriving at a place where this is a time where most people don’t really enter into their 50s and 60s with a lot of ideas of what’s next.
(34:56):
And so it’s a time to look at your values, look at your beliefs. The ones that cause you pain are usually the ones that need the most attention because it’s possible that they’re actually signs of like a misbelief. For example, the idea that my best years are over tends to hurt. And that hurt is kind of a clue that maybe it needs to be reassessed and reformed. So I mean, that’s kind of straightforward cognitive behavioral therapy is to look at your values, your beliefs, and then rewrite them.
Julie Church (35:26):
Yeah, totally. I can hear some narrative in there, narrative therapy, the CBT act, right? Acceptance and commitment therapy. I can hear some of that in there. Exactly.
Katie McKenna (35:36):
So
Julie Church (35:36):
That’s wonderful. Yeah. And like you said, I mean, you can always be unearthing stories and traumas that would be there too. And you mentioned EMDR earlier, which is a trauma treatment that some folks can seek out. I could see all of that being maybe this is a time where somebody’s doing that work for the first time.
Katie McKenna (35:55):
Well, and what also tends to happen here is midlife can be a time where there’s high caregiving burden. There could be financial concerns, there could be chronic illness. There could be grief also around fertility, youth. So there’s a lot mentally and emotionally going on. Specifically also sometimes the things that you thought you dealt with and healed sometimes come back up because it’s just like a different phase of life. And so people can find themselves having things that need to be addressed again with their own parents. Old traumas can resurface. And so that’s also a time to also seek out help and not feel like you have to do it alone. Yeah.
Julie Church (36:38):
Yeah. Well, I definitely want to reflect on who is it that I would looked up to that were older when I grew up. I love that reflection question. It’s something I’d love to think more for myself because it did feel like at least my parents’ peers were something, but I kind of want to go one generation older, like, “Ooh, who was around that was older than my parents that I was watching age?” And just kind of think through what my take homes were from that, from my childhood. One of the things that we always hope, I suppose, when we’re seeking help and support, and especially if we’re wanting for our mental health and our mood to improve, is that then we start to have an outlook that’s maybe more positive. Would you say that as one does this transition through perimenopause into menopause, that there can be some hopefulness?
Katie McKenna (37:31):
That’s really true. I think what’s important is to be able to have this whole perspective, to hold this space for any of the physical suffering that’s coming from the hot flashes or libido issues or depression, the shadow work that comes with maybe grief and loss at this time. But then also, if we’re looking into this idea that you are now free, you have permission to now step deeper into who you are, to be more aligned with your own values, your sense of what’s authentic. People often in mid-age talk about how they start to care less what other people think. This idea, again, of breaking the mold. And so here at Midlife, there’s an opportunity to kind of rewrite the script or to dream again about what’s next. And it’s a time more than ever where people are also in the prime of their life. It’s a time of high capacity.
(38:28):
It’s a time of really knowing your skills. And so those are all strengths as well. It’s certainly not all gloom and doom, so it’s a whole mix. And so there’s a lot of renewal and growth that can happen that sets the stage really for the next several decades.
Julie Church (38:47):
I love that. I’m not sure that that gets talked about enough in thinking about menopause. Maybe because folks are just so in the moment of trying to manage and cope. But I love the idea that this is a transition into something new and kind of what new dreams are there and to think that there is a lot ahead, I guess, just a lot of head. And so I love thinking about that. That’s really a good word.
Katie McKenna (39:21):
Yeah, that’s the opposite of what we have been kind of told or taught. If you’re taught that youth infertility is the priority of who you are, and then when it’s over, it’s over. You don’t even know to dream or think beyond that.
Julie Church (39:35):
Yeah, we really don’t. We really don’t. And I still think that’s true. I think youth gets still very much, very much put on the pedestal. And that is just so socialized. It’s so internalized. Well, I have so enjoyed this conversation. I would love for you to share. I have learned a lot and I know that you’re adding more talks and just ways to educate others in at least our community and I think virtually. So can you share more about what I think you’re calling as your menopause talks? Can you share more about that and let our listeners know what that is and how to access it?
Katie McKenna (40:14):
Absolutely. Yeah. I’ve started the project called the Menopause Talks. And right now what it is it’s a two-hour workshop that goes through all of the neurobiological changes that’s actually happening in people’s bodies. And that’s the first half of it. And then the second half is all of the mental emotional things that are happening and then how to support yourself. So it’s a two-hour workshop. Right now it’s happening about every other month. The next one’s going to be June 19th. And it’s just $15 because I really want it to be accessible to people. And over time, I think if that grows into something, I might then create some support groups down the road. But right now it’s the workshops and they’re just fun to do. And there’s just so much to be said about it. And I think people are really hungry for the knowledge, but the wisdom part of it as well.
Julie Church (41:01):
Wonderful. And is it interactive or is it more just listening to you for the chunk of time? How would you describe the format?
Katie McKenna (41:10):
It’s primarily almost like a lecture series, but then I take a break every five or six slides and do these reflective questions. So it’s kind of dependent on the group. Some people have been more private and wanted to journal, and then other people have been pretty chatty. So it kind of depends on who shows up for the day.
Julie Church (41:26):
Cool. Awesome. That’s really great to hear. Well, is there any other last words you would have for our listeners on the topic? I’ve really appreciated all that you’ve shared so far.
Katie McKenna (41:38):
Well, I think in summarizing, especially really thinking about your audience of people who have dealt with eating disorders or disordered eating or loved ones with that is really recognizing that when the physical human body’s going through a lot of these changes, it really can be destabilizing. And it can open up this idea where people start to think like, am I doing it wrong? What’s right out there? As far as what have I been told? And all of this stuff. And it can just be a bit of a hamster wheel. And so the opportunity to invite yourself to slow down and to turn inward, remember all the skills and the strengths that you’ve learned yourself on your own healing journey with the eating disorders. And it’s not necessarily that you need new skills. It just might be like those skills need to come back front and center again.
(42:27):
So to not feel lost thinking that all of your healing efforts are gone, it’s just sometimes they need to come deeper.
Julie Church (42:36):
Thank you. Thank you so much. Well, thanks for being with us, Katie. Sharing with Appetite. I am eager, hopefully, for some of our listeners to join you in the Menopause Talks and go deeper with you. Listeners, if you want to learn more about Katie, please check out the show description for links to social media, to the talks, to her counseling website. And I just want to thank Jack Straw Cultural Center for sound engineering. Thanks to Aaron Davidson for The Appetite’s original music and to David Bazzi for editing. If you’d like to learn more about Opal and our treatment program here in Seattle, please visit opalfoodbody.com or follow us on Instagram. Till next time.
