Where to Start

A good first place to start is by becoming more aware of your automatic thoughts. This will help you have a record to look over and see if there are any negative patterns or unhelpful thoughts that are impacting your mood and need to be changed. To do this, over the next week, when you are going through a tough situation or notice a shift in your mood (feeling more down, more anxious, stressed, etc) ask yourself, “what am I thinking” and write it down. At the same time, write down a little about what else is going on at the time - where you are, who you are with and what is happening- and write down how you are feeling at the time.

Let’s work through an example. Next time you are having a hot flash, you might write down the following:

• What am I thinking? Everyone notices that I am sweating, I look horrible, I can’t deal with this, people will think I am incompetent
• What is going on? At work, around coworkers, giving a presentation, feeling hot and sweating
• Feeling? Anxious, stressed, hopeless, embarrassed

Look For Patterns

After a week of writing this down, look over your entries and start to look for patterns. Are your thoughts overly self-critical? Do you often jump to the worst-case scenario? To help you analyze, when reading your thought record, ask yourself “How accurate is this?”, "Would a friend or loved one say this to me in response to this event?” “Would I say this to them?”

Modify Your Thoughts

Start to think about other, more balanced, and self-compassionate ways that you could respond in these situations. Look at any thoughts that might be more negative and/or causing more distress and ask yourself, “Is there another way to look at this?” and “How can I make this more accurate and balanced?” Write down the alternatives that you come up with.

Let’s go back to the previous example and modify the thoughts above.

• “Everyone notices that I am sweating” —> “Some people may notice, but I doubt everyone does. I notice more than anyone else.”
• “I look horrible” —> “My feelings are intensified but my looks probably don’t look that different.”
• “I can’t deal with this” —> “Just do the best I can to get through this one.”
• “People will think I am incompetent” —> “I know what I am talking about, this doesn’t change the work I have done and what I know.”

It is important to write down these adjusted thoughts because the next step is to review and practice saying these thoughts to yourself the next time this situation happens. It might feel a little forced at first, and that is to be expected. However, with practice, it will be easier to recall and bring up these more accurate and balanced thoughts at the moment. 

Check In With Yourself

Make sure to check in about how you feel after telling yourself these modified thoughts. Do you notice any change in your mood? Any physical changes (breathing slower, more relaxed, etc)? Keep track of what you notice so that you can look back and have a record. Sometimes changes are so slight that it is hard to see progress. However, many slight changes over time add up. So being able to recognize the small changes can encourage you to keep going.

Do What Already Works For You

Another CBT strategy is to incorporate behavioral approaches to improve coping. To do this, start by thinking about a stressful situation and see if there are any things you have done in the past which have helped. Does yoga or taking a walk help when you are feeling anxious? Does talking to a friend help when you are feeling down? What are some activities you enjoy that you can incorporate more regularly into your daily life? The first step is to use strategies that you already know work for you. Life can get busy and often without knowing it we have stopped doing some of the things that bring us joy and help offset some of the stressors we experience. Bringing them back can help initially lift your mood.

If you need some additional tools to what you have done before, here are some quick suggestions for behaviors to engage in based on some of the common concerns of menopause.

Dealing With Anxiety?

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Feeling Depressed?

If you are struggling with low mood and depression the desire might be to isolate. However, isolation can worsen depression. So if you are feeling down, get together with a friend, don’t cancel those plans, and engage in pleasant activities.

Need Help Managing Hot Flashes?

If you are struggling with hot flashes, work on deep breathing. When you start to experience a hot flash focus on relaxing any tense muscles (shoulders, jaw) and do deep breathing to help manage stress. Managing stress will help reduce the length of the hot flash. If hot flashes are also impacting your sleep, use deep breathing when you wake up and also as part of a structured relaxing nighttime routine.

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Continue To Monitor How You Feel

This is not a complete list, but hopefully, there are some tools to get you started. If I can leave you with a final encouragement, it is to use these tools consistently and monitor how you feel. Change does not happen overnight, but you can start noticing improvements soon - so keep with it.

Use Your Resources

Finally, if you feel like you might need a little more guidance on how to incorporate CBT tools into your life, there are many CBT-trained and certified therapists who could help guide you through these techniques. Two resources to help you find a CBT certified therapist are through the Beck Institute or PsychologyToday. 

Tags: Mental Health