Mental Health at Menopause - Tips for staying sane!

This month saw Mental Health Awareness week and Wake up to the Menopause week on BBC Breakfast. As both subjects are passions of mine, I couldn’t decide which to write about. So I’m combining the two!

Around the time of the menopause one of the most common symptoms is increased anxiety. It is also true that if you have suffered from trauma and it is as yet unresolved, you are likely to find it rearing its ugly head at menopause.

I’ve mentioned the benefit of Ashwaghanda before but this adaptogenic herb is a wonder. An adaptogen is a herb that supports your body acclimate to stress. Stress is the root cause of anxiety so anything you can do to prevent or manage stress will also help.

Often at the transitional time of menopause, women are at their most busy; running a business or working long hours, managing family life, coping with elderly parents; all of which is stressful. Making time for yourself is the most important thing you can do. Women are notoriously bad at this. We feel guilty if we step away from our family. We feel that we SHOULD be there for everybody else, but this is stressful and you run the risk of compassion fatigue. Yes, it’s a thing!

Doing something that is relaxing, allows you to switch off mentally and that calms your nervous system will benefit. Literally step away from technology for a time.

Research shows that spending time in nature is fabulous for your mental well-being, so why not go for a brisk walk in the park or the countryside. Spending time with others, especially if they are understanding of what you are going through is extremely supportive. After all, a problem shared is a problem halved as they say. Find your tribe and regularly spend time with them.

If you are suffering from depression and finding it difficult to function, there are many things you can do. Rhodiola is another adaptogenic herb that can help with stress, anxiety and depression.

If you are taking ANY other medication, it is always worth speaking with your GP to make sure it is safe to take supplements. However, you might consider speaking with your GP anyway as according to Dr. Rosemary Leonard, author of Menopause - the Answers, anti-depressants can also suppress other menopausal symptoms.

Diet is important. What you eat can effect your mental health. Speak to a nutritional therapist if you need to but the two most important things to cut down on are alcohol and sugar. Alcohol may be your go to when you are stressed but the high you receive from the release of GABA is short lived. You go for another drink and another and soon find that you only feel that same high after a bottle.

Sweets, chocolate and carbohydrates are another choice when stressed but will spike your blood sugar levels and maybe even give you a high, but you will crash down very soon after and feel hungry again. At menopause we tend to gain weight around the middle which usually heightens your risk of cardiovascular disease. Plus the weight gain doesn’t help your self esteem if you are already suffering mentally.

From a yogic perspective, practicing daily will support your mental, physical and physiological well-being. Observe your energy levels and mental state and consider whether to practice some grounding techniques, strong poses or gentle stretches. There is something for every mood and even a breathing technique that cools your hot flushes. Pranayama is magical for mental well-being, as is chanting and meditation. Ten minutes of practice a day is better than one hour a week. If you come to a class, try and practice at home too. You are welcome to photograph my lesson plan to remind you of what you enjoyed.

Cardiovascular exercise really benefits you physically and mentally. I know it can be difficult to fit it in but ask your family to help. Perhaps they can cook for themselves once a week so that you can go to a class . You might take a ten minute walk before eating your lunch. Little and often is better than nothing at all and really boosts your mood.

The most important thing is NOT to suffer in silence. You are not alone. I am a great believer in choice so do your research, never dismiss advice, try something and if it doesn’t work, try something else; whether that is homeopathy, herbs, medication, yoga, meditation or counseling. What works for your best friend might not work for you, so keep an open mind.

Community, support and exercise will greatly benefit. Reach out to me or anyone else who might be able to help. If women are ill informed about menopause, men are going to be less so. TELL your partner and family what you need; it might be the only way you get your needs met.

Talk about the menopause. The more you do, the better educated future generations will be and the easier the transition will be for our daughters.

Go well . Namaste.

Anneliese

Stress - Begin Where You Are.

It only has to take one event to trigger a complete change in your breathing habit. You might always have breathed in your belly (although you were probably not aware of this), then one day you were traumatised by a major stressor. This could be anything that put you into an immediate stress response, from a traumatic event to being yelled at. How your body responds is what is important here.

Commonly with the stress response, your breath shifts from belly to chest. You want to pull air into your lungs so that oxygen can be sent to your heart rapidly, enabling you to fight or flee from the threat. In a healthy system, once the threat is over, the stress response is switched off and breathing returns to the belly.

In modern society where we are constantly under threat on a psychological and physiological basis, the stress response can be triggered again and again in a single day. So what happens? The breath gets stuck in your chest and whether you feel stressed or not, your body thinks you are and keeps you in the stress response.

With so much threat around us, how do we know that we are stuck in the stress response? There are too many signs to list, but here are some things to look out for:

• Being easily startled.

• Constant doing - restlessness.

• Eyes darting around.

• Constant chatter.

• Rushing.

• Low pain tolerance.

• Consistent tension in the back of the skull, jaw, neck or shoulders.

• Feeling regularly overwhelmed.

• Sensory overload - sensitivity to light and sound in particular.

• Over-thinking and spending too much time in the head.

• Consistent chest breathing and pulling of the breath.

• Mouth breathing.

• Difficulty with concentration and focus.

• Listlessness, exhaustion or fatigue.

Sound familiar? Whatever you do, DON’T carry on as you are! Stress is not your friend. The stress hormones that are constantly rampaging around your body can do serious damage to your health. Now is the time to implement self care.

If you find that your mind is busy, busy, busy, you might need to begin with movement. A simple routine like the cat sequence I frequently teach can be a good place to begin. Don’t worry about the breathing but do notice the contact your body has with the floor.

If you are overwhelmed, begin at your feet. Notice them, feel them on the ground and if that is difficult, massage them so that you really feel the sensations in your feet. Squeezing the arms and legs can be useful if you feel disconnected from yourself.

If you can cope with stillness, concentrate on your breath. Sound is the easiest way of making the shift from chest breathing to belly breathing. It doesn’t matter what it is but you could try, sss, fff, ahh, brr. Sound that can loosen a tense jaw is brilliant!

Practice breathing through your nose as often as possible. It took a single event to alter your breath; it is possible to change it back within 24 hours. It just takes practice. Mouth breathing or shallow breathing reduces the amount of Carbon Dioxide (CO2) you take in. CO2 is necessary for vaso-dilation (dilating your blood vessels) which allows for oxygen uptake. Without this, blood vessels constrict which means the flow of blood is slowed leading to potential complications. Red blood cells hang on to oxygen when CO2 is low, therefore the body’s cells are not receiving enough oxygen to thrive.

If after reading this you start to panic, STOP! This is life and you are not alone. Stuff gets in the way of self care. But now you understand the importance of taking time for yourself and addressing the issue, begin where you are.

If you need support on your journey, do get in touch.

Look after your Adrenal Glands and they'll take care of you!

The adrenal glands sit on top of each of your kidneys. They play a vital role in your body, secreting hormones that are essential for life, stress hormones that also act as neurotransmitters, sending messages to your nervous system and sex hormones.

Here are just a few examples of hormones produced by the adrenal glands:

Aldosterone is responsible for maintaining the body’s salt and water levels which in turn regulates blood pressure.
Cortisol responds to illness and and helps regulate body metabolism. Cortisol stimulates glucose production and has significant anti-inflammatory effects.
Adrenaline, noradrenaline and small amounts of dopamine are responsible for all the physiological characteristics
of the stress response, the so called 'fight or flight' response.
Testosterone plays an important role in sexual arousal, sexual response, libido, bone strength, cardiovascular health, cognitive performance, energy levels and well-being in women. 

In a stress response, adrenaline increases your heart rate, elevates your blood pressure and increases energy supplies. Cortisol dampens all non-essential functions in a fight and flight situation. It alters immune system responses and suppresses the digestive system, the reproductive system and growth processes. Natures alarm system communicates with regions of your brain that control mood, motivation and fear.

Once a perceived threat has passed, hormone levels return to normal. But in the case of chronic perceived stress, the adrenal glands persistently secrete hormones and become fatigued resulting in a potentially dangerous situation. Initially you may experience some of the following:

• Depression

• Anxiety

• Digestive problems

• Headaches

• Sleep problems

• Weight gain

• Memory and concentration impairment

During peri-menopause the adrenal glands produce a hormone that mimics oestrogen. With already diminishing oestrogen levels, exhausted adrenal glands cannot produce adequate amounts adding to the already ageing affects of low oestrogen levels. Long term adrenal fatigue can also result in lower levels of testosterone; lowering libido, thinning bones, damaging cardiovascular health, causing cognitive impairment and low evergy levels.

More serious conditions of adrenal fatigue are overproduction of aldosterone causing treatment resistant high blood pressure. The adrenals may become overactive resulting in Cushing’s Syndrome. Underactive adrenals may result in Addison’s disease. You can do your own research into these diseases if you want to. But I want to highlight that stress should be treated seriously rather than being ignored or dismissed as something to deal with later.

Lifestyle changes may be required; even a change of career! I’m sure you know the score by now, but just in case:

• Deal with any unresolved trauma through counseling.

• Get regular exercise (overexercising is stressful on the body so take it easy).

• Eat a healthy diet.

• Practice relaxation techniques or take up yoga.

• Take time for hobbies.

• Spend time in nature.

• Make time for friends.

• Take action to improve quality of sleep.

Stay well.

5 Ways to Well-being - Wisdom from Sussex Oakleaf

Ever since completing my training in Yoga Therapy for the Mind with The Minded Institute, I have considered myself to be cured of mental illness. But lately I have had to accept that I will never be fully cured of my particular mental illness. It is triggered by stress and even though I advocate that yoga and mindfulness practices are life-long when managing mental illness, stress has a way of blocking them out for me and like every human, I get overwhelmed by the stress and put those practices at the back of the list of jobs to be done. Because in my head, if I tick off all the other jobs that I believe to be causing the stress, I will cope better. But this is rarely the case.

Taking a week off afforded me the time to rest, recuperate and regroup; to prioritise my practices again and therefore my well-being. Consequently I found the space I required to set up strategies that should keep me on the straight and narrow.

I found wisdom from the young that week. The coordinator of the Sussex Oakleaf Youth Mental Health group that I volunteer for 'BeOk', constructed a list of 5 ways to well-being. These are:

Connecting. Learning.  Being Active. Noticing. Giving.

Connecting with family, friends, colleagues and community satisfies a human need of feeling valued and close to others. Connection can also be felt for some through religion, spirituality and nature. In the group we drew mind-maps of things that cultivated connection for us. Other than those mentioned above, examples were communication, reliance, sharing, trust, honesty, love, safety, grounding etc...

This was only the first step on our journey to exploring the 5 ways of well-being together. I find the intelligence, honesty and wisdom of these young men and women incredibly humbling.

Next on the list is Learning. During the BeOk sessions, we have discussed in the past how exams put too much pressure on those of us whose memories have been affected by mental health. But there is always something to learn that can be done just for the fun or fascination of it such as a new skill. Continued learning enhances self esteem and encourages social interaction. Setting goals can be a great way to achieve a sense of well-being.

Being Active is vital for health in general. Regular activity is associated with lower levels of stress, anxiety and depression and is essential for slowing age-related cognitive decline.

Noticing the things around you comes under the umbrella of mindfulness; simply being more present and attentive to whatever you are doing or whoever you are speaking to. Savoring the moment; eating lunch without looking at your phone for example, hearing the words another is saying are ways to help you appreciate the important things in life and in turn, to make positive choices based on your own values.

Giving time to others is incredibly rewarding and helps to create connections. Acts of kindness to a friend, neighbor, community group or charity are more likely to make you feel happy!

I have found that the best strategy for me to cultivate well-being is to be organised. I used to be more organic in the way my days evolved but I found it was too easy to be lazy. So I set myself daily goals, ticking off at least two of five ways to well-being. And it feels good!

What's the buzz? Bhramari Pranayama.

Bhramari, also known as buzzing or humming breath is a wonderful, soothing pranayama practice. Bhramari is a Sanskrit word derived from bhramar, which means “humming black bee.”

By generating a soft buzz or hum we elongate the exhalation. By now you will know that elongating the exhalation puts our bodies into parasympathetic nervous system dominance; meaning we are able to rest and digest and feel calm.

How to practice

Sit comfortably with your spine elongated. When first practicing bhramari, making an actual buzzing sound helps; 'bzzz'. You might then try softening the buzz into a hum by gently closing the lips half way along the buzzing breath so that they are softly resting together but with a space between the teeth. This gives you the impression of how the hum can be created in your final practice by keeping a space between the teeth, the jaw relaxed and the lips lightly touching. Try to control the exhalation; maintaining a steady, smooth, even and continuous sound and energy. Each inhalation should be taken slowly and steadily between rounds rather than being sucked in.

You can play with the pitch and volume. My preference is for a deep sound in which I find the vibrational quality is enhanced, whilst a higher pitch takes the vibration into the skull but for some reason offends my ear! We are all different, so have a play and see what you prefer. You can even practice silently by imagining that you are creating the hum.

Mudras

This beautiful practice can be done using hand mudras or gestures. The bhramara mudra requires one to fold the index finger into the base of the thumb and to rest the tip of the thumb onto the edge of the middle finger nail. In this mudra, that hands can be rested on the belly and the base of the throat or chest which can enable one to feel the vibrational quality of the breath.

Bhramara Mudra

A second mudra suggests placing the index fingers in the ears; lightly closing the cartilaginous flap at the base of the ear, rather than inserting them into the actual ear canal. The thumbs can rest against the lower jaw and the elbows rest downwards for comfort. This shuts out sounds from outside of ourselves. It deepens the sound within and really enhances the vibration in the head. This mudra can cultivate a deeply relaxing and comforting practice.

A third position is called Shanmukhi mudra and is used to reduce sensory input. This can be challenging and less comfortable, particularly if you feel vulnerable in any way. The thumbs are pressing the cartilaginous flap in the ears this time, the eyes are closed with the index finger resting on the upper orbit of the eye and the middle finger on the lower orbit (the orbit referring to the orbital bone surrounding the eye). The ring fingers rest between the nose and the top lip and the little fingers under the lower lip.

Shanmukhi mudra

Benefits

As practicing bhramari shifts the autonomic nervous system into parasympathetic dominance, the practice reduces stress, anxiety and anxious depression in particular. The sound helps to shut out mental stimulation, switching off the ruminating mind. A lower pitch can be more calming or a silent practice that can be done at any time; even on your commute to work or in the office when you are feeling stressed!

When the sinuses are blocked, the vibrations from bhramari help to clear the head. It can help to create a higher pitched sound for this.

If suffering from insomnia, practicing at night using shanmukhi mudra and a lower pitch can be useful.

Whilst there is no scientific evidence, bhramari is thought to help stimulate the thyroid especially if practiced in conjunction with jalandhara bhanda (throat lock) as this directs the vibrations to the throat. Try a medium pitched sound.

During pregnancy, Bhramari can be a wonderfully soothing breath. One client I had practiced often during her pregnancy so that when her baby was born, she could use it to sooth the baby; no doubt because the baby had also benefited from the vibrations within the womb.

When practicing a particularly challenging stretch, bhramari can help to relax the body and therefore soften the stretch. I find it particularly beneficial during king pigeon but it is not advisable to practice bhramari when lying on your back.

If this is your first exploration of Bhramari, I recommed 5 to 10 rounds initially, building this up to 10 to 15 minutes per day; particularly if you wish to use it to good effect. Have a play and enjoy!

Namaste.

NATURA APIS by J.R.R. Tolkein

The night is still young and our drinks are yet long,
The fire's burning bright and here brave is the throng,
So now I will sing you a sooth little song
Of the busy brown bee - with a ding and a dong.

5 Reasons to practice Ujjayi.

5 Reasons to practice Ujjayi - Image by Katie Vandyke

Ujjayi means Victorious Breath. It is warming a calming. If you have never tried this type of pranayama, here's how to do it. Inhale through the nose and exhale through your mouth, making a Haaa sound as if huffing up a piece of glass to clean it. The more slowly you can let the sound leave your mouth, the better. It should sound like the waves of the ocean washing up and down a beach. Some people suggest that it sounds like Darth Vader!

Next try closing your mouth half way along the breath. The sound is first heard aloud and then inside your head. It is a little like trying to push air through a small hole in the base of your throat.

Finally try making the Haaa sound with your mouth closed. You are trying to breathe as gently as if you were blowing onto a baby's face.

It is usually easier to begin with the exhalation alone and to only try Ujjayi on the inhalation when you have mastered the practice.

Here's how you benefit from practicing Ujjayi:

1) You slow the breath down. Physiologically you are tightening the larynx in the throat to restrict airflow. This has the effect of slowing the rate at which you breathe and gives you greater control over your breath. By changing the way you breathe, you can potentially change the way you feel. Slowing down the exhalation makes you feel calmer and more relaxed.

2) The breath moves into the belly. When we are stressed, we tend to pull the breath into the chest and breathe rapidly. This gives the brain the message that we are under threat, that we need to escape the stressor and therefore the body enters the stress response. By slowing the breath down, you can enable the breath to move into the belly, suggesting to the brain that you are at rest and can relax.

3) You have greater control over how and where you breathe. By slowing the breath down, you can direct the breath to specific areas of the body where there may be tension for instance. You can literally learn to breathe the tension away!

4) You gain a heightened sense of self awareness. Because we use Ujjayi throughout our asana practice in yoga, we move more slowly than usual. This heightens your self awareness. It teaches you more about how you move so that you can make changes and improve your posture.

5) It allows us to relax. When practicing Ujjayi, the body enters the relaxation response more quickly. This is because restricting the airflow is thought to 'tone' the Vagus nerve that acts as a brake on the heart, increasing parasympathetic activity such as digestion. 

Ujjayi breathing is particularly beneficial for High Blood Pressure, Irritable Bowel Syndrome or other digestive complaints and in dealing with stress, anxiety or depression depending on the ratio of inhalation to exhalation. Please seek professional help if you suffer from any of these conditions before practicing Ujjayi on your own.