Article #2 in the series on Perimenopause, Burnout & The Nervous System.
Live lecture on March 31st (online): Perimenopause Beyond Hormones – How Stability Shifts And How It Can Be Restored
Fatigue, mood swings, disrupted sleep, reduced resilience… the overlap of symptoms (and not only the symptoms) is confusing. A diffuse change, not for the better, in capacity. Most people in their thirties and forties encounter some version of this. It is a diagnostic problem a) because symptoms of burnout and perimenopause look almost identical at first presentation, and b) perimenopause is significantly under-recognised by the health care system, as well as in public knowledge and media. If you experience lesser known symptoms, like an elevated heart rate, tinnitus, fatigue or mysterious muscle pain, perimenopause might not even come to mind.
We have learned to recognise „burnout“ as a common thread for seemingly unrelated symptoms, but have yet to learn the same when it comes to perimenopause.
The core condition of burnout is the nervous system collapsing under a chronic load that is too high. The core condition of perimenopause is the hormonal system suddenly fluctuating. The core condition of perimenopause burnout is the nervous system collapsing because a fluctuating hormonal system removed or significantly reduced the buffer which was needed for tolerating a high chronic load.
Where the two conditions structurally diverge, is at the level of cause and response. Burnout develops in relation to a situation: an environment, a load, sustained demand that exceeds capacity – and it improves when that situation changes, both practically and psychologically (for example: if you know you will need to return to the workplace that produced the burnout, your recovery will not work properly because your nervous system is already anticipating the return to that nasty workplace).
Perimenopause does not follow such situational logic. Independently of our environment, it produces a cluster[ ] of shifts that do not resolve through rest, no matter how long the rest may be.
Do I Have Burnout or Perimenopause?
If rest is no longer restorative the way it used to be, this likely means that something fundamental has changed – whatever it may be – and that something different is required than simply more rest.
A useful thought experiment to distinguish: if your primary stressor were to disappear overnight, through a lottery win, a difficult relationship becoming suddenly fully supportive, whatever your relevant version of ‚problem gone‘ is – then, would you be able to recover within a few weeks?
If the answer is yes, burnout is likely at least as a contributing factor.
But if your situation, environment, etc. are quite alright, and you still feel like something unidentifiable has changed in your operating system, that points more toward perimenopause. Assuming that medical investigations have already taken place to rule out other physiological causes.
What is with option c – the situation is not alright and there is a new odd shift?
Then you should explore the eventuality that the two occurred simultaneously, which is unfortunately quite common, especially for people with a history of high resilience and high independence, and even more if these were achieved as a response to marginalisation.
What To Do?
That differs accordingly: Burnout calls primarily for removing the stressor and supporting nervous system recovery. Perimenopause, and every other phase, also benefit from reducing stressors, of course. But additionally, perimenopause requires a longer-term shift in your lifestyle and daily rhythm, for maintaining your health, for guiding and keeping your nervous system on a level that is not “nervous but ok regulated” but actually balanced. And medical and therapeutical support needs to be considered.
Perimenopause is a multi-year transition. Unlike burnout, it doesn’t resolve through a recovery period. It is best looked at as a phase that requires a strategy, rather than a ‚problem‘ needing a fix.
Equally urgent and important as a precise diagnosis, if not more, is, whether your current mode of functioning is sustainable at all. Is it actually allowing you to be well? Take a moment to assess this, without minimising what is happening, or waiting to see if it resolves by itself. Whether or not you engage with a crash actively, and use it as a call to listen and get into a dialogue with the body-mind, has significant influence on the outcome (aka the rest of your life). This is not meant as a distraction or toxic positivity (“just think yourself calm”) but as an inquiry into whether there might currently be a built-in readiness to accept stress, or to ignore physical signals. These would now need to be rearranged, in all self compassion.
A shift in energy in midlife (why is it called that anyway, it isn’t even 2/3) does not mean the end of your capacity is near! It is telling you that the previous approach now no longer fits. I wish you the best of health.
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