• Christie Watson felt like she was suddenly seriously mentally unwell, until her therapist asked about her periods

  • Watson shares her experience of rebuilding herself through the process of the perimenopause

  • Welldoing readers can use code CHRISTIE10 for a 10% discount on her book here

  • We have therapists who specialise in supporting women through menopause - find them here

Long before Gen Z and pseudo psychiatry on much of TikTok, I’ve been searching for a label to describe my emotions. A neat box to pathologise myself with. I imagined that such a thing would quieten down my over thinking, but of course self-diagnosis only fuels mental health hypochondriasis. 

My fascination with the mind spans decades. I started training as a mental health nurse at the age of seventeen, a time of great stigma when seriously ill people pinged between overstretched services like desperately sad snooker balls. I spent eighteen months stunned and sad until, luckily, I realised how totally out of my depth I was and changed specialties. 

Of course, the landscape of mental health has changed enormously since then, in many positive ways. There is far less stigma. Thanks to celebrity influencers, some mental illnesses have become almost aspirational. The wellness industry reassures us that we can exercise our way out of depression, and journal to combat anxiety. Talking openly about mental health struggles is now commonplace and mostly helpful. But this space, while well-intentioned and no doubt useful for people suffering mild depression and anxiety, is exclusionary for most patients I’ve ever worked with. There is nothing sexy about serious mental illness. 

Much has improved in mental health, but not enough. Social media presents us with people having a ‘mental health crisis’ and dealing with it by scrapping work and reading novels in cafes while drinking Macha lattes and eating pistachio croissants or jetting off to drink cocktails in Costa Rica. Meanwhile, the Office for National Statistics highlights that in 2022 those who reported difficulty paying energy bills experienced moderate to severe depressive symptoms – nearly three times that of those who found it easy to pay their energy bills.

Mental health professionals work hard to ensure parity of esteem between mental and physical health conditions. Despite this, NHS England reports that on average people experiencing serious mental illness die fifteen or twenty years earlier than the rest of the population. Parity of esteem – or lack of it – between mild mental illnesses as opposed serious ones is even more shocking. Some mental illnesses are more equal than others. Deep filled bubble baths will not cure psychopathy. And if we want mental illness to be shouted about loud and proud, what of paedophilia? Mental health services remain plagued by discrimination. To visit an acute NHS mental health ward in Britain is to witness close up the racism, sexism, classism and ageism that pervades our society.

I had always been lucky with my mental health. Despite trying to label myself with every disorder in the DSM, I had never suffered anything worse than a few months of low mood, a tendency to catastrophise, burnout thanks to NHS nursing, and – as Sarah DiGregorio reports in her recent book, Taking Care, like half of all nurses working in intensive care during Covid – PTSD symptoms. But inevitably, despite my privilege, my luck ran out eventually.

It happened outside Sainsbury’s. I was crying uncontrollably, puffy faced and confused, sitting in the car as people walked past, totally ignoring me. I felt like running away, but my legs wouldn’t move. I wasn’t not sure what I wanted to run from, myself perhaps, but who was I in any case? My body felt like it was floating outside my own skin, and I was looking down at my faint outline, a shell empty of organs, vacant, dissociated. 

Maybe it was insomnia. I had been waking every night at 3.a.m foam mouthed and sweating, like a rabid dog. I began talking to objects like my lost keys in the manner of Shirley Valentine and The Wall. Eventually I walked through treacle air and made it into the supermarket, all the while feeling hot and invisible and outside myself. But it took me climbing into the fish finger freezer to understand that I was having a total breakdown. 

‘I am mentally ill. I must be seriously depressed. Or psychotic,’ I told a therapist, and when she asked me to describe how I was feeling instead of diagnosing myself, ‘I hard relate to Virginia Woolf’s Mrs Dalloway. I climbed into a fish finger freezer…’

She watched me knowingly, then asked my age, and if I was having regular periods. ‘It sounds a lot like perimenopause,’ she said. ‘Which is not an illness but a process.’

I was flabbergasted. As a former healthcare professional, and nowadays Professor of Medical Humanities, surely this word would be on my radar. It is not. Over the next few years, I wrote my latest book, Quilt on Fire: Dating, Sex and Love, so named not because of hot flushes but rather the time I nearly burnt my house down with a polyester quilt, is about perimenopause but also about change and love and therapy and wisdom. Because midlife is all these things, a time to reflect and examine life close up. 

A global conversation has gained traction about perimenopause and menopause, a much-needed conversation and empowering for so many midlife women. But these women seemed a bit out of reach to me and my friends, almost alien. Cold water swimmers, no doubt. I watched them perkily jog past my window wearing Lululemon leggings, as I ate chocolate digestives in my stained Primark dressing gown. Still, I wondered how much aggressive menopausal fun is performative, in any case.

I’m more of a menopausal worrier than a menopausal warrior, I fear.

But after the near self-diagnosed ‘catastrophic breakdown’, I am rebuilding myself in a new way. As Maya Angelou said, eventually every storm runs out of rain. My midlife journey has been messier than I imagined and at times, my mental health has been in a shocking state. But the storm has indeed cleared, and on the other side of this understanding and unravelling, the landscape is clear and fresh and quite beautiful. 

Someone once described psychiatry to me as a blind man in a dark room looking for a black cat that isn’t really there. Midlife is equally mysterious. I discover that menopause is only experienced by women and whales. Magical creatures full of change and wonder and secrets. I am in love with being forty-six, a statement I would not have believed possible at forty-three. The storm has passed, and I feel warm sun on my face. 

Therapy was helpful. And in my case HRT was too. A deep dive into the philosophy of midlife a great comfort. But it was friendship, as ever, that was my best medicine. My friends save me time and time again. How lucky women are. How lucky we all of us are if we are living without a serious mental illness. I think back to those times when I was seventeen and working on mental health wards, where seriously ill people pinged between overstretched services like desperately sad snooker balls. The terrible truth is that – despite cultural appearances – nothing much has changed for these people.

Meanwhile, I look at Generation Z and their mental health self-diagnoses via TikTok and tut disapprovingly. Despite this, I am still in shock and bewilderment about what I thought was an unexpected breakdown and turned out to be a process of change. I am still busy telling anyone I can about the mental health effects of perimenopause and menopause and midlife. And women of older generations no doubt look at me, shouting about this existential crisis as though I am the first to experience it. I can almost hear the tut inside their heads.

Christie Watson is the author of Quilt on Fire

Welldoing readers get a 10% discount using code CHRISTIE10 here

Further reading

Lorraine Candy's tips for midlife women

6 tips for a strong mind and body post-menopause

The menopause and letting go of old identities

The impact of the menopause on relationships

Can hypnotherapy relieve menopause symptoms?