The Day She Thought She Was Going Crazy
- Jun 28
- 6 min read
Written by Nelum Dharmapriya, Doctor & Health Coach
Dr. Nelum Dharmapriya is a Brisbane-based GP with a special interest in metabolic health, menopause, and lifestyle medicine. She combines 30 years of clinical experience with a personal passion for helping women thrive in midlife and beyond.
Perimenopause often arrives quietly, bringing emotional and cognitive changes that leave many women feeling like strangers to themselves and many partners unsure of how to help. This deeply personal reflection explores why understanding, open conversation, and compassionate support can make one of life's biggest hormonal transitions far less lonely.
What every husband and partner should know about perimenopause
A woman in her early forties walked into my consulting room recently, accompanied by her husband. Before I had even asked why she was there, she looked at me with tears in her eyes and said something I will never forget.
"Doctor, I think I'm going crazy." She then turned towards her husband. "Can you please explain to him what's happening to me?"
There was desperation in her voice, but it wasn't because she had received a frightening diagnosis or because she believed she was physically ill. She was frightened because she no longer recognised herself.
She described feeling overwhelmed by everyday life. Little things that had never bothered her suddenly felt enormous. She found herself snapping at her children, becoming irritated with her husband over trivial matters, crying unexpectedly, struggling to concentrate, and feeling emotionally exhausted. Although she wasn't sleeping as well as she once had, poor sleep wasn't even her biggest concern.
What troubled her most was that she felt she was becoming someone she didn't want to be. She felt guilty about not being the wife she wanted to be. Guilty that she wasn't the mother she wanted to be. Guilty that she couldn't seem to control her emotions. Like many women, she genuinely believed she was losing her mind. What made her story particularly important was that she was only in her early forties.
Her menstrual cycles were still regular. She wasn't experiencing dramatic hot flushes. She hadn't reached menopause. Like many women, she believed she was simply too young for any of this to be related to her hormones.
Yet what she was describing is something I hear repeatedly. One of the greatest misconceptions about perimenopause is that it begins when periods become irregular or stop altogether. The years between forty and fifty often represent a gradual transition during which hormone production becomes increasingly unpredictable. Ovulation becomes less consistent, and instead of the beautifully coordinated hormonal rhythm that has existed for decades, women begin experiencing significant fluctuations from one month to the next.
I often describe it as an orchestra. For years, the musicians have performed in perfect harmony. Then gradually, some of them begin arriving late. Some miss rehearsals altogether. Some months, the music is beautiful. Other months, it sounds completely different.
It is this unpredictability that makes perimenopause so confusing. Many women expect hot flushes to be the first sign. The earliest symptoms are often emotional and cognitive. Overwhelm. Anxiety. Loss of confidence. Poor concentration. Brain fog. Irritability. Emotional sensitivity.
Difficulty coping with stress that would once have seemed insignificant. Sometimes these changes appear while menstrual cycles remain completely regular. Blood tests may even look reassuring.
From the outside, everything appears normal. Inside, however, many women feel as though they are quietly falling apart. This isn't because they are weak. It isn't because they are failing. It certainly isn't because they are "going crazy." It is biology.
The receptors for estrogen, progesterone, and testosterone are found throughout the body, including the brain. These hormones influence far more than reproduction. They affect mood, sleep, memory, emotional regulation, cognition, metabolism, muscles, bones, and countless other body systems.
As hormone levels fluctuate, so do the signals being received throughout the body. Understanding this often changes everything. As I explained this to my patient and her husband, I watched both of their faces soften. She looked relieved because someone had finally given a name to what she was experiencing. He looked relieved because he realised he hadn't lost the woman he loved.
She was still there. She was simply navigating one of the biggest hormonal transitions of her life. As I reflected on that consultation later that evening, it struck me that one of the saddest things about perimenopause isn't the hormonal changes themselves.
It's how often couples turn against each other at the very time they need each other most. She feels misunderstood. He feels rejected. She thinks he has stopped listening. He wonders what happened to the woman he married. Neither of them realises that they are often fighting biology as much as they are fighting each other.
What many partners don't appreciate is that the woman sitting opposite them is often just as frightened as they are. She doesn't recognise herself either.
She doesn't understand why her patience has disappeared. She doesn't know why small problems suddenly feel overwhelming. She isn't choosing to be irritable or emotional. She is trying to make sense of changes she was never taught to expect.
Looking back, I realised that I wasn't taught much about this either. Like many doctors, my medical training focused on menopause as the end of reproductive life, defined largely by irregular periods and hot flushes. We spoke very little about the emotional, cognitive, and psychological changes that can appear years earlier during perimenopause.
Perhaps that is why so many women arrive in our consulting rooms believing something is fundamentally wrong with them. This consultation also reminded me of something deeply personal.
I grew up in Sri Lanka and remain close to a wonderful group of school friends. We have shared decades of life through a WhatsApp group, celebrating weddings, children, careers, grandchildren, holidays, and aging parents. One day, it suddenly occurred to me that we had all traveled through our forties and fifties together.
Every single one of us had experienced perimenopause. Yet not once had we talked about it. Not once. I found that astonishing. These were intelligent, educated women who had supported one another through almost every milestone life could offer. Yet we had remained silent about one of the biggest biological transitions we would ever experience.
When I finally raised the subject, the stories came flooding in. Women admitted they had struggled with anxiety. Others spoke about brain fog. Some described poor sleep, weight gain, relationship challenges, and feeling unlike themselves for years. Many had simply assumed they were the only ones. That conversation changed my thinking forever.
I realised that one of the greatest challenges of perimenopause isn't simply fluctuating hormones. It's isolation. When women don't talk, they assume they are alone, blame themselves, and miss the reassurance that comes from hearing another woman quietly say, "Me too."
That is why I believe every woman needs a menopause tribe. Whether it is a sister, a lifelong friend, a walking group, a book club, an online community, or a group of school friends, having women who understand what you are experiencing can be profoundly healing.
Sometimes the greatest gift another woman can give you isn't advice. It's recognition. For husbands and partners, perhaps the greatest gift you can offer isn't a solution either.
It isn't trying to fix every problem, telling her to calm down, and reminding her that she was fine yesterday. It is listening, believing her, asking, "How can I help?" and learning about perimenopause alongside her rather than expecting her to navigate it alone. Because one day this transition will pass.
She will come through the other side. She may not remember every conversation you had. But she will remember whether she walked through one of the biggest transitions of her life feeling judged or feeling understood.
Perhaps that is where we need to begin. Not with medication, blood tests, and treatment. But with conversation. Because when women begin talking openly with other women, and when the people who love them take the time to understand what they are experiencing, something remarkable happens.
The fear begins to lift. The shame begins to disappear. Relationships become kinder. Communities become stronger. What once felt like a lonely struggle becomes a journey that no woman must walk alone.
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Read more from Nelum Dharmapriya
Nelum Dharmapriya, Doctor & Health Coach
Dr. Nelum Dharmapriya is a Brisbane-based GP with 30 years’ experience in women’s health and metabolic wellbeing. Founder of Whole Food Revolution, she empowers women 40+ to reclaim energy and confidence through the three pillars of science, lifestyle, and mindset.
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