Toolkit for hormonal depression

Content warning: mention of suicidal prevention, and my advice on how to hold on and ride out the unexpected crashing lows of autistic perimenopause.

Quick mental health first aid post, for when you are feeling the lowest of the low. This is based on my personal coping mechanisms - please seek support in own your life if these don’t work for you and you need an individualised treatment and support plan.

Remember autistic menopause is a time of regression - our hormonal fluctuations will cause our mood and capacity to instantaneously switch. This can feel completely random, and I have a characteristic symptom of depression providing a sense of impending doom.

Photo by Shamblen Studios on Unsplash

These regressions are temporary, and you will not feel this way forever. I know it is scary with these changes happening beyond our control, but please know that you are loved, wanted, needed, and that things will get better. If you are feeling suicidal, please reach out immediately to someone in your life for help.

During autistic perimenopausal lows, and in general times of depression associated with autistic burnout, I experience episodes where I need immediate techniques and strategies that are effectively life saving. Some will act as mantras, others are just something to note down and keep in a prominent place in case your working memory is not currently serving you well (an enormous understatement, in my case!):

• It’s okay not to feel okay right now.

• Let someone who knows you in real life understand how you feel right now, and ask them to keep checking in on you. Text, email, Facebook groups etc.

• Ask others for support: practical, respite, emotional support, meals, suicide watch. Whatever you need at that time. Know that it’s not your fault if you aren’t getting adequate back up right now, and that you are still seen, needed and loved by others.

• Do not think too far ahead - just get through your next meal, your next meds dose, one activity at a time.

• Things might not feel like they are getting any easier, but that doesn’t mean you are doing anything wrong.

• Anticipate highs and lows/lows and low low lows.

• Set your expectations of yourself to fluctuate along with your capacity at any given time.

• Do not feel guilty or shameful if you are unable to meet your own or other people’s expectations.

• Re-evaluate everything you have taken for granted up until now, and run your schedule on a “skeleton service” as needed.

• Stay stocked up on your safe foods (and your kids’/pets’ food, and everyone’s medications), set up online grocery deliveries if possible. You want to give yourself every reason to stay home and rest when unexpectedly needed.

• Have respite and escapes available within your home in the form of audiobooks, meditation tracks, quick mood lifting exercise routines on YouTube, etc.

• Regulate yourself in order to cope with changes in mood and capacity: stim, music, arts and crafts, look out the window, step outside, stroke your pet, eat chocolate, punch pillows, journal, have a nap. Whatever works for you in that moment.

• Set up your sensory toolkit using what’s already in your home: carry cans of food in a backpack if you don’t have a weighted blanket. (I have other suggestions but I can’t recall them right now as my kids won’t stop talking to me…)

• Outsource extraneous duties as much as possible.

• Drop as many demands on your time and finite cognitive resources as you can.

Apologies for the repetitive nature of this post, but my kids will not give me enough personal space to reread what I have typed. I am sitting here in noise cancelling headphones and their noise is still making it through!

Let me know what works for you, and let’s build up this as a resource for us all to come back to when everything feels too much to bear.