Ep.192 Anxiety in Midlife & Menopause: Why It Ramps Up and How to Calm It

Anxiety often feels like it comes out of nowhere in midlife—especially during perimenopause and after menopause. You’re doing “all the right things,” yet your nervous system feels constantly on edge. Racing thoughts. Poor sleep. A sense that something isn’t right… but you can’t quite name it.

In this episode of Asking for a Friend, I’m joined by Dr. Lori Davis, licensed psychologist, clinical instructor at Weill Cornell Medicine, and author of the upcoming workbook This Is Your Anxiety on Menopause. Together, we unpack why anxiety often intensifies in midlife—and what women can actually do about it.

Dr. Davis shares both the science and the lived experience behind anxiety, explaining how hormonal shifts, nervous system changes, sleep disruption, perfectionism, and decades of “pushing through” collide in this season of life. We also talk about why anxiety may feel different now than it did earlier in life—and why you are not broken.

In this conversation, we cover:

• Why anxiety often spikes during perimenopause and menopause
• Whether menopause causes anxiety or unmasks an existing vulnerability
• The role of hormones, cortisol, sleep, and the nervous system
• Why worry loops and nighttime anxiety are so common
• Evidence-based tools to calm anxiety (including breathing, exposure, and cognitive strategies)
• When therapy or medication may be helpful—and when lifestyle alone isn’t enough
• How to stop fighting anxiety and start working with your nervous system

This episode is grounding, practical, and deeply validating for women navigating midlife changes. If you’ve ever thought, “Why am I suddenly anxious when nothing is technically wrong?”—this conversation will help you connect the dots.

👉 Share this episode with a friend who needs reassurance that they’re not alone—and not failing.

You can find Dr. Lori Davis at https://www.drloridavis.com/

Instagram https://www.instagram.com/drloridavis/?hl=en

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If you’re doing “all the right things” and still feel stuck, adding a layer of support may be an option. I’ve partnered with a trusted telehealth platform offering modern solutions for women in midlife—including micro-dosed GLP-1 and other peptide therapies.

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Transcripts are created with AI and may not be perfectly accurate.

Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your qualified healthcare provider with any questions regarding a medical condition.

Transcript

Safety Disclaimer & Sponsor Note

Michele Folan 0:00

The information shared on this podcast is for educational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional regarding your individual health needs.

GLP1s And Peptides Context

Michele Folan 0:12

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Framing The Midlife Anxiety Topic

Michele Folan 1:43

wellness, fitness, and everything in between. We're removing the taboo from what really matters in midlife. Today we are talking about anxiety, specifically why it so often intensifies during midlife and after menopause, and what women can actually do about it.

Dr. Davis’s Personal Anxiety Timeline

Michele Folan 2:10

My guest is Dr. Lori Davis, a licensed psychologist and clinical instructor of psychology in psychiatry at the Wild Cornell Medical College. Dr. Lori Davis, welcome to Asking for a Friend.

Dr. Lori Davis 2:23

Thanks so much. It's a real pleasure to be here today and happy to discuss these issues. They're so important.

Michele Folan 2:29

And that is specifically why I asked you to be on the podcast. I see anxiety ramping up in people around me, whether they be clients, friends, family. And it's so interesting. And then I saw that you wrote this book, and I'm like, oh my gosh, it connected a lot of dots for me. So I want to start with you though. You have a very personal journey. So before we get into the science, can you share when anxiety first entered your life and what that experience was like for you personally?

Dr. Lori Davis 3:07

Absolutely, Michelle. I think that many women and also men, you know, have sort of early roots in anxiety, but they don't really know what it is. And so I think that was the case for me, in that as far back as I can remember, I would get sort of, I would get, I mean my heart would race, or I'd get a stomachache, like if I was away from home too long. Or let's say I'm going for camp, I would have sort of separation anxiety. So there were these early pieces about anxiety, but you know, they don't teach you, especially back then, they didn't teach you about anxiety at school. I mean, it just isn't how it is now, where there's so much information online and parents are so informed about anxiety, ADHD, and depression and the effects of social media. Like it just wasn't around. So I had these early pieces about like something didn't feel quite right, but I was high functioning otherwise. And so as I got older, I remember when I got my driver's license. Like all of a sudden, I was kind of I was nervous about driving on the highways and I would want to kind of get back home. But again, I was high enough functioning that nobody really noticed, but I felt like something was off. So as I got into my early adulthood, I then started having sort of a panic attack. And I didn't know what that was. It was really freaky. For people who have panic, it's sort of like it kind of seems to come out of the blue. You feel like you can't breathe, you're gonna pass out. A lot of people end up going to the emergency room or, you know, like feeling that they're gonna die, they're having a heart attack. And so I definitely had that kind of experience. And I finally got evaluated, and they were like, Yeah, you have anxiety. And I I remember reading everything I could about the subject. Um, and again, this way proceeds in my career as a psychologist. I read every book I could find, old books, new books. And then, you know, the treatments were a little bit different then. And I just soaked it all up because I do think that information is power no matter what you're dealing with, whether it's nutrition or mental health or physical health and so forth. And so I learned what I learned. I think it was a natural progression for me to be a psychologist, to be a therapist. It's kind of my personality, but I didn't do it. I had a second career. It was a second career. I worked in publishing, had my own business, sold it, and then was like, okay, now I want to go back and help other people. And anxiety was like, it was a focus, but I ended up doing a lot of clinical research and trauma, PTSD, and 9-11 and a bunch of other things that happened. I sort of fell into that. So that was my focus. And then so I decided to return to my roots because I've always been anxious. And during menopause, during that whole perimenopause, menopause stage, I started getting anxious again, like it kicked up again. Uh, you know, drop in hormones. I wasn't sleeping well. Um, you know, that affects neurotransmitters. Like I was moody, you know, I didn't know what was happening to my body and brain. That causes anxiety. And the other piece about which is a lot of what my book is about, is midlife, right? So you're juggling the physiological changes and your body's changing,

Stigma Then Versus Now

Dr. Lori Davis 6:15

and it's like, what's this muffin top thing around my waist? What is this tire? While you're also juggling a lot in life, right? Like family, work, financial stuff, health issues, aging parents, like it's just an endless list of things that you're constantly multitasking about. So that causes anxiety. So I try to apply my own lessons learned and my own, also my clinical knowledge, you know, what I was trained for, and combine those two to educate other people like, hey, you can be anxious and you can still live your life, you can set goals and so forth. So my own journey has been varied. Like I was anxious and then I was okay for a while. And that can happen with people. They're like, why all of a sudden am I anxious again? And perimenopause, midlife, as you know, this is your thing. Midlife is a huge time of change. Yeah. Reevaluating who you are. So you know, and that includes everything in your life. And so I experienced that too. So this was this sort of the last kick up in anxiety, and now I'm managing it. You know, I've I've figured out how to how to do that for myself. And it's different for everyone.

Michele Folan 7:22

Yeah. I appreciate the story because it it makes it makes a lot of sense. And I I bet there are women out there that are identifying with with your story. When you were first diagnosed, how old you said were you in your late teens when you were diagnosed?

Dr. Lori Davis 7:38

I would say at the time I was probably about 19 or 20.

Michele Folan 7:43

What year would that have been? That would have been in I I'm not I'm not picking out like I'm not trying to figure out how old you are.

Dr. Lori Davis 7:50

That would have been in um yeah, like around 1980 or something like that.

Michele Folan 7:56

Yeah, and and what what the reason I'm asking is we didn't hear a lot about anxiety in 1980. I was I was in high school. Certainly plenty of us had it at the time.

Speaker 2 8:10

Yes.

Michele Folan 8:11

But are you finding that now the the the discussion has changed? Because I'm even impressed that anybody would diagnosed you back then. You know, because it you we kind of grew up in a suck it up buttercup, you know, kind of environment.

Dr. Lori Davis 8:28

We did. And I think that yeah, it's like

Break: Show Purpose And Community

Dr. Lori Davis 8:31

chin up, just plow through and you don't talk about your feelings that much. And so, um, and you know, there are varying environments. Yeah. I like I got I there was no education about mental health issues in my schools. Like I that just wasn't there. So I it was a kind of a relief for me when I did get the diagnosis, because like you said, there wasn't a lot of conversation around it. Now I know a lot of women who had, like you said, who had anxiety, but they just didn't know what it was, or they were told, Oh, you're just nervous, just deal with it, it'll go away. It's but it's it's a real diagnostic thing. Like,

Biology, Early Life, And Learned Messages

Dr. Lori Davis 9:11

and there was no dialogue about it. Even like I never really even Michelle talked to friends about it. Like I have one really dear friend, she's still one of my closest friends. Like when I was diagnosed, like I I told her. And it was kind of new to her too. You know, but she helped me and I was able to say, hey, like I'm nervous driving, or I feel like there are too many people at this concert, and I want to like get out of here, quick escape, or traffic, being stuck in traffic or a tunnel. I was like, so I was able to express it. And then, of course, going to therapy and meeting with someone who was able to put words to it to give me strategies to explore. Like I'm I mean, I integrate in terms of therapy. Like I'm a cognitive behavioral therapist, which means, you know, looking at your thought patterns, the things that make you really anxious and nervous, and then what can you do about it? Like action-oriented. But I also had regular talk therapy, which is like, how does this link back to early messages I got about feelings? Right? Like it's okay to be anxious. You're not, you know, I I think women are socialized too. We we're supposed to multitask. We're supposed to just, like you said, push through everything. And, you know, we hit a wall sometimes. And I think I hit a wall earlier. You know, obviously, kind of early adulthood, I hit a wall about going out into the world, being an independent person, establishing a career, you know, um, just being an adult. I think, and that's often a time that now adults like women

Menopause: Cause And Amplifier

Dr. Lori Davis 10:41

in midlife now see this often with their kids. Is the kid achieving flight? Is the kid getting a job? Um, is the kid still living at home? Like, and kind of that worry about um about kids and often using the words like my child is anxious or my child has ADHD, or it's used so freely, like I'm amazed because we just didn't have that. So I think that there was very little information. In fact, when I went to the bookstore, I said I tried to read everything I could. First of all, there was no um, there was no Google.

unknown 11:13

There was no Google.

Dr. Lori Davis 11:14

So whatever you could find to read, you went to a bookstore, right? And so I would walk around looking for books about anxiety. And I remember there was one book called The Anxiety Disease, and it was like a groundbreaking book. And I I read it like 10 times, you know, because it was like putting words to my experience. But now, you know, you can go, you can go to Barnes Noble or go on Amazon. I mean, you you know how many books there are on mental health and anxiety and nutrition and health. And I mean, there's so much available that's almost dizzying, like what had you know, try to filter what's good. Back then there was hardly anything. So, you know, I appreciate how much uh focus on mental health has has changed. Yeah. Oh gosh. Um, and I think, you know, for women going through midlife, I'm so thrilled also that the guidelines around

Same Symptoms, Different Meanings

Dr. Lori Davis 12:07

menopause are changing and the HRT thing, and like, you know, it it's only a positive thing. Yeah. It only can be a positive thing.

Michele Folan 12:15

We have so much more than our mothers had. Yes. You know, the resources that we have are so much better.

Speaker 2 12:20

Yeah.

Michele Folan 12:21

I'm gonna take a real quick break, and then when we come back, I want to talk about from a clinical perspective where anxiety comes from. Quick pause because if you're here, you already know this isn't just a health podcast. Yes, we talk about nutrition, strength, and taking care of your body and midlife, but we also talk about life, relationships, energy, boundaries, and what really matters in this season. This isn't about perfection or shrinking yourself. It's about staying strong, curious, connected, and actually enjoying the years ahead. If this resonates, share the episode with a friend who'd appreciate the conversation and follow us on Instagram at asking for a friend underscore pod. All right, we're back. Dr. Davis, how do genetics, early life experience, and then nervous system wiring contribute to anxiety?

Dr. Lori Davis 13:23

So that's really an excellent question. And uh people often ask that, you know, why do I have anxiety? You know, I don't like it. Why do I have it? So having anxiety really comes from varied places. It comes from, in part, biology. Studies do show that if you have a close relative

Generalized Worry And Rumination

Dr. Lori Davis 13:41

who has anxiety, uh, you have a higher likelihood of having anxiety yourself. That is true. It comes from early experiences, people who have uh early loss, maybe of a parent, childhood illness. They there's early trauma. They suffered, uh they were part of a natural disaster, you know, they were surrounded by domestic violence, right? They were this, you know, uh the victim of uh violence, interpersonal violence in some way. So there are those early experiences that combine with your biology. So not everyone who has these experiences are necessarily going to become an anxious person. They may become scattered, they may shut down, you know. So some people kind of veer toward anxiety. So there is a physiological component combined with your early experiences. There's a third piece, though, which I think is something worth exploring for everyone. And um, there are some exercises I have in my book about that. What early messages did you get about your feelings? So we all internalize things, messages we got. Like for some people who have like generalized anxiety or health anxiety, they got messages, not to blame any parents, just no one's perfect here. No one's a robot. They got messages, the world is a dangerous place. Be careful when you cross the street, be careful when you do this. This could happen. They're so worried about the well-being of their kids, they might at times overdo it, right? Or over monitor the kids' behavior. So there's a message the world's dangerous. You really have to be on the lookout all the time. So that can kind of kick up feelings of anxiety, or just push through your feelings, you know,

The Worry Loop And How To Interrupt It

Dr. Lori Davis 15:20

like there's no such thing as anxiety. Like forget about anger. Like, so bury your feelings. Burying one's feelings, eventually you're gonna hit a wall with that big time, right? Right. Where the feelings are gonna get the better of you and you're gonna start to get panic attacks or depressed or angry, and it's you're gonna hit a wall. You can't do that forever. So early messages about feelings. And and anyone who's listening now, ask yourself, what messages did I get about my feelings? What messages did I get about the world as a safe place? About relationships, what messages did I get about that? They're wonderful, but yeah, you can have some problems, or relationships are like it's too chaotic. So we all we're like sponges. Kids soak up everything in their environment naturally, because they want to know what's going on. So those three pieces combined can conspire to cause anxiety in certain individuals.

Michele Folan 16:15

So then how does menopause change the nervous system? Because I guess I'm trying to vet whether or not if you view menopause as causing anxiety, or is it more an unmasking or intensifying of existing vulnerability?

Dr. Lori Davis 16:35

Yeah, I think it's both. Okay. I think both are really important. So obviously, with the decrease of certain hormones, that completely disrupts sleep. Not having sleep causes irritability. It causes worry. I'm not sleeping. Am I going to be able to perform well, get my job done, take care of the kids? Um, I have a to-do list that's really long. So

Mornings, Evenings, And Cortisol

Dr. Lori Davis 16:59

certain um again, hormonal changes, even about the body, you know, what's happening to me? I look in the mirror, I don't recognize myself anymore. I'm changing. This is too much for me. I feel overwhelmed. So I think that the literal changes from menopause, what you're talking about, can cause anxiety. I also think that underlying issues re-emerge. During midlife, there's a big there's an evaluation, like, where am I? Am I happy in my job if someone is working and has a career? Am I happy not working? You know, not to say that um being a homemaker isn't work, it is, but you know, am I happy with where I'm at basically? Am I happy in my relationships? Do I want to be living where I'm living? So there's another piece about midlife itself that I think causes women going through in this age range to reevalu everything, and then that causes anxiety. So you talk about chicken and egg. I think they're both working in tandem. There are physiological changes, neurotransmitters change. The brain also, you know, be bet starting around, you know, 40s, the brain also starts to change. Our memories, you

Breathing And Calming Techniques

Dr. Lori Davis 18:12

know, part of that's menopause, part of it is aging. Our brains start to slow down. We don't, you know, we don't process as quickly. So we feel the changes we can't remember. Some of that's again from biological changes during menopause, and some of it's just phase of life. So I think there's so much that's working at the same time that you can't get an exact answer. So I think they're both causing um things. The that underlying vulnerability for sure. If you're perfectionistic by nature, right, and all of a sudden these um your memory's not as sharp, or you know, you wake up in the morning, you're like, I'm so tired. Like, I need more coffee, which also makes you more anxious, by the way. I know if you drink too much coffee. We and I fall into that trap all the time. Some days I'm much I'm better than others. So you feel tired, right? You can't perform, your brain's not working the same way, then that causes you worry. If you're perfectionistic and that's your underlying way of coping, and that gets disrupted, and you feel like you're not handling things as well, then that just kind of makes you more worried. So you see, all these things are working together. If you are a person who's a doer and all of a sudden you don't get out of the house anymore, right? You're not happy with where you're at. Well, being in the house can cause um anxiety because you need to be out and engaged with the world. So there are so many pieces to this.

Michele Folan 19:32

Oh gosh. And then do you think anxiety presents differently in say post-menopause or menopause than it does when, say, you're 14? Do we respond to it differently?

Dr. Lori Davis 19:45

That's an interesting question. I think how what what attributions we make about it are different. The symptoms of anxiety are the symptoms of anxiety, right? So if you if you look in a diagnostic book, so heart racing, tightness in the chest, stomach ache, irritability, feeling on edge, can't

Comfort TV And Personal Soothers

Dr. Lori Davis 20:04

concentrate, right? Feeling like your head spinning, um, numbness and tingling, right? Feeling spacey, like those are the those are symptoms of anxiety. Those are universal, whether you're 13 or whether you're 50. Like those are the symptoms. What we think about them is different. Like when woman is in midlife, it might be like, oh no, you know, who am I now? Like, what's happening to me? I have no control over everything. I'm not, you know, I don't know if a 13-year-old is like, oh, I don't have control over this, or you know, they're just sort of like trying to deal with their symptoms, or maybe tell hopefully they can tell their parents about it, right? Something doesn't feel right, or hopefully someone at school will notice something. But I think as women, we're so wired to be achievers. You know, it's like way too much at this point, right? We're like constantly pushing. It's we don't rest enough, we don't relax enough. Like that's really important too. So I think we make these attributions. Uh-oh, something's wrong. I'm not productive enough. I'm not functioning. My memory's going out the window. I can't find anything. You know, I'm not the person I was. Who am I anyway? You know, there's just so much static around that at this point in life. So how we think about it, I think, is very different.

Michele Folan 21:17

Right.

First-Line Treatments: Exposure And CBT

Michele Folan 21:20

Yeah, there's a lot. There's a lot of layers there. And then and then it's like, is am I, is, am I truly anxious, or is it that my hormones are wacky? And then you've got that whole layer of of concern as well. There are many forms of anxiety. I know generalized worry, there's panic, there's health anxiety, relationship anxiety, social travel.

Dr. Lori Davis 21:48

Travel phobia, yes. But there's there's f specific phobias like fear of dogs or snakes or what yeah. So there are basic phobias too. Yes.

Michele Folan 21:57

Do you see something more often? In in these women?

Dr. Lori Davis 22:01

The thing I see most in since we're speaking about kind of midlife is kind of that generalized anxiety. Generalized anxiety disorder is sort of like that worry, the constant worry. What if this happens? What if this doesn't happen? And then the desire to fix it somehow, like, okay, let me make it happen, or it's what if this happens to my kid? What if someone gets sick? What if I can't handle it all? These huge questions, right? This generalized worry. When you have worries that are that big, it's very hard to figure out what to do for them because they're so big in your head. It's like a mushroom cloud over your head. If you break down things into smaller pieces, then you can come up with strategies and plans and set goals and follow through. But I do see this big worry. Where am I going in life? What do I want? Who am I? What's going to happen to my kids? Are they going to be okay? It's so big. And sometimes with that comes panic. Um, sometimes not. Sometimes it's just a boatload of worry and you can't turn it off.

Michele Folan 23:01

Yeah.

Dr. Lori Davis 23:02

Like it's just ruminating, you know, ruminating worry all the time.

Michele Folan 23:05

And then what about the patient that says, I know I'm anxious, but I just don't know what I'm anxious about?

Dr. Lori Davis 23:12

Yeah.

Michele Folan 23:13

It it it comes out of nowhere.

Dr. Lori Davis 23:15

Yeah.

Michele Folan 23:15

Kind of.

Dr. Lori Davis 23:16

Yeah. That's that's an interesting phenomenon. Um, because, you know, when people come into therapy, for example, I always ask, like, why are you coming into treatment now? You know, and they're like, because I just have panic attacks, and I'm like, well, what's going on? I don't know. My life is the same. It's the same as it's been the last two years. Why I don't know why I'm getting panicky

Advances And Why Anxiety Exists

Dr. Lori Davis 23:36

now. And I usually say, it there's a stockpiling effect. Like, we all deal with stressors, we tuck away what we can, we manage the best we can. And I think people, like I said, people hit a wall sometimes. So they're like, but nothing happened like, you know, this past year. So I think, yes, some of it could be menopausal changes, bodily changes, brain changes, of course. But some of it is the coping strategies you're not that you've been using for a long time are not working so well, like avoiding your feelings, right? Or not seeing your friends anymore, or being able to approach large issues that are kind of getting at you anyway, like, do I want to relocate? Do I want to switch careers? Right? Am I again, am I happy in a relationship? You know, and

Normalize Midlife Anxiety

Dr. Lori Davis 24:23

so if you don't deal with those underlying pieces, you can find yourself all of a sudden panicking and peep feeling really worried. And that's why people are baffled. Like, why is this happening now? Even good things can cause anxiety. Like, you know, kids getting married, like that's a really happy event. But it's like a lot of juggling, and um, there's financial issues, there's you know, there's so much loaded in that. So even happy stuff in life, job promotions, anything like that, can people discount that? Happy things also cause anxiety because it's a change, and people don't respond well to change, even if it's change they want, or it's re it's affirming, it's still change, and and people can get really thrown off when there's a lot of change. So people minimize the good stuff that that can cause you distress too. Yeah. Oh, well, I should just be really happy because this is happening. Well, okay, well, now I have to fork

Dr. Davis’s Self-Care Toolkit

Dr. Lori Davis 25:21

over this much money for like an engagement party. You know what I mean? Like it's it's not just things are just not one way or the other, you know. And um, so I think people can be mystified.

Michele Folan 25:31

Yeah, I'm I'm only laughing because I've watched my sisters go through this with wedding planning. And I'm like, I am not in a hurry for my children to get to get married. So you you do talk about this thing called the worry loop. Is that kind of the same thing where it it's hard to break off that hamster wheel?

Dr. Lori Davis 25:53

Yeah, I think that um once people get caught up with a particular worry, it kind of takes on a life of its own. It kind of grows and then it's sort of like, yeah, it's like whether you want to think of it as a hamster wheel or a carousel ride, like you can't get off. It keeps going round and round and round, and it becomes this worry loop that doesn't stop. And I think that's when it's important to think about literal strategies. How do you stop that loop? Uh, and that can range from which I do is I like I put I click the microphone on my iPhone and I go, okay, I'm doing worry time. And I go, I'm really worried about this, and what if this happens and what doesn't happen? And I give myself carte blanche to just like let it rip, just get all the worries out. And I set a timer and I do that for a few minutes and I feel some relief. It just allows me to not bottle it up, to get it out, and then I shift to a different activity. So that's one way to break the worry loop. Another way is breaking the worry down, as I mentioned earlier, into smaller pieces. Like if you're worried about uh you want to change careers, it's so big. You break it down into what are some early steps I can do? And I know you

Book, Resources, And Where To Find More

Dr. Lori Davis 27:06

do coaching and stuff about things, you understand this, like, okay, what's the thing you can do this week? You can go online and read about different careers. That's it. So it's a way to manage the worry, make it smaller with actionable steps. So there are a number of ways to break that worry loop because just telling yourself, oh, stop worrying, like that doesn't do anything. Or invalidating your worry, what's wrong with you? Why are you worrying about this? Get over it. Like, you know, other people are doing better. What's wrong with you? Like, that's just negative self-talk. Right. That's like this art from I call that negative trash talk. Like that's not helping you in any way. So there are different ways to break that worry loop, but it's very, very common. We all have our loops, whenever that's how we do.

Michele Folan 27:48

I'm sitting here nodding. Yeah, Davis is sitting here talking. I'm like, yep, yep, yep, yep, yep. Yeah. Yeah, if it's not me, it's somebody I know. It's everyone. Yeah. I know. And then women often say that their anxiety is worse at night. Is there a clinical reason for that?

Dr. Lori Davis 28:07

It's interesting. Some studies show that actually cortisol, which is our primary stress hormone, is actually highest in the morning. So there are a lot of women who report when they wake up being flooded with anxiety

Closing Gratitude And Newsletter

Dr. Lori Davis 28:20

to the point that it's hard to get out of bed, or they jump out of bed and have to get an action right away. So studies do show early morning actually can be a difficult time. But I would say that behaviorally, the evening is tough for a lot of people because you are we're also scheduled during the day that you're in the zone. I have to wake up, do this for my family, go to work, or you run errands, make dinner, whatever it is, work out, find time for everything. And then at night, you've got breathing room, and then things can come flooding in, you know, your underlying thoughts and feelings. So when you have time to sit still and you're not attending to it earlier, then there it is. Yeah. It's coming in. And when you get into bed, for example, that's a time to take it down. Your brain's still going, especially during menopause, the brain doesn't shut off. So then you kind of get flooded with anxiety at night. Uh, and that's also why it's so important at night to try to take it down by like not watching too much news, especially now, trying to watch, watch a funny uh sitcom on Netflix for 30 minutes, or stare at the wall, or snuggle with your pet or your loved one, or do something that's going to help bring your nervous system down. Uh, do some gentle, I did gentle stretching, open up, open up the hip flexors, the lower back that get really tense, you know, kind of take a warm bath, take it all down, which can then help take the busy mind down as well. But there's more time to think at night. Yeah. When you're supposed to be relaxing. When you're quiet. Sometimes people get anxious. They're not, they're not in their usual habit. They have all the time in the world to be like contemplating the universe, you know.

Michele Folan 30:01

Well, I tried uh deep breathing exercises. Those those help me any anything that where I have to count. So I don't think about what I have to do the next day. I just I'm counting.

Dr. Lori Davis 30:13

Which ones do you like?

Michele Folan 30:15

Um, I I breathe in for eight, hold for seven, exhale for four. Right, yeah.

Dr. Lori Davis 30:22

Like a four, seven, eight breathing. Yeah, that's a that's an easy one. That's a really good one, actually. I do that one too. And box breathing is super easy.

Michele Folan 30:30

Yeah. And can you explain what box breathing is for anyone that doesn't know what that is?

Dr. Lori Davis 30:34

Yeah, this is like this is like the easiest thing to remember. It's like you breathe in for four, hold for four, breathe out for four, and hold it for four more, and you just do it like five to ten times. All these things, right? They reset your nervous system, they give your brain a rest. It feels like something you can control. I do, I do uh box breathing before bed every night, every single night. It takes no time. And I find myself just like it just bring, you know how the breathing is, it's just because we breathe we we breathe from from the top of our chest when we're anxious and running around. And you know, we don't have time to breathe sometimes. And so it forces you, as you know, you start breathing from the diaphragm, which is here. Shallow breathing is coming from here. And that can cause you to get more stressed instead of taking it down. So a box breathing, any any type of breathing, any um leaves on a stream exercise is a really good visualization exercise. You take your worries and you put them on a leaf and then you visualize it going down the stream. It's like, bye-bye, worry. And then you take the next worry out of your head and you put it on a leaf, and then it's going down the stream. Bye-bye, worry. And these are just ways to cause a distraction, a delay, and also to feel like you're doing something. And it makes it can make you feel like, yeah, I'm I'm really affecting some change here. They were these strategies do work, you know, but you you have to do them kind of regularly. Yeah.

Michele Folan 32:11

And you had uh done a post or real recently, and you mentioned this a little bit earlier, but that you watching old reruns, that predictability, that kind of it's that mindless. It's kind of why like I I watch HD TV at night because they're they've got money and they're going to buy a house.

Dr. Lori Davis 32:33

I mean, it's it's I used to love I used to love house hunters years ago. Like I never missed it.

Michele Folan 32:38

Yeah, I watch House Hunters all the time. And I know most sleep experts will tell you not to watch TV at night because of the blue light, whatever. But we watch, I can't tell you how many times we've watched reruns of The Sopranos. Now, Sopranos in itself is not a relaxing show to watch, but we've seen it so many times. It it's the predictability piece. Does that really work?

Dr. Lori Davis 33:03

Uh, I think it works for many people. I I think it works for me. Yeah, I agree. Look, like watching, you know, violent movies before you go to bed is probably not a good idea. But the familiarity piece, I think, is is there's really something to it. Like a few months ago, I had I was working on the book, and I was like, I had a lot of work to do between that and my practice. So I just decided to watch the whole series of Sex in the City, uh, the origin, you know, the original series. And I watched it every night because I knew exactly what was going to happen. I knew who the people were, I knew when I was gonna laugh, I knew when I was gonna feel sad or whatever. I found it so comforting. And there are people who also, to your point, watch. Um I've met a lot of people who watch Law and Order for some reason, like two in the morning if they can't sleep. And my first reaction was like, well, that's like crime stuff. Like that's they said, but I know I it's like seeing a family on TV. Like, I know all those people and I know all the episodes. So if it works for you, great. For other people, it's it can be stimulating. I think there's no one size fits all about worry and anxiety treatment and you know, stress management. If it works for you, good, great, keep doing it. If it doesn't work, just acknowledge it and try something else.

Michele Folan 34:18

And what are first line treatments for anxiety? How do you match the patient up to where to begin? That's a good question.

Dr. Lori Davis 34:26

There are some patients who come in where they're really in a panic and it's hard for them to function and get through the day-to-day. So there may be a sort of a conversation about, you know, do you do you want to think about medication? I'm very middle of the road about medication. I think a lot of anxiety can be treated without medication, but I'm not anti-medication. So sometimes medication is a piece of it to help stabilize someone's symptoms. And I think people can often say negative things about themselves. Why can't I do this on my own? Why do I have to rely on medication? And I think it's sort of part of being, you know, we get mean mean to ourselves. And I think sometimes it can help someone stabilize enough to then do the deeper work about what the heck is going on in my life right now. But the first line treatment really is uh for anxiety is um exposure work. That's the gold standard, which is basically if you start getting anxious and you are avoiding things, if you're saying no to social invitations and you don't want to see your friends anymore, or you're having trouble driving or flying, the goal is for you to get back out there, expose yourself to the fear. When you can approach your fears little by little, your anxiety gets kicked up. That's true. You're gonna get more anxious. And as long as you keep approaching, your anxiety will start to come down and stay down. So, so that exposure work is key for reducing anxiety and having it stay low. And it really studies have shown there's a lot, there's there's so much research in support of that. The other piece is we all have thought patterns around anxiety. So cognitive behavioral therapies is also the other piece to it, which is if you go on a job interview and you think no one's ever gonna hire me, see, this is never gonna work out, you know, like this self-fulfilling prophecy, not that it's your fault, but we get into thought patterns that aren't necessarily true. Like maybe you're not getting hired because the job market isn't great right now, or the economy stinks, right? Right? Or maybe you're older and there's an age discrimination, like maybe there's a real issue here. I think we get we get caught up in these explanations that may not be totally true. Like my friends don't like me anymore. I hear this a lot. Well, is it true that they don't like you anymore, or they're really busy, you know, they're they're you know, they're busy with their family, or there's some problem going on that they're dealing with. Is it is it necessarily because they don't like you anymore? So it's challenging the thoughts that people have because we have faulty thoughts. We have faulty thought patterns, right? Um people say, yeah, I I I'm not attractive anymore, right? Or um is that really true? Or you have you're experiencing some bodily changes from menopause or perimenopause, right? Does that mean you're not attractive? No, maybe it means you need to lift some weights or right or get a larger size clothing for a while, but does it mean you're not attractive? You know, so we all go to these places. And part of the therapy is challenging those thoughts and creating a more realistic portrait of what's really going on. Because we can go to very big places. Um, so it's challenging the thoughts, looking at faulty patterns. We all do it combined with approaching your fears. And people say, Michelle, like, I don't want to approach my fears. Like, if I'm afraid of like going through tunnels or going on bridges, why the heck would I want to do that? It's supremely uncomfortable. Why do I want to torture myself? If you don't, then the anxiety will remain, but it won't get better. So there is a little bit of um there has to be some pain before the gain, like it's gonna be uncomfortable, but it works because we're a little bit like laboratory rats. You have to approach, it's conditioning. If you start avoiding things, you're just feeding anxiety. So those are kind of main treatments for anxiety. This old-fashioned talk therapy, going for support, exploring your childhood, um, talking about relationships like that counts too. So there are a number of ways to approach um anxiety and and therapy and depression and and um self-esteem and and also just dealing with midlife and change.

unknown 38:40

Right.

Michele Folan 38:40

And then are there advances in anxiety treatment that you're seeing now and on the horizon?

Dr. Lori Davis 38:48

There are um, and I'm not an expert in in this area of of research, but they're looking at things like changes in the brain and stimulating the brain and new medications and uh new types of therapies. So I think that there's been some advancement in terms of um seeing anxiety markers genetically, which I read about, I don't know, with sometime within the past year, which is interesting because if they can identify kind of those uh those markers, maybe they can do something about that. Uh we've been, you know, we're wired to be anxious. We need anxiety because it helped it helps us survive. Survive. Like if someone's chasing you down the street, you know, like uh, or if you like were in the cave and you know, you could die, like anxiety helped you be alert, right? It tells you like fight or flight or freeze, or you know, you're trying you're trying to save yourself. And so that anxiety kind of then applies to our lives today. Like you someone, a grizzly bear might not be chasing you, but you might be perceiving some threat in your life. It could be an emotional threat. So I think there are advancements sort of genetically. People are looking at that. I think there's a lot of research on family history and how much that may relate to the development of anxiety. So I think there's a lot of research going on about anxiety. Um, how that will, what that will look like, you know, five years from now, I'm not totally sure. But people are really working on it, and I think that's very encouraging. But anxiety is always going to be part of the human condition because we need it. It's always gonna be there, right? It's really just managing it. And when the alarm bell kicks off too much, uh-oh, uh-oh, that's when you might develop sort of like an anxiety disorder.

Michele Folan 40:33

All right. And, you know, we know that women, as our estrogen declines, cortisol does kick up. And so for women that have started experiencing anxiety and they it's they feel like it's coming out of nowhere, just for them to understand that they're not broken, that this this is sometimes a very normal part of menopause, correct?

Dr. Lori Davis 40:58

It it is, it is. And I think, you know, a phrase that I think has been helpful to me and sometimes to others is expect it, accept it. Anxiety is not ever look, not everyone gets a kick up in anxiety during menopause, but I know a fair amount of people who've had that experience for whatever reason. Yeah, understand that it it is a part, it is a combination of body and brain changes and life changes and re-evaluation. And if you can accept that and normalize it for yourself, then you can figure out what to do for yourself instead of fighting it. Oh no, I shouldn't be anxious. Oh no, what's wrong with me? You know, the things that again, the mean things we say to ourselves. So I think that um it is a part, anxiety is a part of this time of life. And people are shocked. What happened? One day I was fine. The next minute I heard someone talk about they were in the car and they were driving to work. Next thing you know, boom. They're panicking and they're like, What what happened? All of a sudden everything feels different. Well, yeah, you know, things are changing physiologically.

Michele Folan 42:10

Yeah.

Dr. Lori Davis 42:11

So, um, yeah.

Michele Folan 42:13

So I'm curious, this is kind of a personal question. What is one of your core self-care must-haves? How do you manage your day?

Dr. Lori Davis 42:23

It's a good question. Um, I do a couple of different things, and I always encourage people to engage in trial and error. And part of the thing that I write about in my book is like, here are a bunch of different things that might work for you. Use a combination of them. If it doesn't work, no sweat. Don't be down on yourself, not everything's gonna work. So the things that work for me are if I'm really anxious, I do take a warm bath a lot. Not hot baths because during menopause, right, if the water's too hot, it's gonna dry out your skin, like our skin changes. Um, don't, you know, don't have your phone right next to the bathtub where you're checking social media or the news while you're trying to take a bath. So a warm bath, 15 minutes, helps relax. It also gives you a timeout. And so that's one thing I do. I, as I said, I do box breathing at least once a day, probably a few days. If I'm super anxious, so this is kind of embarrassing, but like when I'm traveling, I have a mini heating pad. I take the heating pad and I pack it. And so if I'm feeling really anxious, I turn on the heating pad and I just put my hands under the heating pad. And just the warmth kind of and some breathing, it just kind of relaxes me. So that's one thing that works for me. Um, I actually a bottle of cold water, you know, like I I can get sort of socially anxious or I can get nervous doing interviews and stuff. So sometimes I'll have a bottle of cold water or like a stress ball or something like that. So I do that. Um, I try to talk to a friend. If I'm really anxious, I will call a friend and say, tell me about. About your day because it gets me out of my experience. Maybe I've and maybe I can offer something up, or maybe we just laugh about something silly. Um, I do watch silly pet videos on social media. Not that pets are silly because I love pets and snuggling with pets is a great thing. But watching silly videos, just like watching silly sitcoms, I also like dramas. I'll get absorbed in a drama. But yeah, watching the videos, I've definitely cut my news consumption a lot. Okay. And that has definitely helped. Like 20 minutes in the morning and then maybe 20 minutes at night, and that's it. Because it's diminishing returns. You're gonna get all worked up. The news is still gonna be waiting for you. And if something huge happens, believe me, someone's gonna tell you.

Michele Folan 44:40

You'll know about it.

Dr. Lori Davis 44:41

You'll know about it. That is a big change, you know, that I've made. There are so many things I do. I do a lot of gentle stretching, light yoga, and that helps me a lot. Just like I said, keeping the chest area open. We often sit like this, you know, we're so busy, we're like the shoulders are up, you know, we're leaning forward on our phones. So, like bodily, that makes you more anxious. So doing body checks, shoulders back, making sure like they're back here, not here. I because I'm definitely scrunching up my neck, tightening my tummy, you know. So I do visualization exercises too. I imagine safe space. My safe being on the beach late afternoon, no one's there. There's maybe a gull ahead, the sand is warm, and it's just quiet, and I imagine myself there for three minutes. That's called the safe space visualization works beautifully. There are so many strategies, and some of them really work for me. I do challenge my thoughts. I do break problems, big problems into smaller pieces and then come up with an action plan. Um, and I try not to make my to-do list too long because you know, sometimes they're like the size of your living room, all the things you have to do. So I go, all right, what do I literally need to do today? What's the necessary thing? And then I have a longer list. Like these are things I need to do in the next few weeks, right? Someone's birthday's coming up, I need to get a gift or whatever. But what do I need to do today? Make it smaller. You the thing when things are too big, it's like, ah, I just want to like escape or I can't handle this. Make everything smaller.

Michele Folan 46:13

Yeah. How do you uh eat an elephant one bite at a time? And that's yeah, absolutely. Yeah. All right, Dr. Lori Davis, where can the listeners find your work and learn more about your book? This is your anxiety on menopause. Yes.

Dr. Lori Davis 46:30

So um, I have my Instagram account at Dr. Laurie Davis where I talk about I have anxiety too, because I do. And so I try to provide tips and strategies and inspiration for living with anxiety and being productive and having a meaningful life despite anxiety. And I'm on Facebook as well, Dr. Laurie Davis. Um, my book is coming out actually in November. Um, New Harbiger Publications, they've been great, and they do a lot of psychology books, and it's a workbook. So there are tons of exercises to write in, write letters. Um, I really break it down into here's how to do this, try this, try that, and help you come up with your personalized anxiety plan. Not everybody can afford to go to therapy. Right. Or you can go to therapy and use a workbook. So the fact that you want to make it accessible to more people, that's a lot of what my book is about. So they can find my book in November, it should be on Amazon and Barnes and Noble or whatever. And I'll probably be giving some talks about it. And um, I do all the things in the book. Like this is stuff I've tried, everything in the book, and it's all evidence-based, all research, but I've lived it all.

Michele Folan 47:39

Yeah, this is fantastic. And I want to make sure that when your book does come out in November, you ping me so that I make sure we tie the bow around this with this conversation and and your book launch because that's absolutely and then we can talk about it. Yeah. So yeah, this is exciting. We can do a live or something, but I I would love I would love to do that.

Dr. Lori Davis 48:01

That would be great.

Michele Folan 48:02

I really enjoyed this conversation, Dr. Davis. Um, I it just really normalizes this for women at this phase of life. And I really hope that even if you listeners may not feel that anxiety is is daunting you, but maybe someone in your life is that you uh pass this episode on to them.

Dr. Lori Davis 48:26

Thank you. Help is available, definitely.

Michele Folan 48:29

Yeah, thank you for being here today. Thanks, Michelle. Have a great day. You too. Bye. Before you go, thank you for being here. If you want to go a little deeper, make sure you check out the show notes for this episode. That's where I link anything we mentioned, resources, partners, or tools I actually use and trust. And if you're not already on the Asking for a Friend community newsletter, that's where I share practical midlife tips, favorite finds, recipes, and the things that don't always make it onto the podcast or Instagram. You'll find the link to join in the show notes. Take care, and I'll see you next week.