There is something I have observed throughout my years of clinical practice that I believe every woman in her forties — and the people who love her — deserves to understand. The emotional upheaval so many women experience during this decade is not a response to their lives falling apart. In most cases, it is a response to a profound hormonal transition that no one warned them was coming. What Is Actually Happening Perimenopause can begin as early as the late thirties. Many

Why You Are Not Falling Apart. I want to tell you something that women reaching their mid-forties need to hear. What you are experiencing has a name. It has a physiological explanation. And it does not mean you are falling apart.

What Happened With Lori? There is a moment I have witnessed many times across my many years of clinical practice — a moment when a woman sitting across from me hears, perhaps for the first time, a coherent explanation for what she has been experiencing. Her face shifts. Relief and disbelief arrive together, as if they have been waiting just outside the door. This is what happened with Lori. She came to me at forty-five — severely depressed, highly anxious, unable to sleep, an

What inspired you to write The Fifth Decade: Is It Just My Life or Is It Perimenopause? I became inspired to write The Fifth Decade when I saw women struggling with the perimenopausal transition without the benefit of understanding what was happening to them. There was some information available on the physiological changes women experience, but too many people thought of menopause as something that happens to older women and is primarily about hot flashes. Women, and their f

"Why am I here?" he asked. "Are you asking why you are alive?" I responded. For ninety-seven years, her father had been a man of action, not words. Emotions lived in what she came to think of as his vault—a place so deeply protected that even he seemed to have forgotten the combination. He was stoic, traditional, someone who showed love through providing and protecting, not through emotional expression. Then The Thief arrived; a relentless degenerative illness that systematic

"Grief is the other side of the coin that is love. You can't have love without grief." When she spoke these words to her father, she was struggling with the overwhelming sadness of watching him decline. Every day brought new losses, new dependencies, new reminders that the strong man who had shaped her entire understanding of security was slowly disappearing. She questioned the nature of suffering, unsure of how to understand what his subjective experience was. Was he sufferi

There is a moment when you realize your parent is no longer your protector — you are theirs. “I was walking beside my 95-year-old father as we made our way back from the restroom during a family vacation when I noticed it — evidence that his body had betrayed him in the most basic way. Confused and concerned about how to manage this difficult situation, I did all I could think of in the moment. I quickened my pace and positioned myself directly in front of him, creating a h

I decided to create this space to afford an opportunity for conversations about emotional health, identity, change, resilience, and the complicated seasons of life that often arrive without a roadmap. Many people quietly struggle through experiences that can feel isolating or difficult to explain: • the emotional and psychological impact of perimenopause and midlife transitions • caregiving, grief, and chronic or degenerative illness • changes in relationships, family role