Perimenopause is a profound biological transition that marks the beginning of the end of a woman’s reproductive years. While many associate this phase with hot flashes and irregular periods, far less attention is given to the complex emotional and mental health changes that can arise as the many body-wide systems are impacted by hormone depletion. Typically high-functioning, already overwhelmed New York City women are caught off guard. For many, perimenopause is not just a hormonal shift but a neurological and psychological one, capable of reshaping how they think, feel, and relate to themselves and others.

My mental health is tanking—what’s happening to me?

So many women have no idea what is happening to them during perimenopause. They feel emotionally off-balance, disconnected, or unlike themselves—and often, they’re met with confusion or dismissal. Their doctors may be undereducated about the emotional and neurological dimensions of hormonal changes, or tell them they’re "too young" for hormone therapy. Many are left feeling brushed aside or undersupported. Compounding this is the reality that most mental health professionals receive little to no formal training on how hormonal transitions impact emotional well-being. This lack of awareness can leave women misdiagnosed, misunderstood, and unsure where to turn. In my Manhattan-based boutique psychotherapy practice, I regularly hear from high-functioning, high-achieving women who have been struggling in silence, unaware that their mental health challenges are rooted in hormonal change. Therapy that integrates an understanding of these transitions can be a game-changer—offering validation, regulation, and real tools for relief.

Some common reasons people reach out for therapy and counseling is to address their new or longstanding mental health challenges. Symptoms such as anxiety, depression, addiction, insomnia and lack of motivation are often so debilitating that they are unable to live the life they desire. In my experience, psychiatric medications are essential for many, and truly life saving. But for those who have not had success with traditional psychiatry, it’s worth considering the highly-effective natural solutions that are rarely offered in conventional medicine.

Many mental health symptoms are all indications that levels of neurotransmitters such as serotonin, GABA, and the catecholamines dopamine and norepinephrine (there are more) are low. This is otherwise known as neurotransmitter dysfunction or imbalance. There are four main neurotransmitters involved with mood and behavior, and they are: serotonin, GABA, endorphins and the catecholamines (dopamine/Norepinephrine). The main focus with Amino Acid Therapy in clinical practice is on the serotonin-catecholamine system. Low levels of each of these, lead to a very specific pattern of mental health symptoms. It’s important to know that there are many reasons why brains become depleted and imbalanced, such as, trauma, chronic stress, chronic pain, loss, poor nutrition, addiction, hormonal changes and genetic predisposition, and thankfully, there are effective and powerful ways to restore brain health.

Our bodies need amino acids to work properly, and they are crucial to metabolic function. Some amino acids are made by the body, and others come from your diet. Typically, when you consume a protein, your body breaks it down and what's left is the amino acid. Amino acids are precursors to neurotransmitters, and when these vital messengers are deficient or imbalanced, information is not relayed optimally in the brain, and symptoms arise. Amino acid therapy aims to heal and restore the brain to optimal functioning by supplementing what’s missing based on history, symptoms, behaviors and response to trial treatment.