Perimenopause mood changes are biological, not just psychological
Haver presents the shift from viewing perimenopausal anxiety, insomnia, and mood swings as psychological or stress-related to understanding them as biologically driven by hormonal changes, supported by new research.
Why this matters: This directly challenges decades of medical training that framed women's midlife mental health complaints as somatization or personality flaws, and it reframes the historical use of sedatives like barbiturates as a silencing of biological symptoms.
For decades, the medical establishment often dismissed perimenopausal mood symptoms as 'excessive stress,' 'unresolved trauma,' or the opinion that women are 'just unhappy at this age.' Haver's mother was prescribed a barbiturate—a central nervous system depressant—rather than being offered hormone evaluation or support, exemplifying a pattern of pathologizing and medicating women's distress without addressing underlying biology.
Haver recounts how her mother, in her 40s, was given butol (a barbiturate derivative of phenobarbital) to 'help her relax' while running a restaurant, raising eight children, grieving the death of her oldest son, and navigating a chaotic family life. No one discussed hormones or estrogen with her. Haver herself was trained in a medical system that taught that women tend to somatize emotions—that their symptoms were usually psychological. It took her years to untangle this bias. Now, she points to scientific research that demonstrates the cognitive and emotional aspects of perimenopause are biological, not character flaws. The hormonal changes of perimenopause directly affect mental health, and recognizing this is the lever to change clinical practice. She frames the old approach as a form of silencing: barbiturates literally suppress nerve impulses and cognitive function, quieting women rather than treating the root cause.
Haver shares a core memory of her mother holding the bottle of butol 'like a talisman,' the only thing tethering her to calm. She recalls her mother's nighttime roaming, mood swings, and overwhelming feelings. As a medical student, she learned what butol actually was—a barbiturate—and realized her mother had been prescribed a CNS depressant to manage grief, life stress, and likely perimenopause symptoms. She also describes her own journey of unlearning the dismissive attitudes ingrained during her medical training, where women's health complaints were routinely framed as psychological.
I realize now that her mental health was pathized, melicalized, and silenced. Quite literally silenced because barbaturen nerve impulses and cognitive function.