If you have started feeling like a different person in your 40s – more irritable, more tearful, more flat, more reactive, less resilient, less recognisable to yourself – and you cannot fully explain why, this article is for you.

The mood changes of perimenopause are one of the least discussed and most disorienting aspects of this transition. Women describe feeling unfamiliar to themselves. Crying without obvious reason. Snapping at people they love. Losing pleasure in things that used to bring joy. Feeling flat where they used to feel engaged. Experiencing rage that surprises them. Carrying a low-grade sadness that does not quite reach the threshold of depression but does not lift either.

Most of these experiences are dismissed – by doctors, by family, by women themselves – as stress, midlife crisis, hormonal moodiness, or simply the demands of a busy life.

If anxiety has appeared in your 40s – or significantly intensified after years of being relatively manageable – and you cannot point to anything in your life that fully explains it, you are not alone, and you are not imagining it. This is one of the most common and most distressing experiences of perimenopause.

If you have noticed that stress hits you harder than it used to – that small things tip you over more easily, that you feel less resilient, that the recovery from a difficult day takes longer than it should – you are not imagining it. This is one of the most common experiences of perimenopause, and one of the least adequately explained.