Grief and Perimenopause: Why So Much Is Rising to the Surface Right Now
- Michaela Kozlik
- Nov 10, 2025
- 7 min read
Updated: 2 days ago
The grief that shows up in perimenopause doesn't always have a name or a clear object like a person, a loss, a specific thing you can point to and say that's what I'm grieving. It's more diffused than that. It can feel like heaviness or sadness that shows up in the car, in the shower, at night when the rest of the house is quiet and there's nothing between you and whatever is trying to surface.
And underneath it, for so many women, is a voice that says: don't go there. If I start feeling this, I might never stop.
I want to talk about that voice. Because I hear it often from the women who find their way to my practice in Illinois, and from the version of myself that had to learn, the hard way, that grief is not the ocean you drown in, but the passage you move through.
But first, let's talk about why it's showing up now.
Why Perimenopause Brings Grief to the Surface
If grief has been rising during perimenopause in ways that surprise you, there's a reason for that. And it has everything to do with what perimenopause actually does to your brain and nervous system.
As I explain in You're Not Losing Your Mind. You're in Perimenopause. the hormonal shifts of perimenopause directly affect the brain's capacity for emotional regulation. The coping strategies that helped you keep a lid on hard feelings start to become less reliable. The armor gets thinner.
And what's underneath starts to come up.
For many of us who have spent decades moving through life without fully stopping to grieve the losses, the disappointments, the things that nobody ever held space for, perimenopause has a way of bringing all of that forward because your system knows, on some level, that you can't carry this unprocessed weight into the next chapter of your life.
Add to that the very real, present-tense losses of midlife and perimenopause brings a lot of them including the sense of identity up for complete renegotiation... something I wrote about in depth in Who Am I Now? Navigating Identity Shifts in Perimenopause.
It's a season saturated with loss. And the grief that comes with all of it is real and valid and deserves to be met.
Why We're So Afraid to Go There
So many women tell me they're terrified of their own grief. And when I ask why, the answers are always some version of the same thing:
If I start crying I might never stop. I don't have time to fall apart. I should be over this by now. Other people have it so much worse. I can't afford to go there because I have too many people depending on me.
Sound familiar?
Here's where those messages usually come from. Many of us learned from the families we grew up in, from the culture around us, from the survival requirements of our lives that emotions were dangerous and strength meant holding it together.
We learned that grief was something to get through quickly and quietly, not something to actually feel. That if you started to really go into the pain, something would break and you'd never find your way back. And so we got very good at not going there and staying one step ahead of the feeling.
Perimenopause, as I wrote about in What Chronic Stress Is Actually Doing to Your Body makes that strategy much harder to maintain. The nervous system becomes more reactive, and our window of tolerance narrows. The things you've been outrunning start catching up.
What Unprocessed Grief Actually Does to You
Here's something worth knowing because it changes the way you think about what you might be experiencing right now.
Grief that doesn't get processed doesn't disappear. It lives in the body and shows up in other forms like anxiety, irritability, as exhaustion, as vague sense of emptiness. As the chronic stress and nervous system dysregulation I describe in detail here.
And grief doesn't only arise from the obvious losses. It also comes from the losses that nobody ever acknowledged as losses like you didn't receive as a child or the relationship that never became what you needed it to be, or maybe the version of yourself you had to suppress in order to belong or be loved.
These more subtle griefs are often the ones that surface most powerfully during perimenopause. And they are just as real and just as worthy of being held as any other loss.
Grief Is Not the Ocean You Drown In
I want to come back to that fear "if I go there, I might never come back" because it is so common and so worth addressing directly.
Grief is not a place you get lost in forever. It is a process that the body and nervous system actually know how to move through, when they feel safe enough to do so.
What I see in my work with women is that grief moves. You go into the wave, you feel what's there, and you come back to the shore. And each time you let yourself feel the thing and discover that you can survive the feeling, your nervous system learns something new. It learns: I can go there and come back. I can feel deeply and still find my way back to myself.
That learning is everything. It is the difference between grief that gets processed and integrated, and grief that gets stuck in the body and quietly runs your life from underneath.
The key is that this kind of grief work needs some sense of safety and support.
The Grief We Rarely Talk About in Midlife
There is a grief that is particular to perimenopause and midlife that I want to name specifically because it is so rarely given language and so many women carry it in silence.
It's the grief of a life that was lived partly on other people's terms. The grief of looking back and realizing how much of yourself you set aside, how many of your own needs, wants, and truths got quietly shelved in the service of being who everyone else needed you to be. How much energy went into managing and performing and accommodating and making yourself manageable.
This grief is not self-pity, but the most honest reckoning a woman can have with her own life and perimenopause tends to make it impossible to avoid.
And on the other side of it, is clarity and freedom to ask: what do I actually want? Who am I actually, when nobody is watching and nothing is required of me?
That question is the beginning of something. I wrote about it in Who Am I Now? Navigating Identity Shifts in Perimenopause. If it resonates, I'd encourage you to read it alongside this one.
How to Begin Without Diving Into the Deep End
If you've been afraid of your grief for a long time, you don't have to start by going all the way in. Healing happens in small, manageable moments — in doses your nervous system can actually tolerate and integrate.
Here are some gentle ways to begin:
Name what you've lost. Not just the obvious losses but all of them. Naming it is the first act of honoring it.
Notice what happens in your body. Where do you feel the grief? The tightness in your chest? The ache behind your sternum? The pull to look away? Try placing a hand there. Offer a slow breath. You don't have to fix it. Just meet it with a little bit of awareness and see what happens.
Let the waves come when they come. Grief has its own rhythm and it mostly knows what it needs. Try not to shut it down before it's finished.
Stop trying to move on and start moving with it. Our culture treats grief like a problem to solve... something to get over and get back to normal. But grief doesn't follow a timeline and it doesn't respond well to being rushed. Let it change shape as it needs to rather than forcing it to disappear on your schedule.
Rest. This one sounds simple and it's not. Grieving is actually metabolically demanding. It takes real energy. Your body needs time to recover and integrate. Rest is part of the process.
Find support. This is the most important one. Grieving alone, in isolation, almost always makes it harder. The nervous system needs relationship to fully process grief, it needs the co-regulation of another person who is not overwhelmed by what you're feeling and who can help you stay in the wave without going under. That is exactly what therapy and especially a therapy intensive, provides.
Why a Therapy Intensive Can Be So Powerful for Grief Work
Grief work, maybe more than any other kind of therapeutic work, needs time.
It needs time to build enough safety to actually go somewhere.
A therapy intensive gives us all of that. A half-day or full day of focused, uninterrupted work means we can move at the pace the grief actually needs. We can open things and close them properly.
If you're in perimenopause carrying years of unprocessed grief alongside the very real present-tense losses of midlife, this kind of immersive, sustained support can be the thing that finally moves what has been stuck for a very long time. Grief can be the passage to something more real in our lives. You don't lose yourself in grief, but actually find yourself in it. And you don't have to go there alone.
📞 773-343-5005 🌐 www.inpsychotherapy.com 📧 Michaela@inpsychotherapy.com
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