The Dr Louise Newson Podcast - 294 - Alcohol addiction and menopause: Rachel's story

Episode Date: February 4, 2025

Content advisory: this episode includes themes of mental health and suicide In this episode, Dr Louise Newson speaks with Rachel Birch, a doctor who shares her personal journey of menopause, mental health and alcohol addiction. Rachel discusses the lack of training on menopause in medical education, her experiences with anxiety and depression, how she found herself using alcohol as a coping mechanism and how she is navigating her recovery. Rachel emphasises the importance of self-advocacy, community support, and self-love in recovery. The conversation also highlights the need for better awareness and understanding of menopause and its impact on mental health. Rachel also shares the following advice if you find yourself struggling with addiction: Listen to your body and trust your instinct Be your own advocate – you know your body best Prevention is better than cure: be alert to drinking habits Don't suffer alone, reach out for help. Click here to find out more about Newson Health Contact the Samaritans for 24-hour, confidential support by calling 116 123 or email [e-mail].

Hello, I'm Dr Louise Newsome. I'm a GP and menopause specialist and I'm also the founder of the Neuson Health Menopause and Wellbeing Centre here in Stratford-Pon-Avon. I'm also the founder of the free Balance app. Each week on my podcast, join me and my special guests where we discuss all things perimenopause and menopause. We talk about the latest research, bust myths on menopause symptoms and treatments, and often share moving and always inspirational personal stories. This podcast is brought to you by the Newsome Health Group, which has clinics across the UK dedicated to providing individualised perimenopause and menopause care for all women. So today on the podcast, I'm very excited actually. I've got someone who I've known for a little while now. And unlike many of my guests, I met in real life when I was on my tour.

So she is a doctor called Rachel Birch. And she's got a very interesting, quite emotional story that she's happy to share about, and it does have a happy ending. I just hasten to add. So welcome, Rachel. Thanks so much for joining me today. Oh, thank you very much. I'm really excited to be here, actually. And I think the work you're doing is great. I love these podcasts. I'm an avid listener. And hopefully, you know, what I'm going to talk about today will help others. That's the aim. Yeah, well, I mean, I set up the podcast because it's just another forum, isn't it? And I feel it's such a privilege, actually, because my diary, as you know, is really busy. So to have time with people, understanding more, not just from people who are experts, leaders in their field, but also real people with real stories.

Because, as you know, Rachel, in medicine, you learn a lot from the data, from the studies, from the trials, from the academic papers. But actually the icing on the cake, which really changes our clinical practice, is clinical experience, listening and learning from patients and people. And that's the most privileged part of being a doctor, isn't it, is being allowed to listen to these stories. Well, absolutely. Yeah. I mean, I think almost everything that I learned really has come from patients, from listening to people. You know, you can learn, of course, what the books say, what the papers say, but, you know, how it translates to people's real lives. It's, you know, that's the important bit. Absolutely. And I'm very fortunate at the clinic that we have.

We have a lot of time. And the time is something that has gone so much, actually, over the last 25, 30 years of me being a doctor, is that people are so rushed and then you don't get the bigger picture. So tell me a bit about you, if you don't mind. Yeah. So, yeah, a little bit about me. Wow, what to say.

I'm 53. I'm a mum. I've got two children who are now 21 and 23. I am a doctor. I trained as a GP and worked as a GP happily for many, many years. Now I work for an organisation that actually supports doctors, which is equally rewarding as being a GP actually in different ways. Hobby-wise, I love cold water swimming.

I love Pilates. I've got two dogs that are very active and keep me out in nature. I practice Pilates, yeah, photography. Got a lot of interest, but one of my passion is, is menopause as well. And even within my workplace, I'm part of our menopause support network. You know, I'm passionate about mental health and I'm passionate about, you know, women's health. So, yeah, they're big interests of mine. Really. And probably like me, you didn't have much training about menopause and certainly

menopause and mental health when you were undergraduates. Goodness, no. No. As an undergraduate, honestly, the message was, you know, when women become menopause or their period stop. Like that was it back in those days. I think we're the same age. I qualified in 94. I think maybe you did too. Yes, I did. Certainly the same. Well, yeah, we probably had very similar training then. I mean, I think they didn't know as much. It's not that we weren't necessarily, it wasn't hidden from us. But, you know, I really think that, you know, we knew about hot flushes and night sweats. We knew that the periods could become erratic, could become more frequent, could become less frequent, you know, but ultimately would stop. And that was

it. You know, a woman was, you know, medical. that they called it post-menopause, didn't they back in the day. Yeah, mental health as well, you know, I mean, I did quite a lot of psychiatry training as an undergraduate. And, you know, there was really no mention of hormones and their relationship with mental health. So that wasn't really an issue I kind of really got until I became a GP and started seeing for myself, you know, that actually, you know, they were very closely linked hormonal health and mental health. you know, listening to people, listening to patients. Yeah, and I didn't realize either like you, I've done a lot of psychiatry, I've done a lot of general medicine, a lot of general practice,

but I didn't put the two together. And it's only the myriad of people we see who have actually come from psychiatrists. And they've treated as much as they can about their mental health, but they're still having symptoms as well as physical symptoms of menopause or hormonal changes. And then when we give them the right dose and type of hormones, everything fits into place. And then going back and reading papers, reading how these hormones work in our brain, reading how they affect the levels of, you know, serotonin, dopamine, our happy hormone, our reward hormone. You know, it's all there, but we just don't, if we don't teach it,

you don't know. So tell me a bit about your story. We said at the beginning that you had an interesting, but not unique story. And actually, I think it's more common than people led to believe. So tell me a bit about what happened with you, Rachel, if you don't mind. My story is not unique, actually. And also, you know, what I like to say is that, you know, when I was working as a GP, I probably heard this story fairly frequently, you know, and perhaps didn't really quite realize the implication of the story. So, you know, I think this story is a good one to share for women so that they appreciate, you know, what I went through. And, you know, for GPs as well, just, you know, to give another lived experience, you know,

and put that out there. I think I was about 44. I was working as a busy GP. I had teenage children. I'm a single mum. I became really anxious and it was almost overnight, you know. I mean, I'd been quite stable, quite sane. Suddenly I just became really anxious. I couldn't really put my finger on it. I just felt really on age, illities. I was getting really really. really horribly mood swings. They started to appear. They would occur over minutes. And again, mood swings is something I'd never really experienced before. So, you know, one minute I could be absolutely fine. The next bit I'd be snapping at the kids, you know, really losing their plot. I wasn't really doing this at work because I think you can maintain a kind of professional

persona, can't you? And you perhaps don't give in to your personal sort of feelings just quite so much. But at home, I think I was a horror. You know, I was. was snapping at the kids, I felt really down. The kids started calling me Volcano Mom, you know, and that was appalling. I couldn't believe that. Yeah, yeah, I felt for the kids because, you know, I realized, you know, I was doing it. You know, it would come from nowhere. I didn't really have any control. I was forgetting things. I couldn't think, you know, I just felt like I was losing my mind. I felt quite down. That came later, really. I think, you know, the mood swings and the anxiety were all there. And I just felt,

helpless and I thought, what is happening with me? I thought, have I got dementia? You know, it's very scary, isn't it? It was terrifying, actually. It was terrifying. And I talked to friends about it and nobody at the time had really sort of experienced anything similar. So I just thought, gosh, that's me. You know, what's happening? I think that's, you know, yeah, and that happens so much actually, Rachel, that people blame themselves. Yeah. Because if you don't understand what's happening. You know, you've already said you're single, anyone knows bringing up children can be very hard. Bringing them up on your own can be difficult too. And then having a job, you know, it's so easy to internalize and say, well, it's probably because I'm not coping with my situation.

Yes. And that happens so much, doesn't it? Totally. I beat myself up. I thought it's you. You're not coping, you know, with having a job of bringing up children. You know, this is a defect in you. This is your problem. None of your friends are having this, you know, totally. I'm a perfectionist. I think many doctors are anyway. It goes with the territory. And I did. I just, I had a history of mental health, you know, issues. So I just thought, oh, it's, it's, it's you not coping, Rachel, you know, it's, it's really sad. So what did you do? How did it? I went to my GP and, you know, explained what was happening. I mean, I guess I probably, you know, again, I'm not.

the best person are actually asking for help and I thought, oh, it's me, it's a phase, you know, I think I waited, I had a holiday, I waited to see if it improved when I'd had some rest and relaxation. Because again, you know, sometimes you're overworked and perhaps you do just need a holiday, but didn't settle. So I went to my GP and she was lovely, you know, but she said, oh, well, you know, you've got recurrent depression. This is another episode. And I said, well, you know, I don't know what it is. And she said, oh, you know, but you've got teenage kids now. this is kind of path of course. You know, she had kids of a similar age and, you know, I get that.

Teenage children are challenging, you know. Mine were challenging in wonderful ways if you're listening kids. But, you know, and again, you know, I don't blame her. I think, you know, it was a fair, it was a fair thought, you know, is it recurrent depression? I had had three episodes of depression in the past. One was postnatal, you know, I think we all can realize now that that was probably hormonal. You know, the other two were in the sort of 10 years before, you know, this episode, and it could well have been to a moment too.

But, you know, I kind of, I suppose I'd been labelled and perhaps labelled myself as having recurrent depression, you know, almost like it's a vulnerability in me. And therefore, of course, that's what it was. Yeah. So, you know, she increased the dose of my medication, which, you know, I was happy to try, but it didn't help. I just felt worse because I got sort of side effects from a higher dose. I kind of went back to her a few times

so, you know, we talked, you know, she said, well, you know, let's give it a little bit more time, you know, do you want to change antidepressant? I wasn't really keen on that. I went to see a psychiatrist myself privately. I thought, look, I'll get some input there. And he suggested changing the antidepressant, you know, which he did. So nobody really thought about hormones.

And actually, I didn't think about hormones. So there's no blame here because, you know, I'm a doctor. My GP's a doctor. My psychiatrist is a doctor. I do think that we kind of fell into the trap of, oh, it must be depression, you know. And it took four years before I really just suddenly thought one day. Four years?

Yeah, yeah. I mean, that's shocking, isn't it? Suddenly, you know, I just thought, gosh, you're 48 now. Hello? You're a paramedopausal age. You know, and I could have kicked myself, you know. I went to my GP and she immediately said, oh, gosh, yeah, you're right. And we tried HART and gradually.

And is that because you went to your, so you went to your GP saying, I think it's my hormones? Yeah, yeah, I did. And she immediately said, no, I think you're right. You know, I can see you've been struggling on. You know, it's clear it isn't just depression. You know, I think there's always the suspicion, isn't there, that I could have two things going on? And maybe I did. But the antidepressant medication and, you know, seeing a psychiatrist and trying, you know,

counseling and self-help that that hadn't been enough. So she was very open, you know, immediately. You know, she is of a similar age to me, you know, possibly, you know, she was on her own journey, you know, I don't know. But she was very open straight away. So HRT that day, you know. And then what happened? Gradually, gradually, everything improved. It takes a time. I had a marina coil, which I think clouded the issue because I haven't had periods for 20 years, because I've been one of the lucky ones to be amenorrhoic, no period on the marina coil. So since my son had been born, you know,

I'd, so there was never that clue. You know, and again, you know, maybe if my periods had stopped, I'd have thought, or got erratic. We would have all put it together more quickly. But, you know, that clouded the issue. So I started on patches, gradually increasing the dose,

and it just gradually got better and better. And, you know, I'm on the three hormones now, actually. I'm on testosterone as well. and I feel absolutely great, you know. So it's clear because none of the stresses have changed, really. You know, I still have a really heavy job, a really important job. I work full time. Still got children who still need me, you know, got two dogs who need me, a crazy cat, you know, all of the same things that possibly could have contributed to, you know, the worry pot in my mind. You know, they're all there. So, so, you know, the only thing.

thing that's changed is that, you know, I've, you know, I've got recognition from myself, from others. And also, you know, I'm on the treatment, which is really helping, really helping. So. But you had a few years of struggling on your own. Yes. And I have to say, during those years, it was awful. And I couldn't do anything to get relief. And so the only thing that gave me relief was red wine.

You know, at the end of the day, when everyone went to bed, I would have a glass of red wine. You know, I self-medicated. You know, it's clear now to see that I couldn't get rid of that horrible feeling of snapping. I also had, towards the latter two years, I started getting quite horrific suicidal thoughts and urges as well. And they came from nowhere. And again, you know, everything was getting worse rather than better. My confidence was going. I started not believing in myself.

I actually changed jobs. You know, that's when I stopped being a GP. I wondered that, you know, maybe it was my job, you know, which was a really drastic step, but one I felt that I had no choice to make. You know, I started drinking a glass of wine a night. Then it became two glasses of wine a night. Before I knew it, you know, actually, it was nearly a bottle a night, you know, which is a hell of a lot of units.

If you add that up, you know, I was on 60 or 70 units. plus a week, which is so damaging. I would wait until the kids went to bed, usually. I mean, I have to confess sometimes I didn't, and I would have a couple of glasses, and that didn't help my memory, that didn't help my night sweats, that didn't help the itch, that didn't help my buoyancy of my mood. I felt more depressed, you know, the suicidal thoughts got worse, but the only thing that would just make everything stop was just obliterating it, really, and just numbing everything. And I think that's quite common. I've been reading a lot. I've listened to some podcasts, you know, of yours on the subject. And I think, I think it's a trap that we can fall into because

it's very common. Yeah. Yeah. And it's very common. And I hadn't realized how common it was until, like you say, before you said at the beginning, you learned from patients. And of course, part of the history taking, you ask people about alcohol and smoking and lifestyle. And you can always tell when people are lying as well. And, you know, the beauty, of our consultations is they're confidential so that people then open up in a way that they often haven't opened up, even to themselves before. And so I do have a sort of, maybe I'm a bit witch-like, but I do have a way of getting things out of people. And when they do tell you, and it's not just often one bottle, it could be two or three, but it's not just the bottles of alcohol. People

have told me about their drug addictions as well, or their gambling addictions. anything that's, you know, escaping from reality, actually. And they know it's not healthy behavior, but they don't know how to get out of it because they feel so awful. And actually, it might be a short-term escapism, but actually the reality is still there that they're feeling dreadful.

And when I first started to hear these stories, I just thought, goodness, this is a bigger problem. This is a far bigger problem than perhaps people are realizing, and last year, as you probably know, we did a questionnaire about addiction and there were free text answers as well. And, you know, I still feel very sad when I read those free texts about people that have turned to class A drugs in their late 40s because they needed to escape from what was going on and they knew it wasn't right. Now, these are highly addictive, illegal drugs that women are turning to. And I'm not saying

it's very common, but it's still there. But actually what is very common, like you say, is alcohol because it's so readily available. It's socially acceptable. People laugh about their whiner clock, you know, the children, not going on. Yeah. And that's okay as a glass, but not when you're using it as a tool. And as many of you know, I don't drink alcohol at all. And it's not because I've ever had a drink problem.

It was because really of my migraines. And if you, I know that if I had a drink, I'd got to have a migraine. So it's easy for me not to drink. Yeah. But so many times when I've been under stressful or difficult situations, either at home or at work, I can see why people go, oh, I just have a glass of wine. But I can't.

So I meditate or I do yoga and that's good. And probably a lot healthier. But it's so easy to do it. And I think there's many reasons. One of them is because people are feeling low and flat. They want to escape. But the other thing is the addiction side, because like we said at the beginning, these hormones affect dopamine levels.

Now, dopamine is our reward, you know, that pleasure that you get opening the curtains, the sunshining, oh, lovely day. Now, if you don't have dopamine, and often when you're Easterdale, progester and testosterone are low, then you have a negative fever, so you have low dopamine as well. So when you open the curtain and it's sunny and you're like, oh, what the hell, it's another day, I just don't want to, I'm just existing, not living. of course then you're going to need that bit more to actually just feel a bit of pleasure from something as well.

Yeah, I think you're right. I mean, yeah, the pleasure would be short-lived, you know, with that first couple of sips, but, you know, it was there. And I think it probably did give me a temporary dopamine hit. And the more I learn about, you know, chemicals, you know, brain chemicals, the more I realize that that's what happened. I mean, I, and COVID happened, you know, to me then,

while I was, you know, and obviously that that caused so many challenges to people. I suspect that COVID and menopause and drinking was probably the perfect, you know, wasn't it? It got a bit worse, you know, but three years and two, three years and two months and a couple of days ago, I just actually saw the light and thought, right, you've got to stop because I realized I was addicted. So, you know, I think some people don't become addicted, but many people do. And I did become addicted. I became addicted to alcohol and I realized that I was at the stage where I couldn't get through an evening without it and that's terrifying. There's a lot of shame, a lot of shame. You know, I felt I should have known better because again, I'm a doctor, you know, forgetting that I'm actually a human and a woman, you know, and that's okay.

There was a lot of shame and I had to accept it and I had to admit it. And again, that's a really difficult step sometimes. but admit it I did and then I hit it with everything I had. I told my GP, I went to Alcoholics Anonymous, I got lots of books and downloads. I had started practicing mindfulness by then and meditation, so I did lots of that. I just did everything that I could. I got an app on my phone which was really helpful that tells me how many days I've been sober. All of this, like I just used every tool because I didn't want to fail.

I wanted it to be the only attempt. and it was really hard. I have to say, I did not know how hard it would be. I did have quite a lot of physical symptoms. I had crazy psychological symptoms where I just felt I really needed a drink. It kind of peaked around day 18, 19, 20. It was unexpected, but Alcoholics Anonymous got me through that. I mean, I'm really grateful to all my colleagues and friends and pals there

because, you know, they were really helpful. And I managed to do it first time, you know, but I'm mindful that, you know, it's day by day. In the early weeks and months, I replaced my alcohol drinking with eating chocolate. Okay, so I couldn't have a drink and I just needed something to get through those evenings, so I would eat chocolate. And that definitely helped my dopamine levels, but gradually I'll reined myself off that. And now, you know, hopefully the levels were a little bit better.

I'm going out in nature loads more, and cold water swimming even more than ever. mindfulness I think really does help with the whole dopamine thing as well, some practices of self-love, self-compassion. You know, just giving myself love, give myself a hug. It all helps, actually. I think that's really important. And I think it's something, this is a generalisation, of course, but I think it's something generally people, especially women, don't do. And, you know, the last few months have been quite difficult for me for various reasons. And I'm trying to teach myself some more self-love. And it sounds really cheap. easy when people talk about self-love because I don't look at myself and think I'm the most

amazing person or the most beautiful or the most lucky or the most whatever or talented. But actually deep down, there's something inside everybody where there's a bit of something that needs loving and whether it's related to past trauma, whether it's related to a poor relationship, whether it's related to just how you're feeling. But it's that deep down self-love. It's not that, oh, I've got a new dress on, don't I look lovely? That's too superficial for me. It's more something within, isn't it? But I think even more when you're on your own, even more when you've got lots of stresses,

it's actually two things really, taking time for yourself, but also acknowledging that a bit of you somewhere needs a bit of a cuddle and warmth. And you're not going to get that by drinking or talking or offloading to someone else. You've got to do it from within. and that's quite a hard thing to do, I think. It's really hard, and it's taken me a while. I have been practicing mindfulness. I'm studying it as well, and I've been practicing it for about two and a half years. And I can say, actually, on camera now that I do have self-love.

I can say I love myself, which, you know, honestly, two years ago, there's no way I would have dared to say that. And I do give myself hugs and I do gratitude journals and put myself in the journal. I think it does make a difference. It does sound cheesy, but it does help if you keep going and you get used to doing it. We are great. Women are great. Yeah, we are.

And we shouldn't be stripped down and we shouldn't be gaslit. And we shouldn't be accepting something that isn't right. But we have. It's society, it's history, but we shouldn't. But one of the things I noticed when I was on the tour and you came to watch, you were with a group of other people. Yes. And there was a lot of all, you give so much positive energy. And I wonder whether it's come, I didn't meet you before all of this, but I wonder whether it's come because you are in a better place, physically, mentally, spiritually, that you're able to give others even more. You've probably always been that sort of person, but you're just, there's something that's coming out of you that I think is incredible and he could feel other people picking up on that too. That's a lovely thing to say. Thank you. I think you're right. I think you're right. That's a really

lovely thing to say. And I believe you're right. I do think that if you exhibit positivity, you know, there is research that has been done. I mean, we have these things called mirror neurons in our brains. And you tend to mirror other people's sort of behavior and affect, you know, at mood. And so I think that has an effect. But also I think, you know, greater than that, I think we are all interconnected. You know, we are all human. We do have common humanity here. And I think positivity has a ripple effect.

You know, my Pilates class, I will shout out to them, Bev, Diane, Kirstie and Viv, hello. They are brilliant. And they have helped me as much as I have helped them. Because we are a small group that meet every week and we talk about the menopause. We talk about our mood. We talk about how we're feeling. I think we all buoy each other up. So I think once one person is positive, the next person, you know, perhaps becomes more positive.

And again, that ripple effect happens. So, you know, I do think being positive about the men, of course, as much as we can, being positive about our mental health and just thinking, look, let's do our best. Let's not shy away from talking about it. Let's, let's, you know, not embrace it because, you know, but go with it. Yeah, but it's so important because I think so often people have, this conversation has been. normalized about menopause. Oh, you will feel like that, you will feel like that, or you won't feel like that. We're all different. But also there's this big conversation as you either take HRT and you feel wonderful or you don't take HRT and you've got to try all these other things. But actually, in my mind, whether you take HRT or not, you've still got to be thinking about ways to improve your mental and physical health. And that's so important. You can't just use HLT as something that's going to turn you into this amazing person because you're still going to have

challenges in your day, whether it's work or home or you're still going to be making food choices. You're still going to be making choices about doing exercise. You know, this morning I woke up and I'm really tired, but I still got up to do 20 minutes of yoga before I got in the shower and I feel better for it. You know, it's only 20 minutes, but actually it would have been really easy to have just set my alarm 20 minutes later. But, you know, I feel better. I ended in a headstand.

I did some meditation and I'm like, I can bite this day. but that's not HRT. HRT is good, but it's not everything. But on the flip side, there's so many women who aren't able to access HRT, who like you were thinking, this is just my lot. And this is nothing to do with my hormones.

And this is also, and it's sad because you were blaming yourself. Yeah. But actually you saw different doctors. So how we do this joined up process where we can empower women, but also we can educate. healthcare professionals from every specialty.

Just to think, could any of Rachel's problems being related to our hormones? And even if it was only 5 or 10%, treating your hormones might have been enough to stop you becoming, you know, having problems with alcohol. Yeah. Or just having a better time with your children or just not giving up your, or changing your job. There's lots of little things. And I think as doctors, we need to tease out every single bit. We're not just blaming one part.

But if we don't have a whole 360 approach, like you not having the hormones was definitely a bit of the puzzle that was missing. You know, it was. And I think once I got the hormones, I was able to see the bigger picture. You know, I think my mental health was, I guess, so impacted by the time, you know, I became 48 and I had my light bulb moment. Thank goodness for the light bulb moment. But, you know, I had started to make all those wrong choices with diet and with exercise as well. You know, you know, I think, I think, I think, I think, HART just, just improved my mental health to the, I mean, it improved it hugely. But in the early days, it improved it enough for me to actually then tackle the alcohol. I mean, because I am an alcoholic, it's, you know, it's, that's what I am.

I'm addicted to alcohol. And again, I have no shame in saying that, you know, probably a couple of years ago I might have done. but, you know, it happens. It happens. It's just something that happens. We're humans. You know, what can I say? You know, there's no shame.

I really want to break down the stigma, as you do. I really want to get conversations opened. I think it's really great work that you're doing. And back at you with the positivity, I mean, your positivity has a massive ripple effect too. And I think, you know, talking about this has a massive ripple effect. And we have to keep spreading the word because people, you know, women and doctors can be educated. I mean, me, my GP, the psychiatrist, back in the day, none of us thought menopause. I would like to think that if the same person had the same symptoms as I had now, you know, nine years on,

I would really like to think that maybe it would be different. But I guess it's only from talking it through more and more, that maybe we can get it out there to every doctor and every woman. Yeah. Well, it's been amazing, Rachel. And I feel very honored and privilege that you've shared your story as well, because I know it's going to help people, either people directly who've been listening or people indirectly who will know, you know, people will know others that they might be able to reach out to and just start that conversation and try and help. So I'm very grateful. So before I end, I always ask for three take home tips and you're no exception. You're not escaping from it. So three things. I think that you would either say to your former self or to others that were maybe just realizing that they're on that slippery slope and addicted to, it doesn't matter what, to anything, what would you say to those people? Yeah. Okay. The first message, I think in many ways, is the most important message. And I would say, listen to your body and trust your instinct because you know yourself best. You know, you live with yourself 24-7.

Your mind and your body are one. So your body, when it's telling you things, is as valuable as your mind. And just look at the whole picture, listen to yourself, notice, and, you know, don't put them down to anything. Just think, look, my body's trying to talk to me and I'll listen and what's it trying to say. And that leads on to number two, because then I think number two is be your own advocate, because you're the one that knows your body most, best. It can be particularly challenging for people like me who had pre-existing history of mental illness. I had a history of episodes of depression. But if you think this is different, if your body's telling you, this is different, tell your GP and don't be afraid, as I say, to advocate for yourself

and say, look, I know you think this is depression, but, you know, could this be the perimenopause? I've done a bit of reading. I've listened. I've watched a podcast. My body is telling me that that something is different. Because for me, my mood swings and the suicidal thoughts and all the crazy sort of up and downness, that was new. You know, so new things, I think, listen. And the third thing, it relates to alcohol addiction, really. Prevention is better than cure, okay? I wouldn't really want anyone to get to where I was because it was pretty horrible and a little bit lonely until I accepted it. So be alert to the fact. Notice if your drinking is creeping up and tell people, You know, tell people, don't suffer alone like I did, you know, because there's help out there if you want to prevent problems as well as, you know, if you find you are addicted and you are drinking too much. There's help there at that stage too. Hit it with everything. Alcohol anonymous, you know, friends, GPs, family, you know, tell as many people as you can to get the help. Don't suffer alone because, you know, there's loads of help out there. And, you know, this can all be better.

So that's what I would tell myself. That's what I tell myself but she didn't listen. Well, hopefully others will. So thank you so much for your time. I really appreciate it, Rachel. You can find out more about Newsome Health Group by visiting www.newsonhealth.com. And you can download the free balance app

on the App Store or Google Play.