Perhaps you can pool resources to find a low-cost sitter through your local college or university. Or fear? But I can also see the awe. Around the corners of people's eyes and mouths, you can read the calm joy of knowing what to say, of knowing they can participate fully. Mary had been the executive director of the Alzheimer's Association Minnesota-North Dakota article, and so she was well aware of the challenges faced by people who were striving to live at home rather than move to a care setting--like isolation, depression, and paralyzing stigma. They also knew of Jeanie Brindley-Barnett's work as cofounder of the MacPhail Music for Life program at MacPhail Center for Music in Minneapolis. Jeanie was working magic with the Sing for Life chorus of older men and women. Mary and Marge decided that their tribute to their parents would be a chorus for people with dementia, and brought in Jeanie as music director for a pilot year. To kick-start the chorus, Mary worked her connections with the caregiver groups at the Alzheimer's Association article. When they gathered for their first of fourteen weeks of rehearsal, there were thirty people in the room: people with dementia, caregivers, and volunteers alike. Helen Kivnick, a renowned gerontologist, was among them. How dare he! It was your turn! You've waited all this time! It's not fair! Right now, you could say that man who cut you in line is making you angry. It's ingrained in us, even in our language, to put the responsibility of our emotions on other people and external situations. Think about it: when a situation arises, and we have an emotional response, what do we say? She (or he) just made me so upset. We displace the emotional responsibility from ourselves to the other person involved in the situation that displeased us.

But back to the checkout line: you could say like anyone else would, that that man just made you so angry. Here is my best suggestion for busy women, with or without children: take a few moments right now to shut your eyes and ask yourself, If I had a free two hours, what would I like most? If two hours seems like too much to imagine, ask yourself what you would like for an hour, or half an hour. Then see what comes to mind. Is it time by yourself, with a friend, or with your romantic partner? Do you want to read, take a bath, go for a walk, see a movie, or have a fabulous cup of coffee in a local cafe? Imagine what weekly treat would make you feel happy and relaxed--and then see what you can do to work toward it. Throughout this article I've suggested ways to let go of what doesn't work: a sweet, starchy diet, missed meals, lack of exercise, insufficient sleep, and excessive stress, including historical stress. I also want to suggest letting go of the insufficient treatments that most conventional practitioners commonly prescribe: antidepressants and birth control pills. I'm all for antidepressants if a woman is moderately or severely depressed and needs biochemical support to balance her neurotransmitters. Even in that case, though, it's remarkable how much progress many women can make with diet, exercise, herbs, nutritional supplements, and the psychological support they need. Helen began her career working with Erik and Joan Erikson and had developed her own focus on vital involvement. I had been lucky enough to have Helen on my dissertation committee (so long ago now) and was eager to reconnect and interview her about her experiences with Giving Voice. At first I sang with the baritones because that's where they needed me, she said. I had to sing their part in their range--which posed interesting challenges for me. Helen participated, observed, and conducted interviews with a research assistant to evaluate the pilot. When I asked her for her general observations, she said, Being in a choir activates everything wonderful about music and music making and everything good about being part of a group where everyone has active ownership. Every participant engages in growth and mastery, being helpful and being helped. And the audiences can't believe what they see and hear. What really struck Helen about Giving Voice, though, was how it made her think about disability.

What I kept being reminded of is how everybody who is alive has both disabilities and abilities. But the truth is, what's actually creating that emotion rising in your chest is the way you perceived the situation and the thought process you used to land on your emotional response. It's called Cognitive Appraisal. Apart from special circumstances where emotions really are caused directly by actions (breaking your leg, for example, causes pain), Cognitive Appraisal says that your emotions are your own responsibility. Your feelings are derived directly from how you've appraised the situation before you. This can feel a little unnerving because our language so strongly relates actions to our emotions. My brother was mean to me, so I am sad. My car broke down, so I am frustrated. That man cut me in line at the grocery store, so I am angry. But this mental model actually theorizes that in any given situation, we can change how we feel by adapting our thought process. What's interesting about cognitive appraisal is that it occurs without us using it intentionally all the time, every time something stressful happens. Antidepressants can be less effective for mild depression, let alone for hormonally induced mood swings. A recent study claimed that for treating mild depression (as opposed to moderate or severe depression), antidepressants were no more effective than placebos! Yet far too many practitioners are influenced by the pharmaceutical industry, which sends armies of sales representatives to educate practitioners about the virtues of a particular medicine. I can see why in some cases antidepressants might be effective. Most antidepressants that are prescribed for hormonal issues are SSRIs, selective serotonin reuptake inhibitors. This type of antidepressant basically keeps more serotonin in your system, enabling you to benefit from this key hormone. Serotonin combats depression, builds self-esteem and a positive outlook, and creates feelings of calm. It also supports healthy sleep. Clearly, having access to increased supplies of serotonin can be terrific when you are struggling with PMS, painful periods, or perimenopause.

However, SSRIs don't help rebalance your stress hormones and they don't address the diet, lifestyle, or psychological issues that contributed to your stress in the first place. I see that no place more clearly than in this choir, said Helen. That first pilot had people with fairly advanced dementia, including two women with aphasia, which corrupts one's ability to speak. But they could both sing in the choir. One of them told Helen's research assistant that if she had a psychotherapy session after rehearsal, sometimes she could still talk. Her partner said she had fallen in love with this woman because of her voice. Being in the choir enabled her partner to hear that voice every single week and to fall in love with her all over again. Like Mary, Helen saw the power of Giving Voice in its rigorous expectations. These were two-hour rehearsals over fourteen weeks with a professional music director. Jeanie Brindley-Barnett was adamant that participants would not be infantilized with low expectations. We are going to treat our people like we treat ourselves, she said. You come home from work one day to find that the dog has dug a hole under the fence in the backyard and escaped. In this case, your dog being lost means you will have to go out and look for him. The plans you made to settle in on the couch with a glass of wine and an awful episode of reality tv are gone. If you don't find him, the impact on you will be the loss of your pet. Secondary appraisal begins not long after primary appraisal. It takes into account all the information the primary appraisal concluded and develops your emotional response based on that information. Realizing you might not have a dog anymore might make you sad. The recognition that you will now spend what would've been a relaxing night at home on the streets searching for your dog might trigger a frustrated response. In any case, as you run out the front door yelling your dog's name with treats in hand, you have unwittingly gone through the cognitive appraisal process to land at an emotional response.

Now that you're aware of this mental model, you can start to use it logically to change your thought process and response. I want you to be in glowing health throughout your life--through perimenopause, menopause, and beyond. If antidepressants make you feel well enough to cope with your life stresses and make some key changes, I'm all for them. But if your practitioner uses them to mask the hormonal issues, I'm concerned because I want to be sure that the underlying problems are solved and that your potential hormonal dangers are overcome. After all, no one ever got depressed because they were suffering from a Prozac deficiency. Depression is a complicated condition that is at least partly set off by hormonal imbalance. Rebalancing your hormones and restoring hormonal health is the most important thing you can do to combat your depression. So before you start the antidepressants, try the 28-day plan in the second part of this article, which will help combat mild depression as well as hormonal imbalance. If a woman chooses birth-control pills to enable her to have an active sex life while avoiding the risks of pregnancy, that might be a wise choice. But we still don't fully understand how the pill affects a woman's body. We only know that it takes over a woman's ovarian function, so that her body does not produce its own hormones and instead depends on the pill to supply them. Yet, while she had vast experience working with older adult choirs, she had never worked with a chorus made up primarily of people with dementia. She was in new territory. much new material can we present? She decided that the group could handle new music as long as it resonated with their heart and soul. And that resonance would come through in performances. Brindley-Barnett decided to aim high but to make the rehearsal process accessible to everyone. Some could read music, some couldn't. So she always made recordings available for people to learn parts by listening, as well as the traditional music. She told me a story that reinforced her impulse.