Story Session: When Perimenopause Makes a Crash Landing with Amanda Bullat, RDN

If you’re not expecting perimenopause, or you’re one of the lucky ones that starts perimenopause early, it can be hard to diagnose. The late thirties and forties are full of almost every sort of stress you could imagine. For one, life is just full of all the expected responsibilities, including raising kids, managing a career, and taking care of aging parents. But then unexpected stressors have a way of making a crash-landing during this season too.  

In this episode, I’m joined by Amanda Bullat, for this unique expert and story session combo episode. For Amanda, some of the most frustrating symptoms of perimenopause showed up through anxiety, mood swings, and sleep disturbances. Yet when she tried to address it with healthcare providers, most of them dismissed the idea that she could be in perimenopause since she was working through losing her mom to terminal cancer in addition almost losing her partner to a severe medical condition. 

While her trauma (combined with collective trauma of COVID) was significant, Amanda listened to her intuitions and bravely ventured out to do her own research about perimenopause. She had felt alone, confused, and unable to cope with stressors that she was capable of navigating in the past. What she discovered was that when she was able to practice self-compassion and embrace her limitations at this stage, she was able to move through challenges with more ease. Two big pieces of this puzzle included healing her relationship with food and embracing her need for rest. 

Using the wisdom and experience she's gained on her journey, Amanda now specializes in supporting middle-aged women of all sizes who are struggling with disordered eating, chronic dieting, eating disorders, and body shame. Using the frameworks of Intuitive Eating, Health At Every Size®, and the therapeutic Be Body Positive Model® created by The Body Positive.

To learn more about Amanda, visit her website at www.alpinenutrition.org  or follow her on Instagram @alpinenutrition.

TRANSCRIPT

Jenn Salib Huber 0:02
Hi and welcome to the midlife feast the podcast for women who are hungry for more in this season of life. I'm your host, Dr. Jenn Salib Huber. Come to my table. Listen and learn from me. Trusted guests, experts in women's health and interviews with women just like you. Each episode brings to the table juicy conversations designed to help you feast on midlife. Hi and welcome to another episode of the midlife feast. Today's guest is Amanda and this is a combined story session slash expert interview because Amanda like me is a dietitian who works in the non diet space and works with people in this age and stage of life. But she also had a crash landing of life and perimenopause that makes for a very relatable and interesting story. So snuggle up, listen to Amanda's story, and learn how she took her experience of being in perimenopause and dealing with life and has incorporated that into her professional life in a very interesting way. Hi, Amanda. Welcome to the midlife feast.

Amanda Bullat 1:14
Thanks so much for having me, Jan, I've, it's been so fun to see your podcast grow and develop. And I'm just honored to be a part of it. I'm looking forward to our conversation today.

Jenn Salib Huber 1:26
Well, and this is going to be a little bit of a different story session. So this started out as Amanda wanting to share her story. But Amanda is also a dietitian, who works in the anti diet, non diet space and also works with people in this age and stage of life. So I think your story is going to be a little bit unique. And I'm really excited to share it with everyone. So orient us to where you are in midlife right now.

Amanda Bullat 1:55
So I'm on the younger side of perimenopause. So I'm 42 years old. But I started experiencing some of these, you know, early Peri menopausal symptoms, I didn't know what that's what they were at the time when I was about 38. So there was some life stresses going on. And so I thought, well, maybe that's just attributed to this. But after the life stresses went away, which we have to make it into, the symptoms just didn't go away. So that's when I honestly, I just came across to you and the resources you offer, I think probably on social media. And I was like, Oh, maybe I need to learn something more about what's going on with my body. So some of the symptoms that had started showing up that were very different for me were, you know, some cycle changes, but not dramatically, mostly around the mental health piece of things. I've never really been particularly an anxious person. But that just started popping into my head more like more worry, more concerns, more sleep disturbances, little changes in my bodies, but again, not dramatic, yet. I'm looking out for that. expecting that to show up at any time. But really the mental health stuff, those symptoms, I think, so far have been the most jarring and have really pushed me to look outside of, of the coping skills I already had. And go I think I need some more resources. I need to learn more about why this might be going on. Not in a let's fix it, but just understand what's going on. And how can I support myself in this way?

Jenn Salib Huber 3:38
Yeah, you know, and it's so interesting, because, you know, your experience was like mine, it was on the earlier side. And, you know, I think that for anybody who starts to notice these Peri menopausal changes. on the early side, it often is the mood piece that in hindsight, we realized was an early sign and symptom. But I think it's also the reason why so many women slip through the the diagnostic cracks as it were, because you can find a million reasons why a 38 year old woman is feeling anxious and stressed and tired and all that kind of stuff, right? So one of the things that I think happened to you that you have this crash landing of life, combined with perimenopause, and that experience, really, you know, took its toll. So what can you tell us about that? So tell us about that crash landing and what that all looked like. Yeah, sure.

Amanda Bullat 4:35
happy to share that. So when I was, let's see, I was 3037. My mom was diagnosed with terminal cancer. It was her first or her second go around with cancer, but she was not going to beat it this time. And it was breast cancer. Breast Cancer initially came back in we I think we would still call it breast cancer, but it was a different form. Very aggressive. required massive surgery. She was 78 years old. So she lived a good life. She chose to do the surgery, but did not choose to do further treatment after that radiation, chemo, she just didn't want to live life that way. She was told by the doctors that she would probably be fighting it for the rest of her life. Anyway. So diagnosed when I was 37. Pretty much and that was near my birthday. So the whole following next year, is me and my dad supporting my mom through terminal cancer. And right in that's about the year then, right after she passed away or right close to that it's when I started not feeling feeling not only the emotional changes, but I also started to have problems with sleeping. And related to like night sweats too. Now someone can look at that and say, Well, yeah, your mom's dying of cancer, like lots of emotional upheaval is going to happen.

So like you said, it's kind of this perfect storm. My mom passed away. I mean, she, we she had the best care possible to be able to go home and be comfortable and sail on into that next stage of her, you know, quote, unquote, life next stage of being for her the following spring, so she died in the fall, the following spring, my partner had his third cardiac arrest. He's had them it's genetics in their family sudden cardiac death syndrome. And luckily, he has a defibrillator, which saves his life every time he has these, or at least the last two. But that for him triggered not only needing an another stent put in, needing his device changed out battery. So there's some operations involved there surgery involved, they're also triggered for him a major mental health breakdown, having had lots of stress at work kind of been the instigator to this kind of happening for him. So get through my mom, now we go through my my partner having some major medical, physical and mental trauma. So there was a lot and then on top of that, we just decided to throw in a pandemic, which honestly, like the pandemic has been a breeze and I don't mean to make that light in the sense of what it is.

But compared to what myself and my family had been through two years prior, the pandemic just didn't seem like a you know, blip on the radar type thing. But again, with the the mental and emotional capacity that I was coming into the pandemic with, which is pretty fragile. Then we come into this the pandemic situation of which many of us were experiencing, like the uncertainty, the grief, the loss of connection with people in our support system. So there was this really turbulent, three years going on with that. But like I said, as I dealt with the grief of my mom got through the emotional emotional turmoil with my partner, he everything turned out fine for him had a healing period of about six to nine months, and things are great with him, luckily.

But the again, the symptoms didn't go away for me. So I still experience night sweats, particularly around my when I'm going to start my period. And the anxiety piece wasn't going away, either. So but, and we may, maybe we'll get into this, because this life was crashing into perimenopause. For me. It led to more invalidation from my providers, because I am on the early side of things with age. And they're like, oh, and you went through all these life traumas like, so we can't just blame it on perimenopause, which I think is true, you know, those, those life traumas are gonna affect me as well. But having that invalidation mostly around my age, and mostly the fact that I am still having somewhat regular cycles, kind of initially, let me go in well, but I still feel like crap, what am I? What do I do?

Jenn Salib Huber 9:13
Yeah, I mean, I can't even imagine that level of stress. You know, I lost my dad when I was in my 20s. I was, you know, 27 Or maybe 28. And, you know, I was newly married. I had, it didn't have kids at the time, I really only had myself to take care of, but you know, I didn't have that all of the life stuff. On top of dealing with grief and worry, like you had a career you also had a partner who was you know, not, you know, in the best of health at the time, and I think that we expect to get to midlife feeling more capable to deal with these major life stressors. We because in many aspects of our life, we do feel pretty darn confident by the time we get to be in our mid there 30s and 40s about things you know, there's lots of things that don't faze us anymore.

But the problem with perimenopause when it crashed lands with life is that it often changes our coping abilities, the ones that we thought were rock solid, the ones that we thought were never, you know, couldn't be shaken, all of a sudden just feel like they're fragile. And that, you know, emotionally, everything is just sitting right there at the surface. And whether that's anxiety or just strong feelings, whether it's being caused by or a consequence of lack of sleep, like, yeah, there is a whole big mess of hormonal soupy stuff that's happening. And all of the reasons are valid. But if we don't acknowledge that, the changes in perimenopause, change how we cope, we're not helping women, by dismissing it and saying that, Oh, it's all these other things that's not helping anyone. Right? We have to acknowledge that some of that anxiety is a hormonal problem that's piled on top of life. So that's so much to go through. So what are some of the things that have surprised you about perimenopause

Amanda Bullat 11:11
I think just the the level of uncertainty of just noticing how like in the course of a month, and again, mostly mental health side of things, because that's the kind of the the thick of it that I'm in how dramatically my energy levels can change. And I've always been a fairly energetic for active person, and how there will be times during the month either slightly before or after my my period that I'm just I could spend the day in bed. Just so so tired, and I hadn't felt that level of fatigue before. That has been surprising. And the surprising in the increased PMS symptoms, too. I was luckily, not one of those women that had lots of cramping, or, you know, maybe some mild mood swings here. They're coming into my period, but now they're more intense, especially the mood stuff. Like, I remember talking to my primary care. And this is been maybe a year ago, not not a little over a year ago, and saying like, I just like what is wrong with me, I want to jump out of my skin. Like I want to yell at that person bagging my groceries.

Like I have no, no tolerance on my bullshit meter anymore. And she kind of laughed at me. And she's like, well, that's not necessarily a bad thing. I said, I know. But the poor person bagging my groceries, who's just trying to do a good job, like they don't deserve me getting bitchy. Yeah. So that has been really surprising too. And when those emotional upheavals happen is when I really go, I don't even know who I am. And now through finding some new coping skills, learning the power of rest, say I was not I was not arrestor. Prior to all of this, I was a go, go, go. And now I'm learning like the importance of, of listening to my body and learning to take rest. And I think this is where all of my professional work and study around intuitive eating, mindfulness, all of that has really come into helping my own personal journey to going like how this is why it's important to get to know our bodies and shut up and listen, because they are trying to give us really good information that can help us get through this really kind of confusing and tumultuous times stage of life. And I love your analogy of hormone soup, because that's totally what it feels like. It feels like we're flailing around in this hormone soup. Trying to sort things out.

Jenn Salib Huber 13:56
Yeah, I mean, I remember so I'm a little later. I've mentioned this on lots of episodes that I'm a little later into perimenopause. I, I've been I've been tricked into the waiting room of menopause a few times. But I'm back at the beginning now. But I'm definitely in the stage where I am routinely going several months between a cycle I've gone up to eight months. And what I noticed is that that mood, stuff had settled down a lot.

And it was such a relief to actually feel a little bit like myself again, mood wise, that you know, that roller coaster of emotion that worsening PMS that was going from two days to 10 days, you know, where I felt like I didn't even want to make an appointment with anyone in the like two or three days leading up to the cycle because I just didn't know if I had like the mental emotional capacity to filter myself like, you know, and I know that that might seem dramatic, and I probably am a little dramatic about it, but it was it was tangibly different when I entered that later phase. And interestingly, you know, kind of two weeks before I started the cycle, after almost eight months of not having a period, I had one day where I snapped at everything, everyone, and it was just like, everything was like nails on a chalkboard, and no one could do anything, right? And all the reasons why I was mad are still super valid. But wow, was my reaction really out of scale?

You know, and when you're going through that level of up and down, and up and down every month, it feels exhausting. It's emotionally exhausting. It's physically exhausting. And so, you know, it's just been a really interesting experience, because I think of my attunement skills and being able to kind of tune in to what that's like to be like, Oh, wow, I'm really glad to be past that stage like this. This is good. I can take this for another little while if I have to be in the waiting room for another year. But it really does change your coping, because on top of all the other things, you're dealing with that? Yes. And that's what I think so many women dismiss.

Not intentionally, but they dismiss it as just PMS. You know, my PMS is worse, because Because Because without thinking that maybe the PMS is getting worse, because these changes are happening below the surface. Right. So, so yeah, so that that was a lot of crash landing that was happening. And the lack of validation is is hard, especially I think, as a health care provider, somebody who works in health care. You know, when when that's dismissed, it feels not hurtful, that's not the right word, but it doesn't feel good. And especially when you practice and teach attunement, you feel pretty confident about like, No, this is, this is what I think is going on. But you kind of turned this around, or, you know, put it to good use, and have been able to incorporate these experiences into your professional life of, you know, working with people in on their relationship with food. Tell us a little bit about that. And tell us about how that led to savor. Because I actually don't know this whole story. So I'm excited to

Amanda Bullat 17:10
get you know, I had always wanted to when I started my private practice, private nutrition counseling practice seven years ago, I just seem to be drawing women in midlife. And I didn't know anything about marketing that I didn't know anything about, you know, language that we use to hit a target audience or whatever that meant. But that's who was showing up in my practice. And so as I started to experience these own life situations myself, having that attunement, like you said, with my own body, and noticing, like, Oh, this is a thing, I started to keying into, oh, this is what's going on with my clients as well. And this is why it's really hard to talk about hunger and fullness signals and cues now, because there's a whole big backstory going on behind them when they're in their late 30s 40s and 50s. And so through my own experience, and being able to have compassion for what else is going on behind the scenes for midlife women, that has significantly informed how I practice and relate and counsel women in this age group. And I'm really open with them, too, if there's something that at a technique I've been trying or, you know, a recommendation that I've had from one of my providers, I mean, I will say like, this is something that has helped me or I've heard from other clients that this has helped feel free to try it on.

Again, it's anecdotal, I'm not looking at it from an evidence base. And I'm very clear about that. All of my other recommendations are evidence based too. But if someone is just feeling like I can't, I can't get the validation from my care team or something, then I might just say, okay, full disclosure, if this feels comfortable to you, this is kind of what I've gone through, if that feels helpful for you to check out, feel free. Again, feel free also to do your own homework around it. And so that has helped kind of building that even stronger rapport with clients, and they're like, Oh, you get it, because you're here to, and particularly with my clients who are are active people similar to how I was and so all of a sudden, like they've been able to be active and, and maybe even competitive in the activity that they were doing and now they're, they're dragging like I was saying like they're feeling really tired and, and what is that like? So, being able to share my own experience with clients is kind of helped us kind of find this common community and humanity within that, and where this relates to savor so the the tagline of my practice is savor food and body. But saver is actually an acronym that stands for stop. Awareness, validate options, reflect and release, meaning that someone could look at This in a big picture way, say stop dieting, have awareness for how diet culture messages affect your mental health, affect how you your shame about your body, validate,

Hey, these are where these messages came from. It's not your fault. This is how you feel in your body. It's totally legit and deserves to be validated options, what are we going to do going forward to help you take care of yourself in the face of now this reality check. And then choosing that options, you know, choosing new people to follow cleaning up your social media, again, we're looking at it from a big picture point of view. And then reflect have those options helped you have a better understanding about your relationship with food and your body, and releasing like releasing what you've been told all of these years, maybe you've all the diets you've done.

And let's go forward in in a new way forward trying something new, not harder, but trying something different and new. And so that's how that acronym can be used in like a big picture sort of way. I've also used it with clients as a strategy for an in the moment. So say for example, someone is having some emotional upheaval or they're crazy bored with what they're doing for the day. And they find themselves going to the pantry. Okay, stop in the front of the pantry. Have awareness. What's my hunger level? Like right now? How long ago did I eat? Do I maybe need a snack even if I'm not feeling hungry, but it's been a few hours since a maybe I do need a snack.

Or I'm avoiding doing this thing I need to do for work. And okay, that's valid, you can still have the snack. But we're having awareness around like why am I even finding myself here with food right now? Again, validating, validating, yeah, it's just a project I don't really want to do this is the part of my work. I don't really like validating Oh, yeah, it's actually it's been few hours since I ate it's it's definitely time for a snack or maybe even another meal. Having that option, then go choose your food, like open the pantry door, go for that. Or if you're finding that food is not what you need, right now, choosing another option, maybe you need to pop yourself on the floor and have a rest having some grounding time, go outside, get some fresh air and get some oxygen going in so that you can like power through that project that you're bored with.

And then of course, choose one of those options, including food, if that's what you need at the time, and reflect and release, did that option help you in that moment, get through either a difficult emotion, give you new energy because you hadn't had fuel in a while. And then release the experience move on with your day. You learned something move on, you can decide if you want to do the same behavior next time or not. And but we're moving on we're moving forward. So that's kind of two example of how I use savor from a big picture standpoint. And then an in the moment standpoint.

Jenn Salib Huber 23:05
No. Yeah, I mean, that whole process of you know, just bringing awareness to any situation that feels reactive. And you know, and being able to just kind of pause I just I call it the pause and reflect so you know, kind of same kind of thing like it's, you're not trying to stop it. You're not trying to control it. You're not trying to like push it away. You're just pausing and you're learning to sit with it and actually listen like what is it that I want to need? And I love that you have an acronym for it. That also ties into food is perfect.

Amanda Bullat 23:37
Yeah, it was one of those Amanda bike pedaling brainstorms, Mike Oh, look at look at this. I think this is kind of college

Jenn Salib Huber 23:44
psychotherapy here. Yeah. Yeah. So it's like, I love it, too. It's, you know, when you're out, you know, cycling or doing something, and it just really gets the wheels turning,

Amanda Bullat 23:56
it sort of says, Oh, I love that. Yes.

Jenn Salib Huber 24:00
Thank you so much. I know that this experience that you've shared will be, you know, recognized by many other women and people who are going through this and so I always end every episode asking, What do you think the missing ingredient in midlife is?

Amanda Bullat 24:21
I think a validation, validation for our experiences, both our lived experiences up until this point, or emotional experiences, and just being able to sit with that validation, celebrate it where it needs to be celebrated. Ask for help when you need to ask for help. And just, you know, validating that here we are. And this is a this is an exciting time. It's a challenging time. And it's a it's a season of change. So here we are, and let's move through it together.

Jenn Salib Huber 25:00
I love it. Thank you so much. Thank you for sharing your story. And thank you for the work that you do I value you as a colleague in the space and and like to think of you as a friend too. So I'm really honored to have you on the podcast. Oh, the

Amanda Bullat 25:14
feeling's mutual. Jen, you're gonna come to the northwest and we're going to hike and I'm going to come visit you and we're going to bike I see this whole relationship developing here. Excellent. Thank you so much for having me.

Jenn Salib Huber 25:27
Thanks, everyone and I will put Amanda's links in the show notes if you want to learn more about her approach to savoring body and life. Have a great day. Thanks for tuning in to this episode of the midlife feast. If you're looking for help with menopause nutrition or just want to figure out how to make peace with food on midlife. Check the show notes so you can learn about how to work with me and sign up for one of my group programs. And just a reminder that beyond the scale, my most popular group program will be starting up again in May and registration opens mid March. So make sure to get on the waiting list if you'd like to be the first to hear about it.