My mom is one of those rare women who “loved being pregnant,” did not have painful periods, and breezed through perimenopause and menopause with nary a symptom. The degree to which all of these same experiences took me out makes me wonder if we are even related. In a world that, until recently, didn’t talk about women’s experiences in any meaningful way, I, like many others, was invalidated and ignored when I tried to explain what was happening to me and find solutions—most especially when talking to medical “professionals”—half of whom were women themselves.

Someone recently said to me that perimenopause is like “being dragged backward through adolescence by the ankles with your hair on fire,” and that seems like a pretty accurate description. Officially, there are a possible 35 perimenopausal symptoms, which range from itchy ears to homicidal thinking, but actually, I’m guessing the number is closer to infinity. Why? Because everything in our bodies (which includes our brains) is impacted by hormones, and when a person’s hormones go through a complete overhaul, so does the person. Except for my mom. But I digress.

I’m someone who has been diagnosed with C-PTSD and, as a result, has suffered from and attempted to manage clinical anxiety and depression for as long as I can remember. I don’t say this to earn sympathy points, but rather to make it clear that I know what mental health does and doesn’t feel like. It seems like I have spent most of my life in the pursuit of healing and mental well-being, with varying results. On my worst days, I’ve dealt with intense suicidal ideation. On my best, I am positive and hopeful.

Until I turned 45, I thought I pretty much had a handle on things. Life was good, my kids were growing old enough for me to focus on myself a little bit, my marriage was healthy, and I was back in school to do work I love: becoming a therapist. Then I woke up one morning with a world-class, rollercoaster-level anxiety that made my previous anxiety look like a kiddie ride at a local fair. It felt like the world was spinning and I was about to fly right off. The intensity of my fear seemed both groundless and all-consuming. I felt like a wild animal—trapped, unable to breathe, convinced I was going to die. I stopped sleeping. I couldn’t recall simple words. Everyone seemed hostile and dangerous, even my own family.

I begged my doctor for help. I was told that this was “normal” and that I would just have to “deal with it.” That it would pass. I wasn’t sure I would make it through one more day, much less the years it would probably take to let it pass. Meanwhile, I was expected to act like everything was fine. I bought a cooling pad for my bed so it wouldn’t feel like I was lying in a volcano pit at night. I cried endlessly to my poor therapist, who earned every single cent I paid her and then some. I prayed my husband wouldn’t leave me because I was obviously not the person he married. And I started drinking too much. I just wanted relief from the chaos between my ears so badly.

By the time I was 46, I was overweight, my hair was falling out, my self-esteem was destroyed, and I was a shell of my former self. By the time I turned 48, I was done. I decided to get serious. Enter ketamine.

Medical ketamine infusions involve administering low doses of ketamine intravenously in a controlled clinical setting, typically under the supervision of a physician or anesthesiologist. Originally developed as an anesthetic, ketamine at sub-anesthetic doses has rapid-acting antidepressant and anti-suicidal properties. I knew about ketamine thanks to my profession, but I had no idea what doing infusions would feel like for me personally. As a person who enjoys being in control—one might even call me Type A—I’ll tell you, those infusions are some of the most frightening experiences I have ever had. They had me, for one hour, two times a week for three weeks, and then once monthly for a year, lose all touch with reality as I staggered mentally through what felt like a sadistic video game I was doomed to lose, after which I’d be knocked out and immobile for about 24 hours. But I did start feeling better afterward.

Then one night I went to dinner with my girlfriends, and all of us, being of a certain age, started discussing the ins and outs of this weirdo time of life we found ourselves “living” through. Quotes, because was it really living?

One of my friends brought up hormone replacement therapy and mentioned that she had a wonderful doctor who had helped her a lot. HRT is considered controversial because now-outdated studies have linked it with cancer, but cancer later versus ketamine infusions—or what happened to my brain when I wasn’t doing infusions now—seemed like a reasonable risk. I called that doctor the next morning. And wouldn’t you know it, after seeing her, getting a bunch of bloodwork done, finding out my testosterone was at ZERO and everything else was bad too, and getting my first hormone pellets, within two weeks I morphed back into the old me. The joyousness of that return to self was almost worth those years of torture I’d endured. Almost.

Now, at 55, I still actively, and mostly successfully, manage depression and anxiety, but I don’t have to manage insanity—for that was what that was. My weight is back to normal, my hair looks decent, and my husband and children aren’t scared of me anymore. I can have a glass of wine like a normal person, and I even sleep some nights (that’s been the hardest thing to recover). My gratitude runs deep.

It is not lost on me that my relief is a measure of my privilege. Both ketamine and the kind of HRT I do now are expensive and not covered by insurance. Not only that, but if I didn’t have access to the information about either treatment to begin with—which doctors are not sharing—I wouldn’t even have known what might help. Needless to say, if hormonal changes in midlife were a men’s issue, information about how to mitigate them would be abundant and the treatment would be accessible. Which means this is a feminist, not just a female, issue.

More and more women are speaking out about their experiences now, which is the only antidote to the silent suffering many of us have accepted. I believe and hope that by the time my four daughters get to be my age, things will be dramatically different for them. Meanwhile, I have trained my staff of 29 clinicians to ask women questions that doctors are not asking, to assess for possible hormonal shifts that may be contributing to mood disorders, and to offer solutions beyond a shrug and an assurance that this is just a normal part of life.

If you are reading this article, I imagine the title resonated with you and that you likely have some questions about what’s happening to you—or are looking for affirmation that you are not crazy. You aren’t! My best advice is to doctor-shop until you find someone who will look you in the eyes and listen to what you’re saying. Doctors like this may not be the norm, but they are out there, and you deserve to be cared for properly. The bottom line is, it isn’t easy living in a female body, but it’s doable if you get the right support.