Dr. Carlen Costa: Mental Health and Midlife Sleep Changes

0:00  
What's keeping you up at night? Hello and welcome to the bedtime edit podcast. I am your host, Alana McGinn, and today we are going to be talking about a topic that I think is going to be an important lesson for a lot of us in midlife, and that is the connection between sleep and mental health. It's Blue Monday, a day coined as the unhappiest day of the year. It's also day coined by a travel company. So we might not put too much stock into that day, but I think it's important to put stock in how lack of sleep affects mental health, and really it's a cycle. So a little bit about how my mental health is going. In midlife, I went through basically a three year pandemic, straight into a divorce. So for five years of my life, went through a lot of change, a lot of uncertainty, a lot of fear. And I will say prior to that, I mean, I Yes, I go through anxious moments. I do have some anxiety. I always say I came out of the womb a warrior. I overthink everything. I never understood how someone could get to the point of not being able to get out of the bed, to get to that point where their mental health was so rocked and they were going through so much that it was impossible just to start the day until I went through my divorce, and for a year and a half of that process, I was living with my ex and my kids. It's not something I recommend going through the stress of that divorce. There were days when, you know, I would wake up in the morning before my eyes were even opening, I was crying, and the thought of getting out of bed, I swear I'm not gonna cry in every single episode, but I might cry, but the thought of getting out of bed seemed impossible. You know, I had three teens that I thought I can't put a smile on my face for these kids again today. You know, walking on eggshells and dealing with my ex for that day, it seemed impossible. So yes, we're gonna be talking about all of this today, not necessarily about my situation, but about how so many women struggle with mental health during their midlife because of different transitions. It could be menopause, it could be relationship changes, career changes. We go through so many transitions. And my very first guest on the bedtime at it, I think, is the perfect person to talk about. This psychotherapist, Carlin Costa. She is also a fellow women in media network podcaster, the spicy, fat podcast, which is coming back soon. Carlin, you're my first guest. Hi, tell us a little bit about yourself as I dry my tears. Yeah,

2:35  
I know. Girl, me too. Don't worry, it's okay. I was like, Please don't cry. Please don't cry. You're her first guest. Please don't cry. But like, also, why not cry? You know, we'll get to that, right? That is actually one of the reasons why a I love being in community with women, but also, women also experience depression and anxiety rates at alarming numbers. And it's one of those big factors, one of those big reasons. And I know we're just kind of jumping into this, but like, buckle up. We're gonna talk about some things. But yeah, you know, normalizing the cry, normalizing the feel, yes, normalizing taking up space, emotionally being able to take up space. So girl, cry, all you need to. So I'm Carlin. Carlin Costa. I'm a psychotherapist, clinical sexologist, host of the spicy fat podcast here on the women in media network, which like, hey, family, we're sisters now, I'm super happy to be here with you today.

3:30  
Yeah, thank you so much. I feel so comfortable interviewing you. So this is great. Okay, let's get to the big questions. So I work with a lot of clients in midlife. I speak to a lot of women, a lot of friends, a lot of people around me in midlife, and whether it's that 3am waking or whether it's just the inability to fall back asleep, why, in your opinion, are so many women in midlife struggling with sleep?

3:56  
Yeah, that's, that's, there's the question, right? So Statistics Canada really maps out three different age groups, right? So the 20 to 34 range, the 35 to 49 range, and then 50 to 65 and then, you know, there's another 65 plus, right? And women in every age group struggle with sleep, but when we're looking at especially that kind of like midlife time that 35 to 49 even 50 to 65 I kind of see that as like a midlife giant chapter for women. You know, there's really, like four main factors really or unique pressures to that age group that influence our sleep and our ability to be restful. So things like career challenges. Women at this time, you know, are experiencing burnout, are really taking note of gender based discrimination, are considering any kind of changes in their career. Another factor is also child care responsibilities, or caregiving responsibilities, even you know. Know this age group is also known as the sandwich generation. So we're not only taking care of our kids, but we're also taking care of our parents or family members that are aging,

5:10  
something that one of my listeners actually or one of my listeners I don't have listeners yet, one of my members sent to me. Most women start off as the default parent. And then as our kids get older, they get more dependent, we start maybe gaining some time for ourselves, but then we go into that sandwich generation. Perhaps we have aging parents that we need to now start taking care of, and women are now falling into that default caregiver. And I never really thought of it that way, because I'm fortunate where both my parents are healthy. I'm not at that stage yet, but yeah, so yes, that will be a feature segment for sure. And

5:46  
here's another reason why we may struggle with our sleep, biological vulnerability, so things like hormonal changes, perimenopause, menopause, post menopause. What does it mean? What does it look like? How do we treat it? Do we even talk about it enough? I don't think

6:01  
so. Yeah, it's that perfect storm of like biological and life changes exactly. Add

6:05  
on relationship challenges, right? That age group, 35 to 49 is the highest in divorce rates or separation rates. Add in, then mental health struggles on top of that, social isolation, because we're dealing with mental health struggles, because we're trying to get ahead in our careers, or figure out our career challenges and caregiving younger than us, older than us. Girl, of course, we can't sleep, you know,

6:28  
right? How has that been affecting our mental health? Yeah,

6:32  
yeah, in all the ways, really, it's bad. Sleep is like a toxic X, okay, it messes with everything, every aspect of your life. Sure does you know? Because when you don't sleep well, your brain doesn't clear out like the trash that it accumulates through the day. It leaves you emotionally frazzled. It leaves you cognitively fuzzy, right? So sleep deprivation and not honoring sleep cycles and what that means for you, right? We also have to talk about that. What a sleep cycle actually means for you. Has been linked to higher rates of anxiety, depression or even worsening symptoms of perimenopause and menopause. We have to pay attention to our sleep hygiene, and at the same time, we cannot talk about sleep hygiene in a, you know, like a blanket method. It can't just be like Mark Wahlberg, who wakes up at 4am and says, If you don't wake up at 4am you know, you're not successful for the day. Well, Mark, listen, my hormones fluctuate a heck of a lot more than yours do. I don't know what you're taking. I hope nothing. You seem like a nice guy. I'm just saying. But like, my body is doing so many more things than your body is at any given time, so talking about sleep hygiene has to also be with the awareness of what your mental health is. So whether that's anxiety, whether that's depression, but also whether that's neuro divergence as well.

8:01  
Yes, let's talk a bit about that. You had mentioned that in our notes, and that's interesting to me, because I don't know enough about that, so I would love you to speak more on that. Yeah,

8:09  
so neuro divergence. So neuro divergence is the spectrum of alternate ways that our brains can be essentially right. Typically includes ADHD, of which I'm one of the neuro spicy women. So I have ADHD for sure. So this is also very important to me, but ADHD autism, ADHD autism and ADHD all mixed together and then going on to OCD, but then even hitting the branches of anxiety and depression, but neurodivergent people, which is about 20 to 30% of the global population, a majority of which are actually women. Interesting, interesting, yeah, firstly, our circadian rhythm is different than a neurotypical person's. Our circadian rhythm is different. My body naturally wants to stay awake later. Night owls, if you hear of a person being a night owl, more likely than not, they are neurodivergent. Now that is also a blanket statement. It's general. That doesn't apply to everybody. I know many neurodivergent people, especially women, who are very early risers. But then you add sleep sabotage on top of that, because we're dopamine seeking, because we're trying to recover from some things with perimenopause. Oh, it's gonna be fun for me the next 20 years.

9:34  
You know, you had mentioned there's a higher risk for suicide, yeah,

9:38  
there is. There's a higher risk of suicide in this age range, and it is because of all those factors that we discussed right? We talked about hormonal changes, so entering perimenopause and what that means, menopause, post menopause, looking at relationship challenges, right? A large majority of divorces and separations begin or happen between. The ages of 35 to 49 and then being in that kind of sandwich role, right? That sandwich generation, you know that is a lot of pressure to perform, to perform, not only as a woman in your job, or a leader in your job, or even just to get to your job, right, to perform as, more often than not, a primary caregiver in your home and outside of your home. And then on top of that, your hormones are doing, you know, the like the salsa that nothing feels consistently parenting

10:36  
teens that are going through puberty themselves, yeah, well,

10:39  
and then that, right, right? You're going into perimenopause. Your kids are starting puberty. You're coming into, you know, their own menstrual cycle. And it's just like, oh, there's too many hormones in this house.

10:54  
Yeah, that stat and that information both shocked me and didn't, because I get it. I'm thankful that I feel like our generation now that is going through midlife. There are so many more conversations about it, so much more in focus on menopause and perimenopause, which is so important. But again, there are other that's what I'm hoping with this podcast, is there are other stories that are happening in this age range that need that community. And I don't know that generations before us really had that so that I feel is at least a step in the right direction. Yeah, and

11:25  
Atlanta, you know, when you do this, where you're talking about sleep, you know, yes, women, on average, need more sleep than men, just on average, regardless of how your brain presents. Study Show it. Show it. We know it. So we definitely need more sleep. But also looking at, you know, needing more sleep, and please correct me if I'm wrong. Doesn't necessarily have to be like, consecutive, you know what I mean, like 10 consecutive hours. So, you know, in my practice, women will come in, they'll be like, you know, I fell asleep. I finally fell asleep at like nine o'clock, but then I was up at like one, so then I worked until like, four, and then fell asleep again for another three hours. And I was like, Okay, well, did that equal to eight to 10 hours? They'll say no, because they're judging themselves, and be like, well, if I'm awake, I must be awake. Why would I go back to sleep? There's things to get done, right? And looking at sleep as always being accessible and not necessarily like the static experience or event that needs to happen.

12:26  
Listen, that's how our ancestors did it. Back in the day, it was stage one of sleep and stage two of sleep. It was never consecutive, you know, seven to eight hours throughout the night. But modern technology has kind of forced us into that. And I think we also need to look at, I know this is something that I've taken a lot of focus on as I'm getting older, is just the power of rest. You know, sleep is one thing, yes, and rest can equal sleep, but just the power of rest. You know, there's seven different stages of rest that we can talk about and not feel that guilt for it. It's okay, like we said, it's okay to cry, it's okay to feel the feels. It's okay to slow down, it's okay to rest, it's okay not to power through all the time. I think there's importance to that too, and is needed and necessary.

13:13  
Totally and doom. Scrolling, is it resting? Sorry to say that

13:19  
it is not. It is not. And that's something that I know, I Yeah, and listen, that is a band aid for a lot, like when I was going through my divorce. I mean, even knowing what I know the do's and don'ts, tick tock was my escape. You know, it was my and I knew it wasn't a great thing. I knew it wasn't helping my mental health at that time. It was something that I needed to change, and I have since, but that was my escape from my own reality. Was just consuming other reality to kind of turn off my brain, and many of us are guilty of that, especially when you're going through something major, right? So what are some tips that you feel that midlife women can use to improve their sleep. I love this. Okay,

14:03  
so the first tip is, is your mattress right for you the most important piece of furniture in the home. It really is right. And I literally just went through this with my partner. We needed to get a new bed Black Friday. Let's do it. And our sleep has dramatically shifted. We're like, oh, okay, this is part of what why we've been a little bit grouchy these days, right? We needed a new bed. So definitely like, invest in a good bed. Now, the second tip, I would say, is set a bedtime routine. But what does that mean? Okay, because my defiant self is, like, you set a routine like I'll sleep when I get there. You know, I have things to do, but setting a bedtime routine is less about consistency, even though it is about consistency, but more about. Kindness, and it is about extending yourself a kindness, because you deserve to have that time. You deserve to have like you know, your pre sleep ritual and your sleep Association tools and get yourself into a way to just like actually wind down whether that's an hour, half an hour, or even 15 minutes.

15:29  
And I do think that's important to know, is it doesn't have to be this elaborate to do. I mean, I talk a lot about giving you and giving yourself an hour before bedtime, and, you know, I go through a slowdown Hour, which I'll explain in later episodes. But I also just think, like, it could just be five or 10 minutes of just focusing on you and allowing that connection between your brain and your body to slow down and sleep. It doesn't have to be anything elaborate, and

15:56  
that's why I'm big on like sleep Association tools, especially as a neurodivergent person, right? So I do have a fan that is on in my bed. I do listen to the exact same playlist every single night with no words. My brain now associates these things with, hey, it's sleep time, you know? So those types of things can help encourage the routine and the delivery of it, along with something like cooling your room down. I used to, like, not want, like, a cold room, but now that I'm I think I'm perimenopausal, and I don't even know what's happening, to be honest with you, but now that things are going up, I'm so hot. I'm so hot all the time, and I'm just like,

16:39  
this is the first winter where, so I have a ceiling fan, and normally it runs for the summer, but by like, you know, October, November, it's off. Yeah, this is the first year where that ceiling fan is still running, and we're like, you know, in January, and it is not getting turned off anytime soon. So I am right, and my dog is, like, right up beside me, and he's like, a little human furnace, like, two hours, and I'm like, say, move over. Like I cannot with the heat. Yeah,

17:06  
my dog now rolls over to my partner side.

17:11  
Well, and that's what I'm doing. I'm shopping him over to him. But, yeah, no, regulating temperature is big, especially for us midlife women. 100%

17:19  
Absolutely So temperature. And then I also love looking at what am I ingesting before bed. So ditching the wine. You don't need alcohol before you go to sleep because it messes with your REM sleep. So Herbal Tea Way better. Having even a tech time out 30 minutes before bed, right? Blue light is the enemy of melatonin. Right? Neurotypical women, you know, make a certain amount of melatonin, but neurodivergent women don't. So it actually is really important to, kind of like, Ban screens or limit screen time, or at least use blue light blockers of some kind. Yeah, before that. And then another thing I like to do is that's when I take my magnesium. So, yes,

18:05  
okay, let's talk about that. Let's talk about the M that we lay Yes,

18:10  
magnesium is so, so important for women, especially in this 35 to 49 age group. You know, it helps relax the muscles, helps calm the nervous system. Study shows that it helps improve sleep quality. I'm a big fan of, like, taking, you know, a bi glycemic pill every night, doubling it up the week before my period, and during my period, actually, which is when I need it even the most at that time. And then, you know, hanging out with my magnesium, and it really does help, but being mindful of that, you know, being mindful of when I'm on my cycle. So my sleep hygiene may need to shift and adjust 100%

18:51  
I can tell, you know, the either the week before or obviously the week during my sleep is just different, and then it's even changing even more now as I'm heading into those perimenopause years. So you know when you're going to be going through those hormonal shifts, you likely won't be sleeping as well. You also need to accept that. I think that's important too. And then what do you need to do to better your sleep during that time? So like for you, you're doubling up on your magnesium. For others, it might be changing bedding. It might be making the room more cold, changing what you're sleeping in, changing your bedtime routine, or even, like,

19:25  
seasonally, you know, Spring Summer, I'm up with the sun. Yes, winter, I'm not, and I tend to be more of a night owl, just naturally hibernating. Yeah, just naturally. So, you know, that's, that's the one thing I dislike about when we talk about like sleep hygiene and routines, is that there doesn't feel like there's any flexibility. And consistency is actually about flexibility. It's about consistently giving yourself what you need, not about consistently giving yourself the same tools, the same

19:57  
things, right? But then there's. The emotional side of sleep and our emotional relationship that we have with sleep, what emotional changes would you make to better our mental health, alongside of when we're working on our sleep, not necessarily sleep hygiene, if that makes sense.

20:17  
No, it's a great question Atlanta, you know. And the short answer, we can expand it, but the short answer really is, if you're working on your sleep hygiene and all of these things that you're doing doesn't work, then it means you need to go to therapy and deal with your shit, right? Like, like, that's, I'm a huge proponent for therapy. That's, that's, that is the money right there, right? You You can only eat so much magnesium and cool your room down so much, and drink herbal tea as much as you want to. But if your brain continues to ruminate and you're not addressing the actual stressors or the challenges or the emotion your emotional body, then it doesn't matter what you do, because your body isn't regulated, your emotions aren't regulated, and that's what we need

21:06  
to address. Yeah, therapy saved me during my divorce, for sure. Unfortunately, there's only so many sessions that you can do until while your benefits cover it. So I know that it's not it's not an option for everybody, right? But it is so important, because working on our cog again, our cognitive relationship with sleep, betters our mental health. It's not always about the temperature in the bedroom and what time you're going to bed at, and it's not always as simple as that, even though sometimes those changes may not feel simple, but working on like for me, it was a big thing of just the simple act of learning to let it go. You know, there was so many things I had to learn to let go I can control how I respond to others. You know, giving up the the want of controlling how others responded to me, or how others thought of me like even just how many times are we lying in our bed replaying conversations in our head of what we should have done different so, like little steps like that can, in turn, help you sleep better, therefore help your mental health. Absolutely,

22:03  
absolutely and prioritizing joy in that as well. Oh yes, I love that. Yeah, prioritizing joy. So whether that's dancing, journaling, apparently brings some people joy reading, reading books, right? But like prioritizing emotional well being is not just about dealing with your shit, but it's also about putting a light in your life where you also deserve to celebrate, where you have let things go. Just because you have some heavy doesn't mean you don't also have some light, you know, and

22:39  
you don't have to spend a lot of time on it, either. A lot of people think by us saying, you know, it put joy in your life. It's like, I don't have the money to take a painting class that I want to do, or the time to go dancing, you know, like it could just be, you know, I talk a lot about just like five minutes. Five a five minute action is going to motivate you to do more. So we can all fit in five minutes a day to prioritize ourselves and find joy in some way, as you incorporate that more you can, you know, increase the time and do more. But yes, I love that you said that because we need to insert more joy and peace into our lives. However, that may be,

23:16  
yeah, like, how do we get dopamine? How do we get serotonin? How do we get oxytocin? Right? If your body is depleted of those things, all you're going to be continue to do is crank up that cortisol, which is going to hit against that melatonin and like, again, it doesn't matter. I love that. You said that, you know, because financial burden is also a big stressor for people. So it's like you said, How do I find joy? I can't afford the art class. I can't afford the dance class. Cool, same, right? But like, yeah, exactly. I can't afford to go to the dollar store and call my girlfriends over, or, like, even throw on a free YouTube video that is going to walk me through something like a class of some kind, whether it's a dance class or a paint by numbers or something like that. But also finding joy is also about defining what turns you on. So many women I talked to her like Carla, I'm not I'm not crafty. I'm like, Cool Me neither. We try our best. But you know, so my joy isn't necessarily linked to that. My joy is linked to community. My joy is linked to I love cooking, for example. My joy is linked to to reading. My joy is linked to shared intimacy and sex, right? Sex also helps you fall asleep, and so does masturbation. Let's talk about that in a minute, but

24:40  
that could be another episode that we had. Okay, great, great, but Right?

24:44  
But like, what does Joy mean? Because I'm tired of hearing everybody say, go take a bubble bath and write a journal. And it's like, that's not it for everybody. Yeah, and

24:56  
I love they said that, because I actually use the same explanation. And when, you know, obviously, when we talk about mental health and we talk about lowering stress, I mean, that's a big thing that I do is, you know, sleep more, Stress Less, obviously, the topic of meditation and mindfulness. And, you know, mindful breathing comes into play. And what I always like to explain is meditation doesn't necessarily always have to be the Act of, you know, sitting cross legged in the meditative state, because for a lot of people, that in itself can be overwhelming. Now I have to learn how I don't have time to learn how to meditate. Now I have to learn how to meditate. So for me, my meditation and my way of kind of organizing my thoughts, clearing my mind, which you never fully clear your mind, but just being a more present state of mind. Was walking. I walked before COVID made it cool. Okay, I've been walking since I was a teenager, but that's just what works for me. I get the physical activity, but I don't actually even do it for the physical activity. I just enjoy the art of walking. But for someone, as you said, it could be baking, it could be cooking, it could be cleaning your house. It could be organizing a cupboard. We could call it joy, or we could call it just peaceful, calm mindset. And again, it doesn't have to take a long, long time during the day to do it.

26:06  
No, and the advice like you just need to learn how to meditate. Because, like you said, So meditation doesn't actually have to be stillness. Meditation is actually about focus. Is there definitely merit to being able to just clear your mind and sit in silence, sure, but not everybody's brain can do that, so it's about focus and being able to relate to your thoughts in peaceful ways. That's what kind of stillness really is. But ecstatic meditation is one of my favorite ways and most accessible ways for me to meditate. Ecstatic meditation actually can look like you throw on some music really loud, and you just move and sway your body like in ways that just actually feel really good for you, which is actually also a form of somatic therapy, which moves through anxieties and things that you're holding on to in your body that you don't necessarily want to be and moving it through you right? That's why Doom scrolling doesn't work. Doom scrolling just makes your body, your brain, busy, but it doesn't actually like move the energy that you need to in your body, and it just keeps it there, which is why we see as we get older women, we tend to compartmentalize, but like within ourselves, and then we become like emotional luggage, which is why we have a harder time losing weight, which is why we have a harder time accessing joy, which is why we have a hard time getting to sleep, and it's because we are keeping everything inside of us and then, like saying, Hey, it's okay. I have PTSD. It's fine, right? I I'm

27:54  
fine. Everything's fine. I have

27:56  
anxiety. Everything's fine, right? Unmanaged and undiagnosed potential neurodivergence. It's fine, right? Everything is fine. No, honey, it's not fine. It's not fine. You are not emotional luggage. Stop carrying things around. You're right.

28:14  
You're right. Are there any misconceptions or myths that you think around, like midlife, sleep or mental health?

28:21  
Yeah, yeah, yeah. So we kind of touched on the one. So the first myth is you need like, eight hours of sleep at once, right? I think quality means more than quantity, so if you're refreshed after six or seven hours, then that's really great. Now women do need more sleep than men, so we are kind of aiming for that 789, hour kind of stretch. But that doesn't have to be all at once. So normalizing napping, right? Even if it's a quick 20 minutes, normalizing sleeping, getting up, getting some energy out, and then going back to sleep. Also, I think that's a first good myth, which goes into the second myth, which is midlife means you'll never sleep well again. I remember my mom and her friends always talking about, like, oh, well, we're menopausal, we're never sleeping again. You know. And hormonal shifts can definitely make sleep trickier, but with the right tools, you can absolutely improve it. So whether that is like a hormonal response or an emotional, mental health response as well an

29:29  
environment response too, when you know that you're not sleeping while making certain changes, there's a lot more couples now that are sleeping in separate bedrooms because they want to get better sleep. And unfortunately, you know, it deems the term sleep divorce, so it has this connotation that it's, you know, it's a bad thing for the marriage, but it's just in order to sleep better. And sometimes that alone can help your sleep. And then once you're through the menopause stage and you're sleeping better, you can join up again, or not. You know, whatever works for. Yeah.

30:00  
Well, you know what I love about sleeping separate is that a you actually get a good night's sleep, because if you're a star Fisher like me, right, you're not, you're not disturbing your sleep or your partner's sleep. But also, what I love about it is that it makes intimacy more intentional. You know, because when you share a bed with your partner, for example, you often get it tossed into that, like, lazy, like, okay, just like, roll over. Let's do a quick thing and then, like, move on. And some mornings, let me tell you, some mornings that's the best, right? Some mornings, it's calming. It's all I need, right? But you know, what that can actually do is start to build some resentment that things aren't intentional, that like intentional connecting isn't happening. So if you're sleeping better, then you have more space to emotionally address things and challenges in your relationships, such as intimacy, such as finances, such as capacity, right? So sleep and sleeping separate could actually be the answer to having a better sex life, yeah,

31:09  
and a better marriage, really? Yeah, right, absolutely, absolutely. Okay, so let's end this. We're gonna have you back, because there's so much more that we can talk about for sure, but let's end this on like what would be one we've talked about so many takeaways, but what would be one key takeaway that you think anyone listening to this could do to better their sleep and therefore their mental health as well? I think

31:33  
the key takeaway this episode is that sleep is your superpower. Sleep is your superpower. It's not selfish to prioritize it. It's necessary for you to show up as your best self, and allows you to fuel being able to address any challenges or barriers that you handle, especially from a mental health perspective, and it really is the foundation for everything else that you do. So figure out what sleep hygiene means to you and then roll with a girl. Love

32:08  
that and agree wholeheartedly. But in my opinion, it really is the foundation of all our other pillars of health, for sure, because when we're not sleeping, we're not really doing anything proper or right right, including bettering your mental health. So thank you, Carlin, for coming on today. Let everyone know where they can find you.

32:27  
Yeah, hey. Okay, so you can find me a few different places. Check out my website, Carlin costa.com or spicy fat.com as well. If you want to check out the podcast and yeah, hit me up, Instagram, YouTube, all of the different places, but check out my website, and you'll be linked to all the fun things that I'm doing in my life,

32:46  
amazing. And all of her contact information will be in this show's notes. Follow and subscribe to the bedtime edit podcast. Wherever you download podcasts, you can also find this episode on the bedtime edit.com I want to hear your stories. If you are struggling with sleep mental health issues, let's share some stories on another episode. You