The Grief No One Talks About: Menopause, Caregiving & the Weight We Carry

A few weeks ago, I lost my dog Bradley, and I actually recorded this podcast at that time. It was about a week later, and it took me like 3 or 4 tries to even be able to talk without my voice breaking. And oddly enough, when my podcast engineers went to listen to the recording and get to it, it was corrupted. It was no longer there. And I was so disheartened because I really wanted to have this conversation. And, and I don't know if it was The value of time and the universe happening for me, not to me. But I want to talk about grief today. And I want to talk about in the context of grief around Sandwich Generation, our experience, and also the grief of losing a dog. Anybody who's a pet owner, especially I would say a dog owner, knows how difficult that can be. Anybody who's a pet owner, especially I would say a dog owner, knows how difficult that can be. And I think it's, it's one of those things as women, we soldier through and it catches up to us, which is ultimately what I'm going to talk about today on Menopause Mastery. So, you know, when I lost Bradley, that it was, it was sudden. He was 6 and a half years old. He was a rescue Great Pyrenees. He was our life. Like I bought a new car so I could help Bradley get in the car because my other car didn't really fit him because he was huge. You know, lots of things. Like he was, he was spoiled, rightfully so. But he had a congenital kidney disease. His kidneys were underdeveloped and we, you know, we found out kind of late and there was not a lot we could do, but he went from being kind of okay to overnight going into kidney failure. And when it happened, I went completely still, not dramatically, you know, crying on the floor still, but the other kind, the kind where you keep functioning. Where you keep working, keep answering emails, you keep doing things when something kind of underneath you has stopped. And that stillness is really what I want to talk about today because it's not new for me. I've felt it before when my dad died well over a decade ago and when my mom had her stroke and when I helped her go through hospice and ultimately dying earlier this year. And I think if you're a woman in midlife listening to this, you already know exactly what I mean, you've felt this stillness before. You haven't had a chance to say so out loud maybe, but you felt it. So I want to talk about the part of midlife today that no one really talks about and puts on a hormone panel, right? You're not going to test this in a blood work. It's the grief. It's the caring and the caregiving and the sheer weight of what we're carrying every day and why so many of us don't let ourselves feel until it forces its way out. And this one's really, really personal because I'm going to tell you about my dad, my mom, my dog. And I'm going to also, you know, bring what I always do, which is the receipts. I'm going to back it up with some data, but mostly I just want to be honest with you today. You know, so I'm going to start with my dad. So my dad and I were very, very close, like really close, the kind of close where he was one of the only people that probably understood me before I understood myself and figured myself out. And he's been gone well over a decade. And here's what nobody really says to you when you're losing a parent that you were really close to. You think you grieved it. You, I mean, I, we, we had a life celebration, you know, all these things. You, you had the funeral, you had the casseroles, the people stopping by, and you went back to work in a week or so, like you were supposed to. And then years later, something small, a song, a smell, somebody who looks like him or, or laughs like him. And you're right back at the surface again, just like it happened yesterday. And that's not you being broken. That's just what grief actually is. It doesn't move in a straight line. It doesn't respect timelines anyone sets for you especially. And it definitely doesn't show up when you think it's convenient. So my relationship with my mom was also never easy. And when you really kind of go into the experience of my relationship with my mom, We were very, very different. And that's the, probably the hardest thing is, you know, my mom and I were, were complicated. And it's, it's a dynamic that I think most women that are probably listening to this may have had an experience with, I would say more so than not. And, and you don't have to necessarily spell it out, but I think a lot of it was I exhibited behaviors my mom didn't appreciate. And I also had a life that my mom to some degree may have also envied. You know, she grew up in a time where she couldn't have her own bank account, couldn't buy her own house, couldn't have her own credit card. And she loved my father and she loved being a mom, but I think she also had unfulfilled dreams that she never got to act on. And so I often was told I kind of had the tall poppy syndrome or, you know, that, that I was too big for my britches kind of thing, especially as a kid. And then as I got older. So it was complicated, but 3 years ago she had a heart attack, a catastrophic heart attack that brought on a catastrophic stroke. Prior to that, she was living on her own. She ran her own life, living fully on her own and fully independent. And she went to needing full assistance for all activities of daily living in 24 hours and went into a memory and assisted living facility. So overnight I went from being a daughter to really a caregiver and even wanting to have her in my home, there's no possible way because she was unable to do anything. And, and really in order for me to make sure she had the care that she needed, she needed to go to an intensive long-term care facility, but I had to become the chief decision maker, the medical manager, the financial manager, medical proxy while I was running my own business, seeing patients every day. I was actually in the middle kind of activities of finishing my PhD research. And for nearly 3 years, I sandwiched daily, hourly caring for my mom, going and seeing patients, starting up Minerva and getting that built, writing and finishing my PhD dissertation, working with my committee, and then going to an assisted living center every night and then coming home and filtering through paperwork and legal documents and taking care of things because that's another thing no one tells you is the sheer volume Of bullshit paperwork that you have to do to manage the life of somebody else. And then my mom died after a long journey through stroke-induced dementia. And I thought I had grieved my mom earlier this year in January when she was lost to her stroke. I thought I had grieved her. I thought I was— I had grieved her in the final 2 weeks of her hospice care while I watched her slowly die. And I sat by her bedside for over 2 weeks straight. But I wanna be really clear about something. I don't think that my story here is really remarkable. I think it's really ordinary. And I think what women are living through every single day, we've been told and gotten so good at absorbing all of it, just all of it, that we've stopped noticing how extraordinary the load actually is. And it's only through the perspective of hindsight that you can really see it. And this is why we call it the sandwich generation. And the data on the sandwich generation is really staggering. So 1 in 4 US adults are now caring for both aging parents and a child of some sort at the same time. An AARP in 2025 noted that caregiving in the US report estimates about 16 million Americans fall into that category with the average caregiver in that position being 51 years old. And that load obviously isn't split evenly. Roughly 60% of the caregivers are women and especially who spend measurably more time caregiving tasks every day than their male counterparts. And often what I would say to that also is we may have a statistic much greater than that, because a lot of times what I have found over 22 years of talking to women is they may be caregiving for their spouse's parents, even though their spouse is technically the full caregiver. But often women are also taking on this role for their family members as well, not necessarily as the daughter. of the person in caregiving. But it's not just the time, right? So the time is a lot, you know, like I joked that I had another part-time 20-hour-a-week job just managing my mom's stuff every day. But it's the mental load, the phone calls with the facility, the medication changes, the insurance form, the guilt when you can't be in 2 places at once. One recent industry survey found that 64% of working women in the sandwich generation reported being at a breaking point. With escalating mental health strains, rising healthcare costs, and real productivity loss. And burnout risk is highest in women navigating the most complex loads, women managing the complex sandwich generation caregiving along with their own perimenopause and menopause and managing their home, the unpaid labor, and the emotional toil and emotional responsibility that they do every day. This last part really matters to me deeply because that's exactly the population I built this show for. Menopause Mastery is for the woman in midlife. So we can turn around and have the best next third, the best next season of our lives. 'Cause damn it, we worked hard to get here. We're asking women to manage a parental decline, a household, a career, and their own hormonal chaos and their kids and their boomerang children All at the same time. And then we act surprised when something breaks. And I think the stats that we see with divorce and everything else, this is all part of it. Because at some point you throw your hands up and you just say, forget it. Fuck it. I'm done. Right? So I was navigating all of this earlier this year. And when my mom died, it was, you know, this grief that I thought I had gone through. My dad came back up and then a few weeks ago I lost my dog. And I want to talk about this one specifically because it revealed something to me about how I, and I think a lot of people actually process grief. So you can hear it in my voice. Damn. Oh, it's been like a while ago. So losing Bradley didn't feel smaller than losing my dad. It didn't feel smaller than losing my mom earlier this year. It felt enormous. And almost immediately, some part of my brain wanted to apologize for that. It wanted to say, he's a dog. People are dealing with real things. Get it together. That instinct actually has a name. Research calls it disenfranchised grief. Grief that isn't openly acknowledged or socially sanctioned as real loss. All you gotta do is look at somebody's post online about their dog passing. Somebody's gonna troll in the comment section and say, that's not really that important. You know, there's this going on in the world. But pet loss is one of the most common real examples of disenfranchised grief. Research shows that grief following a pet loss is consistently viewed as less valid than grief for when a person dies, even when a person has— people's actual emotional responses are just as strong. And critically, when we suppress that grief for a prolonged period, because we don't think we're allowed to feel it, it doesn't just disappear. It complicates the healing process and it makes it harder to move through. And so I want to give you something specific. I went looking for the research when I recorded this initially, and it kind of stopped me in my tracks. And so there's a study that came out earlier this year led by a psychologist named Philip Hyland, and he published in the PLOS One journal. He surveyed nearly 1,000 adults in the UK and asked them about every kind of loss they experienced. Parents, siblings, children, friends, pets, and which one had hit them the hardest. And here's the part that got me. About 1/3 of the people in the study that had lost a pet, and almost every single one of them had also lost somebody close to them. So this isn't somebody that, you know, hadn't buried a loved one or parent and comparing apples to oranges. These people actually compared it to an experience they'd already had. And of that group, 1 in 5, 21%, said the death of their pet was the most distressing loss of their entire life. Not close to, not almost as bad as, the most distressing. And when the researchers looked at rates of prolonged grief disorder, the clinical diagnosis of grief so despair and so, uh, severe, lasting long, it starts to look like its own condition. Right? So you can have grief that lasts so long that it becomes its own condition. Pet loss showed up at similar rates to someone measuring even higher in some categories of human loss. So the risk of developing that grief after losing a pet was actually higher than after losing a lot of the human relationships that we are taught matter more. And here's the part that makes me hangry on behalf of every person who's apologized for crying too hard over a dog or a cat. The official diagnosis manuals, the ones psychiatrists actually use to label, don't allow for that diagnosis to apply to a pet loss at all. Not because the evidence doesn't support it and says it shouldn't. It's because of how the category was written. So we build an entire clinical framework that tells people their grief doesn't officially count while the data underneath it says the opposite. So if you're a Somebody, and if you're a pet owner, if you haven't had a pet loss, you will have a pet loss. One of the most beautiful and painful things of owning pets and having pets or being allowed to have them in your life is they don't have the same lifespan as us other than birds. Right. But the reality is, is inviting a dog or a cat into your life means you have somewhere between on average 10 to 20 years to spend with them. And they will pass before you do. And the reality is the data says that you don't need to be embarrassed at how hard it took for you to get over or work through or feel the grief of losing an animal. And I want you to hear this clearly. Your nervous system, your nervous system, your brain, your central nervous system didn't get the memo that it was supposed to be a smaller loss. And it turns out neither did the research. So that's the piece I want you to hear. If you take nothing else from this episode right now, Is the grief you're told doesn't count, or the grief that you haven't felt that you need to feel is still grief. The parent you're still mourning while they're still alive, right? I think that is probably the worst experience of caring for a parent that is in some sort of decline, particularly dementia, because often the person they were is no longer present. And You think, hey, I'm going to mourn them when they pass, but the mourning starts at the decline, right? You're, you're already in a process of mourning and bargaining that mourning while they're still alive because the person they were is gone. Uh, the dream you buried, right? So the other things that show up, this is what I found when I was really going through this recently with Bradley, was the other things that you scaled back or the dream you buried or The thing you did to manage a crisis, the career you wanted to have that you, that you put aside because your family requirements were more than that. You know, even finishing my PhD, I was, you know, I was in the dissertation committee season and anybody that's ever done a PhD can tell you that's the most painful experience of the whole experience. But I was in that painful part. There's no more classes. There's no more anything else. It is just you getting stuff done because nobody at the school is going to tell you to get on it. Your people that are on your committee are not going to help you. And so when my mom— had her stroke, it would have been really easy to put it aside. And I think it was probably just the sheer cost of my PhD that kept me from doing that because it was hundreds of thousands of dollars to get. And, but it was something that took me a shit ton long, longer to get done just because I had to set aside the time that I was normally spending a couple of times a week, or at least one day a week. It went to once a month. But I didn't have to bury that, right? I was lucky enough that I didn't have to bury that, but I can tell you talking to women all over the country from stages, from the podcast, the patients I interact with, all of that, so many of us bury something that we dreamed about and we probably never fully grieved it. And what happens when you do have a grief that pops up is that shit crawls back in and it, and it shows up in, in sort of this rolling grief that you feel is More than it should be. And none of that really gets a funeral. We don't have services for the dreams you buried or the thoughts that you really wanted to have and the experiences that you dreamed of that maybe never got made. And here's the part that I want to talk about it and why we suppress it and where it goes instead. And here's what I've come to believe, watching myself, watching our patients at the clinic or our telemedicine patients. Women don't skip grief because we don't feel it. We skip it because we don't have a slot for it. We don't have a place on the fucking calendar for it. There's no calendar block that says fall apart today for 2 hours, but make sure you get your shit back together before the Zoom call. There's a patient waiting. There's a mother who's waiting. There's a mom who needs her meds to be sorted. There's a kid that needs to be picked up from school. There's a boomerang child that can't get it together that is now moving into your basement for the 3rd time. There's a dissertation chapter due, right? So we do what we've always done. We table it and we tell ourselves we'll deal with it later, right? I can fricking tell you for sure I did that with my mom when she had her heart attack and stroke. And I'm sitting in the room. I literally watched her have her stroke in the emergency room bed over the course of 8 hours. And, and I was sitting here going, okay, it's all gonna hit me at once. I've got 8 hours while I'm sitting in this room. To have this grief. And that really wasn't what I had at all. I all of a sudden was like, oh my God, I got to go fight for her care. And that's what I did. So grief doesn't wait for later. It just changes shape. And it also shows up with other things like the short temper you don't recognize in yourself, the exhaustion that sleep doesn't fix, and the sleep that doesn't repair because heaven forbid you're also in perimenopause and menopause, because that's probably already jacked up to begin with. It also doesn't fix as Every time you get like a cold or flu, as soon as things calm down, I remember years ago when I was younger and I thank kind of God for the functional medicine training and everything else, because I was one of those people in my 30s that if I went on vacation, I got sick every time. And it was like, as soon as I took my foot off the gas, my body just fell apart. I don't do that today, but I remember doing that, you know, and how many women are like, yeah, as soon as I took the foot off the gas, I just physically fall apart. And if you're feeling like you're a hollowed out shell and going through the motions and also checked out at the same time, or as the tears come out of nowhere over something completely unrelated, because that's not actually unrelated at all. That's the backlog finally finding a crack. And this is what really, I think for me showed up, but I think shows up for so many other women. I'm not going to sit here and tell you that I've got this mastered because I don't. I obviously, you know, I'm still verklempt over my dog appropriately. So I still feel those moments of grief about my mom and my dad. And I'm naming it out loud to actual people instead of just narrating it to myself in the car, instead of just having this conversation with myself while I'm on the bike, I'm grieving my dog and I'm still not okay. And, you know, I may say it to a friend and I say it out loud. And it also feels a little illegal when you start saying these things out loud. It shouldn't, but I did. And I'm scheduling the fall apart, right? I scheduled some fall apart time. I actually went to Italy. I'm lucky enough to be able to do that right after my dog passed and my husband and I spent 2 weeks there. And it gave me time to slow down because where we, we have a little place in Italy and it's this calm, like very medieval town. And being able to go there where everything is slow helped me not fill up the space with crap on my calendar, activities, busyness. And so I scheduled it, you know, and The way I would schedule anything else and an afternoon alone, a journal, a photo, a drive with no podcast on. There's all kinds of ways that you can do this. But for me, I actually had to kind of put it on the calendar, like time to fall apart with my grief the same way as anything else in my life, because I would have filled that time zone. I would have, I would have filled that up with stuff. 'Cause believe me, my to-do list is just like everybody else's. It's so lengthy that you're just like, it should be a toilet paper roll. And I'm letting the timeline really be nonlinear. You know, my dad's been gone for over a decade. He still shows up. I stopped treating that as a problem to solve. Um, my mom's death still appears as a specter in my mind in inopportune times. I still remember sitting over her bed as she's taking her last breath. I, you know, some people call that lovely. It's cemented in my brain. I don't know if I would call it that, but those things pop up out of nowhere. And I'm separating functioning from fine. I can run my business and be present and be engaged with the people I love and still be actively grieving. Those aren't contradictions. I spent a long time thinking that they were, right? That I needed to be able to compartmentalize the grief that I might be feeling or my feelings just in general, and then be on for my other parts of my life. So this is just me in the middle of right now, what I'm going through and particularly around grief. So what I want you to know is if you are in the middle of this right now, let's say you're caring for a parent who maybe no longer resembles the person who raised you. You're running a household, running a career, telling yourself that you'll deal with your own feelings once things calm down. I need you to hear this. Things are never gonna calm down enough for you to be able to give yourself permission. You have to take it. Because our natural tendency would be to fill it and then keep putting it off. And that's when the shit shows up out of nowhere, inappropriately, as all these other emotional outbursts and experiences in your life that you feel unexplained. You're not extraordinary for carrying this. Most of the women listening to this show are carrying some version of it right now, but the weight is extraordinary. Right. So I don't want you to think that I don't think you're an amazing human being, but the reality is almost all women will carry this. And we have to remember that we're carrying extraordinary weight and the weight is extraordinary and it just deserves to be named, not managed. And so if you're dealing with grief of any type, or you've put it in a box in the corner of your closet and you want to come back and deal with it later, but you haven't dusted it off and it's still there, I suggest taking some time to dust it off and go in and feel it because the next grieving moment will unleash that box out of the closet. And it's better to just play it out and go through the grief than to pretend it doesn't exist. And I wanna thank you for letting me be honest today about this experience. I don't often let a lot of my vulnerability show. And if this episode really is something in you, like it opens something up, found something in you, I'd love to hear about it. And if you're a woman who, who's maybe in the middle of her own sandwich, please know that I hear you. I understand it. And it's okay to feel all those competing emotions. And if you know a woman in the middle of this and you think this episode might help, right? Please share it with her. She probably hasn't had 5 minutes today to sit down and hear that she's not alone. And so I want to thank you for listening to this very vulnerable, personal kind of podcast about my experience of grief. And I hear you and I'm with you. And I will be back with you next week on Menopause Mastery. And we'll be back to the usual science and perimenopause, menopause content. But I appreciate every time that you listen. Thank you.