Mindfulness and meditation

Mindfulness means paying attention to the moment you are in. The NHS describes it as noticing what is going on inside and outside yourself, moment by moment: your thoughts and feelings, and also the sights, sounds and sensations around you.

Meditation is one way to practise it. In mindfulness meditation, says the NHS, you sit quietly and pay attention to your breathing, to sounds or to parts of your body, and bring your attention back each time your mind wanders. It will wander. That is part of it.

You do not need an app, a mat or a class to start. The NHS suggests noticing everyday things, like the food you eat or the air as you walk, and picking a regular moment in the day to do it.

The NHS website says mood swings, low mood and anxiety are common around the menopause and perimenopause. The Pakistan Menopause Society's recommendations list low mood, anxiety and sleep disturbance among the early symptoms of the menopause transition (Table 1), and say mental health problems in Pakistan are often missed because of stigma (section 4.2.4).

The NHS explains what mindfulness is meant to do. It helps you notice your thoughts as they come and go, see their patterns, and recognise when they are taking over. It may also help you spot signs of stress or anxiety earlier. The NHS is clear that it is not about making thoughts go away, but about seeing them as things that come and go.

• The Pakistan Menopause Society names mindfulness-based approaches as one part of mental wellbeing in the menopause years, alongside CBT and support from family (section 4.2.4).
• On CBT, the same recommendations say it is recommended for both hot flushes and mood, in person, in a group or remotely (4.2.4.1). See CBT for menopause.
• The Australasian Menopause Society says mindfulness, paced breathing and relaxation have been studied for menopause symptoms, but that the evidence is not strong enough to support using them.
• The NHS website lists meditation, yoga and tai chi among relaxing things to try for menopause symptoms, and its mindfulness page says NICE recommends mindfulness-based therapies as a way to treat less severe depression.

The same NHS page is honest about the limits: "Many people find mindfulness helpful, but it's not right for everyone." It says some people find it does not help, or makes them feel worse. If that is you, set it aside and take it to your doctor.

Mindfulness sits alongside medical care, never in place of it. If low mood, worry or irritability have lasted weeks, are affecting your sleep, your work or your family, or simply feel unlike you, book an appointment. The Pakistan Menopause Society asks doctors to screen for depression and anxiety at menopause consultations, using standard questionnaires (section 4.2.4.6).

The Pakistan Menopause Society's recommendations write about Salah in this section. They describe the daily prayers as built-in mindfulness breaks that bring grounding, rhythmic breathing and a sense of routine (section 4.2.4.7). Roshara reports that as the PMS says it. What prayer means is between you and your faith, and this page makes no claim about worship.

The same section also writes about dhikr and dua. Questions about those, and about how practices like muraqaba sit within your faith, belong with a qualified scholar you trust.

At home, a quiet moment can be the hardest thing to find. The PMS asks doctors to involve family in counselling, because in Pakistan's family-centred culture a husband's and family's support has a strong say in how a woman looks after her health (4.2.4.4). Asking for a closed door is a reasonable request.