Navigating the Unseen: Perimenopause and Mental Health in First Responder Women by Ann Webb

Ann at Instructor School hosted by Miami Dade FPD

I have been thinking about this essay for weeks now. Drawing upon the insights from Bulletproof Spirit by Captain Dan Willis, a recommended text, and The Power Manual by Daniel M. Blumberg, Konstantios Papazoglou, and Michael D. Schlosser. Both offer invaluable guidance on mental health, recognizing stressors, and developing coping mechanisms for first responders. While these books provide a strong foundation, they overlook a critical dimension of mental well-being for women in our profession: the profound impact of hormonal changes, particularly perimenopause, on mental health. This essay argues that addressing this often-unacknowledged aspect is crucial for supporting female first responders throughout their career. I also have a dear friend who wrote a book about mental health in the First Responder world, who I think would be a great guest on your Podcast. Dena Ali, Hope Out of Darkness - A Guide to First Responder Mental Wellness. Dena started her career as a Police Officer and then transitioned to a Firefighter with the Raleigh Fire Department in North Carolina. She is currently a Chief with the Fire Department and a Director at NC Peer Support. Dena and I are both part of an organization that rides (bicycles) every year through North and South Carolina in honor of our fallen first responders, Carolina Brotherhood. I know I have digressed from my essay, but I felt it was important to recognize Dena for a moment. 

Back to my essay, I read my books as instructed, but I felt something was missing from them. There is a subject matter that is not being discussed that is extremely important for women in this career. I'm not talking about women's empowerment or equality for women in the job, I am talking about mental health and hormonal changes as we grow into this career. I feel the only way I can explain why I feel this way is to give you a background on me, my career, and the struggles I faced. 

My perspective on this stems from over two decades of experience in law enforcement, a journey that has profoundly shaped my understanding of mental health challenges within the first responder community. My career began as a Security Police Officer in the United States Air Force, a field with minimal female representation, which quickly taught me to suppress emotions and push through adversity. As a single mom, I worried about the possibility of deployment.  I then transitioned to the Asheville Police Department, where I specialized in traffic crash reconstruction and impaired driving enforcement, becoming a recognized expert and educator.  During this time, I also became a Hostage Negotiator. This position gave me opportunities to learn about mental health and how to talk with people in crisis. Because of this education and working knowledge, when our department decided to implement the Peer Support Program, the Hostage Negotiation Team was deemed the core foundation of the program. We were trained to deal with people in crisis, but nothing prepared us for dealing with our brothers and sisters in crisis. The department then implemented a program bolstered by partnerships with specialized counselors for Military members and First Responders. This gave the Peer Support group better resources to help our officers who were in need. During the tumultuous periods of civil unrest and the COVID-19 pandemic, I was instrumental in establishing the departmental Wellness Program, developing policies for physical fitness standards and comprehensive mental health support, including securing grant funding.

Despite my extensive training and dedication to mental health initiatives within law enforcement, I, too, fell victim to the very challenges I sought to address. In my career, I have had my share of crisis incidents.  My roles as a traffic officer and hostage negotiator exposed me to significant trauma, including frequent encounters with death, life-altering injuries, and individuals in crisis. I became connected to families at the worst time of their lives. I was their last connection with a loved one they lost in a motor vehicle collision. Sometimes those connections were good, and I was able to bring closure to the families. Sometimes those connections were bad, and I was the focus of anger for a family who could not find closure. As a negotiator, I dealt with numerous people who were in crisis. Most of the time, I was able to help people find a peaceful resolution. But there were times when that person was set on their intentions, and there was no talking them out of their plans to end their life. While debriefings and mandated breaks were standard, my commitment to my career often superseded personal well-being. I thrived on professional success, accumulating accolades and respect, but this focus often came at the expense of my personal life, culminating in a divorce. Recognizing the classic pitfalls of burnout, I actively sought to manage my stress and maintain a strong personal foundation. As I advanced to Sergeant and prepared for promotion to Lieutenant in my 40s, with my son embarking on his own Air Force career and a new relationship blossoming, I felt a sense of control and optimism. However, just before my promotion to Lieutenant, I started noticing my mind was not as sharp as it used to be. I equated it to getting older and several concussions that I sustained during my career. After I got promoted, I noticed my confidence in myself had changed. I started noticing brain fog, my memory getting worse, I could not remember my officer's names, I couldn't form words, and I was emotional. I gained weight, which was totally out of character for me. I was a Physical Fitness instructor, and I took great pride in my appearance and physical abilities. I had no idea what was going on with me. These symptoms were bewildering. My attempts to seek professional help were not successful; physical examinations gave no answers beyond "getting older," and embedded counselors, though well-intentioned, often found themselves with little to offer beyond affirming my coping mechanisms.  The last 18 months of my career were my worst years on the job. I was supposed to be reaping the benefits of all my hard work and be proud of where I was, but I wasn't. I was emotional, could not think clearly, and was embarrassed by the weight I had gained. When I retired, I felt disappointed in myself. I felt I had let my officers and department down. I was not sure what I was going to do the rest of my life, but I was sure my place in Law Enforcement was over. 

No one ever talked about the symptoms of perimenopause with me, not even my OBGYN. Within the last year, I started seeing articles about perimenopause and the effects it has on the body and mind. I started learning about Hormone Replacement Therapy and how it can help with hormone imbalances in your body. I sought out an OBGYN who specializes in perimenopausal and menopausal women to get some help. I am just now starting to feel like myself again. I wish I had had this information before. I had no idea how much this phase in life could affect you mentally and physically. I remember being a young officer and thinking the older female officers had lost their edge and should no longer be in Law Enforcement. Maybe they didn't lose their edge, maybe they were experiencing that phase in life that no one talks about. I know this is not the same mental health healing that all these books talk about, but it is our mental health, and it needs to be talked about. I was someone who knew all the right steps and put them in place, but was still did not understand what was going on with me. Women have a hard enough time in this career, even to this day. Our lack of understanding of the way our body and hormones work should not be a detriment to our career, and we should not be ashamed to talk about it. 

So here I am, one year outside of retirement. I have a better understanding of my mental health, my body, and I have the confidence to know that I still belong in the First Responder Community. When Yoga for First Responders offered a class on a grant, I took the leap, knowing this would be how I would give back to the career I worked so hard for and loved dearly. Now I am excited to give new and veteran First Responders the tools to help them survive and thrive through this career. I am also happy to share my story with fellow female first responders, so they don't feel as alone as I did.