Nine years ago today, a 49-year-old woman took her last breath. She was my friend. I had known her for almost twenty years. Through medical school, residency, attendinghood, motherhood. She was quiet. Unassuming. A sharp contrast to the loud, obnoxious person I was almost thirty years ago when we met. She asked a lot of questions—to the point of seeming nosy. It was only after some time and maturity that I realized she was genuinely interested in learning about other people.

Your nervous system is the command center. Mission control. The situation room. And what happens when the main office has an inbox that has exploded?

September is Suicide Awareness Month. Not only do the leaves change color in September, but kids go back to school, schedules become filled with activities, meals are eaten in the car on the way to soccer practice, and feelings of overwhelm and loneliness can set in. September is a period of change. And for my friend, and many other women, sudden change—no matter how prepared you think you are—can be jolting to the system.

Let's talk about estrogen: what it's actually approved to treat, where the evidence is strong, and where we're still waiting for better data.

Studies estimate that 45–70% of women experience depressive symptoms during perimenopause, compared with roughly 25–30% of premenopausal women. One small study even found that the risk of depression was 14 times higher during the two years leading up to menopause than during the preceding three decades. No wonder so many of us feel like we're losing our minds.