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Why Am I Wide Awake at 3 AM? Perimenopause, Anxiety, Hormones, and Sleep Waking up at 3 AM and suddenly feeling wide awake? During perimenopause, changing hormones can affect sleep, anxiety, stress tolerance, and your ability to settle back down. And no, you're not necessarily doing anything wrong. In this article, Dr. Tera explores the connection between perimenopause, progesterone, cortisol, anxiety, and insomnia—and what you can actually do when your brain decides 3 AM is

If your child has a food allergy, you already know that vigilance is part of the job. Feeding your child is a primal instinct as a parent, and when they have food allergies, it is so much more complicated. You read labels. You ask questions at restaurants. You make sure your child's epinephrine or rescue medications are available. You teach teachers, babysitters, grandparents, coaches, and friends what to do in an emergency. Often, no one takes it as seriously as you do and t

I hate to admit it, but I used to brag about being a perfectionist. For a long time, I thought it was a compliment. Being a perfectionist meant I cared. I worked hard. I was responsible. I got the best grades. I showed up. I tried so hard to do everything well. I thought perfectionism was part of what made me successful. After decades of living, studying, becoming a full-fledged adult, and becoming a clinical psychologist to boot, I see it differently now. What I once called

Learn what heart rate variability (HRV) is and how HRV training, biofeedback, and therapy work together to reduce anxiety and support nervous system healing and regulation.

GLP-1 medications like semaglutide and tirzepatide have become increasingly common. One in 5 American women ages 50-64 have taken a GLP-1 for weight loss, according to a recent report from RAND. It can feel like everyone is on these prescriptions, compounding the pressure to be thinner, as we see our friends literally shrinking. Our diet and body obsessed culture has long fed us (pun intended) the idea that fat is the worst thing we can be-especially as women. Many women st

Through PSYPACT authorization across 43 states, Dr. Tera provides telehealth therapy for locum tenens physicians, travel nurses, healthcare professionals, and high mobility leaders specializing in anxiety, OCD, burnout, parenting stress, chronic illness, and identity work.

Understand boundaries, why it is a a challenge to set them, the purposes they serve, and practical tools to set more effective limits honoring our values.

Holiday gatherings are hard for allergy parents. Learn how to manage food allergy anxiety, family challenges, and anaphylaxis stress — and find support with Dr. Tera.

Connect with a psychologist who gets it, born and raised in the Dakotas providing online therapy in 43 states, including the underserved areas of the rural Great Plains.

Learn about a recent win for perimenopausal women-FDA lifts box warning on HRT. Medical and mental health treatment is crucial in navigating this challenging life transition.

Perimenopause is a season of profound transition — hormonally, physically, and emotionally. For many women, it’s a time of growth, reflection, and redefinition. But for others, it can reawaken struggles with body image, food, and control that may have felt long resolved. Emerging research shows that perimenopause is a vulnerable period for both the development and recurrence of disordered eating . This is not about vanity or a lack of willpower — it’s about complex biological

Perimenopause is rough in many ways, it CAN increase social withdrawal urges because rapidly fluctuating estrogen and progesterone impact mood, anxiety, energy, emotional regulation, ability to deal with stress, and sensitivity to social cues from other people. This is exhausting, no wonder so many women simply don't have the energy to want to be social. Have you recently found yourself declining invitations, withdrawing when you used to be the one keeping everyone laughing,

A few days ago, I sat down to write this very blog post, feeling certain I had a brilliant and important idea. I typed a few words, stared at the blinking cursor, and—poof!—the idea was gone. I wracked my brain, came up empty, and decided to move on with my day. Fast forward to a client session later in the week, where we were discussing her struggles with—you guessed it—brain fog in perimenopause. I giggled internally, thinking: That’s it! That’s what the blog was supposed t

This morning on my hot mama walk, weighted vest strapped on, I found myself thinking about how complicated exercise advice can feel during perimenopause. We’re told to lift heavy weights to protect our bones and preserve muscle. Walk for cardiovascular health. Exercise for our mood. Move for our mental health. And then, somewhere along the way, the conversation turns to cortisol: “But don't exercise too much—you'll spike your cortisol!” So…what's a woman in perimenopause actu

This blog features findings from the WHI study published in 2022, debunks myths about hormone replacement therapy and provides insights about treatment for the mental health issues associated with perimenopause

Midlife is often portrayed as the time when women are supposed to have it all figured out. Career. Kids. Relationships. Aging parents. Household logistics. A body that may suddenly seem to have received its own set of operating instructions. But for many women, midlife is also a period of significant psychological, physical, hormonal, and social change—and we don't talk nearly enough about what that can mean for mental health. Research examining suicidal behavior across women

This blog shares the science behind anxiety increases in perimenopause, treatments, and support with online individual and group therapy

Cougar puberty, aka perimenopause is a challenging time, especially when you are parenting a teen who is on their own hormonal roller coaster, aka the "first puberty". Dr. Tera gets it because she is navigating the same things and has 20 years of experience as a clinical psychologist. Reach out to connect, therapy works, you don't have to do this alone.

Feeling worn out and misunderstood in perimenopause. This is a transition that can be unsettling to say the least and at worst, a mental health crisis. Both individual and group therapy available for support in 43 US states. Dr. Tera invites you to reach out and see if individual or group therapy might just be the help you need to navigate this time with your wits intact.

Learn about PSYPACT, a multistate compact allowing licensed doctoral level psychologists to provide telehealth across state lines.