Key Topics & Timestamps
0:00 - Introduction to Karena Dawn and "The Big Silence"
5:30 - Growing up with a mentally ill mother in Indiana
12:15 - The "decade of darkness" and teenage struggles
18:45 - The pivotal moment in LA that changed everything
25:20 - How fitness became therapy and healing
32:10 - Early menopause triggered by childhood trauma
39:40 - Managing anxiety and depression during perimenopause
47:25 - Ukrainian generational trauma and family history
54:30 - Becoming a caregiver for her mother
62:15 - Grieving and finding neutrality after loss
68:45 - The healing power of fitness and community
75:20 - Stepping into the "magi" phase of life
As a physician, I've witnessed countless women struggle with mental health challenges during their hormonal transitions, but rarely have I encountered a story as raw and transformative as Karena Dawn's. In our recent conversation on The Girlfriend Doctor Show, Karena opened up about her journey from childhood trauma to healing, revealing crucial connections between our mental health and our hormonal well-being that every woman needs to understand.
The Silent Epidemic: When Trauma Meets Hormones
Karena's story begins in Peru, Indiana, where she experienced what seemed like an idyllic childhood until her mother began showing signs of paranoid schizophrenia. By age 10, Karena was researching mental illness at the library, trying to understand why her mother would disappear for days or months at a time, often ending up as a missing person or Jane Doe in mental health facilities.
What strikes me most about Karena's experience is how it illustrates something I see repeatedly in my practice: the profound connection between adverse childhood experiences (ACEs) and hormonal health later in life. As I shared with Karena during our conversation, women who experience childhood trauma often face earlier and more challenging transitions through perimenopause and menopause.
The science behind this is both fascinating and sobering. When we experience chronic stress—whether from trauma, caregiving responsibilities, or life challenges—our bodies prioritize cortisol production. Since cortisol is made from progesterone, that crucial reproductive hormone, we're essentially depleting our hormonal reserves every time we hit that stress response gas pedal.
From Darkness to Light: The Power of Movement
Karena's "decade of darkness" included drinking, drugs, and a suicide attempt—all attempts to escape the chaos and pain of her family situation. But her transformation began with a single realization: "You are not your mother. You will not be your mother."
This moment of clarity led her to fitness, specifically training for a triathlon. As she discovered, movement became her therapy, her meditation, and her pathway back to self-worth. This resonates deeply with my approach to women's health—I always tell my patients that movement is medicine, especially for our mental and hormonal well-being.
The beauty of Karena's approach is its accessibility. She emphasizes that even ten minutes of movement can shift your entire day. Whether it's a walk around the block or a full workout, the key is consistency and showing up for yourself, especially on the days you don't feel like it.
The Perimenopause Mental Health Crisis Nobody Talks About
One of the most important aspects of our conversation centered on Karena's experience with early menopause. At 37, she began experiencing symptoms that her doctor dismissed as "just stress"—irregular periods, insomnia, night sweats, brain fog, and unexplained weight gain of up to 40 pounds.
This dismissal of women's symptoms during perimenopause is unfortunately all too common in medicine. What Karena experienced is a perfect example of how trauma can accelerate our hormonal timeline. The constant stress from her mother's illness, combined with caregiving responsibilities, literally fast-tracked her into perimenopause.
But here's what's crucial for every woman to understand: the mental health changes during perimenopause aren't "all in your head." When our estrogen and progesterone levels fluctuate dramatically, they directly affect our neurotransmitters—the brain chemicals responsible for mood, anxiety, and depression. Karena's increased anxiety during this time wasn't a character flaw or a sign of weakness; it was a biological response to hormonal upheaval.
The Generational Trauma Connection
Karena's story becomes even more complex when we consider her Ukrainian heritage. Her grandparents fled Ukraine in 1950, experiencing camps, threats at gunpoint, and the terror of war while her father was in utero. This generational trauma—what we now understand as epigenetic inheritance—can literally be passed down through our DNA, affecting our stress responses and mental health for generations.
When the current war in Ukraine began, Karena noticed both her father and herself being triggered by the collective trauma of their ancestors. This is something I see frequently in my practice, particularly with patients whose families escaped wars, persecution, or other traumatic circumstances.
The solution isn't to ignore this inherited trauma but to actively work to heal it through the practices Karena advocates: meditation, movement, community connection, and limiting exposure to triggering content like constant news consumption.
Building Your Mental Health Toolkit
What I love most about Karena's approach to mental health is how practical and sustainable it is. Her daily non-negotiables include:
Morning movement (even just 10 minutes)
Meditation or mindfulness practice
Community connection
Accountability partners
Limiting news consumption
Proper nutrition and hydration
These aren't just feel-good suggestions—they're evidence-based interventions that boost oxytocin, our most powerful hormone for mental and physical well-being. As I always tell my patients, oxytocin is the master hormone that helps regulate all our other hormones.
The Caregiver's Dilemma
Karena spent years as her mother's caregiver, moving her from Seattle to California and extending her life by five years through better nutrition and healthcare. This caregiving journey—while born from love—also illustrates how women often lose themselves in caring for others.
The grief that followed her mother's death was complex: grief for the mother she lost, but also grief for the mother she never had. This dual grief is something many women experience, especially those who've had complicated relationships with their mothers or who've lost the dream of the relationship they always hoped for.
Stepping Into Our Magi Years
As we discussed the transition from what I call our "maiden, mother, magi" phases of life, Karena shared something beautiful about reaching midlife. Instead of seeing aging as decline, she's discovered the power of saying no to what doesn't serve her and yes only to what truly aligns with her values.
This is the magic of our post-reproductive years—we gain wisdom, clarity, and the confidence to live authentically. We stop performing for others and start honoring ourselves. As Karena put it, "I know who I am now, and that's either a hell no or a hell yes."
The Healing Continues
What strikes me most about Karena's journey is that she doesn't present healing as a destination but as an ongoing practice. Three years after her mother's death, she's learning to give herself permission to be happy while still honoring her grief when it arises.
This perspective—that we can hold both joy and sorrow, that healing isn't linear, and that our greatest pain can become our greatest purpose—is something every woman navigating mental health challenges needs to hear.
Moving Forward with Hope
Karena's story reminds us that mental health isn't just about managing symptoms—it's about understanding the deep connections between our bodies, minds, and spirits. It's about recognizing that our hormones and our mental health are inextricably linked, especially during major life transitions.
Through her foundation, The Big Silence, Karena is breaking down the stigma around mental health and providing therapy access for those who can't afford it. Her message is clear: you are not alone, your struggles are valid, and healing is possible.
Whether you're dealing with your own mental health challenges, supporting a loved one, or simply trying to understand the complex relationship between trauma and hormones, Karena's story offers both validation and hope.
Ready to dive deeper into this powerful conversation? Listen to the full podcast episode to hear more about Karena's healing journey, her practical strategies for mental wellness, and how she's using her experience to help others break their own big silences.
Frequently Asked Questions
Q: Can childhood trauma really cause early menopause?
A: Yes, research shows that women with adverse childhood experiences (ACEs) often experience earlier and more difficult transitions through perimenopause and menopause. Chronic stress depletes progesterone (which is used to make cortisol), accelerating hormonal decline and potentially triggering earlier menopause.
Q: How does perimenopause affect mental health?
A: During perimenopause, fluctuating estrogen and progesterone levels directly affect neurotransmitters like serotonin and dopamine, which regulate mood. This can lead to increased anxiety, depression, brain fog, and mood swings. These symptoms are biological, not psychological, and require proper support and understanding.
Q: What are the most effective natural approaches for managing mental health during hormonal transitions?
A: Key strategies include regular movement (even 10 minutes daily), meditation or mindfulness practices, community connection, proper nutrition, adequate hydration, and limiting exposure to stress triggers like excessive news consumption. These practices boost oxytocin, which helps regulate other hormones.
Q: How can someone support a family member with mental illness while protecting their own mental health?
A: Set clear boundaries, maintain your own self-care practices, seek therapy or counseling, and remember that you cannot save someone else at the expense of your own well-being. It's important to understand that some relationships may never be what you hope for, and that's not your fault or responsibility to fix.
Q: Is it normal to experience grief for the relationship you never had with a parent?
A: Absolutely. Many people experience what's called "ambiguous loss"—grieving someone who is still alive but emotionally unavailable, or grieving the relationship you hoped to have but never experienced. This type of grief is valid and often requires professional support to process fully.
Links Mentioned:
Listen to The Big Silence Podcast
Buy The memoir, The Big Silence
