Therapy for Midlife Women Who Are Rebuilding, Rethinking, and Ready for What's Next
This isn't the end of your story. It's the plot twist.
☎ Contact:
nikki@nikkisewell.com
(203) 590-9642
➤ Location:
Ann Arbor, MI
My practice is 100% online
Wherever you are in the Midwest or beyond, you don't have to navigate this alone. I offer online therapy across Michigan, Illinois, Indiana, Ohio, Wisconsin, Connecticut, and Florida.
Where would you like to start?
For midlife women navigating perimenopause, life after loss, and the question of what comes next. Convenient, private, and fully online.
A powerful complement to talk therapy that helps you get unstuck from the experiences — big and small — that are still running the show.
Hormonal shifts, anxiety, brain fog, and identity changes — this season deserves real support, not "it's just hormones and aging.”
Something shifted. And everything feels harder than it should.
Maybe perimenopause snuck up on you — the anxiety, the brain fog, the feeling that your body and emotions are no longer your own. Maybe a health scare, a divorce, an empty nest, or a career that no longer fits has left you wondering who you are now and what comes next. You're not falling apart. You're at an inflection point. I help midlife women make sense of what's happening, reconnect with themselves, and build a life that actually fits who they're becoming.
Hi, I’m NIkki!
I'm a therapist — and I'm also a midlife woman navigating this season myself. I know firsthand how disorienting it can feel when your body, your emotions, and your sense of self all seem to shift at once. I also know how dismissive the world can be about it. "It's just aging." "This is normal." Full stop, no solutions.
That's not good enough. And it's a big part of why I do this work.
I've been practicing therapy for nearly 20 years, graduating from the University of Michigan School of Social Work in 2007. Beyond my clinical work, I stay deeply immersed in the research — peer-reviewed literature on perimenopause and women's mental health — and I teach a CEU training for Michigan therapists on the topic.
My approach is flexible, not rigid — you're in the driver's seat of your own care, and I draw on a range of modalities to meet you where you are. My work is always strength-based, trauma-informed, and values-driven.
I'm not here to hand you a diagnosis and a worksheet. I'm here to help you understand what's actually happening — hormonally, emotionally, situationally — and give you real tools to navigate it with agency instead of dread.
I work well with Women who are:
In perimenopause (or menopause) navigating mood swings, anxiety, brain fog, and the feeling that their body and emotions have become unfamiliar, and tired of being told it's just part of aging
High-achieving and accomplished — a career they've worked hard for, a full life on paper — but privately exhausted, anxious, and wondering "is this it?"
Rebuilding identity and purpose after a health crisis or a loss that changed everything and wondering “who am I now?”
Moving through divorce, widowhood, or the quiet grief of an empty nest, and trying to figure out who they are outside of the roles they've held. “Where do I go from here?”
And who are ready to:
Stop white-knuckling through the hard parts and actually get support
Understand what's hormonal, what's situational, and what's been there all along
Let go of the version of themselves they outgrew, and step into what's next — even if they can't see it clearly yet
You've taken care of everyone else. Here's your permission slip to take care of you.
If anything on this page made you think that's me — that's worth a conversation. Reach out below and tell me a little about what's bringing you here. We'll schedule a free 20-minute consultation to see if we're a good fit, and go from there.
Common questions about therapy for midlife women
Is therapy helpful for perimenopause symptoms?
Yes — and it's one of the most underutilized tools available. Perimenopause isn't just a physical transition; it reshapes your mood, your identity, your relationships, and your sense of self. Therapy helps you understand what's happening, develop real coping strategies, and navigate this season with agency rather than just endurance.
Can therapy help with anxiety during Perimenopause?
Absolutely. One of the most disorienting things about perimenopause is that anxiety can appear out of nowhere — even in women who have never struggled with it before. That's not a personal failing or a sign something is permanently wrong. It's hormonal, and it's real. Therapy helps you distinguish what's driven by hormonal shifts, what's situational, and what might have been quietly there all along — and gives you tools to manage all of it.
What's the difference between perimenopause anxiety and regular anxiety?
The clearest signal is timing and history. If you've navigated life without significant anxiety and it's suddenly arrived — racing thoughts, physical tension, a sense of dread you can't explain — and you're in your late 30s, 40s, or 50s, perimenopause is very likely a factor. It doesn't mean the anxiety isn't real or serious. It means understanding the hormonal context changes how we approach it.
What about hormone replacement therapy — is that something you can help with?
HRT is a medical decision that belongs with your doctor, and I defer to their expertise on that side of your care. What I can do is help you think through the right questions to ask, advocate for yourself in medical appointments, and make sense of what you're experiencing so you walk in informed and prepared. Many of my clients find that therapy and HRT work well together — one addresses the biochemical piece, the other addresses everything it stirs up.
How much does therapy cost?
Sessions are $165. I'm private pay only, which means I don't bill insurance directly — but I provide superbills you can submit to your insurance company for potential partial reimbursement, depending on your out-of-network benefits. I also accept FSA and HSA cards, which many clients find makes the cost more manageable.
I've never been to therapy before. What actually happens?
We jump in. I'm not going to spend your first session reading from a clipboard — we'll have a real conversation from the start about what's bringing you here and what you're hoping for. You set the pace, you're in the driver's seat, and there's no script to follow. Most people leave the first session surprised by how much ground we covered.
How often should I come, and how long does therapy typically last?
I recommend starting weekly — research consistently shows clients make faster progress with more frequent sessions, and in my clinical experience that holds true. Over time many clients move to every other week as they find their footing. Sessions are 50 minutes. On average sessions, that varies widely depending on what you're working through.
Can therapy help me figure out what I want in midlife?
Yes — and this is some of the most meaningful work I do. Midlife has a way of surfacing questions that got buried under decades of doing and achieving and taking care of others. Who am I outside of these roles? What do I actually want? Is this it? Therapy gives you a dedicated space to sit with those questions honestly, without the pressure to have the answers immediately.