Dear Annie: I never thought I would need to reach out for advice regarding my marriage, but here I am. I’ve been with my wife for 12 years. It’s the second marriage for both of us. There’s a 14-year age gap between us. She has two children from her previous marriage, and I have two as well. With the exception of one, all of our children are now out of the home and creating new and exciting life memories for themselves.

My wife is in her early 40s and is suffering from pre-menopause. She has been struggling with this for two years now. I have a business outside of our home that takes considerable time and effort and also takes some of my time when I’m at home. My wife was a career woman prior to her condition; however, she wanted to take some time off to get through this. I supported her decision, but after two years, it has placed considerable strain on our marriage. She was always this vibrant woman who was focused on her family and her own well-being.

Today, she’s lost much of that. I’ve tried to convince her to see a doctor as well as a psychologist, but she refuses. When I speak with her about getting help and back into the workforce, so she’s around people, it always ends in an argument. She’s in our home day after day, watching TV and scrolling on social media.

I’ve tried and tried to get her to reach out for professional help but with no success. I basically am running my business and looking after the home with no help from her, and it’s wearing me down. I love her, but these past two years have taken a toll on my mental and physical health. I am reaching a breaking point. However, I don’t want to give up. Do you have any advice? — Lost but Still in Love

Dear Lost but Still in Love: My advice is to be there for your wife. It sounds like she is going through a really tough time.

According to the Johns Hopkins Medicine website, your wife’s pre-menopause symptoms are not unusual. Very often the menstrual cycle becomes irregular. “The same hormones that control your menstrual cycle also influence serotonin, a brain chemical that promotes feelings of well-being and happiness. When hormone levels drop, serotonin levels also fall, which contributes to increased irritability, anxiety and sadness.”

Falling estrogen and progesterone levels can also lead to depressive mood swings. Be patient with your wife. There is help available. Don’t force her to go back to work if she is not ready; instead, encourage her to pick up hobbies that she might enjoy, to exercise daily, to stop spending so much time looking at screens and start socializing more. Go for a walk in nature, and take walks together.

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“How Can I Forgive My Cheating Partner?” is out now! Annie Lane’s second anthology — featuring favorite columns on marriage, infidelity, communication and reconciliation — is available as a paperback and e-book. Visit http://www.creatorspublishing.com for more information. Send your questions for Annie Lane to dearannie@creators.com.