Menopause And Mental Health
Some common menopause symptoms are often mistaken for mental illness by doctors, family members, and even the women themselves. During Mental Health Awareness Week in the UK, I want to explore and shine a light on some workable science-based solutions.
Many women in Western societies understandably have negative thoughts about themselves and their health prospects during menopause. That’s not too surprising when you consider they often have dark circles under their eyes from a lack of sleep, are self-conscious about the look and the smell of flushing in public, have bulging waistlines, libido that seems to have vanished almost entirely and their self-esteem at the lowest ebb in living memory.
Symptoms of low mood, depression, anxiety, panic attacks, and palpitations are common menopause symptoms, and women are often prescribed antidepressants to combat these symptoms. In our most recent survey on 1100 women, we discovered that 37% of women had been prescribed antidepressants during their menopause. Still, over 80% felt this was inappropriate as they were not suffering from clinical depression. A Mayo Clinic Survey in 2019 found that only 7% of doctors and gynaecologists felt adequately educated to help women going through menopause.
If a woman doesn’t have a history of clinical depression, in my experience, it’s best to explore the natural approach to addressing symptoms as we have had so much success with this over the past 28 years. Lorraine was a typical case of a woman who had been written off work by her doctor for a mental breakdown and given antidepressants.
Lorraine’s Story
“I had started getting hot flushes and night sweats even though I was only in my mid-40s and was so tired in the mornings that I struggled to get out of bed. I was feeling depressed, which was uncharacteristic for me, and had been put on antidepressants. I ate tons of chocolate and junk food during the days, and I blotted out my evenings by drinking as much as a bottle of wine. My libido had vanished, maybe because sex had become painful as my vagina was so dry. I had put on masses of weight, constantly felt bloated and anxious and often had palpitations that made me feel dizzy. It felt like my whole body ached, and I longed to feel normal.
I had blood tests and was given HRT by my doctor, but it didn’t suit me, so I came off it. I found I only had one week a month when I felt normal. My stress levels would increase coupled with anxiety and forgetfulness, and my tolerance decreased. I eventually got signed off work as I was simply unable to function. I had a complete breakdown.
One day I was lying in bed wondering how I was going to get through the day. I remembered that Maryon Stewart had helped me over my PMS symptoms in the ’90s and again after my hysterectomy at 30, so I wondered if she would be able to help me reclaim my health again at midlife. I got in touch and signed up for a new programme. She designed a programme for me to follow. We didn’t just talk about my diet, my excessive consumption of alcohol or my lack of exercise, but we delved deeply into my life and the goals of what I wanted out of my life.
I followed Maryon’s recommendations as closely as I could. I started exercising again, although it took a while to get back to running as I felt too tired. Within four weeks, I had lost 7lbs in weight, the hot flushes had stopped, my bowels had improved, and my energy was returning.
Within only a matter of a few months, I felt much more like myself. I have a new job as a Midwife, and my menopause symptoms have gone. For the first time in my life, I feel at peace”.
Changes occur in women’s bodies at menopause and in the years leading up to menopause – perimenopause at the best of times. Anxiety relating to Covid-19 and subsequently elevated cortisol levels have affected the mental health of millions. This has only made it much more difficult for women to manage this midlife journey.
Apart from acceleration due to Covid-19, the incidence of depression doubles during menopause. Women who have struggled in the past with depression or anxiety might also see a resurgence in symptoms.
Understanding The Risks Of Depression
Fluctuating hormone levels during menopause may affect your physical and emotional health. Also, the rapid drop in oestrogen may not be the only thing affecting your mood. Research shows that billions of women have nutritional deficiencies that affect both our brain chemistry and hormone function, literally changing the colour of the lenses through which we see the world. The following factors may also make developing anxiety or depression during menopause more likely:
Diagnosis with depression before menopause
Negative feelings toward menopause or the idea of ageing
Increased stress, either from work or personal relationships
Discontent about your job, living environment, or financial situation
Low self-esteem or anxiety
Not feeling supported by the people around you
Lack of exercise or physical activity
Smoking
What’s Happening In A Woman’s Body?
Throughout their lives, women experience shifts in the levels of female hormones, which can cause mood changes at other stages of life, so it's not necessarily surprising that they can affect mood during the menopausal transition. Premenstrual Menstrual Syndrome (PMS) and postpartum depression are other examples of conditions driven by hormonal changes inside the body — in these cases, before menstruation or after childbirth.
Mood shifts during perimenopause and at menopause are often mild to moderate and caused by a combination of low levels of essential nutrients and a fluctuation in two hormones, progesterone and estradiol (a form of oestrogen). But when it comes to major depression (the more severe form of clinical depression), the link to female hormone changes is not clear. Midlife is a time when women sometimes face multiple sources of stress, including caring for children, dealing with ageing parents, and navigating life changes, all of which may contribute to the incidence of depression and anxiety at this age.
Health Changes And Mood Disturbances
Changes in your physical health at the time of menopause may also drive mood changes. For example, anxiety may be triggered by an overactive thyroid gland, which becomes more common with age. In addition, anxiety and depression may be triggered by a lack of sleep, which also becomes more common at the time of menopause, as hormone shifts cause night time hot flushes or other sleep disruptions that make it more difficult for women to get the rest they need.
How To Protect Your Mental Health As You Go Through Menopause
Be aware that mood changes may accompany other menopausal symptoms.
Monitor your mood and make a note of patterns in other factors such as sleep and stress levels. Seek professional help if symptoms become severe and interfere with daily life.
Learn how to get your nutrients back into an optimum range to help brain chemistry function normally.
Regularly include food rich in isoflavones, plant-based oestrogen, to meet the needs of the empty oestrogen receptors and fool the brain into thinking there are normal circulating levels.
Take licenced herbal remedies, including St Johns Wort which have been shown to help symptoms including depression and anxiety successfully and are reportedly more commonly prescribed by doctors in Germany than antidepressants.
Make lifestyle changes such as increasing exercise, getting adequate sleep, and controlling stress to reduce potential symptoms.
Reach out to others. Don't struggle alone.
Know that it's temporary. Typically, the mood changes that accompany female hormonal changes during the menopausal transition won't last.
Treating Depression Through Lifestyle Changes
Depression during menopause is treated in much the same way it’s treated at any other time in life. Your doctor may prescribe lifestyle changes, medications, therapy, or a combination of these options.
Before attributing your depression to menopause, your doctor will first want to rule out any physical reasons for your symptoms, such as thyroid problems.
After making a diagnosis, your doctor may suggest the following lifestyle changes to see if they provide natural relief from your depression or anxiety.
Get Adequate Sleep
Many women in menopause experience sleep problems. Your doctor may recommend getting more sleep at night. Try to follow a regular sleep schedule by going to bed at the same time each night and waking up at the same time each morning. Keeping your bedroom dark, quiet, and cool while you sleep may also help.
Get Regular Exercise
Regular exercise can help relieve stress while boosting your energy and mood. Try to get at least 30 minutes of exercise a day, five days a week. For example, go for a brisk walk or bike ride, swim laps in a pool or play a game of tennis.
It is also essential to include at least two sessions of muscle-strengthening activities in your weekly routine. Weight lifting, activities with resistance bands, and yoga may be good choices. Be sure to discuss planned exercise routines with your doctor.
Try Relaxation Techniques
Yoga, tai chi, meditation, and massage are all relaxing activities that can help reduce stress. They may also have the added benefit of allowing you to sleep better at night.
Quit Smoking
Research suggests that menopausal women who smoke are at a greater risk of developing depression compared to non-smokers. If you currently smoke, ask for help quitting. Your doctor can give you information about smoking cessation tools and techniques.
Seek Support Groups
Your friends and family members may provide you with valuable social support. However, sometimes it helps to connect with other women in your community who are also going through menopause. Remember, you’re not alone. Others are also going through this change. You are welcome to join my new Midlife Refuel Club to take advantage of free self-help information and connect with other women going through a similar journey.
Treating Depression Through Medications And Therapy
If lifestyle changes don’t bring relief, your doctor may look at other treatment options.
Depression during menopause is a treatable condition. It’s important to remember that several treatment options may help relieve symptoms and provide strategies for coping with changes. If you don’t feel that diet and lifestyle changes are enough for you, talk with your doctor to discover what other options may be the most effective.
For more information checkout the video below.
