Menopause Mental Problem: Beat Them
1. Mood Swings
Emotional health at early menopause requires a balance between self nurturing and the obligations of work and caring for others. Many women are able to identify and describe sources of tension and symptoms of stress, but may still find it difficult to take time for them. Recognizing a problem is the first step to understanding its causes and developing coping mechanisms. Although many stressors cannot be altered, coping skills can enable women to meet life’s challenges and create a renewed sense of self-confidence, balance, and harmony.
When I Should See A Doctor?
Sometimes, coping skills and lifestyle changes are not sufficient to relieve symptoms of stress. These symptoms may be a side effect of medication, a symptom of a medical condition, or the result of clinical depression or anxiety. A healthcare provider can help determine the cause of mental health stressors, assess options, and prescribe appropriate treatment. For example, mood disturbances brought on by sleep deprivation resulting from hot flashes usually improve when hot flashes are treated.
During perimenopause, when levels of hormones are erratic, hormone drugs such as low-dose OCs may help stabilize mood. This may be particularly true for women, whose mood has been previously affected by hormone fluctuations in younger years, including those who suffered from postpartum depression or PMS. However, no hormone drug is government approved for relief of psychological symptoms.
Some women use remedies available without a prescription in an attempt to improve mood and mild episodes of depression. Supplements containing the herb St. John’s wort may be helpful. Side effects include gastrointestinal upset, fatigue, and increased sensitivity to sunlight. When taking this herb, wearing sunscreen, a hat, and wraparound sunglasses is advised when in the sun. Sunbathing must be avoided. St. John’s wort raises other concerns (including not using the herb with drugs that alter blood clotting such as aspirin or Coumadin). Consulting with a healthcare provider is advised before use. Many practitioners avoid using this herb for more than 2 years.
Another nutrient, omega-3 fatty acids, has also been found to improve mood. Food sources include fatty fish (such as salmon and trout); supplements are also available.
2. Depression
“How do I know that it is not ‘blue’ but ‘Clinical Depression’?”
Often a perimenopausal woman will say she feels “depressed.” It’s important that the healthcare provider distinguishes whether she is feeling blue or if she is actually clinically depressed, a condition associated with a chemical imbalance in the brain. Symptoms of prolonged tiredness, loss of interest in normal activities, sadness, irritability, or decreased sex drive that last for more than 2 weeks can indicate this condition. Clinical depression is not caused by menopause, but women who have had depression in the past are vulnerable to recurrent depression during perimenopause. Chemotherapy can also result in temporary episodes of depression.
For severe depression, antidepressant medications can be prescribed to correct the chemical imbalance. Although several weeks are usually needed to experience a drug’s full effect, most women show a marked improvement with these medications and relatively few side effects. Antidepressant medication is most effective when used in combination with counseling or psychotherapy. Although proven effective for mild depression, St. John’s wort is not effective for clinical depression.
3. Anxiety:
“How do I know it just ‘Ordinary Stress’ or ‘Going Crazy’?”
This is the agitated sense of anticipation, dread, or fear experienced by everyone at one time or another. Menopause does not cause anxiety, but women may experience more anxiety because of how they react to physical and psychological changes around early menopause coupled with other stressors. Although anxiety usually resolves without treatment, it may accompany or be a warning sign of a panic disorder. Symptoms of a “panic attack” include shortness of breath, chest pain, dizziness, heart palpitations, and/or feelings of being out of control or “going crazy.” Sometimes, the unsettling feelings that precede a hot flash can trigger such an attack.
Anxiety can be related to depression. Severe symptoms of anxiety can usually be relieved through one of several therapeutic approaches, including prescription drug treatment, relaxation techniques, stress reduction techniques, counseling, or psychotherapy.
When Should I See A Doctor?
Although some individuals feel embarrassed or even ashamed about revealing their mental health problems, no one should suffer in silence. Healthcare providers are better able to help when given as much information as possible about personal and family history. Most primary care providers are not specifically trained in the management of mental health disorders, but they are often knowledgeable and helpful. Consultation with a mental health professional may be appropriate, and an expert opinion can be reassuring. Treatment for a specific problem – such as marital difficulties or an eating disorder – is best provided by a counselor with expertise in that area.