Mood Swings, Depression, & Anxiety
“Sometimes your fears can be worse than what you fear itself”
Regardless of age, the emotional issues that arise in relation to early menopause vary greatly from one woman to another and depend on a wide variety of factors. Early menopause may increase concerns about body image, sexuality, and infertility, or a feeling of growing old prematurely.
For women who experience induced menopause at a young age—especially as a result of treatment for a serious, possibly life-threatening illness—these feelings may be greatly intensified. These women must also cope with the underlying disease, condition, and/or treatment that induced menopause.
Emotional and physical health is closely linked. Physical illness or discomfort can cause emotional distress, and emotional upset can negatively affect the body’s ability to heal and remain healthy. Different concerns for different causes of early menopause. Women who experience early menopause have some things in common, such as their younger age and some of the concerns they may have about menopause, menopause related symptoms, the associated long-term health risks, and the possible inability to use hormones, especially long term.
However, women whose early menopause is caused by medical treatments or surgery are likely to have different concerns from those who experienced spontaneous early menopause, such as:
- Fear of disease recurrence
- Fear of death
- Fear of pain and discomfort related to the disease and/or treatment
- Feelings related to lack of information or “information overload”
- Feelings of loss and grief over body parts removed during surgery
- Insecurities about physical appearance and attractiveness to partners or potential partners because of disfigurement from surgery
- A sense of loss of control, related to illness, treatments, side effects, and hospitalization
- Feelings of guilt about family members who have to deal with the illness
- Embarrassment related to temporary hair loss caused by chemotherapy
- Feelings of resentment toward peers who don’t have to deal with such serious issues and guilt about feeling that resentment
- Apprehension about sexual function, intimacy, and relationships (fear of rejection)
- A feeling of hopelessness, “living in limbo,” and uncertainty about the future after cancer treatment ends
Induced Menopause & Mood Swings
Women who undergo surgery-induced menopause may also be dealing with pain and real or perceived disfigurement. They may also require additional treatment, such as chemotherapy, making it difficult to see the “light at the end of the tunnel.” For instance, women undergoing chemotherapy experience a range of side effects, including extreme fatigue, nausea, vaginal dryness, and hair loss. However, there are many effective treatments for these side effects, and women should speak to their healthcare providers about these before and during chemotherapy.
Eating well during and after chemotherapy helps women better cope with the side effects of cancer treatment, and helps the body fight infection and rebuild healthy tissues faster. Protein is especially important after cancer treatment as it helps to maintain weight and build up and repair skin, hair, muscles, and organs.
Women undergoing pelvic radiation therapy may experience side effects that vary greatly in number and severity depending on the type and amount of radiation used. Women who need radiation therapy should talk to their healthcare providers about their concerns prior to treatment. Sometimes a woman’s fears about side effects can be worse than the side effects themselves, so knowing what to expect can help.
Emotional health after menopause
Some perimenopausal women report symptoms of tearfulness, mood swings, and feeling blue or discouraged. New scientific studies support the belief that perimenopause is occasionally associated with the development of true clinical depression, but this is quite uncommon.
It is unclear whether more common mood symptoms are related to the gradual decline in ovarian hormone levels, but sleep deprivation associated with night sweats often results in fatigue, irritability, and moodiness. Abrupt hormonal fluctuations during perimenopause may have an impact on these symptoms as well. During their reproductive years, most women become accustomed to their own hormonal rhythm. During perimenopause, this rhythm changes, and the erratic hormonal ups and downs—although normal—can create a sense of loss of control that can be upsetting.
Depressed mood during perimenopause is often associated with a history of depressed mood (including PMS) earlier in life, a longer menopause transition, or severe menopauserelated symptoms such as hot flashes. Other causes of mood disturbances during
perimenopause include thyroid disorders, medication side effects, and life stresses.
Understand of what you fear
Women are not unaccustomed to stress. However, some may be especially vulnerable to new situations that often arise, including diagnosis of a serious disease, infertility earlier than anticipated, floundering relationships, divorce or widowhood, struggles with adolescents, return of grown children to the home, undesired childlessness, concerns about aging parents, and elder care giving responsibilities in addition to career and financial issues.
Aging can also be difficult in a society that values youth. Aging women often experience changes in self-concept, self-esteem, and body image. They may begin to contemplate their own mortality and become introspective about the meaning or purpose of their lives. This time can be an opportunity for positive transformation and growth, but some women may feel overwhelmed, out of control, angry, or numb. They may seek refuge in alcohol or drugs and thus compound their problems. In fact, women are more likely than men to drink alcohol as a way of dealing with blue moods, serious disease, early infertility, loss or divorce, or children leaving home.
Although psychological problems are not caused by menopause, it is understandable how they can begin or get worse at this time, particularly when menopause is experienced at an earlier age than expected. Support and encouragement can help women find their way through any difficulty to thrive once again during what can be the best years of their lives.