When we think of menopause, we imagine we will experience all the symptoms that our mothers told us about: the hot flashes, the extra weight around the waistline and the crazy erratic mood swings.
Yet how many of you associate depression with menopause? I definitely didn’t.
When my periods started to become irregular, I found myself fatigued more than usual, and definitely a little more snappy with the children. I knew my hormones were in flux, yet I thought I was actually doing quite well and holding it all together.
I definitely had the blues though. But, as I had experienced an emotional year with some family struggles, untimely deaths and then relocating to a new country, I still didn’t associate these stresses and feelings of sadness with depression.
My marriage was starting to suffer. At some point, my husband pulled me aside and asked me: Were we doing OK? Was I OK?
Without me realizing it, my blues had creeped deeper and deeper inside of me and had taken over my whole self: I really was very unhappy. I felt lonely and isolated, and had no desire to achieve the greatness I had once set out to do.
One of the things that struck me was watching my youngest boy. You see, he is like me in every way (with the exception of our gender): he takes on life with a sense of joy and wonderment, likes to live out each day to the fullest, and loves to experience adventures with people. All these traits that we once shared seemed lost to me; my youthful outlook on life had dwindled to the point where I felt dead inside.
Depression is not a sign of weakness, it is a sign that you were trying to be strong too long. — Sigmund Freud
We Don’t Have to Do It Alone
After my doctor diagnosed me with both perimenopause and depression, I went into a period of feeling ashamed.
How had I let myself become so depressed? I took on this responsibility fully.
How could I do this to my family? I felt a deep sense of guilt.
How could I have risked my marriage falling apart? I felt a failure as a wife.
This went on for a period of time until I decided to turn this whole situation around. I couldn’t let my depression take over my life like this: it was impacting all of those I loved, and I felt like it was ruining all our lives.
I started taking a course of medication and talking to my friends about what I was going through. I felt a sense of huge relief when I did — nobody judged me, everybody wanted to support me.
Additionally, I started making changes to my daily structure so that I no longer felt overwhelmed and also had a lighter schedule in case I was having a particularly bad day. All of a sudden the small changes I introduced were making a huge impact, a positive impact, where previously there seemed to be no end in sight.
Depression can consume us to the point of isolation and selfishness.
I realized that I didn’t want depression to own me; I wanted to have some control over it. This is not an easy task, I may add, but the will to live my life fully again gave me the determination to try all strategies.
I knew that I was normal and that I wasn’t a failure. Depression does not discriminate and can consume anybody. The simple truth is that we all have our problems. We are human, after all, and by sharing our troubles and taking positive action, we can reduce the unwarranted shame that depression hangs over us, and start to make a positive impact in our well-being.
As women, it is in our nature to be resilient. We avoid complaining, and do not want to be judged for it. This can leave us feeling like we are the only ones suffering, shameful about being depressed, and believing that nobody would understand what we are experiencing.
Why Do We Get Depressed During Menopause?
Depression can leave us feeling so isolated, yet the reality is much different: statistics show us that one-fifth of the population will have an episode of depression during their lifetime, and that women are twice as likely to be affected. Furthermore, there is evidence that perimenopause represents another period of vulnerability for women, with African Americans twice as likely to have depressive symptoms .
We are looking at a twofold problem here, as both physical and external factors are at play. On a hormonal standpoint, variability in estradiol levels and rising FSH (follicle-stimulating hormone) levels during menopause increase the likelihood of depression .
Decrease in estrogen levels has also been associated with the mental health issues that women experience during this period, as there is evidence that estrogen has some mood-enhancing benefits. Moreover, the drop in estrogen can also lead to hot flashes that disturb sleep, which can in turn cause anxiety, fears, mood swings, and ultimately depression .
The external factors that may also impact women during this period cannot be ignored. We cannot blame our hormones for everything, and stress, body image, sexuality, infertility, or aging can all — alone or in combination — be at the root of emotional distress. Determining the cause and extent of your “menopause blues” is important, as is looking at all aspects of your life to see where you can lower your stress and make different choices that will allow you to maintain a feeling of calmness or equilibrium .
Nutrition, sleep, exercise, stress management and social support are different self-care options you can look at, as is receiving medical help that may include antidepressants, talk therapy such as Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT).
What I Did to Remain Positive During Depression
In order for me to get through menopause and deal with my depression, I used a strategy called “notice and name” which I learned and adapted from my experience as a Precision Nutrition graduate. Whenever I was hit with a depressed mood, I would notice the signs and name them, with no judgement and no shame.
As I became adept at recognizing the circumstances that could trigger a depressed mood, I then made small changes in both my daily life and my mindset to try to stop the despair and sadness taking hold of me.
I now break my daily tasks down into small manageable chunks so that I don’t feel overwhelmed. If I can’t get through all the tasks I have assigned myself, I just do them the next day, rather than stress myself out to get them completed.
Another strategy is to make time for my family. Each day, I turn off my phone at 3:30 p.m. and don’t check it again until 9:30 p.m. at night when the children go to bed, and then I only look at it for 30 minutes.
I also plan my week so that it always contains a day fully dedicated to the things I want to do outside of work, chores or family obligations — making space for this “me time” is one of the luxuries for working for myself!
Using these strategies has allowed me to manage my stress so that the periods where I feel depressed are fewer and farther between. If and when depression takes hold to the point where I know my quality of existence is compromised, I let it happen. I tell my family what is happening and keep the dialogue flowing. I let them know when I need to be alone, when I need help, and when I need support.
This has proved to be a source of relief for me, knowing that I have a team of people behind me who love me and want me to be better.
I have also started to turn my thought process around, to try to focus on the positive aspects of what menopause really means to me.
I know that for many women, the end of menopause can be a liberating experience — let’s face it: no more menstrual periods or cramps to deal with! (My periods have been so heavy and irregular during menopause that I cannot plan for them, so the idea of being free of them is very exciting!)
My mood swings and depression are so unpredictable, as my hormones continue to be in flux, that knowing this phase isn’t going to last forever, and that these symptoms will start to subside when I am postmenopausal, gives me the strength to continue to push through each day.
Conclusions from a 4-year study at the University of Pennsylvania established that while the depressive symptoms increased as women entered menopause, they also decreased when women were postmenopausal . This gives us ladies a glimmer of hope for the passing of the menopause period.
I now see this time of my life as a huge wake-up call, a chance to make decisions that are going to have a positive impact on my life and that of my family.
I still live with depression, and will likely continue to suffer for the next few years. What this means for me is that I have to be very aware of the factors that can impact my mental health on a daily basis. Understanding that depression does not define me and shouldn’t be stigmatized is part of the solution too, which is why I made the decision to openly discuss my issues — it has been, truly, a freeing experience.
Seeing menopause as a new beginning, the second half of my life is ready to be lived fully. So let the party start — soon!
- Menopausal Symptoms and Their Management, Department of Obstetrics & Gynecology, University of Colorado School of Medicine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890704/
- Is Menopause Causing Your Mood Swings, Depression or Anxiety?, Cleveland Clinic Health Essentials https://health.clevelandclinic.org/2015/06/is-menopause-causing-your-mood-swings-depression-or-anxiety/
- Depression & Menopause, The North American Menopause Society http://www.menopause.org/for-women/menopauseflashes/mental-health-at-menopause/depression-menopause
- Hormones and Menopausal Status as Predictors of Depression in Women In Transition to Menopause, University of Pennsylvania School of Medicine, Philadelphia. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/481940
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