When my mum reached menopause, she told me: “The worst thing about menopause is losing your freedom to have another child”. Mum passed away last year at the age of 93 – she is survived by five children, eight grandchildren, and three great-grandchildren.
Indeed, mum was right. However, when I went to medical school, I recognised that menopause is much more than just losing the freedom or the ability to conceive. It can be a very rough time for some women; yet, others are lucky and sail smoothly through it.
Unfortunately, we need books just to touch on what women go through during menopause. Therefore, this article is a general discussion about the mood changes that confront women during this period. The information provided here is not intended to replace the medical advice of your doctor. If you are experiencing any symptoms of mood changes, or if you are worried that you may have symptoms of depression, anxiety or any other illness related or unrelated to menopause, please talk to your doctor about it.
During the transition into menopause, a lot of things are happening in a woman’s life. Most importantly, her body is adjusting to the drop in the level of both estrogen and progesterone hormones, and this can cause a lot of symptoms including mood changes (snappiness, short temper, irritation, crying, impatience, and anger), anxiety, lower energy and lower concentration.
Other menopause symptoms – like hot flashes, night sweats, lack of sleep, weight changes, loss of sexual drive, vaginal dryness, urinary symptoms, etc. – can also contribute to mood swings.
Menopause can be a turbulent time that often coincides with other factors – like: children growing up and leaving home, losing a partner, caring for your sick elderly parents, change of career, etc. – that may affect your mood.
Mood changes are different from depression, and to make things more perplexing, sometimes both mood changes and depression strike at the same time – and women may not be able to know whether it’s ‘just’ the menopause “mood changes” or “depression”.
Depression is a common and serious mood disorder. Those who suffer from depression experience persistent feelings of sadness and hopelessness and lose interest in activities they once enjoyed. Aside from the emotional problems caused by depression, individuals can also present with a physical symptom such as chronic pain or digestive issues.
The British Prime Minister Winston Churchill (1874 – 1965) called depression his “black dog” because depression shows itself as a persistent feeling of low mood “sadness” – most of the day, nearly every day of the week, for at least two weeks. The other two typical features of depression are: 1) lose interest in activities they once enjoyed (anhedonia); and 2) a lack of motivation or energy leading to increased fatigability and diminished activity.
Yet, depression may present itself through other “atypical” symptoms including:
- Disturbed sleep: patients with depression usually sleep less, but they may stay all day in bed. They may wake up early in the morning and can not go back to sleep (we call it: terminal insomnia). Because a big percentage of depressed patients have also anxiety, they may experience initial insomnia (difficulty falling asleep).
- Diminished appetite and weight loss, and sometimes impulsive eating and weight gain.
- Reduced concentration and attention.
- Reduced self-esteem and self-confidence.
- Ideas of guilt and unworthiness (even in mild type of episode).
- Bleak and pessimistic views of the future.
- Ideas or acts of self-harm or suicide.
Like all mental health illnesses, depression has social impacts on patients’ lives (home, family, friends, work and other social networks).
How can you deal with mood changes?
- The most important step is to contact your doctor for a proper assessment.
- Keeping a journal for your symptoms, this may increase your awareness of your symptoms and what triggers, increase and relieve them.
- Lifestyle changes are very helpful to deal with mood changes. These include getting plenty of rest, healthy eating, regular exercise, stopping smoking, ensuring appropriate drinking, and relaxing activities, etc.
- Counselling, especially Cognitive Behavioural therapy (CBT) is very helpful.
- Medications are also available for women who have depression.
General Practitioner FRACGP, MICGP, MBBCh