Written by Jennifer Millette, LCSW
Menopause, medically defined as 12 consecutive months without menstruation, and the years leading up to it are undoubtedly a time of significant physiological and psychological change. To somebody who hasn’t yet had this impact their life in some form, either through direct experience or that of a loved one, they may think menopause is primarily hot flashes and night sweats. However, it is actually a complex combination of over 30 physical, mental and emotional symptoms that doctors have referred to as Menopause Syndrome. Joint pain, headaches, sluggish metabolism, internal and external dryness, lack of energy, difficulty sleeping, irritability, mood swings, anxiety, depression, and panic attacks are just a handful of symptoms that a person going through menopause may encounter.
Stress management, while always important for physical and mental health, is especially crucial at this point due to the fact that cortisol production, which happens during the ‘fight or flight’ stress response, impacts estrogen production (Dr. Claudia Welch, MSOM, explains this process in detail in her book Balance Your Hormones, Balance Your Life). Midlife, the time when natural, non medically-induced menopause typically occurs, is a time of multiple possible sources of life stress, including raising children, caring for aging parents, planning career transitions or retirement, and coming to terms with how this change impacts one’s personal identify.
Shifts in the levels of female hormones can cause mood changes at other stages of life, so it’s not necessarily surprising that they can have some effect on mood during the menopausal transition as well, says Dr. Hadine Joffe, the Paula A. Johnson Associate Professor of Psychiatry in Women’s Health at Harvard Medical School and executive director of the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s Hospital. “These disorders aren’t 100% hormone-based,” says Dr. Joffe, “but female hormones play a major role.” According to Dr. Joffe, the incidence of depression doubles during this time. Women who have struggled in the past with depression or anxiety might also see a resurgence in symptoms.
It’s also important to recognize that changes in physical health at this time may affect mood changes. Anxiety may be triggered by an overactive thyroid gland, a condition that becomes more common with age, while sleep difficulties due to hot flashes and night sweats can contribute to anxiety and depression.
There are several ways to support your mental health during menopause:
- Keep to a regular routine as much as possible that includes adequate rest, nutrition and exercise.
- Develop mindful practices such as yoga, breathwork and meditation to help regulate your nervous system and manage stress. Petra Coveney has developed an entire program dedicated to this and written an accompanying book, appropriately titled Menopause Yoga.
- Maintain regular connections and contact with supportive friends and family.
- Use a journal or use a menopause app (such as MenoLife, MenoBox, or Healthy Menopause) to track your mood, noting patterns or changes in mood, sleep and stress levels.
- Keep your doctor updated on your symptoms. If it’s determined that medication may help with more severe emotional symptoms, understand that finding the right medication is a process that can take time. Also, it’s important to understand possible side effects and let your doctor know immediately if you are experiencing severe adverse reactions (i.e., suicidal thoughts).
- Consider working with a therapist if you experience symptoms beginning to interfere with your daily life (i.e., you find yourself too anxious or depressed to sleep, are too worried or sad to do the things you want to do, are constantly on edge or starting to experience panic attacks) or you find yourself wanting to talk through these monumental changes with an unconditionally supportive, objective person who can offer a fresh perspective.
- Know that it’s temporary. “Data shows that these hormone-related risks ease with increasing time after menopause,” says Dr. Joffe, further noting that those who opt to treat their condition using antidepressants or other methods won’t necessarily have to continue treatment forever “potentially just through this time period.”
Coventy, P.(2022). Menopause yoga: A holistic guide to supporting women on their menopause journey. Singing Dragon
Menopause and mental health. (2020, March 1). Harvard Health Publishing. Retrieved March 18, 2022 from https://www.health.harvard.edu/womens-health/menopause-and-mental-health
Welch, C, MD (2011). Balance your hormones, balance your life. Lifelong Books.