Midlife and menopause aren’t just about hot flashes and night sweats. They’re also about mood swings and stupid fights or depressed moods.
Many women come in to see us at the Spectrum Health Midlife, Menopause & Sexual Health clinic because they just don’t feel right.
Or worse, they’ve developed anxiety with menopause.
There are usually many factors involved, but the end result is these experiences can change their lives.
And it’s our job to help women sort it out.
A patient I’ll call Jane came in to see us because her sister told her to. She really didn’t want to be there, but she knew her sister had grown worried and, frankly, Jane wanted to stop hearing about it.
Jane had become withdrawn.
She no longer gardened, cooked or attended family functions.
When her sister visited and tried to engage with her, Jane became irritable, snappy and asked to be left alone.
When Jane lost her appetite and began to visibly lose weight, her sister insisted she go see a doctor.
Jane’s primary care doctor checked her out and made sure there were no medical reasons for her symptoms.
Everything checked out fine.
Jane then got a referral to the Spectrum Midlife, Menopause & Sexual Health clinic, as the obvious change had been the onset of menopause.
Her history was straightforward.
Other than not having a period for more than 15 months, she appeared healthy in all the obvious ways.
But even Jane agreed: It seemed like a light inside her had gone out. She felt flat and checked out.
She had no desire to hurt herself or anyone else and she could still accomplish basic daily activities and perform her job at a grocery store.
But she simply felt flat—no passion for much at all.
At one point, Jane had loved to entertain. Now she felt content to sit in her chair and stare, or watch TV and not engage.
I asked about her mental health history.
She could remember having PMS with depressed mood and some irritability as well as mild postpartum depression.
But she always bounced back. She’d never been affected to this extent.
She had lost her husband to cancer 10 years prior. Her grown children now lived out of state, although she maintained contact with them.
She belonged to a church but hadn’t been there in quite a while.
Her parents had died some time ago. She remembered her dad as active and energetic and her mom as someone who became quiet and withdrawn as she got older.
She talked about loss and feeling alone. She wondered if anything would make a difference.
After discussing her options and the role of estrogen in moods and brain function, Jane chose to trial hormone medication.
I knew the prescription would help, but it would require more than hormones to help her feel better.
Hormones and brain chemicals are closely related and low estrogen leads to less functional serotonin, which can greatly affect moods.
Estrogen supplementation can effectively help some women feel more like themselves, but it’s not an anti-depressant and it’s not effective for more severe depression or anxiety.
In addition to menopause symptoms, Jane had more serious symptoms and showed signs of significant depression.
Her situation led her to feel grief. She never expected to be without her husband by her side, or her kids living far away.
She felt alone and cheated out of the life she wanted.
But her mental reaction was not healthy. She needed more help than we menopause specialists could provide.
That’s why we hired Anya Nyson, LMSW, and LuAnn Arnson, LMSW, trained psychotherapists at Spectrum Health who help patients in their battle against severe anxiety or depression. They can also help them understand the effects of midlife and menopause.
Nyson taught Jane some mindfulness techniques, as well as helped her become more aware of her thoughts and emotions.
Over time, Jane felt better and better. She started to re-engage in life. She took her hormone medication and started eating again.
To deal with her grief and find her way in a different direction—different, at least, than what she had once expected from life—she used the tools and strategies that Anya taught her.
Stress and grief can make everything worse. A trained professional is often the best guide to get the lights turned on again.