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While not a problem for everyone transitioning through menopause, the risk of mood changes and symptoms of depression and anxiety are higher during perimenopause, even in women without a history of major depression.
While the risk is higher for women in the age-related and natural menopausal transition, women might also have a higher risk of mood changes after menopause caused by surgery such as hysterectomy or if the ovaries have been removed. Depression also occurs at a higher rate in women with a lack of oestrogen caused by primary ovarian insufficiency.
Mental health symptoms related to menopause can include feeling:
stuggling to focus, concentrate, forgetful,
tired, unmotivated
Some women might experience these symptoms in a mild form which others unfortunately may suffer more severe symptoms of depression (including thoughts of suicide) lasting for at least two weeks. This is known as a major depressive episode and is more likely in women who have a history of major depression during their pre-menopausal years.
While many women do not have mental health issues during the menopausal transition, unstable oestrogen levels can have an impact on the brain, predisposing some women to feelings of depression and anxiety.
Some of the common physical, memory and thinking symptoms related to menopause (hot flushes, night sweats, sleep and sexual disturbances, weight changes and “brain fog”) can complicate and overlap with mental health symptoms.
Another complicating factor is stress related to life circumstances. Feeling stress is common during middle age as personal and environmental changes take place. This can have a strong effect on mood in some women. Life circumstances that can impact mental health include caring for children, teen issues, carers for elderly family members, career changes, body changes, illnesses, pre-existing ADHD, relatonships, pain levels, medication.
The menopause transition is an ideal time to look at your health and consider lifestyle and other changes so that you can live the healthiest possible lifestyle.
For some women, mental health issues and other changes can begin to affect how they live their lives. Your doctor can take a holistic approach to your health to help you untangle the web of symptoms around physical and mental health changes.
Understanding mental health during perimenopausal and postmenopausal changes can include:
When you see your GP/specialist it is important to explain the realm of menopausal symptoms you are experiencing as well as your life circumstances and clinical history so that they can help them to recommend the best treatment options and lifestyle and behavioural changes for your situation.
Lifestyle changes to assist with managing mental health are similar to those recommended for menopause-related physical changes. Changes that can help with mental health symptoms include:
Psychological therapies and social supports can be beneficial to women with mental health symptoms.
Women should have an individualised assessment with their doctor in order to discuss the most appropriate treatment pathway. Options may include lifestyle changes, psychological therapies and medications such as menopausal hormone therapy (MHT) or antidepressants.
While some international guidelines do not recommend MHT as firstline therapy, many doctors have seen a positive effect on mood with the use of MHT in the first instance.
There is evidence that oestrogen has antidepressant effects, particularly in perimenopausal women. We emphasise an individualised approach with treatment tailored to the individual patient.
Oestrogen is not recommended for women with a history of breast cancer.
At this stage, there is no evidence to recommend alternative or complementary therapies for treatment of perimenopausal depression.
If your mental health or other symptoms are bothering you, your doctor can help. Your doctor can help you understand physical and mental health changes and offer options for managing your sympt
Help for depression and mood changes?
If you have severe mental health symptoms or symptoms of depression and have thoughts of suicide, help is available.
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10 Biggest Red Flags to Watch out for in Relationships
Dating someone new can be such a fun time in your life. Ideally, getting to know someone can be really exciting and establishing intimacy feels natural and easy. But for some people, as the relationship develops, you may start to notice little things that feel really “off”.
These uncomfortable behaviors—often called red flags—may start out small but can hint at future problems, so it’s important not to just ignore them or start to justify them. Everyone deserves to be in a relationship where they feel safe, respected, and valued — and that includes you.
What are red flags in a relationship?
Red flags in a relationship are warning signs that something might be wrong. Certain behaviors, actions, or attitudes might indicate a relationship is unhealthy or even harmful. They can be obvious, like physical abuse, or even subtle, like constant criticism.
Pay attention to these signals, because seeing unhealthy patterns before they become deeply ingrained can help you make choices that may prevent pain down the line.
Knowing what red flags to look out for can also help you make better choices about your relationship. You can decide whether to work on the issues with your partner or to end the relationship. No matter what you do, recognizing these signs can help you set boundaries and build healthier relationships in general. You’ll be able to recognize what's unacceptable so you can seek out partners who make you feel respected and valued.
10 biggest red flags
Recognizing red flags in a relationship is critical for your emotional and physical wellbeing, here are 10 of the most common ones to look out for.
1. They exhibit controlling behavior
This occurs when one partner tries to be in charge of the other’s actions, decisions, or interactions with others.
Exercising control over your social circle: Dictating your friendships, or placing limits on family visits
Monitoring your activities including checking your phone, emails or social media accounts without your permission
Making decisions for your about your life, for example your study, your courses, job, how you spend your free time or
Financially controlling you so that you lose your financial independence and access to your own money such as not letting you work, making you transfer your income to the other persons account or paying off their debts for them, the always ask for a 'loan' which is never repaid, they monitor your spending and give you an allowance.
2. Dishonesty, sneakiness and stonewalling
When communication isn’t open and honest and when your partner refuses to talk about certain topics, that could be a red flag.
They refuse to discuss really important topics which impact you too, avoid conversations about feelings, future plans or problems in the relationship
They often give you the silent treatment, withdraw communication to punish or manipuate you, ghost you for periods of time to make you feel anxious
They dont value or respect that you have an opinion or belittle your input.
3. You receive constant criticism from them
Notice if your partner frequently puts you down, makes you feel like crap about yourself, or undermines your confidence.
They make negative comments about your intelligence, looks, appearance, clothing choices.
They belitle your achievements downplaying or dismissing your successes and accomplishments
4. You’ve experienced abuse
Physical, mental and emotional harm a serious red flag that should never be ignored. For instance,
Harming you or threatening to harm you physically - including hitting, slapping, pushing, choking or any other form of physical violence
Stalking and monitoring you
Using guilt, fear or intimidation to control you
Yelling, name calling, defaming you
Sexually abusing you.
5. They have anger management issues
An inability to control anger, aggressive behaviour, which may be harmful and frightening.
Having frequent outburts, exploding in anger over minor issues or high conflict about things
Engaging in destructive behaviour such as throwing or breaking things
Making threats to harm you, your children, family, pets, your property
6. You’ve experienced gaslighting
This occurs when an abuser makes you doubt your own reality or feelings. It can include:
Denying things that happened causing you to question your memory or insisting events or converstations never took place which can make you feel unsure about your recollections or perceptions. You feel like you might "be going crazy" or "losing your memory."
Blaming you for your actions by shifting responsibilty for bad behaviour onto you and guilt tripping you into believing you are to blame for something you are not responsible for.
7. They display secretive behavior or keep things from you
Hiding things from you or being overly private about certain aspects of their life can be a sign that something is wrong. This might include:
Not sharing their phone or computer or being overly sensitive, secretive or protective of their digital devices.
Being vague about their whereabouts, giving unclear answers about where they have been or what they are doing.
Keeping financial secrets including hiding money, borrowing money from you, running up debts including gambling debts, in your name or jointly, or making large purchases from joint funds without your prior consent.
8. They have a substance abuse issue
Substance abuse can severely impact your relationship or your partner’s ability to function normally. Especially if:
They are intoxicated regularly - drunk, high or under the influence more than being sober
Spending more time choosing substances than spending quality time with you
Illegal drugs are being delivered or stored in you home or property.
Spending excessive joint money on supporting their addiction.
9. They’re dishonest
Dishonest behaviors can undermine the fundamental trust in a relationship.
Lying about important things including hiding significant money, information or events from you
Regularly breaking promises and not following through on commitments
They avoid answering your questions directly or get angry for asking about the issue or inconsistency.
10. They exhibit extreme jealousy
While a little protectiveness may be normal, extreme jealousy can be toxic.
They frequently accuse you of flirting or cheating
They monitor where you are, who you are with, and why at all times
They put your friends and family down and try to isolate you from seeing people and attend events and guilt you into staying with them instead of socialising.
Pay attention to how your partner's behavior makes you feel. If you’re frequently unhappy or scared, it might be time to reassess the relationship. Talk to friends, family, or one of our psychologists to help you see red flags more clearly.
If you are concerned and need support to discuss your concerns and way forward, make an appointment today with one of our team:
www.familycounsellingsupportnetwork.com or www.separtionsupportnetwork.com
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