Emotional & Mental support

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Women going through the menopausal transition are at a higher risk of mood changes and symptoms of depression and anxiety.

Common physical, emotional and cognitive issues related to menopause can complicate and overlap with mental health symptoms.

Stress related to life circumstances can also complicate understanding whether changes in mood and mental health are related to menopause.

Having an open discussion about your symptoms, life circumstances and mental health history can assist your doctor in offering suitable treatment options and lifestyle changes.

Therapies proven for the broader population are also suitable for mental health symptoms related to menopause – medication, psychological therapy and lifestyle changes.


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

Mental health symptoms related to menopause can include feeling:

irritable, sad, anxious, hopeless

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.

Untangling physical and mental health symptoms related to menopause

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:

identifying your stage of perimenopause / menopause and any physical and cognitive symptoms

discussing your history of mental health symptoms

discussing your current mental health symptoms

understanding any lifestyle factors that could affect your mood – for example, lack of sleep and exercise understanding other stressful life circumstances contributing to your symptoms – for example, caring for children and parents, career and relationship changes, body changes and illness.

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.

Treatment options for mental health symptoms

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:

ensuring healthy levels of physical activity

improving sleep

considering changes to decrease stress associated with life circumstances

limit alcohol intake

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.

Where can you find more information?

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.

Lifeline – Phone 13 11 14

beyondblue – Phone 1300 22 4636

Menopause Support Centre

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Women's Wellness Blog

ARE THEY GASLIGHTING ME?

Are they gaslighting me?

October 03, 20245 min read

ARE THEY GASLIGHTING, LOVE BOMBING OR HOOVERING?

“That never happened. Have you taken your meds?”

“You’re crazy. That’s not what happened.”

“I only told you that you were fat because you I would hate you to let yourself go.”

“I never told you that.”

“You’re too sensitive. I was only joking.”

Are you often thinking your mind is playing tricks on you? Are you starting to question your own sanity or losing your memory? If any of the above statements sound familiar, you are likely the victim of gaslighting. It’s an emotional abuse tactic that can leave you unsure about yourself, others, and life in general. If you don’t address it, you can have long-lasting effects, emotionally and physically. Counselling can help you understand what you are experiencing, help you set boundaries and reach a decision about the relationship which feels right for you.

What is gaslighting?

Gaslighting is an actual, intentional, and serious form of emotional, psychological abuse. It is a psychological manipulation tactic someone uses to control and manipulate a victim by making them doubt their memories, perception of reality and judgments.

It can occur in romantic, platonic and family relationships – or even at work.

Often victims of gaslighting are not even aware that this is happening to them because it has been happening for so long, in a slow, covert fashion.

How Does It Begin?

A relationship with a gas lighter may seem to start out quite well. They may praise you, the victim, on a first date and very quickly confide in you. This is where the manipulation begins since, disclosure, before any real intimacy has been established, results in trust being quickly established. This tactic is known as ‘love bombing’. Once you become fully engaged with the gas lighter, you become vulnerable and then the next phase of manipulation often begins.

COMMON GASLIGHTING TECHNIQUES

Do you recognise any of the following most common gaslighting techniques?

  • They blatantly lie to you with a straight face. The abuser blatantly and habitually lies to change your reality. Even when you know they are lying, they can convince you otherwise, which in turn makes you start second-guessing yourself. If you call them a liar they turn around and call you a liar or insist they lied for a good reason for example to protect your feelings or theirs.

  • They attack things important to you. They might criticize your job, make snide comments about you, your family or friends. These remarks are meant to make you feel insecure and inadequate.

  • They deny their bad behaviour – their lying, hurting your feelings, or doing anything wrong. They insist that you misunderstood them, that you’re remembering things incorrectly, or that you’re making things up to hurt them.

  • Their actions don’t match their words. They may insist they support you, but always criticise your choices.

  • They will target your insecurities to make you feel weak about yourself.

  • They spread rumours and speak poorly about you online or in face to face conversations. They will often portray themselves as the victims to others.

  • They can’t stand criticism themselves and will take it as a personal attack, no matter how respectfully you complain about their behaviour.

  • They project on you – for example the abuser is cheating. Instead of admitting to the affair, they’ll accuse you of being unfaithful. You end up having to defend yourself rather than seeing what they’ve been doing to you.

  • They manipulate your relationships, whether through isolation or through groupthink type behaviours. They will tell you that your family members don’t really love you and claim that they are liars. They may even try to convince everyone around you that you seem emotionally unstable or “crazy.”

  • They can confuse you with sudden kindness to distract you from their bad behaviour. One minute, they may cut you down and the next, they praise you.

  • They wear you down until you just give up – you stop arguing or defending yourself since you feel so defeated.

SIGNS YOU ARE A VICTIM OF GASLIGHTING

-        You constantly second guess yourself.

-        You wonder if you are just overly sensitive or too hormonal.

-        You create excuses for the gas lighters behaviour and their actions.

-        You stop trusting your own judgement and recollection of events, beliefs, and perspectives.

-        You start to wonder if you are losing your memory, regularly confused, or going ‘crazy.’

WHAT IS ”HOOVERING”?

When you try to leave the gas lighting relationship, they may use the ‘hoovering’ tactic which involves excessive praise, expressions of love, showers of compliments and fervent promises of the ways in which they will make positive changes in the relationship. Unfortunately, it does not take long for old habits and behavioural patterns to resurface, once you commit to staying. Their goal is to always keep you locked in to their control.

WHAT CAN YOU DO TO STOP BEING A VICTIM?

If you identify with any of the signs, here are some tips to take back control of your life and your reality:

·     You need to stand firm and not let their denials cloud your thinking and actions.

·     Remember you are not responsible for someone else’s behaviour. It is not your fault.

·     Trust your own judgment and believe in yourself.

·     Acknowledge the feelings you are having are real.

·     Remind yourself that you deserve to be respected and supported by the people in your life.

·     If someone displays a pattern of behaviour, trust the pattern over anything that person says.

·     Don’t back down if you believe your criticism is fair, even if the gas lighter won’t change.

·     Set clear boundaries to protect yourself and expect them to be respected,

·     Document what is occurring so you can help track the reality.

·     Ask someone independent, with whom you are close and who you trust, if they think you are being manipulated by the abuser.

·     Realise you will never win an argument with this person or get any apology.

·     Limit contact with the gas lighter. Consider ending or pulling back from the relationship if you want to, especially if the gas lighter refuses to change their behaviour.

If, despite attempts to move towards a healthier relationship, you still feel blocked in implementing these strategies, then please reach out to our trained team of psychologists and counsellors who can help you plan and strategise to move forward positively. Furthermore, if you feel unsafe because of someone’s controlling behaviour, seek assistance from the police or call 000 if it is an emergency.

 

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