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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Family Reports in legal proceedings
A Family Report is used to provide a court with an independent assessment of a family law dispute. It offers an independent, expert view of the issues surrounding the parental dispute, which assists the court in making a decision about the child’s best interests in resolving the matter.
As a Family Report can be used by the court to make a decision on parenting matters, it’s important that you fully understand their significance and prepare for any interviews you’re asked to attend.
Why are family reports written?
Family Reports are written to assist parents in dispute about what is in their child’s best interests, or to assist the Court in determining what is in a child’s best interests if the matter is being litigated.
A family report writer’s job is to make observations and recommendations about the future care and living arrangements that are in the best interests of children in parenting disputes.
A family report writer can either be a Family Consultant appointed by the Court or jointly elected by the parties in the parenting dispute. They are usually prepared and written by either a psychologist or social worker who have the relevant skills and experiences with children and families.
Who is interviewed?
After the Family Report writer has been appointed or elected, they will conduct a series of interviews and observation sessions. If your matter is in court, the Family Report writer will also read the affidavit and any other material you and your ex-partner have filed as part of the case.
Usually, each parent is interviewed individually and observed interacting with the child. Depending on the complexity of the case and the number of people involved, others may also be invited to be interviewed. This includes anyone who will be involved in looking after the child or may be living with the child, including grandparents, extended family members, step-parents.
If appropriate, the child or children themselves may also be interviewed. However this depends on their age and health, and the child must consent to the interview.
The purpose of these interviews is for someone independent of the family to gather necessary information and make an informed decision about the best interests of the child. As a result, it’s likely that the interviewer will ask each parent about:
• Your background;
• Your involvement with the child before the separation;
• Whether your involvement with the child has changed following separation, to what extent, and why;
• The issues associated with your family law dispute;
• What you believe will be in the best interests of the child moving forward; and
• Whether you believe there are any risks to the child and/or your response to any allegations that the child is at risk.
PLEASE NOTE: Your interview with the Family Report writer is not confidential, so it is important to remember that anything you say to them can be included within the final report if it’s deemed to be relevant material and has been used to form their judgement.
Do I get to see the Family Report?
In order for you to see a court issued Family Report, it must first be formally released.
Private Family Reports usually take around 4-8 weeks to be released.
Once the report is released, it can only be viewed by you, your ex-partner and the respective lawyers. This means that it cannot be shown to anyone else, including any of the other people interviewed as part of the case unless the court gives permission for this.
It is illegal to publish the report or distribute the information within it.
What happens if I don’t agree with the Family Report findings?
One or both parties may disagree with the observations or recommendations contained in the Family Report. The Family Report on its own is not legally binding on the parties as the Family Court will just see it is an experts opinion, and a judge will therefore use their discretion on how much emphasis they will place on the reports findings.
If you dispute the findings of the report, and your case goes to Trial, you can ask for the report writer to be called as a witness in the trial. That way, they are open for cross-examination on their findings.
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