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
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Tackling Stress Head On
Building Your Resilience to help you cope through the tough times
Everyone goes through tough times in life. There are some stressful situations we can avoid completely and others which are an inevitable part of life – work, children, relationships, money, health challenges. Without the right tools, stress can cause wear and tear on the body and brain and can increase the risk of many health conditions including heart disease, high blood pressure, depression, and anxiety.
How we deal with stress can be very personal, and not every coping strategy suits each person, but it is about learning some strategies that work for you, being self-aware that the stress levels are climbing, and then employing the strategies in a timely way (before too overwhelmed) to reduce the impact of that stress, that will help you avoid the serious impacts on wellness.
Resilience is defined as the extent to which we can bounce back from adverse events, cope with stress, or succeed in the face of adversity. It is not something you are born with. It is more a result of how family, community, and cultural practices—interact. It boosts wellness and protects you from risks to your well-being.
Resilience isn’t just about eliminating stress but more about really leaning in to your own strengths, and finding those protective measures in your life to help cope with the often inevitable stress and to support your own well-being.
Research has indicated that the essential tool box items to help deal with stress and build resilience are:
· Exercise – doesn’t matter how.
· Get some sunshine and play upbeat music.
· Feed your body with healthy options and reducing reliance on alcohol, smoking and/or drugs.
· Express your emotions rather than bottling them up.
· Change your mindset and try to look at a stressful situation as a growth opportunity instead of thinking of it as a threat.
· Say no more often and focus on you - Meeting your own self-care needs rather than aways being the empath and giver.
· Try to find even one small thing every day to enjoy and take time out for YOU! DO NOT feel guilty about that – you are of no use to anyone else you care for if you have exhausted your own emotional energy! Adults who take time for themselves can better help nurture resilience in children.
· Find your people, community and resources - resilience doesn’t happen in a vacuum. Find your support network. At work, school, church, exercise class, in your cultural network? Who can help build your inner strengths and strategies to deal with life challenges?
Write down a few times you were highly stressed before and reflect on:
- what has previously helped you when you were stressed?
- how did you dealt with it?
- who could you count on?
”In 2011 my daughter was incredibly ill and we did not know if she would be brain damaged and/or able to walk again. I was in the middle of a large work project and renovations at the time and had two small children. I don’t recall ever feeling as stressed. I had never done much long distance running before, but I got an awesome playlist together, bought some running shoes and started slowly jogging/shuffling my way around the suburb. The music, sun, greetings from neighbours and the exercise were my saviour that year. I still use these strategies today to get through my toughest times.” Susan
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