Hannah Yoon for NPR
Teri Hines was in her mid 40 years when she began to notice that her body was changing.
Her period was irregular and stricter. “It has often increased, it increased in severity and increased,” she says.
She started getting hot flashes, she got weighed and took energy levels with each other.
“I only had the energy to do what I wanted,” she says, like the long morning walks she liked to take with her dogs, or individual travel planning.
At the time, Hines was living alone in Philadelphia where she worked as an assistant principal in a school. She wanted to get out of bed and work, and she started to pull back from friends.
Looking back, she remembers feeling isolated and no one. “It was such a mist over who I was, what I wanted, where I was going, what I was doing,” she says. “I couldn’t find my base.”
Hines knew she was likely to come through perimenopause, that is the years before the menopause, when monthly hormonal cycles of women become irregular as their body prepares to stop menstruating.
The thing she didn’t understand – and many women don’t know – is that hormonal changes perimenopause can bring pine changes, and for some people, increased risk of anxiety and depression.
“Women who have a previous diagnosis of severe depression or anxiety disorder are going to be at greater risk during perimenopausal time,” says Jennifer Payne, who directs the Center for Women’s Disorders at Johns Hopkins University.
And she warns these women that he is serious. “If you are severely depressed, and you have an impact on your exercise, if you have suicidal thoughts, or feel totally out of hope, this is a major depressive event requiring treatment,” she says.
Often perimenopausal pine swings lies symptoms of premenstrual syndrome; women may be sad, or weak, or funny.
“People said they always thought they had PMS,” says psychiatrist Hadine Joffe, who leads the Connors Center for Women’s Health and Gender Biology at Brigham and Boston Women’s Hospital. “They don’t feel that they are in charge of their mood and that they feel they are gone.”
Generally, however, those mood swings are manageable, she says. “The good news is that most women link to perimenopause without serious mental health issues.”
However, many women have depression symptoms – around 18% in women in early epidemic and 38% of those at the end of the circle. And it seems that anxiety symptoms are more common during this time before menopause, including panic attacks.
Those most at risk from women with mental illness, as well as women whose feelings are particularly sensitive to hormonal fluctuations.
“Women who have had postpartum depression or who have always had significant mood changes are at risk of having more symptoms on them,” Payne says.
It is not that there are any abnormal or abnormal changes to hormones by women who develop serious anxiety or depression. Rather, “their brain is probably sensitive to normal natural hormonal fluctuations.”
“We know that the environment has a definite role in psychiatric illness in general,” said Payne. And during this time, she says, there are often big changes in the lives of women who are at risk of having mental health symptoms.
“Some women go through divorces, children go to school, or leave home, parents are aging and need more caretakers,” said Payne. “There are career changes, etc.”
“There is a lot of stress in the midlands that happens because of where people are in their lives,” said Joffe.
When doctors do not pay attention
The hines were familiar with depression. She had repeated depression and was proactive in seeking treatment.
“I was a barrister myself for depression and self-care and getting the right help, getting counseling,” Hines said. “At times when I wanted [it], using medication. ”
And over the years, she learned to identify her symptoms and her stimuli – often changes in the big, professional or personal life.
This time, however, she says she was too focused on how her body was changing and that she had lost the symptoms of depression.
“The physical nature of the menopause belongs to you and what we teach is to pay attention to it,” she says.
She did not know that her previous depression history posed a higher risk of depression during the semester. But she gave her physical symptoms and energy levels up to her doctor early during a regular appointment. But the conversation was disappointing, she says.
“I think she might say ‘you’re under the age when you start these symptoms, you will start to be perimenopausal,’ ‘Hines recalls.
The doctor did not offer any tips to help her symptoms or even with any information about perimenopause, she says, it doesn’t even last for four years on average, and for some women up to 10 years.
This is not uncommon. More than 1,000 women wrote to NPR with their own stories about struggles during peruseopause. And a majority said that they received little or no information from their physicians, particularly in relation to mental health symptoms.
“It’s a very common case for women, and doctors aren’t keeping up with that,” says Payne.
This is partly because most physicians, even OB-GYNs, do not get much education about perimenopause, says Joffe.
Hines and many other women said to write to NPR that they had to be in the driving seat when he was looking for and getting the right help or treatment.
Women need to be directly with their doctors about their mental health symptoms, says Joffe.
“Just as they would if they had a rash,” she says. “They would make an extra appointment and that is the first thing they say: I have a rash.”
Payne agrees. “No 1 is that women can do honestly with their doctors about their symptoms and what symptoms they have and how hard they are,” she says.
Treatments of that work
Eventually Hines received her doctor’s attention to her mental health symptoms.
But he took her several years before she realized that she could be depressed.
“That’s when I made an appointment with my doctor and I said, this is what I am thinking, this is what I feel, I think, may be depression.”
This time, her doctor ordered her antidepressant. “The moment I went, I felt I had the energy to get to grips with the other things going on,” Hines said.
“Antidepressants can help a woman resign from her major depressive adventures,” says Payne. “They can also be helpful for anxiety symptoms.”
Research also shows that they can alleviate some of the physical properties of perimenopause, such as hot flashes and insomnia.
Hines also used speech therapy, which shows that studies help treat depression.
“I went anti-depressants and then I started consulting,” she says. “When I was under the control of counseling, then I was able to sort the pharmacy, so I could use counseling.”
Joffe suggests that women at this stage of life will take measures to empower themselves. They should carefully monitor the properties so that they can make informed discussions with their doctors.
Most of the time, women try it hard, says Joffe. “Women are tough. Women are accustomed to dealing with physical discomfort and life challenges,” she says. “And I think that a lot of middle-life women expect that this is a very worrying time and discomfort and that it is unsympathetic and is normative.”
But, she says, it doesn’t necessarily be like that. It focuses on resources such as the North American Menopause Association website, which has helpful information on menopause as well as a tool to help women find local suppliers specializing in perimenopause.
“I like [women] I have permission, “she says [women] that they feel to themselves and the people around them, they do not suffer. ”