You Said: “I’m Tired and Angry”
“I just turned 51. I’m tired all the time but struggle with insomnia. I have no interest in anything. I get angry often. I have hot flashes and night sweats. My mother says it’s menopause and to just suck it up. My sister says it’s depression and that I need to talk to a doctor.” --piananana
The Expert Said: “It's All Connected”
“Given your age, it is quite likely that you are menopausal or perimenopausal, because hot flashes (HF) are the ‘calling cards’ of the menopausal transition. Insomnia is a very important symptom to treat. It’s all connected: Untreated HF and night sweats (NS) can cause a sleep disturbance, which in turn can cause symptoms of depression -- sadness, irritability. Your mother’s attitude is common among women who went through menopause a generation ago or more. But there is no reason to suffer in silence! You might try wearing lightweight, layered bedclothes (ditto for bed linens), watching out for foods or beverages that trigger hot flashes and having ice water to drink nearby. Also try to eat foods that contain omega-3 fatty acids, such as salmon and walnuts. If you haven’t been to your doctor in a while, schedule a visit to check for other possible causes and possible treatments. Hormone therapy will eliminate HF, but some women prefer to avoid them, and the recommendations are not to take them for a long period of time. Antidepressants can treat both hot flashes and depression.” --Carol Landau, Ph.D.
Carol Landau, clinical professor of psychiatry and medicine at Brown University’s Alpert Medical School, is a coauthor of The New Truth About Menopause: Straight Talk About Treatments and Choices from Two Leading Women Doctors.
You Said: “The Confusion Is Depressing”
“I know I’m getting more and more depressed. I recently had surgery to remove part of my cervix, and we got rid of all the precancerous cells. I went back a week later and was told that everything was healing nicely. The next day, I started my period, and two and a half weeks later, it’s still here! My doctor tells me my cervix is healing just fine and that if the bleeding doesn’t stop soon, I will need an ultrasound. I’m 48 years old and I’m not sure if I’ve had hot flashes (I’ve felt flushed at random times for an instant), so I don’t know if I’m even at premenopause yet. I’m getting so depressed over dealing with it for this long, and missing intimacy.” --aunt_gwen
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The Expert Said: “Accept the Unpredictability”
“Lets start with some terms. Premenopause is the time before any transition to menopause has occurred. Perimenopause is defined as the time when your periods become irregular. They can have any pattern: shorter or longer between cycles, as well as heavier or lighter flows. Menopause is defined as one year during which you have no menstrual periods. Similarly, hot flashes (HF) vary from woman to woman. Sometimes HFs are just a flush, as you described. Other times, a woman may feel unsettled, then feel a huge increase in body temperature, especially in the face and upper body, and sweat profusely. Most of what you describe can be accounted for by perimenopause. I have found that when women accept the unpredictability -- a tall order, I know -- we feel better about perimenopause. As for missing intimacy, of course that adds to your concerns. I recommend talking to you doctor about when you can resume your usual sexual activity. And remember that kissing and cuddling can occur at any time and will make you feel better. Also remember the goal of the surgery -- it is worth it.” --Carol Landau, Ph.D.
Carol Landau, clinical professor of psychiatry and medicine at Brown University’s Alpert Medical School, is a coauthor of The New Truth About Menopause: Straight Talk About Treatments and Choices from Two Leading Women Doctors.
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You Said: “Meds Feel Like a Cop-Out”
“All the info on menopause and depression has really been making me think. I’ve been feeling really bad for a while, and a friend has been after me to talk to my doctor about depression medication. But in my family, we’re proud that we take care of ourselves, and medication just seems like a cop-out. Still, I’ve been having so much trouble even getting out of bed in the morning. I haven’t felt like myself for a long time, and I don’t know if I can stick it out until this passes.” --auntief
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The Expert Said: “Depression Is a Medical Condition”
“Yours is an important question, and one that many women share; it is an understandable and common attitude. Many women (and men) feel that recovery from depression is a question of willpower, but depression is a medical condition. I think that many women accept it as okay or even normal because it is so common in women. Up to 10 percent of American women are clinically depressed right now. I respect anyone who has tried other options, like exercise, talking with other women and St. John’s wort (which may work for mild mood problems but not for severe depression). But when a woman says she hasn’t felt like herself for a long time and can’t get out of bed, I say let’s try something else and soon! It might be medication. You can start a talk with your primary care professional about it, but also consider psychotherapy with a depression specialist. She may be able to help you with short-term cognitive behavior therapy, and she may also refer you for medication. Don’t suffer alone. You deserve to fell better -- and you can.” --Carol Landau, Ph.D.
Carol Landau, clinical professor of psychiatry and medicine at Brown University’s Alpert Medical School, is a coauthor of The New Truth About Menopause: Straight Talk About Treatments and Choices from Two Leading Women Doctors.
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You Said: “Are There Alternative Treatments?”
“My mom is having a really hard time with menopause. I was surprised to hear this because I remember her talking about how she was starting to go through it 10 years ago. She has tried many things prescribed by her doctor, but is wondering about homeopathic remedies.” --kaybee873
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The Expert Said: “Consider Herbal Remedies”
“A new study from the University of Pennsylvania found that hot flashes (HF) can occur for up to 10 years! Ask your mom if she is getting sleep -- a key to good health and good mood. I know more about herbal products than homeopathic remedies per se. Some people get relief for mood problems from St John’s wort, but she should check any remedies with her doctor to be sure they don’t have bad interactions with current medications. Also, be sure to tell her that support from other women can help.” --Carol Landau, Ph.D.
Carol Landau, clinical professor of psychiatry and medicine at Brown University’s Alpert Medical School, is a coauthor of The New Truth About Menopause: Straight Talk About Treatments and Choices from Two Leading Women Doctors.
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You Said: “I’m Crying All the Time!”
“I had my ovaries removed a little over a year ago because of a tumor and cysts. I am 49, so it’s about time for menopause anyway. I tried hormone replacement therapy, but I think it made my depression a worse. My youngest daughter, who is 23, has ADHD. I think that I have it too. My daughter is not coping well with her ADHD, and she lashes out at me when her stress gets to be too great. With my current emotional state, I wind up crying for days. I have been in counseling for a while now, and it has helped in my relationship with my husband, but not with my daughter. How long does this last?” --tobylady
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The Expert Said: “Set Some Ground Rules”
“Hysterectomy and the removal of the ovaries can lead to feeling like your emotions are out of control, because the drop in hormones, in contrast to normal menopause, is sudden. So that may well be part of the problem. Hot flashes may last for years, but you can gain control of your moods more quickly. It also sounds like you and your daughter need to find some peace. If she (and you) have ADHD, then one aspect of it is a problem with impulse control, and this includes ‘lashing out.’ In a moment of calm, you might try to set some ground rules as to what to do if one of you feels that way. (Time out!) Perhaps your counselor can see you and your daughter together once as well. Another option is for you and your daughter, separately or together, to find a mindfulness or stress-management class. This will help you relax and feel less likely to cry for long periods of time. Keep at it, as you say your counseling is helping.” --Carol Landau, Ph.D.
Carol Landau, clinical professor of psychiatry and medicine at Brown University’s Alpert Medical School, is a coauthor of The New Truth About Menopause: Straight Talk About Treatments and Choices from Two Leading Women Doctors.
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