by Jontie Hays~Racing heart, palpitations, night sweats, insomnia, electric shock sensation under the skin and in the head, dizziness, nausea, brain fog, memory lapses, joint pain, crashing fatigue….what could it be? Cancer? Heart disease? Swine flu? Ebola?
These are just some of the physical symptoms I look for when my female clients come to see me because they are experiencing symptoms of depression and anxiety. I am not a physician; I am your neighborhood psychotherapist.
Women between the ages of 35-55 are within the age range of the perimenopausal phase of their life. Perimenopause refers to the time period during which a woman’s body makes its natural transition toward permanent infertility (menopause). A woman’s ovaries are the body’s primary estrogen manufacturer and begin the process of shutting down. This can occur anywhere over a 5 year to 10 year span. Hormone levels now fluctuate on a regular basis, creating a physical and emotional roller-coaster ride. The symptoms described above are just some of the physical experiences of this phase of a woman’s life.
For some women, the emotional manifestations of perimenopause can be severe and misdiagnosed as a psychological clinical syndrome when in fact they are a result of the intense fluctuations of estrogen. The process can be quite erratic during peri-menopause.
Feelings of indescribable restlessness, tingling in the extremities, racing heart when resting, shortness of breath, inability to sleep ; all classic symptoms of anxiety. Waves of inexplicable sadness, tearfulness, anger, irrational irritability, foggy thinking, feelings of apathy; All classic symptoms of depression.
Confusion and feelings of powerlessness often plague them as they cannot identify any triggering event that would make sense of their depression and anxiety. Often, these women are at a good place in their lives. While they may feel stressed, they enjoy the full life they have created; Family, careers, friendships…coming into their own as women and yet they often feel emotionally and physically hijacked at nature’s whim.
The first and most important step a woman can take is to identify what is causing her symptoms.
If a complete family and personal history is absent of psychiatric or psychological disorders additional history regarding menstrual regularity, history of post partum depression and severe premenstrual syndrome are explored as well as the female patient’s mothers age of menopausal onset.
Women with a history of clinical depression or anxiety have an increased risk for mood related symptoms during the peri-menopausal period.
It is important to distinguish if the depression and anxiety symptoms are related to a clinical mood disorder, hormonally related mood disorder or an exacerbation of preexisting symptoms triggered by hormonal fluctuations during peri-menopause. Treatment strategies can vary depending upon the etiology of the symptoms of the depression and anxiety.
Ovarian function declines over time and estrogen levels impact serotonin levels. As estrogen rises and falls serotonin levels rise and fall correspondingly.
Not all women experience disruption in mood when serotonin fluctuates but for those who are serotonin sensitive ( Mood and sense of well being are very reactive to even minimal rise and fall in serotonin) it can feel like they are living on the crazy train.
While PMS is like going to a hormonal community you visit once a month, peri-menopause can feel like you have moved in permanently. Women are not powerless in how they will experience this physical and emotional transition. Although symptoms can range from bothersome to debilitating the good news is there are many effective methods to help minimize peri-menopausal symptoms. Treatment options range from psychopharmacology, hormone therapy, dietary changes, life style adjustments and exercise and alternative medicine such as acupuncture.
Perimenopause can also trigger thyroid function which also can manifest similar emotional and mental symptoms.
When experiencing depressive or anxious symptoms women in the perimenopausal phase of their life, it is important they explore with a professional the possible connection to hormonal shifts.