Why am I So Depressed?
Why am I So Depressed?
Mental health matters
According to the WHO, clinically diagnosed depression affects 5% of the global population with a higher incidence among women (4% in men and 6% in women). Some project that depression will become the second leading cause of disability worldwide by 2030.
When I first read these statistics, my sense was that 6% of women worldwide seemed pretty low. But after digging a little deeper, I discovered that the observed rates of depression in perimenopause and menopause range between 20-40% according to the Massachusetts General Hospital Center for Women’s Mental Health. This is incredible to me when compared to a 6% incidence in all women worldwide.
So what is it about this stage of life that is responsible for this mindblowing statistic?
We are more established in our careers with increased responsibility and potentially more stress
Children have left the home
Aging parents
Relationship adjustments
… and let’s not forget, our changing bodies!
One could argue that every stage of life has its stressors. In our younger years, we are climbing the ladder in our careers and paying our dues. We are raising our children - running every which way to soccer games and dance recitals while trying to juggle a job, a marriage, and a life, for that matter, without losing our identities in the process.
But this later stage of life is different because what comes with it are the most dramatic physical changes since the onset of puberty. This is no joke! Hot flashes, sleep disruption, brain fog, and anxiety that comes out of nowhere can shake even the most well-adjusted people. Then you go to your doctor, desperate for help, and you are met with a deaf ear or “solutions” that are not helpful. Now you feel even more alone. It’s a wonder that these depression statistics are not higher.
Making Sense of the Symptoms
Sometimes, it’s easier to navigate a difficult situation if you know exactly what you’re dealing with. If we know why something is happening, we can target our interventions to the root cause and “cut the beast off at the head”.
The most important thing to understand is that every woman experiences her hormonal physiology differently. Two hormonally balanced, regularly cycling, ovulatory women can experience their menstrual cycle very differently. For example, one of these woman may be debilitated by their premenstrual symptoms while others don’t even realize the period is coming. Pregnancy is another example. A woman experiencing a healthy, hormonally balanced pregnancy can have terrible morning sickness while another healthy woman will never experience nausea. The menopausal transition is no different. There is vast variation in how women experience this normal, but dramatic, transition and the key to navigating the often life-altering symptoms that accompany this transition is to target the physical manifestations of these hormonal changes.
Let’s get back to depression. There are several things that can impact mood during this stage of life:
Life and relationship stressors as noted above
Sleep disturbance. This is a huge player in the mood equation.
Urinary symptoms
Hot flashes
Racing thoughts
Anxiety
Energy imbalance. Overtraining/underfueling can cause irritable mood and sleep disturbance
Sexual dysfunction such as low libido, vaginal dryness, painful sex can place strain on relationships and make us feel so woefully “inadequate’ as partners.
Generalized, clinical depression
When I see clients with depressive symptoms, the first thing we do is break down and assess these factors above. Fortunately, there are great pharmacologic and non-pharmacologic interventions for all of these situations.
Sometimes, even if these factors have been optimized, depressive symptoms still exist, leaving women understandably feeling defeated. However, having gone through the process of addressing these issues without the desired outcome may lead to the realization that additional mental health assistance is needed.
Despite the major advances in the treatment of clinical anxiety and depression, there is still a societal stigma that does not always present a welcoming and non-judgmental environment for seeking this help. So what happens? We don’t talk about it and just try to push through it. Much like menopause! Similar societal stigmas and provider misconceptions about this stage of life have created barriers to women getting the help they need.
How Can I Find Help?
The approach to combatting depression and thriving during this stage of life is a holistic endeavor. It’s about physical health, mental health, our relationships with friends, family, and community, and the environment around us. Below are suggestions for how to tap into all of these things:
Start journaling. Self-awareness is a very powerful tool for paving the way to better mental health. Symptom diaries can be incredibly helpful for identifying associations between symptoms, circumstances, and potential “triggers”.
Find your community. Knowing that you are not alone and gaining support from other women experiencing the same things is a game-changer! My friend, Amanda Thebe, published an amazing book, “Menopocalypse”. It is so engaging because she shares her experience from the heart, connecting in such a way that you know that you are not alone. My other shout-out is to my friend, Selene Yeager and Feisty Menopause. This community has grown exponentially because of the life-changing support from the thousands of women in this community and the reputable and practical blog and podcast content.
Consider a Coach. Health coaches and life coaches are fantastic resources that can help you see the “big picture” and identify specific areas where you might be struggling.
Call your healthcare provider. There are so many pharmacologic tools to help alleviate the symptoms of the menopause transition as well as clinical depression and anxiety. But don’t settle! If you feel that your provider is dismissive or not hearing you, find another provider! There are definitely good, menopause-informed providers out there! You deserve to be heard and not to suffer.
Housekeeping….
The Navigate Menopause Course is back for Spring! Sign up today to secure your spot!
This amazing course collaboration with my friends and colleagues at Feisty dispels the confusion and busts the myths surrounding menopause and gives you the tools you need to empower yourself to take your menopause experience into your own hands. Click HERE to learn more!
