Menopause, mood swings and depression: how to stay in control

According to statistics, the fair half of humanity suffers from depression twice as often as the stronger half. Moreover, every fourth woman has experienced deep depression at least once in her life.

• The essence of depression
• Symptoms of depression in women
• Signs of mania
• Symptoms of mania in women
• Reason for women's predisposition
• Additional risk factors
• Is depression genetic?
• Differences in depression in women
• Depression during pregnancy
• Does depression affect pregnancy?
• Does pregnancy affect the development of depression?
• Tips for pregnant women to relieve symptoms of depression
• Treatment of depressive disorder in pregnant women
• Treatment of postpartum depression
• Depression and menopause
• How to relieve menopause symptoms?
• Treatment of depression in women
• Additional materials. Self-diagnosis tests

The essence and definition of depression

Depression is a common, severe mood disorder. It becomes the cause of sadness, a feeling of helplessness and doom, a state of helplessness that was previously not characteristic of a person. Depression can take a moderate form with symptoms such as apathy, lack of appetite, problems falling asleep, decreased self-esteem, and chronic fatigue. Sometimes depression manifests itself in a more serious form. It can last for several months or several years, disrupting the normal life and activity of a woman, her ability to work, as well as relationships with other people. Depression is also strongly associated with the risk of divorce.

Symptoms of depression in women

• The mood is predominantly sad, which can be briefly described with the word “none.”
• Increased anxiety.
• Lack of interest in any type of activity, including entertainment.
• Decreased libido and sexual activity.
• Feeling restless, irritable, fussy, or tearful.
• Feelings of guilt, hopelessness, futility, hopelessness, helplessness, a general pessimistic attitude.
• Changing sleep patterns: a woman sleeps either much more or much less than before.
• Changes in appetite: a significant increase and the woman gains weight, or a radical decrease and she loses weight.
• Decreased energy level (possibly with increased appetite), constant fatigue, and a feeling of some “slowness.”
• Suicidal thoughts and attempts.
• Difficulty concentrating, difficult to remember anything, difficult to make decisions.
• Other multiple symptoms that cannot be treated with traditional methods, such as persistent headache (possibly also migraine), digestive problems, chronic pain of unknown origin.

Since the above symptoms can characterize depression not only as a separate phenomenon, but also as a gradation of bipolar disorder, let us consider the signs of the opposite gradation - mania.

Health effects of depression

Depressive episodes increase the risk of developing cardiovascular diseases or worsen existing ones, and increase the risk of diabetes.

Indifference to food leads to irregularities in the diet, which entails serious disruptions in metabolism. Patients experience increased brittleness of nails, dullness and hair loss, decreased skin turgor, and obesity. Women often look older than their years.

The consequences of long-term depression are expressed not only in the deterioration of physical health, relationships in the family and society. One of the dangers is the increased risk of a repeat episode.

Relapse occurs in 50% of patients. When the second episode occurs, a relapse is observed in 70% of patients; after the third, a relapse occurs in ninety cases out of a hundred.

Against the backdrop of feelings of uselessness, failure, hopelessness, and guilt, women suffering from depression may succumb to suicidal tendencies.

Signs of mania

Bipolar disorder is characterized by the fact that mood can change sharply, occupying completely opposite poles - from mania to depression and vice versa every couple of days, weeks or months. In this case, mania is characterized by a highly energetic state and high spirits. But even if the state of mania may not cause concern due to its inherent positive symptoms, it requires immediate psychotherapeutic help, because at any time it can change to a completely opposite state.

Causes

In most cases, the disease develops after sudden changes that were unfavorable. These include:

1. Marriage breakdown.
2. Dismissal from work.
3. Parting with a loved one.
4. Moving.
5. Completion of studies.

Family problems and conflicts also play an important role. With an unstable emotional background in a family where there is no understanding and difficult living conditions, there is a high risk of developing hidden depression. At the same time, a person himself cannot do anything. He will lead his usual lifestyle, try to resist the environment, but depression will affect his physiology.

Symptoms of mania in women include:

• Dominance of high spirits, previously not characteristic of a woman.
• Frequent irritability or intolerance.
• Low need for rest and sleep.
• Generating numerous big ideas.
• Increased need for communication.
• Jumpy formulation of thoughts.
• Excessive, previously unusual, physical activity, including sexual activity (increased libido).
• Noticeably increased overall energy level.
• Lack of judgment, which sometimes leads to undue risk and behavior.
• Inappropriate behavior in public.

Social consequences

It is worth noting that the effect of depression on a person is always purely individual. It is never possible to predict exactly what consequences the disease will cause. However, there are a number of characteristic qualities that people who experience depression experience.

The consequences of depression include:

• decreased mental activity;
• increased irritability, especially to loud noises such as laughter;
• dominance of negative emotions;
• the appearance of phobias that had not previously manifested themselves, such as fear of heights or closed spaces;
• decreased libido, as well as other intimate problems;
• problems with communication in the work team and at home, manifestations of irritability, apathy, constant desire for solitude;
• constantly being in a state of despondency;
• suicidal tendencies.

All of these problems can accumulate and get worse. This is especially true for the reluctance to live. When a person can suddenly move from simple conversations to real actions. This happens if the negative influence of constantly operating negative factors one day becomes too great for him.

A common problem after depression is a reluctance to interact with groups of people. The person becomes uncommunicative and withdrawn. He cannot bring himself to go to entertaining public places such as bars, restaurants and clubs.

According to statistics, about 40% of people who have experienced depression periodically think about committing suicide. As you can understand, depression is a disease, even after treatment of which a person will need to be monitored.

What is the reason for women's predisposition to this disorder?

In childhood and pre-puberty, the susceptibility to depression in both sexes is the same. But upon reaching puberty, the risk of this disorder in girls increases significantly and, compared to boys, it occurs almost twice as often.

Most experts tend to consider the cause of such “injustice” to be hormonal changes that occur in the female body throughout life. Changes in hormonal levels become obvious during puberty, pregnancy, premenopause and menopause, as well as in connection with the birth of a child and breastfeeding. Added to this are monthly fluctuations in hormonal balance, which sometimes provoke the occurrence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), a serious condition similar in nature to depression and a group of anxiety disorders.

Treatment Options for Depression

For the most part, treatment for depression in women is the same as for men. Unique differences in life experiences, personalities, and biology make treatment challenging; no treatment is suitable for everyone. However, research shows that many people benefit from a combination of medications and therapy, and experts recommend this as a way to combat depression.

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The first step to get out of depression is to visit your GP. Initially, your healthcare provider may do some blood tests to rule out any medical conditions that mimic depression, such as iron deficiency, anemia, or thyroid problems.

He will then create a treatment plan based on the severity of your condition. Mild to moderate depression can be combatted through psychological treatment. In some cases, for more severe depression, you may need to take antidepressants.

Antidepressants

More than 10% of women fight depression with the help of antidepressants. Although complete remission is difficult to achieve, studies have shown that 65 to 85% of people get some relief from taking antidepressants, compared with 25 to 40% of people taking a placebo.

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Research shows that antidepressants are equally effective in women and men. However, people respond differently to the same antidepressants, so the choice of medication is made on an individual basis.

Psychotherapy

Most studies show that women and men benefit equally from psychotherapy. There are three broad options - cognitive behavioral therapy, interpersonal therapy and psychodynamic therapy.

There is no easy answer as to which one works best. Many patients recommend a mixed approach, based on elements of various schools of psychotherapy, as this method of dealing with depression suited them best.

1. Cognitive behavioral therapy aims to correct ingrained patterns of negative thoughts and behavior. The patient learns to recognize distorted, self-critical thoughts such as “I screwed up,” “people don’t like me,” or “it’s my fault.” During cognitive behavioral therapy, the therapist works with the patient to evaluate the truth behind these statements, with the goal of transforming such automatic thoughts and recognizing events that are beyond one's control.
2. Interpersonal psychotherapy focuses on the acute aspects of the patient's current relationships. Weekly sessions over several months help the patient identify and practice ways to resolve recurring conflicts. Typically, therapy is based on one of four specific issues: grief from a recent loss, conflicts about roles and social expectations, the effects of a significant life change (such as divorce or a new job), and social isolation.
3. Psychodynamic therapy focuses on how life events, desires, and past and current relationships influence the patient's feelings and choices. In this type of therapy, the therapist helps the patient identify unconscious defenses against painful thoughts or emotions. For example, someone with a domineering parent may find it unconsciously difficult to risk developing intimate relationships for fear that all close relationships will involve a dominant partner. When patients learn about these patterns, it is easier for them to overcome this barrier. Although the duration of psychodynamic therapy can be unlimited, a variation called brief dynamic therapy is limited to a specific period of time (usually 12 to 20 weeks).
4. Group and family therapy can also be part of treatment for depression. Group therapy relies on the support of the people in the group and uses the dynamics among them, as well as the assistance of the leader, to explore common problems. Family and couples therapy also delve deeper into the interaction with the individual. As with group therapy, the goal is to identify destructive directions. These treatments can recognize hidden problems and make connections to the current condition. Family therapy is especially helpful when a person's problem is disrupting the family.

Additional risk factors

Among the factors that increase the risk of depression are biological (fertility, heredity), characteristics of interpersonal interaction and specific personal characteristics. In addition, if a woman is exposed to increased stress for a long time or is a single mother, this further increases her chances of developing symptoms of depression.

Additional risks include:

• Family experience of mood disorders.
• The presence of a mood disorder in a woman in adolescence or early youth.
• Loss of a parent in childhood.
• Loss of family, friendly support or threat thereof.
• Intense or prolonged psycho-emotional stress (possibly dismissal, problematic interpersonal relationships, separation or divorce).
• Violence experienced in childhood or recently: physical and/or sexual.
• Certain medications.

In addition, some are susceptible to developing postpartum depression, as well as so-called seasonal affective disorder, depending on the time of year.

The impact of depression on the professional sphere

We have already mentioned that when depression occurs, the professional sphere is the last to suffer - the woman tries to maintain her business position to the end. This can be done with timely contact with specialists. If the disease is advanced, sooner or later it becomes impossible to perform your work duties.

This is caused by a real deterioration in well-being, mental and physical inhibition, uncertainty, and difficulties in understanding what is happening. Gradually, even familiar tasks that were previously performed “automatically” become incredibly difficult.

Depression can become chronic, especially when the episode is severe. Therefore, it is extremely important to contact a good specialist as early as possible. Timely diagnosis and treatment make it possible to relieve symptoms in time and prevent further development of the disease.

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How is depression different in women?

• It appears earlier, lasts longer, relapses occur more often, is more associated with stressful life circumstances, and is subject to seasonality.
• Female representatives are more predisposed to self-flagellation, experiencing feelings of guilt and are prone to making suicidal attempts.
• Female depression is more often accompanied by various kinds of anxiety disorders and eating disorders (food addiction, psychogenic overeating, nighttime overeating, bulimia (often with a cyclical connection), less often anorexia).

Diagnostics

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In a conversation with a patient, the doctor first of all pays attention to long periods of depression, a decrease in the range of interests, and motor retardation. Patient complaints of apathy, loss of strength, increased anxiety, and suicidal thoughts play an important diagnostic role. There are two groups of signs of the depressive process that the doctor takes into account when diagnosing. These are positive and negative affectivity (emotionality). Additional diagnostic signs of depression are:

• family history - if among the patient’s relatives there were people suffering from depressive disorder (especially bipolar), or if there were suicides among the immediate family;
• patient's personality type – anxious personality disorder is a risk factor for depression; previous history of depression or mania;

concomitant somatic chronic pathologies; alcoholism – if the patient is partial to alcohol, then this is also a risk factor for depression.

Most people with underlying depression experience migraines, neck pain, and headaches.

Depression during pregnancy

It is assumed that the expectation of the imminent arrival of a child should be directly correlated with a sense of well-being, which in turn protects a woman from psychological problems. But in practice, it turns out that pregnant women are just as likely to be depressed as other women.

Factors that increase the risk of developing depression during this period include:

• Having depression, severe PMS or PMDD before pregnancy.
• Age of the pregnant woman: the older the woman, the lower the risk.
• Social withdrawal.
• Deprivation of social and friendly support.
• Marital quarrels.
• Uncertainty about the desirability of having a child.

Diagnostic features

A consultation with a psychiatrist in our clinic includes:

• Listening to complaints.
• A survey to clarify the details of existing manifestations. It is important to identify the primary causal factor in the occurrence of deviations.
• A careful examination, during which a specialist must identify the presence or absence of a connection with existing signs of disease and internal organs.
• Laboratory diagnostics.
• Taking an ECG.

Psychodiagnostics. For this purpose, questionnaires, surveys, and tests are used. They help to identify the client’s character traits.

Does depression affect pregnancy?

The following trends are highlighted:

• The insidiousness of this disorder is that a person stops taking care of himself. For a pregnant woman, this may be critical. Pregnant women suffering from depression are less likely to follow doctors' recommendations, sleep and rest patterns, physical activity and a balanced diet.
• This disorder can push a woman to drink alcohol and smoke tobacco, which negatively affects both the health of the expectant mother and her baby.
• Worsening depression may interfere with bonding and bonding with the child.

On the other hand, pregnancy also affects the course of depression:

• An pregnant woman's increased sensitivity to stressful circumstances and their more severe experience may contribute to the development of a depressive disorder or a worsening of existing symptoms.
• Without appropriate therapy, depressive symptoms do not disappear with childbirth, but the name changes - postpartum depression. To assess the signs of depression, take the Test: Postpartum Depression (it is also aimed at pregnant women).

Consequences of maternal depression for the child

Practice shows that children whose mothers suffered from depression are more likely than others to experience mental disorders. Of course, genetic predisposition also makes a contribution when it comes to endogenous types of disease. But psychogenic factors are no less important.

Mental disorders are recorded in 80% of children whose mothers experienced the so-called. unipolar depression, and in 70% of children whose mothers suffered from bipolar depressive disorder.

The consequences of postpartum depression deserve special attention. If the depth of the disease is such that the child is actually separated from the mother, he may develop anaclitic depression. As a rule, this happens during a long separation, more than three months. The condition is reversible; after the mother’s depressive episode ends and contact is restored, the baby’s mental health is restored.

Tips for pregnant women to relieve symptoms of depression

The preparatory efforts associated with the birth of a baby are energy-intensive and require significant effort and time. But the health of the expectant mother should be given priority. Try not to get hung up on the fact that everything has to be perfect, cut down on current, routine work and do what contributes to your relaxation and calm. Discussing any issues that concern you with your loved ones will help you establish peace of mind and have a beneficial effect on your well-being. Maintain trusting relationships with friends, partner, and loved ones.

If you feel that you are unable to cope on your own, seek professional help from a psychotherapist.

Prevention

The only effective method is to visit a doctor before the disease has time to gain strength and affect the body. By following his instructions exactly and constantly being under the supervision of loved ones, the patient is able to recover fairly quickly. However, here lies the main problem - the vast majority of people usually do not perceive depression as something serious. Because of this, a person’s life can be destroyed, since it is depression that becomes the basis for future illnesses and problems with society.

Treatment of depressive disorder in pregnant women

In this case, the treatment plan and the chosen strategy must be carefully thought out, and the risks for the developing fetus and the pregnant woman must be weighed. Only a psychotherapist can effectively cope with such a task, who will either prescribe medications to get results as quickly as possible without the risk of harming the child, or recommend special psychotherapeutic methods for a quick and most reliable result.

Remember, you cannot select and self-prescribe medications, especially for a pregnant woman. This should be done by a doctor based on the results of diagnosing a particular case.

Treatment of postpartum depression

It is treated in the same way as any other form of depression, which involves the use of psychotherapeutic methods and/or medications. If a woman is breastfeeding during therapy, this should be reported to the attending psychotherapist in order to draw up a correct treatment plan. Since it is assumed (not yet confirmed) that the active substances included in antidepressants may pass into breast milk in small quantities, the doctor will need to weigh the possible risks and benefits of using antidepressants and, perhaps, focus more on non-drug therapy for depression.

Since the birth of a child and, in connection with this, a change in lifestyle can affect both the psychological well-being of the woman herself and her relationship with her husband, it is recommended to pay attention to the recommendations of psychologists on how to improve relationships with her husband after the birth of a child, as well as what prejudices the mother should get rid of so as not to drive yourself into depression.

Masked depression: treatment

Treatment of somatized depression is carried out at the Yusupov Hospital according to individual programs. Experts have found that the appearance of depression is caused by a violation of the metabolism of norepinephrine, serotonin and dopamine, so patients with this diagnosis can be prescribed antidepressants as a basic remedy.

Psychiatrists at the Yusupov Hospital follow the recommendations of the World Health Organization and use non-drug methods in the treatment of masked depression, which include:

• psychotherapy carried out within the framework of various directions to determine the nature of personality;
• biofeedback;
• autogenic training;
• physical therapy;
• art therapy.

Somatized depression, the symptoms and treatment of which depend on the stage, affects the patient’s quality of life. The main task in treating patients with this diagnosis is to return them to an active life and improve its quality. One of the most effective methods is psychotherapy, which helps relieve psychological trauma and relieve behavioral symptoms.

Consultation with a psychiatrist in cases where other specialists are unable to establish the cause of somatic complaints is the first step on the path to recovery. A person suffering from depression may not associate it with any events that have occurred, since masked depression has a variety of symptoms. During the consultation, specialists are able to identify the existing problem and determine the possible causes of its formation.

Psychiatrists at the Yusupov Hospital provide consultations by appointment, so to clarify the time of visiting a specialist, you must contact the staff of the medical institution by phone.

Depressive disorder and menopause

By analogy with other periods of a woman’s life, during menopause there is a close relationship between hormonal levels, physical manifestations and emotional reactions and experiences. Among the physical symptoms, the most common are hot flashes or chills, excessive sweating, dry skin, excess weight gain and a number of others. Mental symptoms include irritability, sleep disturbances, tearfulness, headaches and migraines. These symptoms, together with increased anxiety, cause depression. Most often, menopause begins after 45 years of age, but due to the characteristics of a particular organism (for example, surgical removal of the ovaries), it can begin earlier.

How can a woman cope with menopausal symptoms?

• Eat healthy foods and maintain moderate but regular exercise (workout is effective in controlling anxiety levels).
• Get involved in a creative activity, find an interesting hobby that will guide you towards pleasant achievements.
• Find a technique that can balance your mental state: this could be meditation, certain relaxation breathing techniques, yoga (other techniques, strategic self-help for anxiety).
• Try to keep the air in the bedroom at a cool temperature, which will help prevent sweating during sleep and, as a result, sleep disturbances.
• Seek emotional support from friends, close family, or professional help as needed.
• Maintain family relationships, communicate in different interest groups, strengthen friendships with other people.
• Follow your doctor's instructions regarding taking vitamins, dietary supplements, minerals and other medications prescribed to you.
• During periods of frequent hot flashes, give preference to loose-fitting clothing.