The Emotional Rollercoaster of Menopause – What It Can Look Like

Menopause looks different for every woman. Some are lucky enough to breeze through with the odd hot flush and not much else, while others are hit with a rollercoaster of symptoms. The emotional symptoms of menopause can be just as difficult to deal with as the physical symptoms. Some common emotional symptoms include:

• Mood swings
• Anxiety
• Irritability
• Sadness
• Difficulty concentrating
• Difficulty retrieving words
• Loss of memory
• Fatigue
• Depression (1,2)

Thankfully, studies have shown that women aged 45 to 55 years are not associated with an increase psychiatric illness, nor are they more likely to use health services more than what they did prior to this age bracket. (1) This doesn’t rule out the possibility of these symptoms not happening, simply that they may come and go, or that there may be only a few isolated instances.

These emotional symptoms may occur due to the drop in oestrogen, which causes many changes throughout the body. One such change is oestrogen’s effect on serotonin and norepinephrine. Serotonin regulates anxiety, mood and the feeling of happiness. Norepinephrine is a neurotransmitter that sends messages across nerve endings in the body. It is also important for emotions. Low levels are associated with depression, anxiety, low energy levels and lack of concentration. (3)

Risk Factors

There are a few risk factors that can make these emotional changes worse.

1. Hot flushes – Women who experience hot flushes are also likely to experience night sweats, which will lead to a restless night’s sleep. This can follow the next day with irritability, bad mood and poor memory. (1)
2. Pre-menstrual symptom – Women who have a history of severe pre-menstrual symptoms are more likely to suffer mood swings during peri-menopause. (1)
3. Depression – Women who suffered from depression at any time during their life prior to peri-menopause have an increased risk of depressed mood during peri-menopause. Studies show that the likelihood of depression decreases after menopause. (4)

Other things that can increase the emotional symptoms of menopause include:

• Life stressors – including children leaving home, caring for ageing parents and teenage children, financial stress, renovating homes, juggling work and personal commitments, among other things, all lead to stress.
• Unsatisfactory relationships with loved ones
• Inadequate social support
• Difficult living situations
• Negative attitudes toward menopause
• Adversity or struggles in childhood (abuse/neglect, family problems, poverty and unsafe environments)
• Poor health and low levels of physical activity (3, 5, 6, 7)

What Can You do?

This rollercoaster of emotions (mood swings, irritability, sadness, etc) can play a big part in our lives. While there is the option of medications or hormonal treatments during this time, there are some lifestyle changes that can help to improve symptoms as well.

• Improve your sleep or rest more often. Introduce a bedtime routine, make sure the bedroom is dark and at a comfortable temperature, turn off the Wi-Fi in the house.
• Diet can impact anxiety & mood swings. Minimise packaged and processed foods and try to reduce refined sugar intake. Aim for a large variety of vegetables and 1-2 serves of fruit a day.
• Increase your physical activity. Exercise can help with your mental health as much as your physical wellbeing.
• Pursue supportive friendships. Talking about how you are feeling with friends and loved ones can help unburden your emotional load.
• Connect with community – join a community group, start some volunteer work.
• Learn to relax and be mindful. Try yoga, meditation, journaling (writing down your feelings) or breathing exercises.
• Prioritise yourself. Look after yourself by doing the things that you enjoy (exercising regularly, doing your hobbies, learning a new skill, cooking, sewing, gardening, painting or art).
• Find a counsellor or qualified mental health professional if you feel that you need more help than your social relationships can provide. (2, 5, 8)

If you are feeling strong emotions, try to figure out your feelings. What are you really feeling? Why are you feeling that way? Are you masking something that you feel uncomfortable expressing? (8)

If you are feeling stressed, try to identify the cause of the stress. Give the stressful situation a rating out of 10 (it may not feel so bad if you realise it has a relatively low rating). Remember that your feelings are yours and it’s ok to feel certain ways in certain situations. Sometimes, by acknowledging the feelings we are feeling, we can find them easier to deal with, and feel better sooner. (8)

Jean Hailes for Women’s Health suggests thinking about your inner voice and doing a regular emotional audit.

What messages are your inner voice sending?

• Is it being overly critical, or demanding perfection, or is it depressed or anxious? These can contribute to negative feelings about yourself.
• Challenging the negative inner voice is important. Ask yourself why are you talking to yourself in this way? What purpose is it fulfilling?
• Trying some positive affirmations can be helpful – such as “I can do this”, “I am worthy”, “I am happy”. Come up with an affirmation that means something to you. (8)

Check in with yourself regularly for an emotional audit. Ask yourself the following questions:

• Is there an issue that has been on my mind?
• Do I have a plan to do something about it?
• What can I do about it? Do I need others to help me?
• Take time out to think about what’s going on in your life and how you can best manage it. (8)

Ask For Help

Remember, it’s OK to ask for help. Often, as women, we tend to take on many different roles – mother, wife, partner, daughter, friend; and that’s just in our personal lives! It’s important to check in and see if we really need to be doing it all and find out if we are doing things to look after ourselves as well. If you find that your emotions are too much to deal with, or they are worrying you, talk to your GP or seek help from a health care professional. Some useful contact details are:

• Lifeline – 13 11 14
• Beyond Blue – 1300 22 4636
• Australian Government’s Head to Health initiative

Did you know we have a psychologist available for phone consults? Contact us on 1300 883 405 for more details.

Conclusion:

Menopausal emotional changes can hit some women with a vengeance. Others, not so much. There are things we can do to help improve the symptoms – heading into menopause with a positive attitude is the first step. Lifestyle changes, such as a healthy diet, keeping active and making time to look after yourself are all important. However, if your emotional symptoms are disrupting your day-to-day life, please seek help from your general practitioner or relevant healthcare professional (or contact us for phone consults with our psychologist).

 

 

References:

1. Carter D, 2001, ‘Depression and Emotional Aspects of the Menopause’, BC Medical Journal, 43(8): 463-466, viewed 13 September 2020 <https://bcmj.org/articles/depression-and-emotional-aspects-menopause>
2. Dieker A, 2018, How to Manage Emotional Changes During Menopause, viewed 13 September 2020 <https://bloodandmilk.com/how-to-manage-emotional-changes-during-menopause/>
3. Dimaraki E, 2019, Hormone: Norepinephrine, Hormone Health Network, viewed 13 September 2020 <https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/norepinephrine>
4. Dalal PK & Agarwal M, 2015, ‘Postmenopausal Syndrome’ Indian Journal of Psychiatry, 57 (suppl 2): S222-S232, viewed on 13 September 2020 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539866/>
5. Dresden D, 2017, What causes mood swings during menopause?, Medical News Today, viewed 13 September 2020 <https://www.medicalnewstoday.com/articles/317566#Overview>
6. Ayers B et al, 2009, ‘The impact of attitudes towards the menopause on women’s symptom experience: A systematic review’ Maturitas, 65 (1): 28-36, viewed on 13 September 2020 <https://www.maturitas.org/article/S0378-5122(09)00397-1/fulltext>
7. Bromberger J & Epperson C, 2018, ‘Depression During and After the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease’, Obstetrics and Gynecology Clinics of North America, 45(4):663-678, viewed on 13 September <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6226029/>
8. 2017, Menopause: Mental Health and Emotions, Jean Hailes for Women’s Health, viewed 13 September 2020 <https://www.jeanhailes.org.au/health-a-z/menopause/mental-health-emotions>