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Menopause and Mood: It's Not All In Your Head

Coping with the Ups and Downs of Menopause

By

Updated June 18, 2014

Have you suddenly begun crying during sad commercials? Snapping at your teenagers when you used to be calm? Had a meltdown during a staff meeting, seemingly out of nowhere? As many as a third of women will complain of some sort of mood problem during the menopause years, and these changes can begin as early as your thirties.

There are several ways that your mood can be affected by the hormone changes and other events around menopause, and nothing will make you burst into tears faster than someone who dismisses it as “all in your head.” You know it’s not in your head, although it can feel a little crazy sometimes. Understanding why can help you cope, and it also gives you a way to explain it to your less-than-sympathetic family or colleagues.

A number of forces converge during midlife to shake your emotional equilibrium, and some women are more vulnerable than others. If you are one of the women suffering from mood shifts, there may be an underlying clinical reason for it and there are treatments and solutions that can help. Pay attention to the nature of your mood problems, and see whether one of the following could be at the root of your emotional symptoms.

Hormone Sensitivity

Some women are just more sensitive to hormone changes than other women. Although only about 8% to 10% of women fall into this “super sensitive” category, it can be pretty unnerving to be easily thrown by small hormone changes. Some signs that you might be a member of this group are:

  • You have suffered from premenstrual symptoms in the past
  • You noticed that you were emotionally up and down during a pregnancy
  • You have had a postpartum depression

Any of these could be a warning that a change in estrogen levels is likely to throw you for a loop more than other women your age. Estrogen plays a major role in how neurotransmitters -– chemicals that affect brain and nerve function -– operate. This, in turn, can affect your mood and behavior. If you fall into this category, discuss the hormone treatment options with your medical provider and see whether a short course of hormone therapy would help smooth out the mood roller coaster.

Recent Cancer Treatment or Surgery to Remove Your Ovaries

As with the hormone sensitive group mentioned above, women who have had their ovaries removed, or women whose ovaries have stopped function as a result of medical treatments, may notice the impact of low estrogen. Because the shift is rapid –- from normal levels of estrogen to very low levels -– the effect on neurotransmitters can be quite dramatic, causing serious mood problems or instability.

Treatment for sudden loss of estrogen depends on the cause. There are hormone therapies and selective estrogen receptor modulators (SERM) medications that may be very useful to you during this time. This is definitely a topic for you and your medical provider to explore. If you are anticipating surgical removal of your ovaries, or a medical treatment that affects them (such as chemotherapy), talk to your doctor ahead of time to minimize your symptoms.

Sleep Deprivation

Women who have a lifestyle that cuts sleep time short, or who are having vasomotor symptoms like hot flashes and night sweats, are likely to be suffering from some form of mood problem caused by sleep deprivation. After 40, your chances of having a sleep disturbance rise. Sleep disturbance or a sleep disorder changes your mood -– and not in a good way. If any of the following are true for you, you might be suffering from sleep deprivation:

  • You wake up at night with night sweats. Even if your night sweats are mild, they can keep you from getting deep, restorative sleep. You might think you are getting 8 hours of sleep a night, but if you never get down into deep sleep, you could still be suffering sleep deprivation.

  • You regularly get fewer than 7 hours of sleep a night. We have a culture that worships “productivity” and going without sleep is often a badge of honor. But the truth is that we are less productive and will have problems with memory and concentration if we ignore the need for sleep. Finding a way to get enough sleep could boost your effectiveness in ways that will surprise you.

  • You wake up thinking about problems. Stress is a major reason for sleep loss, so learning stress management techniques, and ways to fall back asleep, can give you more emotional stability to cope with life’s challenges.

  • Your partner tells you that you snore. Snoring could be a symptom of sleep apnea. If you are a snorer and are tired during the day (like night sweats, sleep apnea can prevent that lovely, restorative sleep), it is probably time for a sleep study to see if you need treatment. Weight gain and age can contribute to sleep apnea, too, so midlife is a common time to develop this condition.

Sleep deprivation or a sleep disorder can cause irritability, anxiety and even depression if it goes on for long. If midlife is cutting into your sleep, or the quality of your sleep, it can affect your mood.

A History of Depression

If you have a history of major depression, you are more likely to suffer mood problems during your menopausal years. If you have been on antidepressants in the past, or have been diagnosed with a depressive disorder, the menopause years may bring another bout of depression. If you notice that your mood is suffering again, get help as soon as you notice so that the depression doesn’t get a head start.

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