Menopause or Madness? Misdiagnoses, Miconceptions and Coping with Menopausal Mental Challenges
Virtually all women will go through menopause, and often, experience symptoms and complaints as a result of this life stage. Yet why do we still not seem to know enough about it? Why are there still misconceptions about it? And why aren’t we talking more about it?! Did you know that some women are misdiagnosed with having a mental illness like, anxiety or depression, instead of realising that they’re experiencing menopausal symptoms?
While the physical changes of menopause are well-documented, the impact of hormonal fluctuations on mental health is often underestimated. This oversight has led to misconceptions, even among medical professionals. So in this blog, we’re going to explore the mental health symptoms of perimenopause and menopause, the reasons behind these misdiagnoses, and strategies for women to better cope with the psychological challenges of this life stage.
Understanding the Mental Health Symptoms of Menopause
Perimenopause, the phase leading up to menopause, can begin as early as a woman’s late 30s or early 40s. Hormonal fluctuations during this period can cause a range of mental health symptoms, including mood swings, irritability, anxiety, and difficulty concentrating. These symptoms can intensify during menopause itself, which typically occurs in a woman’s late 40s to early 50s. Sleep disturbances and decreased energy levels also contribute to emotional distress during this time.
The Misdiagnosis Conundrum
The similarity between mental health symptoms of perimenopause/menopause and disorders like depression and anxiety often leads to misdiagnoses. Due to a lack of information and the fact that menopause still seems to be a taboo topic, menopause remains unrecognised and unaddressed. This is certainly out of balance when you compare it to the attention and support that there is for other life stages women will go through, for instance, getting their periods, or when experiencing pregnancy.
The stigma surrounding mental health further compounds the problem, causing women to be reluctant to attribute their symptoms to hormonal changes. Even medical professionals can fall into this trap, focusing solely on treating the apparent mental illness without recognising the hormonal underpinnings. As a result of all of this, women do not recognise their bodily signals or do not dare to ask for help.
Another reason for the difficulties in women and healthcare professionals noticing menopausal mental health challenges, is also because at this time of their lives, women are experiencing a range of life events that may impact on them emotionally and mentally. For instance, midlife is often characterised by having new responsibilities for ageing parents or suffering from bereavement after the loss of parents. Or women might also have teenagers, which can be one of the most challenging (and stressful) age groups to parent, or perhaps their children are leaving the family home and they’re becoming empty nesters. Also by midlife, women may have gained more seniority and responsiblity in the workplace, which can cause additional stress [1, 2]. You can see how disentangling menopause from other phenomena related to the life course can be challenging.
Strategies for Coping and Overcoming Challenges
So what can be done to overcome the misconceptions, the misdiagnoses, and management of menopausal mental health symptoms? We have come up with a list of strategies to consider:
1. Education and Awareness: Understanding that the emotional upheaval is a result of hormonal changes rather than a standalone mental illness can be empowering. Women should educate themselves about perimenopause and menopause to recognise the connection between their mental health and hormonal shifts. Jean Hailes for Women is an excellent source for information.
2. Communication with Healthcare Providers: Women must openly discuss their symptoms with healthcare providers. Advocating for themselves, not being shy about discussing symptoms and insisting on a thorough evaluation can help ensure accurate diagnoses and appropriate treatment plans.
3. Lifestyle Modifications: A healthy lifestyle can significantly alleviate psychological symptoms. Regular exercise, balanced nutrition, stress reduction techniques (such as mindfulness and yoga), and sufficient sleep can positively impact mental wellbeing.
4. Menopausal Hormone Therapy: hormone replacement therapy (HRT), now known as ‘menopausal hormone therapy’, is recommended to balance hormonal levels and alleviate symptoms. HRT has had a bad rep in the past due to perceptions of bad side effects based on a flawed study, however newer studies have put this to bed, and concluded the benefits far outweigh the risks. In fact, HRT can be critical for women’s long term mental health and brain functioning, especially if they start using HRT earlier when symptoms first arise during perimenopause. HRT is now considered first-line treatment [3]. So don’t delay. Consult with a healthcare provider.
5. Mental Health Support: Seeking support that helps women develop effective coping mechanisms, better handle emotional challenges and negative thinking can be helpful. Programs based on Acceptance and Commitment Therapy (ACT) can help with building mental resilience. Go to www.kemar.com.au for details about such programs that exist for women.
6. Peer Support: Joining support groups or connecting with friends who are also navigating perimenopause and menopause can provide validation, shared experiences, and emotional support.
7. Self-Care: Prioritising self-care activities that bring joy and relaxation can contribute to overall wellbeing. Engaging in hobbies, spending time with loved ones, and dedicating time for oneself can be immensely beneficial.
8. Engage in Self Compassion: Many women might notice during menopause that they tend to be more self-critical rather than self-compassionate, like “What’s wrong with me?”, “I’m such an idiot for being forgetful!” or “I can’t concentrate, I am useless”. So showing self-kindness, by acknowledging that this life stage can be difficult, remembering that it is part of the human condition, and talking kindly to oneself. Also, having a positive attitude to ageing, welcoming this life stage and seeing it as a new beginning has shown that women will cope with symptoms better.
In conclusion, the mental health symptoms of perimenopause and menopause are a significant aspect of a woman’s life transition that deserves more attention. Awareness, open communication with healthcare providers, lifestyle adjustments, and seeking support can empower women to navigate this phase with resilience. By understanding the underlying hormonal causes of their emotional challenges, women can reclaim control over their mental wellbeing and embrace this new chapter of their lives with confidence.
References:
1 Dennerstein L, Leher P, Dudley E, Guthrie J. Factors Contributing to Positive Mood during the Menopausal Transition. J Ner Ment Dis. 2001;189:84–9.
2 Atwood JD, Mcelgun L, Celin Y, Mcgrath J. The Socially Constructed Meanings of Menopause: Another Case of Manufactured Madness? J Couple Rel Ther. 2008;7:150–74. doi.org/ 10.1080/15332690802107156
3. Iliana, C. Fine, A., Antoniades, M. L. & Jacobson, M. (2023) A pragmatic approach to the management of menopause. Canadian Medical Association Journal, 195(19). doi: 10.1503/cmaj.221438