No woman probably needs convincing about how difficult the time leading up to the menopause can be. Problems such as significant hot flashes come to the fore in the peri-menopausal period, but they are not the only complaints faced by patients. Indeed, the pre-menopausal period can be associated with the emergence of mental health problems - often overlooked by the patient and those around her.
Factors contributing to psychological problems in the peri-menopausal period
The mere presence of somatic problems puts premenopausal patients at increased risk of mood disorders. For some women, however, this risk is further increased: this includes patients who have already suffered from affective disorders in the past or who have experienced an episode of postpartum depression. The possibility of psychiatric disorders is also exacerbated by events that occurred early in the patient's life, such as in the case of victims of rape or other sexual abuse.
However, factors favouring the emergence of psychological problems in the peri-menopausal period are not only changes in hormone levels in the body. A number of psychological aspects must also be taken into account, which can have a significant impact on a patient's mental health. The knowledge that menstruation will soon cease may cause the patient to lose her sense of femininity (after all, the onset of menopause is linked to the fact that she will no longer be able to become a mother). This risk is also increased in patients who do not accept the ageing process and in women who experience social isolation.
Peri-menopausal depression: symptoms that should definitely give cause for concern
A patient experiencing significant somatic complaints may deny the existence of other problems in herself. She may consider irritability or sadness to be the effects of ageing, which they are not! However, it is not the case that every episode of depressed mood or psychological wellbeing in a peri-menopausal woman should be a cause for concern. Particularly relevant are complaints that last longer than two weeks (this is the time criterion necessary for the diagnosis of depressive disorders), which can be:
- significantly lowered mood,
- loss of interest and inability to feel joy in aspects that the patient previously enjoyed (so-called anhedonia),
- a feeling of emptiness and meaninglessness of the world around you,
- a constant feeling of fatigue,
- appetite disturbances (both increase and decrease),
- unwillingness to leave the house,
- increased irritability.
In extreme, most severe cases, peri-menopausal depression can even be associated with suicidal thoughts or attempts.
Sleep problems are also associated with depressive disorders. Here the relationship is bi-directional: sleep disorders can be a symptom of depression, but they can also induce it. In the peri-menopausal period, sleep problems are one of the complaints of patients, and they themselves - especially if they persist over time - can be a trigger for the appearance of mood disorders.
