An article in the latest edition of Australian Prescriber, an independent peer-reviewed journal, explains how mental illness is very prevalent in women approaching menopause. This phase, known as perimenopause, typically occurs between 42 and 52 years of age.
Melbourne psychiatrist Professor Jayashri Kulkarni says research targeting the mental health of perimenopausal women is lacking. There is a gap in recognising and providing appropriate treatments for middle-aged women experiencing depression related to the hormonal changes of menopause.
“Perimenopausal depression can be hard to diagnose. Some symptoms are like those seen in depression in other groups of people, while other symptoms are unusual,” Professor Kulkarni wrote. “However, it’s important to know that once the diagnosis is made there are many treatment options.”
Symptoms of perimenopausal depression
- Low energy
- Paranoid thinking
- Irritability or hostility
- Decreased self-esteem
- Somatic symptoms
- Sleep disturbance
- Weight gain
- Decreased sexual interest
- Problems with memory and concentration
“The course of mental illness in women differs from that of men and is greatly influenced by biological, psychological and social changes over the life cycle,” wrote Professor Kulkarni. “However, most treatments for mental illnesses have been developed and trialled in the ‘typical’ male patient which may not be the optimal treatment for women with mental ill health related to the menopause.”
Management of depression during perimenopause can include psychotherapy and other non-drug interventions like education about menopause, regular exercise, mindfulness techniques, yoga and dietary advice. There are also medicines available, such as antidepressants and hormone replacement therapy.
“The process of menopause can take many years, during which the patient’s quality of life and that of her family, may deteriorate irreparably. Most women with perimenopausal depression respond to treatment”.
“A tailored management approach is essential to maintain the quality of life for women experiencing perimenopausal depression.”