Hajia Laraba is 51 years old. For the past two years, she's been crying at random moments, while cooking, and in the middle of work meetings. She forgets words in mid-sentence, names of people she's known for years, and where she placed her phone five minutes ago. She wakes at 3 AM drenched in sweat, heart racing with inexplicable panic. Some days, she's so angry she wants to scream at everyone. Other days she feels empty, like she's disappearing. She has been moody. Her family thinks she’s losing it and might be under spiritual attack by jinns.
Mrs Okafor, a 52-year-old woman, recently reached menopause. Her children are studying in university, and she is isolated at home with an unsupportive husband. She became severely depressed. She stopped eating, stopped bathing, and stayed in bed most of the time. She started thinking about being better off dead, convinced her family would be better off without her.
Mama Dupe has been experiencing all sorts of uncomfortable symptoms after she attained menopause surgically at the age of 42 years. She had multiple fibroids that were causing her excessive bleeding. Thus, her gynaecologist suggested removal of the womb and ovaries at once…causing the surgical menopause. She had gone to several doctors about her discomfort and symptoms but they simply told her to be patient, and it would get better. She is depressed and miserable and unable to find joy in things.
Discussion
Menopause is a normal part of women’s lives. It is a biological process of ageing that signifies the end of a woman’s reproductive ability. It is often confirmed only after 12 months without menstruation. Typically, it occurs between the ages of 45 and 55, and hormones start to fluctuate, and menstruation becomes irregular. Menopause is when menstruation eventually stops completely.
Despite the importance of the menopausal phase, it is still poorly understood. The culture of silence means many women know little to nothing about menopause until they experience it. The lack of understanding of menopause also means that the mental health impact of menopause is often ignored and misunderstood. Yet the hormonal fluctuations associated with menopause also influence mental health, resulting in terrifying, unexpected mental health symptoms.
Common Mental Health Symptoms
Menopause affects mental health profoundly because reproductive hormones (oestrogen and progesterone) also regulate mood, memory, sleep, anxiety, and emotional stability. When these hormones fluctuate wildly, your brain chemistry also changes. Some of the mental health symptoms associated with menopause include:
● Depression: Menopausal women with no previous history of depression may start experiencing profound emptiness, hopelessness, inability to feel joy, disconnection, and loss of interest. This sudden experience is often severe and disabling.
● Anxiety and panic: Women also experience social anxiety, waking up in panic, constant worry, social anxiety, and other forms of anxiety they have never experienced before.
● Sudden anger and irritability: You may start struggling with emotional regulation due to the hormonal changes. This can make you irritable, unreasonably angry, and take things out of context.
● Brain fog and memory problems: You may find yourself unable to concentrate, process information quickly, follow complex thoughts, remember important dates, and information you’ve always known.
● Insomnia and sleep disruption: Chronic sleep deprivation is another sign associated with menopause. Hot flashes and discomfort make sleep difficult. Another sleep challenge is waking up multiple times during the night, finding it difficult to return to sleep, and not feeling rested, no matter the number of hours of rest.
● Loss of identity and purpose: The loss of the ability to reproduce may result in an existential crisis for some women, especially as a result of the association of menopause with old age. Many women may ask themselves, ‘Am I becoming old and irrelevant?’, ‘Am I still a woman?’, and other self-reflection questions.
● Other symptoms: A myriad of other symptoms can also occur and vary widely from person to person such as a reduction in libido, social withdrawal, suicidal thoughts etc.
Physical Symptoms of Menopause
These physical symptoms of menopause can also worsen the mental health of menopausal women. They include hot flashes and night sweats, poor sleep, weight gain, joints and muscle pain, fatigue, headaches etc.
How to Survive Menopause With Optimal Mental Health
● Educate yourself about menopause and its mental health impact
● Track your symptoms and keep a record so your doctors can diagnose and treat you effectively. Do not allow others trivialize or dismiss your experience and concerns.
● Make lifestyle modifications such as exercising regularly, reducing alcohol and caffeine intake, staying hydrated, and eating well.
● Maintain good nutrition, and include enough whole grains, fruits, vegetables, calcium and vitamin D sources.
● Build your support system, and have people you can talk to, such as supportive spouses who can at least allow you to ventilate and help you feel supported.
● Seek medical help if symptoms become disabling – there is no shame in identifying depression or anxiety due to hormonal fluctuations and receiving treatment or medications for it.
