Meg Mathews – Debbi Clarke

Since 2018, Meg Mathews has been one of the UK’s foremost menopause campaigners, determined to use her profile to end the stigma surrounding it. In a her Stella magazine column, she reveals what she’s learnt. This week: how to tackle low mood.

When I started perimenopause at 48, I went through a whole host of feelings that were difficult to describe. I walked into my doctor’s surgery and burst into tears. I didn’t know I was experiencing menopause symptoms, I didn’t know what was happening to me. After 10 minutes with a GP – and clarifying that I felt terrible but that I wasn’t suicidal – he prescribed antidepressants. There was no mention of the menopause.

Even now, it’s difficult to describe how I felt – although some of you will have experienced this darkness, too. Imagine having little or no self-confidence or self-esteem and being overwhelmed by a constant feeling of tiredness that doesn’t go away even if you rest. People that you know and love start to lose their shape; they seem like two-dimensional sketches that you can’t relate to any more. Nothing feels real. You walk around, not living, just existing from one day to the next, wondering if this will ever end. I couldn’t leave the house for three months and I had no interest in anything. I now know that I was crippled with anxiety.

Oestrogen stimulates serotonin, a mood-boosting neurotransmitter responsible for happy feelings and well-being. Declining oestrogen is directly linked to declining serotonin. This can make you feel depressed or experience feelings of anger and rage, all common symptoms of perimenopause.

I have had times when I’ve felt low over the years but I don’t claim to have suffered from depression. I have friends who have struggled with depression and it is debilitating. When my hormones were out of balance it caused my anxiety to go through the roof. The antidepressants helped me to manage these feelings but I wouldn’t say they ‘cured’ me. Taking them along with HRT helped, as the HRT got my hormones back on track and the antidepressants levelled out my anxiety.

Because I was a public figure, going through the menopause and having to always be on top form was very overwhelming. When asked to go on a TV show or talk at an event in front of hundreds of people I felt the antidepressants helped me manage my anxiety and get me to a place where I felt comfortable but it did take months of trial and error with different medications to get there.

It’s important that you find the right treatment for you. Many GPs are quick to prescribe antidepressants, but if the cause of your depression or feeling overwhelmed is the menopause, then the treatment should target the menopause, not the depression.

NICE guidelines state that HRT should be considered to alleviate low mood arising from the menopause and there is evidence that oestradiol can improve mood.

Therapy is also encouraged as a safe and effective way to treat depression, anxiety, and any other mental-health problems. For the menopause, cognitive behavioural therapy (CBT) is often recommended, as it focuses on acute depression, which often occurs with the menopause (as opposed to long-term depression).

There is a high rate of suicide among women aged 45-55, which some studies have linked to the menopause – and experts have highlighted that perimenopausal depression is under-recognised.

When you go to your GP, go armed with a list. Write down all your symptoms as and when they happen to you. When I finally realised I was experiencing the menopause, I found keeping a list really helpful as when you are with your doctor it’s easy to forget one or two of the symptoms. Remember there are 34 menopause symptoms and we all experience menopause differently. You want the right solution for you and that might be HRT, antidepressants or simply some time to yourself to close off from the world and read a book.

As well as medical intervention, it’s worth looking at lifestyle factors too and some simple ways that can help alleviate feeling low. Blood-sugar imbalances (caused by skipping meals, along with drinking too much caffeine, and eating too much refined sugar and white carbs) can compound low mood and depressive symptoms, so keeping a healthy, consistent, balanced diet can help manage your mood. Focus on protein-rich meals with plenty of vegetables and wholegrains.

Magnesium is a nutrient that can help increase levels of serotonin, so an Epsom salts bath can help. Yes, you can find magnesium in leafy greens, legumes and nuts, but a warm Epsom salt bath is not just more fun, it can also help de-stress you. In fact, a 2018 study found that taking a warm afternoon bath at least twice a week seems to be a ‘fast-acting method of improving depressive symptoms’.

My advice is to seek help as soon as possible. I wish more people would talk openly about this so women didn’t feel so alone. Talk to your friends and loved ones about how you are feeling. When I opened up to my daughter, I felt like the weight of the world had been lifted from my shoulders. Also remember to take your time. Your menopause journey is exactly that – a journey – and it’s different for everyone. Depression, anxiety and anger aren’t something that can be stopped overnight.

Read more: ‘The menopause killed my sex life. Here’s how I got it back’

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