Emotions and the menopause: mood swings, anxiety and depression

Women’s emotional symptoms during the menopause vary. Some have no symptoms at all, others have mood swings, anxiety and depression. These symptoms can be frightening and surprise many women, adding to the burden of hot flushes and irregular periods. They talked about these symptoms and how they affected their lives.

A range of emotions
Some women noticed no emotional changes during the menopause, or found their moods levelling out as their periods declined.

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Others, however, talked about losing control as symptoms such as mood swings, depression, worsening premenstrual tension (PMT), anxiety, panic attacks, anger, snappiness, short temper, irritation, crying and impatience took over their lives. Women were ‘like a bear with a sore head’, ‘getting very ratty’, or ‘flying off the handle’ at the slightest thing. One woman was so irritable that she ‘just wanted to have a row with someone’; another thought she was snappy because she was tired.
Women’s personalities changed as emotions threatened their sense of balance and well-being. Some felt uncharacteristically depressed and even subdued. They used phrases like ‘this isn’t me’, ‘I’m not the way I’d normally be’, ‘it’s not like me’, ‘normally I’m quite a sensible person’ to describe this new, changed identity. One woman found herself ‘crying over things’ which wouldn’t have bothered her before; another felt disconnected from her emotional self, as if she were ‘floating and watching’ herself shouting. Confused by irrational emotions, women understandably wondered ‘what’s happening to me?’. Several were so worried about how they felt and concerned that it might be depression that they consulted their GP (see ‘Consulting the doctor’).
How emotions affect family members
Emotional symptoms can also affect relationships with partners and children, adding to the stress of daily life. Family members may become the target of an onslaught of emotions when seemingly innocuous things are ‘blown out of all proportion’. Women highly valued the support of sympathetic partners who tried to understand how they were feeling. One woman, however, attributed her moodiness as much to the lack of support at home as to the menopause. Relationship difficulties, divorce, worries about children, bereavement, moving house, and work pressures may also bring further strain (see ‘What is the menopause?’, ‘Family, health and life events’, ‘Relationships, sex and contraception’).
Trying to keep a lid on emotions at home can itself be exhausting. Women often had to do ‘repair work’ to restore harmony after an emotional outburst by expressing regret and apologising for their behaviour. One woman had felt ‘a failure’ because of her lack of control and spoke of the need to ‘snap out of it’ for the sake of her family.
Emotions at work
At work women may feel particularly vulnerable and subject to public scrutiny. Anxiety, low self-esteem, loss of confidence and insecurity threaten to undermine women’s status in the workplace (see ‘Work’). One woman’s business was affected as she became increasingly irritated with customers; another felt unable to make decisions; and workmates started to avoid a third because she ‘barked’ at them.
Maintaining composure in the workplace is difficult. One woman said she ‘silently seethes inside’ and ‘bites her tongue’ when somebody at work says the wrong thing; another ‘bottled up’ her feelings at work while being ‘freer and easier’ with her moods at home.
Coping with emotions
Fearing at times they were ‘going mad’, women found relief by talking to people or consulting internet forums. They could cope with their moods better once they realised that emotional symptoms could be ‘part and parcel of the body clock’ and ‘quite normal’ at this stage in life. Some found homeopathy or over the counter remedies helped (see ‘Complementary therapies’). Keeping healthy by eating well, cutting down on alcohol, and exercise also helped women feel better about themselves (see ‘Changes in the body and keeping healthy’, ‘Non-HRT and lifestyle options’).
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Others sought help from their doctor or a counsellor when severe symptoms threatened their quality of life, work and relationships. Some women were treated for depression or prescribed HRT (see ‘Hormone replacement therapy (HRT)’). One woman was given Prostap (leuprorelin) injections to induce a medical menopause when her premenstrual tension became unbearable, but this is an experimental treatment.
Some women can suffer debilitating mood swings and anxiety which have a significant effect on quality of life. The postmenopausal period can bring longed-for relief when the symptoms become milder. It’s important to remember, however, that feeling low, angry, irritable and upset, and losing confidence can also be signs of clinical depression. If you are at all concerned, contact your doctor for advice.

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Last reviewed July 2018.



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