What to know about menopause and mental health

Let's get into some health news. This month is menopause awareness month. Of course, it's October. As we recognize this month, mental health expert and physician assistant Rebecca Barbie is joining us now to discuss how menopause can intensify emotional challenges for women living with serious mental health concerns, including bipolar disorder. Rebecca, thanks so much for joining us to talk about this very important topic. Thank you so much for having me. Yes. So first, let's get into this. We know that October is Menopause Awareness Month. Why is it worth talking about mental health during menopause? Absolutely. The menopause transition time period is actually one of the highest risk windows in a woman's life for either new or recurring mood symptoms. So this is a particularly vulnerable time period in a woman's life. Thank you so much for sharing. And before I ask you one more question, let's get into the difference here. of menopause and perimenopause? So there are staging systems we use to determine whether someone is in perimenopause or menopause. It is the cessation of menstruation. But the perimenopausal symptoms that affect so many of us are symptoms related to changes in mood, changes in our sleep patterns, changes in cognition, brain fog, attention problems. So that perimenopause time period can go on for years, oftentimes average length four to seven years. Average length four to seven years. What age does this start for young women? That's going to depend. It will depend on family history. There are even menopause can occur related to other health conditions or surgical procedures. So it really does depend on personal and family history. Typically, it's occurring in our 40s or 50s. And what do you wish more women knew going into both stages of life here when it comes to perimenopause and menopause? I wish more women knew that what you're feeling is real. It is common. It is treatable. We need more information, more psychoeducation around how this perimenopausal transition time period can impact underlying mental health conditions. So ask for help. Talk to your clinician. And let's talk about the changes in mood that women commonly notice during perimenopause and menopause. The changes in mood are actually quite varied. Commonly, my patients are saying, I don't feel like myself. Something feels different, whether that looks like being more irritable or having a shorter fuse, feeling more sad or lacking motivation, more easily overwhelmed by things that we used to feel able to handle on a day-to-day basis. Cognitive changes, as I mentioned earlier, feeling that brain fog, difficulty focusing, word-finding difficulties. And why can it be a little more difficult for women to regulate their mood and emotions during this time? It's not simply the matter of lower estrogen. It's the hormonal fluctuations, the ups and downs that occur during this transitional time period. Estrogen interacts intimately with serotonin, norepinephrine, dopamine, those systems that regulate mood, stress response, sleep. And Rebecca, let's talk about what loved ones can do during this transition. Loved ones can ask their family members, the women in their life, how are you doing? How are you feeling? Be a sounding board. Be there for support. And then also helping encourage those around us to reach out for help, to talk to their clinicians. We don't have to have the perfect words. It's a matter of something feels different. Let's talk about it. And let's get back into menopause and also its ties to mental health. How can menopause make feelings of depression and anxiety worse, especially for women who already live with a mental health condition? Absolutely. So in addition to those hormonal fluctuations that occur that impact serotonin, norepinephrine, dopamine, this is often also commonly a time of life transition. Our children may be getting older. Our parents are getting older. There's relationship changes. And there is still this pervasive feeling of this is just something we have to get through. So the more we talk about it and realize, hey, this is something that there are treatments for, there are things we can do to help improve your quality of life, that helps us all around. And if a woman is watching this, going through one of these stages of life, How can she start the conversation with her doctor and loved ones? I really like it when my patients bring in notes. So as I said, it doesn't have to be perfect. It's a matter of something feels different with my mood. Could this be related to menopause, perimenopause? And then have a list of what your concerns are. We know that health care appointments are never long enough. So being aware of the things that we really want to discuss and are important to us, I really appreciate as a clinician. That's the starting point. that's the starting point thanks so much for sharing tomorrow is world menopause day what do you want people to remember from this conversation and and what do you how what else do you want them to know about supporting loved ones experiencing this what what someone is feeling is real it's common it's treatable this isn't something just to get through it's also not a personal weakness So medication changes may be required. Maybe historically we had a treatment regimen that worked for whichever condition we were previously treated for. Sometimes adjustments do need to be made. Therapy, lifestyle, and sleep support. There are options beyond medication, but we've got to start the conversation. Rebecca, thanks so much for joining us to talk about menopause and perimenopause and its correlation to mental health. We appreciate you for joining us and the work that you're doing out in the community when it comes to caring for patients experiencing this. Thank you so much.