Depression: The Menopausal Journey From Hopeless to Hopeful

So many women (more than I can mention) have told me that while they themselves didn't understand the connection between their mood, memory, energy changes and hormonal shifts; their health care providers didn't make this connection either. Many of these women have been diagnosed with depression, and it's true -- they were depressed. Yet their providers had looked at their feelings of depression (or anxiety, lack of energy, or sleep disturbances) separately, outside the context of what was going on with their hormones; in many cases these women left their providers' offices with a prescription for an antidepressant medication.

In recent years, new antidepressant medications have come on the market that represent real hope for people with clinical depression. I'm not opposed to antidepressants -- they do wonders for many people. But I am opposed to over-prescribing antidepressants to women whose depression (or anxiety) is only one piece of a larger, more complex picture.

If you are dealing with depression or anxiety, it helps to think through your feelings. Are these feelings new? Do they seem random or are they connected to any life situations that you can identify? Then, if antidepressant medication is offered as an option to you, here are some questions to discuss with your health care provider before you decide to take it:

• Has a thorough evaluation of my hormone levels been done?

• Which medication is recommended, and which symptom(s) will it alleviate?

• How soon should I expect relief? How long will I need to take the medication?

• Are there any side effects I can expect? If so, what are they, and what can I do to minimize them?
• If this medication does not relieve my symptom(s), what is the next course of action?

Most important, if you are not comfortable taking a particular medication recommended to you, don't do it! And, let your health care provider know about your concerns. If anything about a medication seems intimidating to you, or if you are unsure of the consequences of starting or stopping it, it's perfectly acceptable, and in fact it's in your best interest, to say "That's not for me." Antidepressants are not your only choice.

Cycles of fatigue, depression, anxiety, or forgetfulness do not have to rule your life in menopause, although these troublesome symptoms can seem to edge out your former energy and zeal.

The first step toward gaining renewed energy and a more positive outlook is to recognize that there may be a hormonal component in these changes - you are not simply less able to cope or keep up. Secondly, it's helpful to decide what you want to change, internally and externally, to recapture your physical and spiritual vitality. Our bodies give us the best guidance and the clearest messages when we need more rest, less pressure, more joy, and fewer tasks.

Memory, mood, and energy changes may be hard for you and your health provider to sort out - there aren't any pat, "off the shelf," "one size fits all" answers to these issues, any more than there is a standard prescription for medication that works for everyone. Yet by no means do you have to resign yourself to fatigue, worry, or depression, as if they were an inevitable part of growing older.

It's important to keep the big picture in focus as you look not only for the cause but for the best solution to these symptoms. The intricate interplay between your hormones and how you feel, what you remember, and how much verve and energy you have can't be overlooked in your evaluation of what you need to feel healthy and fulfilled. Nor should you underestimate the value of making lifestyle choices that may improve your sleep, jump-start your energy, and restore a sense of peacefulness and contentment.

Before you consider any medication for your menopausal symptoms, make sure you are taking care of yourself with diet, exercise and meditative time for yourself. If you are not taking care of the basics, trying a medication probably won't be effective. Take 10 days to care for yourself by eating well, exercising and reserving a few minutes each day 'just for you.' See what the results are. Then, if you seek outside advice, be sure you are working with a health care provider who fully appreciates the role hormones can play in your overall health.

The idea of women holding on to each other for strength is a deeply resonant one for us in menopause. You may find strength and inspiration by listening to the wisdom of an older woman who has gone through this 'change,' asking her what it was like for her and what she learned. It can help simply to talk to someone who has been through menopause, gotten to the other side, and has not only survived but in all probability is better and stronger for it.

Founder of Full Circle Women's Health in Colorado, Stephanie Bender has significantly contributed to a much larger understanding of women's health through her books, lectures and television appearances. Her most recent book is, "End Your Menopause Misery, " which she co-authored with Treacy Colbert. You can post a comment or read more about Stephanie on her website, by clicking here. You can also follow her on Facebook by clicking here.