Mood swings can be difficult for just about anyone to deal with, but they can be especially challenging for women going through menopause. Why should we care so much about learning how to cope with this annoying menopause symptom? Because too many women suffer in silence, and a mood disorder can develop into anxiety or depression if you’re not aware of what’s happening to your body.
I’m excited to talk to you about mood swings, not only to help you understand them, but also because May happens to be Mental Health Awareness Month. I want to help you understand why you’re having mood swings and learn how to cope with them before they develop into anxiety or depression.
When my patients come to my office seeking help for mood swings, I let them know there is hope, they are not alone, and they shouldn’t feel ashamed! In fact, mood disorders are very common—about one-third of all women will experience a mood disorder in their lifetime. For many women, having a mood disorder affects their close relationships, work, and health in negative ways, and there is no need to suffer in silence! The good news is that mood disorders are very treatable, and it is possible to feel better. That’s exactly what happened with one of my former patients.
Jane (not her real name) was 47 when she came into my office and said, “I just don’t feel like myself. I always feel on edge and I just can’t relax. I’m irritable, yell at my kids all the time, and fight with my husband over the stupidest things.” She also mentioned that her co-workers could tell she was on edge, proving that it was affecting other areas of her life. Jane continued, “I don’t get it! My life is good. I like my family, I don’t have any major worries, and my parents are healthy. Help! Why am I feeling this way?”
I asked Jane about some of the other symptoms she was experiencing, including things like hot flashes/night sweats, irregular periods, energy level, and sex drive. These symptoms (and a few others) are part of something I call the Menopause Transition Scale (MTS) [link to MTS]. The MTS is a tool we use at true. Women’s Health and includes a list of seven symptoms that occur in the ten years or so around a woman’s last period. Jane revealed that she was having irregular periods and night sweats before her periods, which told me she was probably in early perimenopause. Her symptoms were worse around her periods, and she also had lower energy and sex drive than she had two years before. All of these symptoms were affecting Jane’s quality of life and she needed some relief.
I then asked Jane if she was practicing her Seven Essential Elements of Daily Success (SEEDS). Jane admitted that she wasn’t drinking enough water, taking vitamins, getting enough fiber, eating good carbs, sleeping, exercising on a consistent basis, or taking time to be grateful. In other words, she wasn’t doing her SEEDS on a daily basis. Practicing your SEEDS can really affect your daily life, and if you start feeling a change in how you feel (i.e., a mood swing), it’s time to get back to the basics.
When I explained why Jane was having mood swings, she had tears of relief. I used the analogy of money in the bank and how it relates to brain chemicals. Here’s how it works: When we sleep, we produce brain chemicals called serotonin (“money”). If we aren’t getting enough sleep, we aren’t producing enough serotonin. We also “spend” these brain chemicals (“money”) on stressful events like COVID, being overwhelmed, or having too much on our plate, and we spend them faster when our estrogen levels fall (like during menopause). Brain chemicals are part of what make us feel normal and more like ourselves, so when we aren’t producing enough and we’re spending so much on stressful events in our lives, we don’t have as much to spend on our normal daily events. The result? Mood swings!
So, here’s what I recommended to Jane:
- Get back to the basics (SEEDS)—They work!
- Look at the Menopause Transition Scale (MTS)—Use the scale to track her symptoms.
- Consider taking an SSRI—An antidepressant such as Lexapro can be incredibly helpful and only needs to be taken at a low dose to be effective.
- Start on a hormone medication—Jane decided not to do this at the time, but she knew it was an option for her.
I saw Jane in my office a few months later and she was doing great—feeling like herself again. She was practicing her SEEDS every day and felt like the Lexapro was helping immensely.
Does Jane’s story sound familiar? It’s one that I hear from so many of my patients and I’m guessing many of you can relate. Sometimes it can be difficult to determine if you are just having a bad day/mood swing or if there is something more serious building up.
So, what is a mood? I think about moods as how we feel and behave. It’s normal to have ups and downs, but a “good’ mood” is when you feel like yourself, have appropriate reactions, have good energy, like to do things you normally enjoy, and can problem solve without being overwhelmed. Of course, we all have bad moods from time to time, but if that bad mood continues for a period of time, you might need to seek help.
Sometimes it can be difficult to admit you need help or even know if you are experiencing some type of anxiety or depression. Both of these are treatable, but you need to know what to look for:
- Depression and/or anxiety disorder—Feelings of sadness, low interest in activities, change in eating habits and sleep patterns, feelings of worthlessness, difficulty concentrating, use of alcohol or drugs such as marijuana, and thoughts of self harm. Risk factors are a family history of depression or anxiety, certain personality types, the environment, and brain chemicals.
There is a brief questionnaire we use in our office to screen for mood disorders called the PHQ-4. This questionnaire can be used to assess your risk and even help with self-awareness. A score greater than six likely indicates you are experiencing at least moderate distress and you need to have a conversation with your healthcare provider.
Coping is a topic I love to discuss because women ask what they can do to deal with all the challenges of life and stay feeling like “I’ve got this!” I first came upon this topic years ago when I saw a paper on the COPE Score used in postpartum moms. It is a score used to determine a person’s coping style. It is now widely used by many providers to help people better understand coping. We use it at true. Women’s Health with our patients, and it’s discussed in my I Want to Age Like That book and corresponding workbook (available next week).
Coping is something we do when there is a challenge or a stress, and I believe it is a choice. However, not everyone is good at it, and I believe it can be learned. Some of us had good role models to teach us how to cope and some of us were born with good coping skills. Either way, it’s never too late to learn how to be better at coping. I believe women who cope well do three things very well:
- They believe they deserve to be happy.
- They keep a support network.
- They are able to and do ask for help when they need help.
Here at true. Women’s Health, we are here to help you understand your mood swings and learn how to cope with life’s challenges.