Anxiety or Menopause: Behavioral Changes in Aging Women

Anxiety disorder or menopause?

Hello doctor, my mother is currently going through menopause.
She previously visited a clinic for anxiety and insomnia and hasn't taken medication for a long time.
She often has a furrowed brow, even while watching dramas.
Over the past year, she frequently sighs and gasps.
For instance, when she thinks about buying groceries while walking, she suddenly exclaims loudly, startling nearby cyclists.
At home, she often shouts unexpectedly.
She sometimes starts cleaning in an unusual manner, complains about being tired in the middle of it, yet insists on washing everything she doesn't usually use and takes it all to the balcony.
Afterward, she often lies down for an entire afternoon nap, and then continues to say she feels exhausted, regretting that she washed everything.
She has always been a bit impatient, which leads her to forget her keys, wallet, or phone when going out, or to call family members by the wrong names, sometimes trying three different names without getting it right.
She often forgets what we've said, asking about the same thing three or four times and questioning whether she has already asked.
(Her memory issues began in her 40s, accompanied by anxiety, panic, and insomnia.) Over the past year, I've often heard her calling friends and complaining loudly.
Recently, she has been calling different people every week to vent, portraying situations as very dire (this has noticeably increased).
Her usual routine is to turn off the lights by 10 PM, and I can hear her getting up at night, but she claims she sleeps well and doesn't have insomnia, only getting up a few times to use the bathroom.
Previously, she rarely scolded us (the children), but this year it seems she gets angry no matter what we do.
However, her tone is different when she talks to friends on the phone compared to how she speaks to us.
Even when my dad compliments me on my looks, she comments that I look very different before and after makeup, and when she looks in the mirror, she says she looks like her 20-year-old self.
When I ask her, she says she is very happy and not nervous at all, just has an impatient personality.
I would like to know if this situation could be anxiety disorder, as many symptoms have been persistent, but her personality has recently changed to one that frequently complains without reason, almost as if she has grown to dislike me.
Previously, she only complained about my dad.
Or could this be a normal condition associated with menopause? Thank you.

Niming, 20~29 year old female. Ask Date: 2020/08/07

Dr. Huang Xiaoxian reply Psychiatry

Dear ttkk, it sounds like your mother is indeed experiencing some anxiety.
Women going through menopause often face changes in their physiological state, which can contribute to anxiety.
Additionally, at this age, they frequently confront issues related to the passage of youth and mortality, making them more susceptible to emotional distress.
Generally, this is influenced by multiple factors.
It is advisable to seek an evaluation from a psychosomatic specialist to assess the extent of her anxiety and determine if medication or psychological therapy is necessary for improvement.
Wishing you all the best.

Reply Date: 2020/08/07

More Info

Understanding the behavioral changes in aging women, particularly during menopause, can be complex, especially when considering the potential overlap with anxiety disorders. Your mother's situation presents a multifaceted picture that warrants careful consideration.

Menopause is a natural biological process that marks the end of a woman's reproductive years, typically occurring between the ages of 45 and 55. During this time, women experience significant hormonal changes, particularly a decline in estrogen and progesterone levels. These hormonal fluctuations can lead to a variety of physical and emotional symptoms, including mood swings, irritability, anxiety, and even depression. It's not uncommon for women to experience heightened emotional sensitivity during this period, which can manifest as increased frustration or anger over seemingly minor issues.

From your description, it appears that your mother is exhibiting several behaviors that could be associated with both anxiety and menopause. The frequent frowning, sighing, and sudden outbursts of frustration, such as yelling unexpectedly, may indicate heightened anxiety levels. Additionally, her compulsive cleaning and organizing, coupled with feelings of fatigue and irritability, could be symptomatic of both anxiety and the emotional toll of menopause. The forgetfulness and confusion you mentioned, such as calling family members by the wrong names or repeatedly asking the same questions, could also be linked to stress or hormonal changes affecting cognitive function.

It's important to note that while some of these behaviors could be attributed to menopause, they may also suggest an underlying anxiety disorder, especially given her history of anxiety and panic attacks. Anxiety disorders can persist or even worsen during significant life transitions, such as menopause, due to the added stress and emotional upheaval that often accompany this stage of life.

Your mother's claim of sleeping well, despite waking up during the night, might indicate that she is experiencing fragmented sleep rather than true insomnia. This can be common in menopausal women due to night sweats or other discomforts that disrupt sleep patterns. The fact that she expresses feelings of being overwhelmed and frequently complains to friends suggests that she may be struggling with her emotional well-being.

Given the complexity of her symptoms, it would be beneficial for her to seek a comprehensive evaluation from a mental health professional. A psychiatrist or psychologist can help determine whether her symptoms are primarily due to anxiety, the effects of menopause, or a combination of both. They can also recommend appropriate treatment options, which may include therapy, lifestyle changes, or medication if necessary.

In addition to professional help, there are several strategies that may assist your mother in managing her symptoms. Encouraging her to engage in regular physical activity, practice relaxation techniques such as mindfulness or yoga, and maintain a balanced diet can be beneficial. Social support is also crucial; maintaining connections with friends and family can help alleviate feelings of isolation and frustration.

In conclusion, while your mother's behaviors may be influenced by menopause, they could also indicate an underlying anxiety disorder. A thorough evaluation by a healthcare professional is essential to determine the best course of action. Open communication with her about your concerns, while encouraging her to seek help, can also foster a supportive environment for her during this challenging time.

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