Complex Symptoms in Menopausal Depression: A Guide for Families

I am not sure what the symptoms are?

Hello Doctor: My mother is in menopause and is taking medication for depression.
She experiences full-body pain daily, including tooth pain, spine pain, and rib pain (doctors have said there are no issues with these).
She also continuously produces foamy saliva, experiences alternating hot flashes, and during painful episodes, she screams and cries.
She shakes her head and says things like "spare me" or "take me away" (but she does not have self-harm or suicidal tendencies).
Sometimes she suddenly loses strength while walking and needs assistance, but then she can walk again.
She requires daily massages, companionship, or entertainment to keep her engaged.
Her emotions are very unstable; if things don’t go her way, she becomes upset or cries if she feels provoked.
She often instructs others to do tasks (like washing or retrieving items) while claiming she has no strength, yet she can still perform activities like writing notes or using her phone.
She meticulously records her symptoms and what she eats throughout the day.
I would like to ask the doctor if these symptoms indicate a psychological issue where her brain is not functioning properly, leading to physical manifestations, and how we can cope with this situation (the family feels mentally and physically exhausted).

Baozi, 20~29 year old female. Ask Date: 2023/07/30

Dr. Qiu Junda reply Psychiatry

Hello.
I'm not sure why your mother is taking antidepressant medication, how long she has been on it, whether there have been any interruptions, or how effective it has been.
Initially, if general health checks have not revealed any significant findings, your mother's condition may also be a manifestation of depressive symptoms (primarily physical complaints and pain).
I recommend accompanying your mother to see a psychiatrist.
It is important to cooperate with the treatment (requiring patience and confidence) in hopes of achieving improvement soon.
During the visit, you can also discuss with the doctor ways for family members to cope.
Thank you.

Reply Date: 2023/07/30

More Info

Understanding menopausal depression can be quite complex, especially when it presents with a variety of physical and emotional symptoms. Your mother's experience, as you described, highlights the intricate relationship between psychological and physiological responses during menopause.
Menopausal depression is often characterized by mood swings, anxiety, and depressive symptoms that can be exacerbated by hormonal changes. During menopause, the body undergoes significant hormonal fluctuations, particularly in estrogen and progesterone levels, which can affect neurotransmitter systems in the brain. This can lead to symptoms such as irritability, mood instability, and even physical pain, which your mother seems to be experiencing.

Symptoms Overview
1. Physical Pain: The widespread pain your mother is experiencing, including tooth pain, spinal pain, and rib pain, can be attributed to several factors. Hormonal changes can lead to increased sensitivity to pain and may exacerbate conditions like fibromyalgia or arthritis. It's essential to consult with healthcare providers to rule out any underlying conditions that may be contributing to her pain.

2. Emotional Instability: The emotional symptoms, such as crying spells and feelings of being overwhelmed, are common in menopausal depression. The mention of her saying "please spare me" or expressing a desire to be "taken away" indicates a deep level of distress, although you noted that there are no suicidal tendencies. This emotional volatility can be linked to hormonal imbalances and the psychological stress of coping with menopause.

3. Physical Weakness and Fatigue: The sudden loss of strength and the need for assistance while walking can be alarming. This could be related to both physical deconditioning and psychological factors. Depression can lead to fatigue and a lack of motivation, making it difficult for individuals to engage in physical activity, which can further exacerbate feelings of weakness.

4. Behavioral Changes: Your mother’s need for constant reassurance, her tendency to direct others, and her emotional outbursts suggest a struggle with her sense of control and well-being. This behavior can stem from anxiety and a feeling of helplessness that often accompanies depression.

Psychological and Physiological Interplay
The symptoms your mother is experiencing may indeed reflect a combination of psychological distress and physiological changes. The brain's response to hormonal fluctuations can lead to changes in mood and behavior, which can manifest physically. This is often referred to as psychosomatic symptoms, where psychological factors contribute to physical ailments.

Coping Strategies for Families
1. Open Communication: Encourage open dialogue about her feelings and symptoms. Sometimes, simply having someone to talk to can alleviate feelings of isolation and distress.

2. Professional Support: It may be beneficial for your mother to see a mental health professional who specializes in menopausal issues. Therapy can provide her with coping strategies and a safe space to express her feelings.

3. Medication Review: If she is already on antidepressants, it might be worth discussing with her doctor whether her current medication is appropriate or if adjustments are needed. Sometimes, medications can take time to work, or they may need to be changed if they are not effective.

4. Physical Activity: Encourage gentle physical activity, such as walking or stretching, which can help improve mood and reduce pain. Exercise releases endorphins, which can act as natural painkillers and mood lifters.

5. Mindfulness and Relaxation Techniques: Practices such as yoga, meditation, or deep-breathing exercises can help manage stress and improve emotional regulation.

6. Family Support: As family members, it’s crucial to take care of your own mental health as well. Supporting someone with depression can be draining, so ensure you also have outlets for your stress and feelings.

Conclusion
Menopausal depression is a multifaceted issue that requires a comprehensive approach to treatment and support. By understanding the interplay between psychological and physical symptoms, families can better support their loved ones through this challenging time. Encourage your mother to seek professional help, and ensure that you and your family are also taking care of your emotional well-being.

Similar Q&A

Understanding Mental Health: Is It Depression, Anxiety, or Menopause?

Hello, doctor. I apologize for the lengthy description. My mother is 52 years old and runs a store at home, but the revenue fluctuates significantly between the summer and winter seasons. She has been worried about this issue for many years, and due to some family problems and li...

Dr. Liang Sunyuan reply Psychiatry
Hello: Stress often leads to emotional burdens, and after a period of adjustment, it is possible to overcome or adapt to it. However, if stressful events occur in quick succession, there may not be enough time to cope or adapt, leading to feelings of anxiety or depression. Busine...

Understanding Depression: Signs and Symptoms in Middle-Aged Women

Hello doctor, I am a 44-year-old middle-aged woman. I suspect that I have depression, even though I am not yet in menopause. I have been feeling very down, tend to overthink things, and always need to get to the bottom of issues. I find it easy to feel hopeless and feel that I am...

Dr. Chen Guangpeng reply Psychiatry
Hello, Amiao user: I apologize for the delay in responding to your inquiry! From a broad perspective, it does seem that you are experiencing symptoms of depression. However, to determine whether you meet the criteria for a diagnosis of "depression," more information nee...

Understanding Anxiety and Menopause: When to Seek Help

1. If a person tends to think negatively and frequently experiences anxiety, should they see a doctor? 2. Is menopause defined only by the cessation of menstruation? What symptoms can occur?

Dr. Duan Yongzhang reply Psychiatry
It is not always necessary to see a doctor, but if your work, studies, or daily life are affected, or if you experience depression or thoughts of self-harm, it is essential to consult a physician. Women typically undergo physiological and psychological changes when they begin men...

Understanding Depression: Managing Symptoms and Medication Challenges

Dr. Chen: Hello! My wife (45 years old, homemaker) has been experiencing difficulty sleeping and low mood since the 921 earthquake. She was diagnosed with depression at a clinic in Fengyuan and has been on medication for six months, during which her condition improved, but she ga...

Dr. Chen Wenke reply Psychiatry
Kines: From your question, it seems that your wife may have had some emotional issues from the beginning, possibly due to personality traits that make her more prone to anxiety and worry. Therefore, when faced with significant stress, she is more likely to exhibit emotional probl...