Posts Tagged "depression"

Shaken. Not Stirred.

Posted by Liz on Nov 11, 2011 in aging, apparel, appearance, breast cancer, menopause, women's health | 5 comments

I have been inspired by my friend Gini Dietrich’s weekly Gin and Topics posts over at Spin Sucks, so much so that I’ve decided to up the ante and bring back a Roundup-like feature to Flashfree (if  you’re unfamiliar with the Roundup, think monthly highlight recaps. You can find them here.)

Shaken. Not Stirred is intended to highlight a few choice finds that I  believe are worthy of mention in this space. They might not warrant an entire post, but they’ve shaken me up in one way or another  to break (or pause, if you will) from our normally scheduled programming and deliver information in a format that is distinct from what you’ve come to expect. In that vein,  this feature won’t appear on a regular schedule as I do believe that into every blog should flow a bit of the erratic; after all, that’s what keeps things lively, right?

So, without further ado… I bring you the Shaken. Not Stirred.

Bottom’s up!

1. There’s a new kid in town and you may want to get to know him better. So you chat about him online with your other online pals, weigh his pros and cons. And then decide collectively whether or not to befriend him. That’s what the new patient portal Treato is doing. Only this time, the new kid is a medication you might be considering taking for your menopause-related depression and you’re not sure about its side effects. Can you find someone just like you to talk to about it, read/hear their experiences, obtain advice from a medical expert who might be weighing in and then make a more informed decision? Treato is doing just that in one consolidated location. Granted, I’ve not thoroughly vetted the site for accuracy and like any medical information that circulates on the web, ‘whatever is received’ requires vigilance on the part of the user. But I am a huge advocate of leveling the healthcare playing field and patients should be participating in their healthcare. Check it out. And let me know what you think.
2. Who knew that weight loss could be so easy? One pair of Zaggora HotPants can help you zap away that unsightly cellulite. How? By incorporating “a comfortable bioceramic material that emits infrared rays to help wearers naturally and efficiently amp up weight-loss regimens. The shorts’ Celu-Lite technology smoothes thighs and other dimple-prone areas by galvanizing the skin’s internal zamboni to promote a deep warming of body tissues and promote lymphatic drainage. This process boosts sweating by up to 80% and aids in eliminating the toxins responsible for cellulite. Gotta give the company props for the term ‘internal zamboni’ but  the reality is that nothing has been scientifically proven to rid the body of cellulite.
3. Since we are on the topic of do’s and don’ts, why not end this week’s Shaken. Not Stirred with a bit of alcohol-related news? My guess is that many of you have seen the news about drinking and breast cancer and are as confused as I’ve been. My friend Elaine Shattner, over at Medical Lessons Blog, has done an excellent job distilling the facts down to ‘what you need to know,’ much better than I ever could have. Like me, Elaine (who is a trained oncologist, among other things) agrees that women no longer need to be stigmatized by their decisions, writing “Women, in my expe­rience, are gen­erally more vul­nerable to the put-​​downs of others. And so my concern about the BC-​​alcohol link is that this will, somehow, be used, or have the effect of, making sur­vivors or thrivers or women who haven’t even had breast cancer feel like they’re doing the wrong thing if they go to a party and have a drink. And then they’ll feel badly about themselves.” Do yourselves a favour: read this post.

And if you would, can you do me a favour and weigh in on Shaken. Not Stirred?

Yay, nay or meh?

Wednesday Bubble: Timeout

Posted by Liz on Oct 19, 2011 in aging, menopause, stress | 8 comments

Back in 2009 I posted a story about a woman’s death being blamed on menopause. It seems especially poignant a day after World Menopause Day, a day unlike any others, when we put down our prejudices and celebrate everything menopause.

As my grandmother would say “oy vey.”

How about we focus on how, as women, we are constantly manipulated by ‘disinterested’ parties? How about we call “timeout?”

A bit of context…

In 2009, the BBC ran a story about a woman who committed suicide. The headline read:

“Woman’s Death Blamed on Menopause.”

“A woman who refused to take hormone replacement therapy died while suffering a menopausal episode, an inquest had heard. Margaret Drew…was killed when she walked out of her family home on to a nearby railway line and was hit by a train…There is no trigger to this at all, except hormones making her do things that she normally wouldn’t do, Dr. Carlyon [Cornwall Coroner) concluded…”

Menopause. The silent killer. Oh really?  Drew’s husband claims that his wife was “delightful, lovely and friendly” 99% of the time; the other 1% she’d become “totally irrational.” Yet, she refused to try HRT, he says. On the day of her suicide, he said that his wife was “clearly angry about something.”

Something.

Obviously, the conclusion is that that the “something” is hormones. This reminds me of vintage advertising copy that conveys the simple message that a pill a day can cure all that ails, wipe away the tears, mood swings and instability so that women can “transition without tears” (or better yet, without killing themselves).

Notably, a search in the National Library of Medicine’s PubMed database turned up only one recent study specifically dealing with suicide ideation across reproductive stages. In it, researchers compared data in 8,794 women, and found an increased risk of thinking about suicide among women during perimenopause, not before or after entering menopause. These findings remained after controlling for risk factors such as anxiety and mood disorders. HOWEVER, the researchers noted that the study design did not allow them to form any definitive conclusions about the specific reasons for thinking about suicide.

Another search yielded information that the risk for a major depression increases during perimenopause, primarily as the direct result of vasomotor symptoms. The same does not hold true for women before menopause begins or once they enter menopause. Note that while major depression is a risk factor for suicide, not everyone who is depressed will actually kill themselves.

Are hormonal fluctuations the sole cause of such deep unhappiness that women want to kill themselves? Or their careers?

Let’s look at a more recent story that appeared this week in the Denver Post.

“Former Elbert County assessor blames menopause medications for crimes, is sentenced to 60 days in jail, fined $10,000″

“Elbert County Judge Jeffrey Holmes might have thrown the book at former county assessor P.J. Trostel just for her management skills alone. Instead, he sentenced Trostel today to 60 days in county jail, three years of probation and 200 hours of community service on two felony counts…In asking for leniency, Trostel and her lawyer said a variety of factors led her to make bad decisions. Those included depression, symptoms from menopause, medications and stress from family and work. ”Some of the things I don’t even have an answer,” Trostel said. “I know I made terrible judgments and decisions.”

It sounds as though Trostel would have done better with different legal representation. And a sounder argument.

And while Trostel is chewing on that concept for the next six years while incarcerated, perhaps we can start to change the paradigm and focus on the ills of the Menopause Industrial Complex, disinterested parties who perpetuate societal myths that menopause is a disease that requires treatment and that as women, our attitudes, belief systems and actions are hormonally-based and driven. That we are hysterical beings who need guidance on how to find our way and fulfill our dreams, realize our paths, but only if we calm down. That we can’t hold a job down, keep a marriage intact or play nicely with others. That we need a timeout (this would entail a long, long time, by the way).

Seriously though, a timeout from the hype would be a welcome addition to the change, don’t you think?

Menopause: the symptom? Or, the disease?

Posted by Liz on Sep 23, 2011 in emotions, estrogen, menopause, women's health | 4 comments

A few years ago, I ran across the following story on the BBC:

“Woman’s Death Blamed on Menopause.”

“A woman who refused to take hormone replacement therapy died while suffering a menopausal episode, an inquest had heard. Margaret Drew…was killed when she walked out of her family home on to a nearby railway line and was hit by a train…There is no trigger to this at all, except hormones making her do things that she normally wouldn’t do, Dr. Carlyon [Cornwall Coroner) concluded…”

Menopause. The silent killer. Oh really?  Drew’s husband claims that his wife was “delightful, lovely and friendly” 99% of the time; the other 1% she’d become “totally irrational.” Yet, she refused to try HRT, he says. On the day of her suicide, he said that his wife was “clearly angry about something.”

Something.

Obviously, the conclusion is that that the “something” is hormones. This reminds me of vintage advertising copy that conveys the simple message that a pill a day can cure all that ails, wipe away the tears, mood swings and instability so that women can “transition without tears” (or better yet, without killing themselves).

Notably, a search in the National Library of Medicine’s PubMed database turned up only one recent study specifically dealing with suicide ideation across reproductive stages. In it, researchers compared data in 8,794 women, and found an increased risk of thinking about suicide among women during perimenopause, not before or after entering menopause. These findings remained after controlling for risk factors such as anxiety and mood disorders. HOWEVER, the researchers noted that the study design did not allow them to form any definitive conclusions about the specific reasons for thinking about suicide.

Another search yielded information that the risk for a major depression increases during perimenopause, primarily as the direct result of vasomotor symptoms. The same does not hold true for women before menopause begins or once they enter menopause. Note that while major depression is a risk factor for suicide, not everyone who is depressed will actually kill themselves.

So, are hormonal fluctuations the sole cause of such deep unhappiness that women want to kill themselves?

Interestingly, just a week after the menopause/train suicide story hit the interwebz, a rather controversial set of data also emerged: since 1972, women’s overall level of happiness has dropped. These findings held true regardless of child status, marital status and age. Researcher Marcus Buckingham, writing in the Huffington Post, said that women are not more unhappy than men because of gender stereotyping and related attitudes, due to working longer hours or because of the inequality of housework/responsibilities at home, but rather, the hormonal fluctuations of menopause may be to blame. What’s more, he leaves us hanging so we’ll tune in for part two of the piece to learn the true cause of our declining happiness or better yet, read his book (which evidently guides women through the process of finding the true role that they were meant to play in life).

Importantly, reactions to this study (and various pundits’ assessment of it) have been mixed. One of the most poignant comments I’ve read asks the question “how is happiness measured? What does it mean?”

I have no idea what caused Mrs. Drew to walk into a train and kill herself. Perhaps she was depressed. Clearly she was suicidal.

I have no idea why research shows that women are less happier than they were three decades ago.

However, is menopause the cause? Aren’t these conclusions an example of how the Menopause Industrial Complex perpetuates societal myths that menopause is a disease that requires treatment? That as women, our attitudes, belief systems and actions are hormonally-based and driven? That we are hysterical beings who need guidance on how to find our way and fulfill our dreams, realize our paths, but only if we calm down?

Feeling angry? Blame it on menopause. Unhappy? Blame it on menopause. Not realizing your dreams? Blame it on menopause. Overworked, overstressed, undervalued? Blame it on menopause.

Blame it on menopause.

I don’t know about you but I’m tired, tired of hearing that menopause is not the symptom but the disease. Isn’t it time we start fighting back?

Wednesday Bubble: Depression and midlife – “overmedicalizing” the menopause

Posted by Liz on Jun 15, 2011 in depression, menopause | 4 comments

What’s the lowdown on depression, midlife and women? And how does the menopause come into play?

I written previously that depression may affect as many as 20% to 40% of women during menopause. However, gender differences in depression evidently begin well before the menopause and women are 1.5 to 3 times likelier than men to report a lifetime history of depression. Moreover, these distinctions start as early as the teen years and continue until the mid 50s, which researchers say, corresponds to female reproductive. Hence, experts have connected waning and altered hormone levels to high rates of mood and anxiety disorders in women.

Is this hypothesis valid? And, where did it originate?

According to a review in the early online edition of the Journal of Affective Disorders, some research has suggested that premenstrual, post partum and menopausal mood disorders are linked and that women are especially vulnerable during certain time periods. This has led to a proposal that reproductive-related depression have its own classification, and that during midlife in particular, all women should be routinely screened for symptoms. Interestingly enough, however, it has also led some researchers to question if we are “overpathologizing the menopause?” Hallelujah! (If you want to read more on medicalizing the menopause, check out one of my favourite Flashfree posts.)

The key finding?

Although studies demonstrate that significant numbers of women in midlife report depressive symptoms, menopause is only one of a range of factors purported to lead to depression during this timeframe. Others include stress, family life, general health issues and a lack of exercise, as well as a history of some sort of anxiety disorder. What’s more is that how women perceived the effect of menopause on their physical health almost doubled the risk that they would first develop depression at the onset of menopause.

The researchers say that although women might score high on self-reported mood scores, these scales or instruments tend to exaggerate the rate of depression in women in midlife and menopause. They also note that if a score is only taken at one time point that is might indicate temporary distress rather than a long-term problem. They add that during menopause, certain symptoms, such as sleep disturbance and fatigue, may be easily confused with depression even though they have nothing to do with a mood disorder and everything to do with hormones.

The bottom line is that symptom overlap and environmental factors can confuse a diagnosis, and that depression is not necessarily more prevalent during menopause than during other periods in a woman’s life. Consequently, like many things, the studies that are out leave more questions than provide definitive answers. Hence, the call for all women to be screened for depression during menopause may be an example of extreme assumption and not based in true necessity.

Is it possible that depression is just the tipping point in the medicalization of menopause?

What do you think?

Working through the menopausal transition..the first step is the deepest

Posted by Liz on Feb 21, 2011 in Work/occupation | 1 comment

Back in July of last year, I wrote a post entitled ‘Working through the transition? Or is the transition working you?’ In it, I discussed some research being conducted in the UK that is looking at the effect of menopause and its accompanying symptoms on the work environment and preesenteism, i.e. impact on productivity while at work. Not surprisingly, an overwhelming majority of women surveyed reported that their symptoms, namely fatigue and insomnia, were impacting workplace functioning and relationships with managers and co-workers. Less clear, however, were the roles of other factors, like perceptions and stress.

This raises one of the most common and yet inconsistently addressed issues during menopause: quality of life.

Quality of life is a subjective construct and one that is significantly influenced by a multitude of factors that intersect at any given time, factors such as how well we function, what we think about our lives, how we deal with stress, the type of social and economic support we have and overall wellbeing. And when you throw a bunch of symptoms like hot flashes, depression, anxiety, insomnia, backache, joint pain or forgetfulness on top of any of these, well, all hell can and does break loose!

When researchers looked at 184 women in both early and late transition to menopause who were part of the larger, Seattle Women’s Health study, they learned just how intricate the interrelationship between all these factors truly is. Indeed, among women in their mid to late 40s who were juggling work, families and relationships, the degree to which symptoms interfered with work most relied on how they perceived their health, their life stress and how depressed they were or were not. The findings:

• Symptoms like hot flashes, mood issues, sleep issues, pain, or concentration had a significant impact on work productivity.
• However, when researchers started to tease out and analyze the symptoms over time, they found that  how symptoms influenced how women felt about their health was most important. If women felt that their health was excellent or very good, symptoms tended affect their work productivity to a lesser extent than if they perceived their health to be poor or only moderate.
• Perceived stress levels reportedly influenced both work productivity and social/intimate relationships.
• Depression and difficulty concentrating were the final straws in the work/relationship back, affecting performance and the ability or interest in socializing or engaging in intimate or family relationships.

The one thing that these reports and the UK reports had in common were nighttime awakening.

So, let’s take a look at this. How we feel about our wellbeing affects work productivity, as does stress. If we are depressed or have difficulty concentrating, the ability to focus and be productive, either at work or in our worlds in general, starts to fall apart. Frequent awakening during the nighttime hours as a result of both aging and hormones can cause fatigue, depressed mood and concentration issues. In turn, this can influence how well we function  at work and at home and the quality of our relationship, to ourselves, our children and our partners.

The conclusion is that we need to step back, take stock and think about how we feel and how that is affecting our wellbeing and our lives.

The solution isn’t simple. Part of it lies in learning how to best address symptoms like sleep disturbances, depression or focus. The other lies in openly communicating to our work colleagues, our managers, our partners and our friends how productivity and our relationships may be suffering and actively involve them in finding solutions to improve wellbeing.

It’s hard work, no doubt. But the more insight we have, the better we are able to deal. And while it starts within, without it, the menopausal tendrils can extend far and widely into our lives.

The first step? Step back deep within yourself, and take stock. It may ultimately be the insight that you need to turn those symptoms on their side where they belong.