Most women over 45 know only too well how the daily burdens of life combine with peri-menopause to produce depression. Many women find the hot flushes and sweaty nights come just when everything else is at a turning point as well. Maybe there are job problems, sex problems, divorce or just plain sleeplessness. On my desk every day there is a box of tissues and they are frequently needed!
Hormones are often the last straw and very often getting them sorted will tip the balance so that the tears dry up and life is bearable again. But if there has been a low grade depression ticking along for several months or years, then simply adjusting your hormones may not be quite enough.
Then the option of anti-depressants has to be discussed. Roughly 75 percent of patients with depression at this stage of life will refuse to take any tablets for it. I have written about this before, I know. But it distresses me to see my lovely, sensitive, caring women crying their eyes out month after month when the other 25 per cent took the treatment and are their old selves, smiling again.
Queen Progesterone is a calming influence in anyone’s life, but even the queen has a hard time dealing with a full clinical depression. Why is it that we still think there is such a stigma to taking anti-depressants? Well, the answer lies unfortunately with the old habit of some doctors just giving them out like lollies to any woman who cried in front of them. We have probably all heard of women in the 1960s and 1970s and even later who became addicted to Valium or Serepax or other sedatives, and even anti-depressants and could not get off them. So the fear of being a “pill popper” was born. What a tragedy! Not only for those women made dependent, but for all of us who became wary and fearful of medications that could turn life around.
The proper way to deal with medically diagnosed depression is to take the tablets! It may be that some women know they are depressed, but some don’t realise it if they are not in tears every day. Symptoms of depression are not always obvious. But if you wake during the night, have no energy, lack interest in your routines or your family, find yourself sleepy at the wrong times, then you may still be medically depressed. The only way to break out of the cycle after any more than 3-4 months of this is to be treated properly.
I start with a low dose (unless the patient is almost suicidal!). Even a child’s dose can make a difference. Gradually increase the dose every 2-3 weeks until the symptoms are controlled. Then continue that dose for at least 3-6 months. The early stopping of these treatments can exaggerate the depression again, and when they have to be stopped, they are weaned down over several weeks. This is not because they are addictive but because suddenly stopping the tablets can bring back a rebound of the depression, but that can be avoided by careful staging of the run down from the tablets.
But there are things that have to be done while the tablets are in place and once the mood improves. A lot of people think after 3-4 weeks that they are better and so they can stop them now. But, please note, you may be feeling better because the tablets are working so this is not the time to stop!
To help yourself, you should be making note of the things that are going well, and add up all the small things you enjoy. For instance I had a lovely moment today driving home. I was in a line of traffic that stopped at the red lights. The sun shone in through the windscreen, I felt warmed and comfortable. It’s Winter here now so the sun was welcome! I closed my eyes and felt great for just a few moments. Then I realised that it is those tiny moments of joy that disappear when someone is depressed. So practice finding tiny things you are grateful for and relish them.
Also, really taste every mouthful of food and if it is not really good, find something else to eat. When you stop to consider the taste of chocolate, it doesn’t last, does nothing for you, and has nothing nutritious in it. So drop it in the bin and go get something you truly love and is good for you. In our world there will always be more food, so there is no need to finish everything on your plate if you don’t need it! Be really picky about eating quality food as the right nutrients can help lift the depression amazingly. The vitamin B group are well known for their benefit on the nerves so go for it! A strong dose of B group will really help. But a small word of warning. Vitamin B revs up the system so don’t take them after midday or you won’t sleep!
So, since mid life is a time for taking stock of your life, don’t be afraid. If you are depressed, get help. Life is too short and too valuable to waste it on tears and misery! Enjoy the little things and they will build up to something great.