治疗更年期的心理健康问题

Fluctuating levels of estrogen and progesterone are the hallmark of the menopause transition — the years leading up to cessation of menstrual periods. 这些荷尔蒙的变化影响到身体的每一个主要器官系统, 包括大脑, 这可能有助于 更容易焦虑和抑郁.

Mood changes are common during the transition known as perimenopause, 每10个人中就有4个人易怒, 低能量的, 悲伤或难以集中注意力, 根据 美国妇产科医师学会.

有时, these mood changes can become disruptive to normal functioning because perimenopause symptoms can arise suddenly and unexpectedly, at a time in an individual’s life already often filled with responsibilities at home and at work, 拉吉塔·帕蒂尔说, MD, 皇冠hga025大学洛杉矶分校健康中心的新主任 更年期综合护理 程序.

“Mood disturbance and disorders not only have a direct impact on short-term quality of life,” Dr. 帕蒂尔说, “but they also increase the risk of chronic conditions such as cardiovascular disease and dementia.”

That’s why the 更年期综合护理 程序 includes access to psychologists and psychiatrists trained in reproductive health.

焦虑和抑郁 

Menopause is a natural part of aging that happens to everyone with ovaries, typically around midlife. The average age is 51, but it can occur as early as 40 or as late as 60. 而更年期只是时间的一瞬间, 12个月没有月经, the years leading up to it bring significant hormonal changes that can affect well-being both during and after the menopause transition.

焦虑和抑郁症状在这段时间很常见, 特别是对于有精神病史的人, 说 凯蒂Unverferth, MD, medical director of the Maternal Mental Health Program at 皇冠hga025大学洛杉矶分校健康 and a collaborating physician with the 更年期综合护理 程序.

“People think a lot about premenstrual dysphoric disorder or PMS, PMDD. 他们想到怀孕. 他们会考虑产后问题. But menopause is also a time of big hormonal transitions that can last years,” Dr. Unverferth说, adding that “it’s kind of a chaotic time from a hormonal perspective.”

It’s not just hormonal changes that contribute to mood and anxiety issues for people in menopause, 路易斯·迪克森·德·席尔瓦指出, 博士学位, 从事更年期护理项目的临床心理学家. 一个人对衰老的感觉, 生育能力, their place in society and other environmental-social factors also play a role.

例如，如果某人经常 潮热 — the most common symptom of menopause — it can have a domino effect on their life that impacts their mood, Dr. 迪克森·德·席尔瓦说.

“They may start to do things like avoid going to social events,她说。. 或者当他们感到脸变暖的时候, they may immediately start to get really anxious and then overthink.

“所以除了引起这些症状的生物变化之外, 这些症状改变了人们的生活方式. And we know that when people stop seeing their friends or are having trouble at work, 这也会增加抑郁和焦虑症状.”

For these reasons, it is crucial to not silo the treatment of mood disturbance in menopause, Dr. 帕蒂尔说, adding that the 更年期综合护理 程序 evaluates mental health alongside sleep, 要妥善处理潮热和心理压力. 

认知行为治疗支持

Dr. Dixon De Silva is leading a six-week cognitive behavioral therapy group for people experiencing vasomotor symptoms such as 潮热 and night sweats. The group will support participants in changing their thoughts about these symptoms and teach techniques for relaxation and stress reduction. 研究 show that four to six sessions of cognitive behavioral therapy can significantly reduce 潮热 and improve sleep, 心情和生活质量.

“A really nice perk of the group is that you are going to be around other people that are experiencing the same issues that you are and can support you in that position,” Dr. 迪克森·德·席尔瓦说. “These are not topics that we commonly talk about — women and aging and menopause — so gaining support is really, 真正重要的.”

Not everyone will experience mood or mental health issues during the menopause transition. But for people who do have symptoms of depression or anxiety at this time, help is available.

认知行为疗法是一种选择, 还有抗抑郁药, which have been shown to be effective in treating depression and anxiety symptoms and improving quality of life, Dr. Unverferth说.

“Certain antidepressants can also help with 潮热,” she adds.

Hormonal changes associated with the menopause transition can bring about a range of physical and mental symptoms, but the 更年期综合护理 程序 is prepared to address them, Dr. 帕蒂尔说.

“我的愿景是提供证据, 全面而个性化的全人护理,她说。. “It’s really about putting the power in the patient’s hands after having the right information and the right understanding of their health so that they can make the best decisions for themselves.”