Q I am in my 40s and I frequently get bursts of really low mood. I feel fuzzy, tired, listless and black. I don't want to do anything and feel like I function on autopilot. At first I thought it was hormonal but there doesn't seem to be any consistency in my cycle as to when it hits. What do you think? Could I be depressed? Could it be my hormones?
A It is clear is that you are having a really rough time. So many factors can influence depression, such as a combination of your genetics, biology, history and environment, life events and hormones. The lifetime risk for women experiencing depression is 25pc more than men.
When looking at influencing factors, hormones can impact depression most notably during the reproductive years and the transition to menopause. Many reasons can come into this, from unique physical and emotional stresses on women to the fluctuations in hormone levels. Something of a dismissiveness can occur for women when discussing hormones, but remember you know yourself and your body best.
In pre-puberty, the rates of depression between boys and girls are roughly the same, according to Rita Nonacs, MD, PhD, Associate Director of the Center for Women's Health at Massachusetts General Hospital in her book, A Deeper Shade of Blue. The rates of depression change between the ages of 11 to 13 and by 15 years of age, girls are twice as likely to experience depression as boys and this risk remains constant throughout their lives. Dr Nonacs said, "at no other point are women more vulnerable to depression than during their childbearing years".
Hormonal fluctuations and changes from adolescence to adulthood, ranging from menstruation and its cycle, pregnancy and menopause can trigger changes in brain chemistry that can lead, in some women, to depressive symptoms.
A history of depression or of depression within the family can also increase the risk for some women for hormonally-triggered depression. Your concerns are valid and worth exploring properly. The complexity is, even though women experience the roller-coaster effect of hormones every month, this does not lead to a direct correlation with depression as so many possible and unique contributing factors may also be playing a part. The most important part is to find out what is going on for you specifically.
When it becomes possible, ask to get a blood test done and to also to check your thyroid. Speak with your GP about your symptoms and ask about speaking with a mental health professional to support you.
Functioning on autopilot can feel robotic and disconnecting for yourself and others. Feeling flat and apathetic is frustrating and really tough going as you may want to do things but may not have the motivation to do things that you know may help. This can leave you feeling stuck and sad.
To bring in hope, by writing in, you have taken the first step. I don't underestimate how challenging that must have been as that tiredness and brain fog can make even the smallest task feel completely overwhelming. Give yourself the credit you deserve as you begin to make changes to help your current situation.
A few questions to ask yourself that you could bring with you to the GP or therapist: • Have you experienced the above symptoms consistently for two weeks? • Has there been any stress, or events that could have impacted your mood? • Or does it seem to have come from nowhere leaving you wondering if it is hormone related? • Are you sleeping or eating more or less? • If you drink, are you drinking alcohol more? • Have you ever experienced this before? • Have you written out what the black thoughts are or spoken to anyone about this? • Are you having any suicidal thoughts? Always remember that you have access to the Samaritans (01)-6710071 if you ever are in crisis. Your safety comes first, you can get support.
When it becomes possible, ask to get a blood test done (stock photo)
For present moment guidance, I would advise speaking with your GP, seeking a referral to a psychologist or psychotherapist; you can look up the Psychological Society of Ireland and search under 'find a psychologist' or look up the IACP (Irish Association of Counselling Psychotherapy).
Attend to the basics, even though you won't want to. See these recommendations as the four supportive legs on a chair: • Good sleep: go to bed and get up at basically the same time every day. Good-quality sleep comes from how the day was.
• Write out any worries, fears, sadness or loneliness in the early part of the day. Do one thing to ease those feelings. Rate where you are on this scale from 1-10 (10 being the worst) and do one thing to bring it down by just one number on the scale.
•Go outside and get fresh air every day. A 15-minute walk is great; start with the goal of a 10-minute walk. Feel your soles on the ground, breathe slowly, note five things you can see, four things you can hear, three things you can smell, two things you can touch and one thing you can taste.
•Be kind and nourish your body. Be aware of how alcohol, coffee and sugar impact how you feel. Eat three proper meals per day. Bring compassion to how you are feeling, from what you eat to how you think. Start by being kind to you.
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