Menopause, mental health and suicide – what are the links?
Menopause and suicide are two topics that we don’t often associate with one another. However, for a huge number of women, the decline in their mental health that they experience during menopause can push them to darker places than they ever thought possible.
“I came within a hair’s breadth of putting my car in front of a lorry,” says Diane Danzebrink, a psychotherapist, menopause expert and the driving force behind the Make Menopause Matter campaign. “The only thing that stopped me was my dog, Henry. He was in the backseat and just at that moment, barked. It broke my train of thought. If he hadn’t barked, I wouldn’t be here talking to you now.”
And Diane isn’t alone in her story. The latest data from the Samaritans indicates that the number of women taking their lives rose by 10.2% in 2018 compared to 2017. Of these women, those most at risk were aged between 45 to 49 years old. This is a time also associated with perimenopause and menopause.
“Unfortunately, there’s so little research around menopause and mental health, it’s not yet possible to link the two,” says Diane. “I’ve never been able to find any studies that directly investigate oestrogen fluctuation and mental health. Putting two and two together, it seems the more that we learn about oestrogen, brain function and mental health, the more likely we may find a link.”
Why mental health matters
It seems fair to say that a lack of awareness around menopause’s links with mental health could be contributing to these numbers. So often menopause is brushed under the carpet as ‘just a few hot flushes’, but the symptoms can be so much more than that.
Panic attacks, anxiety, feeling depressed, loss of interest in most things, feeling tired and a difficulty concentrating are just a few of the lesser-known symptoms of menopause. Oestrogen naturally falls throughout the perimenopause and menopause. Decreasing amounts of oestrogen means there’s smaller amounts in the brain to control the production of hormones like serotonin. This is a key player in regulating our mood and feelings of happiness. While HRT can help to bring these levels back up, many women are wrongly diagnosed with depression and prescribed antidepressants, which fails to deal with the root cause.
“My menopause was induced surgically after a total hysterectomy,” explains Diane. “Because it was all done relatively quickly, I didn’t have time to think of the result of the operation. I knew I’d go into menopause – but I thought menopause just meant hot flushes. Nobody sat me down to explain the complexities of it.”
“I’ve spoken to lots of women who are going through dark places and there is definitely a lack of understanding of what they’re going through. It’s not their fault. We’re not taught about it.”
After coming so close to ending her own life, Diane thankfully received the correct information and treatment to bring her menopausal symptoms back under control. As a result of her experience, she launched the Make Menopause Matter campaign to raise awareness of menopause. Diane’s efforts – along with many other campaigners – saw menopause education launch in schools in England in 2020.
Finding the right support
But there’s still work to be done. While future generations of girls will have a better knowledge of what to expect in their lifetimes, there are still thousands of women not getting the support they need.
“There needs to be some way to ensure that all women have access to this knowledge,” says Diane. “A pamphlet with information about menopause that goes out in the post to every woman in her late 30s or early 40s – just like you would for a smear or screening – would capture the majority of women.”
“For instance, if you’re someone who has suffered PMS or post-natal depression in the past, the hormonal fluctuations of menopause can mean you’re more susceptible to encountering issues associated with your mental health. Women need to be aware.”
There’s also the young women who will experience menopause at a much earlier age due to medical or surgical intervention. Many of these women – still in their teens or early twenties – will not only have to deal with the trauma of medical treatment but need to navigate the symptoms of menopause too. Here, Diane says, is where more support is needed to protect mental health.
“Take for example a teenager with a cancer diagnosis – they’ll undergo treatment that could cause damage to their ovaries, meaning they’ll never be able to have children,” she explains. “Through having treatment for their cancer, they’ve had their choice taken away. That is brutal. And it happens very hard and very fast.”
“The current system is all about treatment, but with nowhere to talk about how much this is impacting them. It’s likely that for these women, their mother hasn’t even gone through menopause yet. It’s so important to have someone completely unconnected where you can just be raw and let out whatever you need.”
What to do if you’re struggling
Whether you or someone you know is struggling, it’s important to know that help is out there. While your GP may be your first port of call, it’s important to remember that GPs don’t receive specific menopause training at medical school. Seeking a GP with a special interest in this area – or making an appointment at a specialist menopause clinic – can often save you a lot of stress and worry.
There is also a wealth of online information and support available – such as through Diane’s Menopause Support Network and the Menopause Doctor Website. You can also download Liz’s guides, The Truth about Menopause and The Truth about HRT, to find out more.
“The most important thing is that you reach out,” says Diane. “This might be to a therapist that you can talk to. It’s important that you have someone to talk to for the emotional side of things. It’s also important to see a doctor who can help for the hormone imbalance.”