Mental Health in Menopause: Handling Emotions, Stress and More - The Natural Way

Based on a survey by BBC and ComRes where 1009 women aged between 50-60 were interviewed.

The way you feel can be attributed to fluctuating hormone levels according to a study. Decreasing levels of oestrogen and progesterone during menopause play a role here. And, symptoms of menopause like hot flashes, dryness and sleeplessness can make you feel like a different person altogether.

Menopause, a natural biological progress, is the cessation of menstruation for twelve or more consecutive months expected in the fifth or sixth decade of a woman’s life. It is a significant event that has repercussions on the body and mind.

Now, let's face it, this period is also riddled with numerous sources of stress - Children leaving home, caring for older family members, juggling a full-time job, and so on and so forth.

And, the various myths associated with menopause also add to the stress.

Let’s de-stress and debunk some of the common ones for you

Common Myths of Menopause

Myth # 1: Menopause Is an Illness

Truth: Menopause is a natural biological process and should be considered as a physiological event. It is not an illness

Myth # 2: Menopause Cannot Be Treated

Truth: As mentioned earlier, menopause is not an illness. Though there are many symptoms associated with menopause which can me managed very well by the right interventions at the right time

Myth # 3: Menopause Occurs Only in the Forties

Truth: Menopause can happen not only after forty but also in the early thirties due to certain medical conditions, surgery, and rare genetic disorders

Myth # 4: Menopause Can Affect Your Sexual Life

Truth: Sexual life can be satisfactory even after menopause. Lessened interest in sex may be due to emotional instability or due to painful intercourse because of a dry vagina which can be managed with hormonal therapy, lubricants etc.

Myth # 5: Menopause Makes You Safe from Pregnancy

Truth: Even though a decline in reproductive capacity happens, there are chances to conceive even in the pre-menopause period, so skipping birth control measures is not appreciable. Missing a period at this age doesn’t indicate menopause unless it is for twelve consecutive months.

Mental Health in Menopause - It Matters!

Mental health is affected during the different vulnerable biological stages in women’s lives, such as the phases of the menstrual cycle, pregnancy and postpartum so it would not be any different during menopausal transition too.

Mental health during menopause is equally important since it affects the quality of personal and professional life.

A recent survey reveals that 73% of women are not treating their menopause symptoms. Talking about menopause still remains taboo.

On the other hand, companies like Vodafone, Diageo, Aviva, and more have made a global commitment to support women through menopause as they realise that nearly 8 in 10 women are going through menopause at work. 

3 in 5 working women experiencing menopause feel that their work is significantly impacted. Taking steps towards building a community of healthy women at workplace is also crucial to meet the fast-paced world’s increasing demands.

The menopause revolution has indeed begun!

Common Mental Health Symptoms of Menopause

86% percent of women experience mental health issues during menopause, though most of them do not report it or seek professional help.

Some of the major issues faced by women during this period are listed below:

• Anxiety
• Sadness or Depression
• Mood changes 
• Loss of confidence & self-esteem

Anxiety and Menopause

Been feeling fearful or tense now and then? Are palpitations, increased heart rate, sweating, nausea or headaches a part of your daily life now? If yes, then you could be dealing with anxiety.

According to a nationwide survey conducted in the UK among women in the age group of 50-64 years, anxiety was reported as one of the major symptoms causing a burden on both the health and economic sector.

Technically, anxiety is a future-oriented mood, and linked to fear. Preparing for anticipated events and behavioural responses to threatening situations are the hallmarks of anxiety. Simply put, imagining worst-case scenarios and feeling frightened of possible outcomes are major thoughts that come into play.

How Anxiety Affects a Woman’s Quality of Life?

Unaddressed anxiety can creep into your workplace or home and can cause havoc. It may trigger unpleasant conversations which may later drain you out. Women reported anxiety interfering in making rational decisions at the workplace and maintaining peace at home or with loved ones.

Understanding this particular state of mind and curating a person-centric holistic approach can help in reducing unprecedented events in a woman's life. 

Wondering how you can overcome anxiety naturally? Here you go

• Preplan your chores. Anxious minds dislike last-minute preparations. 
• Avoid excess caffeine and aerated beverages.
• Keep a check on your hydration. Your body is 70% water. Refill it at proper intervals.
• Acknowledge difficult situations. Pen them down. Keep a journal to track your responses and see how
• different the journey has been from the beginning!
• Communicate to people around you how important it is for you to do things in a planned manner

Managing Anxiety with Ayurveda 

The three dosas -Vata, Pitta and Kapha remain in a state of balance physically and mentally when you are healthy. When there is an imbalance of any of the 3 dosas, you may fall sick from a disease or develop a symptom.

Ayurveda considers anxiety as a state of imbalance of vata and pitta dosa. So, diets, herbs and simple therapies to balance vata and pitta are adopted to restore wellness.

Ayurvedic Herbs for Anxiety

1. Jatamansi or Spikenard  herb has an effect on memory and mood.  It also helps in improving sleep.
2. Tagara or Indian Valerian has a  proven effect on reducing anxiety and helps in sedation especially if you find trouble falling asleep
3. Aswagandha or Indian Ginseng has a lot of health benefits. It is widely used in the management of mental health issues like anxiety and depression. It is popular for increasing overall well-being and overcoming exhaustion.
4. Mandukaparni or Indian pennywort is an antioxidant that helps in improving memory and concentration
5. Brahmi or Water hyssop is an adaptogenic herb like Aswagandha that helps in resisting stress and coping with anxiety. It is also used in the management of various conditions like Alzheimer’s disease. 
6. Vacha or Sweet flag helps to improve memory and cognition and can be used to improve brain cell health.

Ayurvedic Diet for Anxiety 

1. Herbal tea with chamomile, indian vetiver, coriander helps you in calming your pitta and vata dosa to help relieve anxiety.

2. Milk porridge (with coconut milk/ vegan milk) - According to Ayurveda, porridge is a soothing food that helps you balance all your dosas. It is the best meal to have when you feel unwell. Adding milk/ coconut milk to it helps in balancing vata and pitta dosa. 

3. 1 tsp of ghee daily (either on empty stomach/with food) - ghee is the best source of healthy fats and according to ayurveda it is ideal for boosting your brain cells.

4. Lentils/pulses like green gram are a great source of plant protein and help heal your body in times of illness. 

5. Meat (mutton or chicken) - when vata and pitta dosa is affected, try nourishing your body with soup made of chicken and mutton.

6. Sauteed veggies like mushrooms are good sources of anti-inflammatory agents and improve gut health.

7. Berries like raspberries and strawberries are good sources of antioxidants and polyphenols. These compounds improve your mood and reduce stress levels.

• Do not indulge in spicy foods. Spicy food can mess up your pitta and worsen anxiety and cause symptoms like acid reflux.
• Cut down on dry foods like crisps and fried items. Foods in this category can blow up your vata to unhealthy levels and cause headaches, bloating and joint pains.
• Limit alcohol intake. Alcohol can upset your digestion and worsen mood and hormones during menopause and otherwise.

Simple Ayurveda Therapies to Manage Anxiety at Home

1. Abhyanga or the process of oiling yourself regularly is a practice observed in Ayurveda. Oils bring balance to your vata and pitta dosa. Your head and feet are the most important places to be oiled. 

2. Nasya - Except for your skin all your major sense organs are located in the head. Interesting observation right? So, one of the methods to take care of your senses and thoughts is to use medicated oil as nasal drops regularly. Researches prove that nasya has a considerable effect in reducing anxiety. 

Depression and Menopause

Feeling less motivated to even get out of bed? Unable to find joy in your daily life? Having trouble falling asleep? Sounds familiar?

Women in the menopause phase can experience a wide range of negative mood changes like lack of motivation to even serious ones like suicidal thoughts. Slowness in thoughts and actions are also common. Statistics show that around 6% of women in the age group 50-60 suffer from depression worldwide

If you have been experiencing any of these symptoms amidst other negative thoughts, you are likely to be suffering from depression.

People tend to misunderstand that depression is a state of mind caused by one’s thoughts. That is not the true case. Depression has an organic background to it.  

Changes in sex hormones alter serotonin and nor adrenaline which play a crucial role in the onset of depression. Women who have a previous history of depression have higher chances of experiencing depression during menopause.

In addition to these biological factors, changes in social life and sexual life can contribute to feelings of isolation and helplessness. Decreased sex drive and loss of partner to death or divorce can also worsen the mental state of women.

How to Beat Depression?

Living with depression is not easy. If you have been going through a tough time recently, we appreciate the courage with which you have decided to show up for yourself everyday. Even finishing up the mundane tasks of daily life shows how much effort you are putting in to keep yourself moving ahead.

Here are some ways you can manage depression (in addition to medications)

• Acknowledge the problem you are dealing with. The sooner the better. Denial is common and makes it difficult to make things better. 
• Seek professional help. Talk to your therapist. 
• Join support groups or clubs that engage you actively. Listening to others talk about their journey of overcoming difficult times can create a remarkable difference!
• Be kind - to yourself and others around you. 
• Volunteer for charitable acts or anything that satisfies you. Research shows that people who volunteered for such acts were able to manage depression better.
• Engage in physical activity. Exercise releases hormones called endorphins that make you feel better. Studies show that people engaged in physical activity regularly had decreased risk of developing depression and in those who were diagnosed, the chances of recovery were high.

Ayurveda to Beat Depression

Depression is considered as a disease that affects the kapha bio energy mostly. Ayurveda aims at the restoration of the balance of kapha through curation of specific diets, including herbal medicines and yoga.

Unlike other systems, Ayurveda considers the body and mind to be closely related and hence ayurvedic psychotherapies like Satwajaya treatment also play an important role in the management of depression.

Finding one’s own spiritual connection with the universe is also important while managing mental health issues. Daiva Vyapasraya techniques are methods to invoke spiritual well being in people. Research on the use of these techniques offer promising results. 

Finding one’s own spiritual connection with the universe is also important while managing mental health issues.  Daiva Vyapasraya techniques are methods to invoke spiritual well being in people. Research on the use of these techniques offer promising results.

Include the following in your diet to feel better:

• Vegetable soups with spices like turmeric and ginger help in improving your digestion and appetite which is usually affected when a person is depressed.
• Porridges help in balancing the dosas, keep you hydrated and full. Ayurveda advises to have porridge when ill.
• Millets are a great source of fibre and have low glycemic index. Foods with lower glycemic index helps in improving overall metabolism and health.
• Bananas are rich sources of potassium and are natural mood enhancers.
• Walnuts and almonds are a great source of nutrients, especially for women in menopause. Have a bowl of cut bananas with a handful of walnuts and sliced almonds as a tasty snack.
• Spices like pepper, and coriander are good sources of anti-inflammatory agents and can help in improving gut health.
• Herbal teas provide relaxation.
• Healthy fats aid hormonal health. Foods like avocado and fatty fish (grilled/ baked) are rich in omega-3 fatty acids which also help in improving brain health.
• Make sure you cut down on refined sugars and trans fat (found in almost all kinds of junk food)
  1. Reduce fatty milk 
  2. Say no to ice creams 
  3. Avoid red meat, especially beef 
  4. Avoid reheating foods 

Ayurvedic Herbs for Depression 

1. Jatamansi or Spikenard (link for research ) has an effect on memory and mood.  It also helps in improving sleep.

2. Tagara or Indian Valerian has a  proven effect on reducing anxiety and helps in sedation especially if you find trouble falling asleep

3. Aswagandha or Indian Ginseng has a lot of health benefits. It is widely used in the management of mental health issues like anxiety and depression. It is popular for increasing overall well-being and overcoming exhaustion.

4. Mandukaparni or Indian pennywort is an antioxidant that helps in improving memory and concentration.

5. Brahmi or Water hyssop is an adaptogenic herb like Aswagandha that helps in resisting stress and coping with anxiety. It is also used in the management of various conditions like Alzheimer’s disease. 

6. Vacha or Sweet flag helps to improve memory and cognition and can be used to improve brain cell health.

7. Pippali or Long Pepper is a herb that has a potent effect on almost all systems of the body, especially gut and brain.

8. Dasamoola - a group of roots of ten ayurvedic herbs that have proven effect in a wide range of mental illnesses. 

Ayurveda Therapies to Manage Depression

Depression can take a toll on your health forcing you to remain least motivated. External stimulation of the skin and senses are considered very important in Ayurveda. Hence, certain therapies that can be practised within the comforts of your home can be tried out.

• Abhyanga - Self oiling with medicated oils on specific body points helps increase circulation and drain toxins from the body. Studies show that abhyanga is effective in improving motivation and imparts better thoughts. (link)
• Siropichu - Oil retention on scalp is an exclusive ayurvedic technique of sensitisation of the blood vessels and nerves on scalp and head. Improves memory and reduces confusion and irritability. (link research paper)
• Nasya - Removing the kapha dosa to make way for balance of the bio energy is another way of tackling depression with Ayurveda. Medicated oils are used as nasal drops on a regular basis. Researches prove the effect of nasya in mental well-being and even improving cognition.

Mood Disorders During Menopause 

Irritability, nervousness, and frequent mood changes are common in women during the perimenopause and menopause stages. Around 30-40% of women struggle with mood changes.

Most often, women try to keep these negative emotions from menopause at bay by investing more time at work or home. However, the onset of unprecedented events may trigger unwelcome thoughts and moods.

Watch out if you are constantly struggling with mood disorders! Check your thyroid functions to ensure there are no thyroid issues. If any of your parents or siblings has a history of mood disorders, there are increased chances of you developing or facing it.

Management of Mood Disorders in a Holistic Way

Living with mood disorders isn't easy. Adopting a healthy lifestyle and using ayurvedic herbs and therapies can help you in dealing with it in a better manner.

• Increase intake of healthy foods. Stay away from foods that cause gut inflammation
• Up the level of water intake. Cut down on beverages like alcohol and sweetened fizzy drinks
• Regulate your sleep schedule. A good night’s sleep is crucial in making you feel better the next day
• Get out in the sun. The role of sunlight in mental well being is indisputable!

If you are still struggling with mood disorders to such an extent that it disrupts your overall performance, talk to a professional healthcare provider. Medications can help you feel better.

Loss of Confidence and Self-esteem in Menopause

A unrecognised yet critical issue of being in your menopause stage is the feeling that you 
are not enough or that you don't fit in! You may want to socialise or meet your friends but then self doubt sets in and you walk out of it.

Physical changes following menopause can impact a woman’s sense of fulfillment and make her feel apprehensive. Changes in sex drive and difficulty in finding partners can also make you feel low.

Don't worry!! Women worldwide go through this difficult phase and yet emerge successful  and happy!

• Working on your self-esteem
• It is all about you. Accepting that this change is natural and acknowledging your new limitations will help you in this transition.
• Take time to invest in yourself. Take care of your skin and hair regularly at home. Do not hesitate to go to the salon for a makeover!
• Prioritise your physical needs. Talk to your partner about the changes and how it would be great to have him/ her supporting you.
• Meditate. Look into yourself and listen to your thoughts. Set aside a time where you can have some peace. 
• Keep moving. Hit the gym or your yoga class to keep those muscles and bones healthy.
• Most of all, be gentle on yourself.

Importance of Gut Health in Mental Health Issues 

The previous decade has been all about how gut health plays an important role in health and sickness. Psychiatric illness and chronic diseases are proven to be closely related to the decline in gut health.

Ayurveda considers the gut as important as the heart and brain. Modern scientists consider the gut as the second brain. Hence, treating mental issues in Ayurveda always targets resetting your gut and improving your metabolism.

Read more about how gut can affect your mental health here - The Gut-Brain Connection: How Your Gut Health Affects Your Mental Well-Being

Role of Yoga and Pranayama in Menopause

The invisible body-mind connection forms the basis of almost all mental illnesses. Yoga is a holistic way of attaining good mental health while keeping a close watch over one’s physical condition as well.

Yoga offers safe and practical methods of dealing with mental health issues. A research on the effect of hatha yoga on menopause symptoms and quality of life offers promising results.

An integrated approach combining Yoga Asanas and Pranayama confers healthier results. You can perceive this as a source of distraction from daily life, stigma and enhance self-esteem. Just focus on the simplicity of movement and forget about work responsibility and other demands.

Benefits of Yoga in Menopause

1. Yoga helps in reducing anxiety and depression.

2. Cognitive functions such as remote memory, mental balance, attention and concentration, delayed and immediate verbal retention, and recognition tests can be enhanced through yogic practices.

3. Meditative asanas like padmasana, sidhasana, and vajrasana aid in mood regulation and concentration. It upsurges plasma melatonin levels, and it has been proved that melatonin improves sleep quality effectively.

Early intervention of yoga even before menopause can help in beating the stress that comes with it!

Benefits of Pranayama in Menopause

1. Sitali, sitkari, and Chandranuloma pranayamas are effective in reducing hot flashes and improving sleep. 
Nadi sudhi pranayama helps to restore mental health.
2. Savasana, or corpse posture, provides deep relaxation to the mind and body. 
3. Practising Yoga Nidra for at least ten minutes is beneficial in counteracting stress from menopause.

Meditation and mental health

Does meditation feel fancy to you? Does it seem spiritual?

Research proves that people who were on meditation for a continuous 6 weeks showed great improvement in their quality of life. Some of the areas where major changes were observed were anxiety and lack of attention.
Meditation helps to counter the emotional effects of menopause and gives stability and a peaceful mind. Meditation, like mindfulness, will help to adapt and accept the transition and maintain inner peace.

• Here are some meditation techniques that have a proven effect on mental stress due to menopause. 
  
  Smriti meditation helps to encounter emotions and distress. It is the modified version of the ayurveda psychotherapeutic technique, which aids the process of introspection through guided interaction.
• Tai chi which is an ancient Chinese form of martial arts involves gentle and slow movements of low impact with coordination of breathing and graceful movements that help to improve mental health and well-being.

When to Seek Professional Help for Menopause?

When symptoms go beyond a limit, you should consult a physician to mitigate the discomfort. If you are regularly unwell and unable to follow a daily routine, you need a doctor’s intervention.

Hormone replacement therapy (HRT) or bioidentical hormone therapy is a choice. But it has its side effects too. Depressed mood and sleep problems are likely to be mutually related and must be treated specifically.

In case you wish to go the natural route or cannot do HRT due to other medical reasons you can seek the help of Therapeutic Yoga, an Ayurvedic diet & supplements.