Suicidality and perimenopause

[Eagle Ray]

Has anyone else experienced severe suicidality in relation to perimenopause? Did anything particular help? There is apparently a strong association for some women.

 I had a major drop in oestrogen a year ago resulting in severe anxiety/depression/suicidal ideation then. It’s re-occurring now. I have complicating factors of c-ptsd and complicated grief. Saturday was the anniversary of my mother’s sudden and distressing death. I was extremely bad on Friday and early Saturday.

I’ve been calling helplines and had some practical help. It helps regulate me for a few hours then I start to disintegrate again. It’s a feeling of totally failing apart. I do have a psych appointment on Thursday and I’ve booked a counselling appointment with the Australian menopause society as well.

HRT may help but I have to look at how it will interact with my liver disease which can be a complicating factor. It’s a rare disease and not well understood or even known about by most medical practitioners. I just feel totally overwhelmed.

[indigo22]

You never need to be sorry with me ER,

I hope you are able to remain assertive and keep your boundaries with this person. As you said, cut the ties if it doesn't feel right. As we age, we get more in tune with what I like to call our BS detector. Better to have a small number of friends that care about you than to have extra friends that don't. I will be here if you want to talk.

Take care,

indigo

[Eagle Ray]

Thanks indigo,

Yes, will do my best handling things tomorrow. Coming off the progesterone led to fractured sleep again last night and increased anxiety this morning. That’s after 12 days of beautiful sleep and almost complete elimination of anxiety. So it may be that I need to go continuous instead of cyclical.

 I just had a text from Centrelink saying I have an interview with them mid January. As usual it doesn’t tell me what it’s about, but I suspect it’s a review of my current status. I’m leaning towards doing the Self Employment Assistance Scheme now so I can at least tell them I’m working towards that. While a few weeks ago the DSP seemed like the only option it now seems feasible to start up a photography-related business idea I have. I’ve been researching it daily and starting to look at new skills relevant to it. I’m basically working towards it already and feel quite motivated.

 I find the feeling of pressure and scrutiny you have with Centrelink is something I would like to get rid of. I really appreciate I live in a country where such support exists. But it does feel like Big Brother sometimes and they have a restrictive, adversarial approach that when you’re already struggling often impairs your ability to heal and return to work rather than helps you. I am so glad I’m generally feeling better at the moment which will help me to manage whatever uncertain requirements they will throw at me next. I would really like to have a sense of freedom and not be tied to them anymore. Self-employment seems the best way out where I have some control of my work day, can manage fatigue levels etc. I’m certainly much improved from even just two weeks ago.

 I hope you are having a good 2024 so far 🙏😊 You take care too,

Eagle Ray

[Fiatlux]

Good evening Eagle Ray,

I know it’s late but I had to get this out while it’s fresh in my mind.

I was talking to my Narc Husband about menopause this evening and I know, why oh why do I bother but during this discussion as usual Narc H is offering his thoughts and advice and turns the subject to poor men who suffer from low testosterone levels and can’t get HRT etc.

I informed Narc H that women also have difficulty accessing treatment and in the past women suffered in silence and were often thought to be going insane, institutionalised and put on all sort of meds and treatment that made them worse. I continued that women are often suicidal as they can’t or couldn’t get treatment and so little was known about this.

Narc H, stated that was because women do go insane from menopause! What a shitty thing to say. BUT, Then I had a light bulb moment. I reminded him that his own mother spent several months in a mental institution as it was known then when she hit her mid 40’s and put on all sorts of meds that put her into a zombie like trance. She still has no idea what was done to her under sedation. (This wasn’t in Australia) But when I met her in Australia for the first time she was 50 and in full blown menopause and was suffering from depression, anxiety and of course extreme hot flushes and fatigue. She has been medicated almost half her life. She’s 84 this year and takes meds for anxiety and to help her sleep.

So, while I am insane, his mother is unwell. She has been suicidal and attempted to and threatened to end her life on numerous occasions. Something that Narc H conveniently doesn’t remember, won’t talk about and has blamed me for some of his mother’s mental illness. I fail to see how I have contributed to her anxiety as I have been nothing but helpful and supportive. 

Thinking back to my own mother during her menopause, I can’t actually remember her ever speaking about it but my mother is a Narc. (My father thought my mother was crazy and just before he passed away told me to cut her off and forget about her).

Thank you for this post as without it, I would never have been able to put my mother in laws earlier suicidal tendencies and menopause together. It makes sense. 

I don’t think Narc H will ever give me his menopause advice ever again 🙏🏼

[Eagle Ray]

Hi Fiatlux,

I think you are onto something regarding your mother-in-law. So many women have been institutionalised in the preimoenopausal/menopausal age bracket. It almost seemed to be a thing last century as people started to live longer, so more women going through those symptoms and breaking down in a society with no support. But it's still happening now with the same horrendous silence around that suffering.

There's an excellent podcast interview with Professor Jayashri Kulkarni who has spent 30 years studying perimenopausal depression and women's mental health. It's on the Liz Earle Wellbeing podcast and is called How Hormones Influence the Brain if you want to see/google it. At the beginning of her career Professor Kulkarni, a psychiatrist, was working with institutionalised women. Even the women themselves were often identifying they knew it was their hormones, but were getting no help in this area. So Professor Kulkarni has made it her life's work to understand what is happening here and now runs a clinic in Melbourne.

The really tragic stories I've read and stories I'm hearing still from other women involve ending up in the psych hospital and being put on antidepressants, antipsychotics and sedatives, none of which worked. Just like with your mother-in-law, they might reduce someone to a zombie-like state, but they don't address the underlying hormonal issue. It was the stories I'd read and heard of the women who'd been through all this, then finally got onto HRT, then had a massive recovery in like a week, that made me want to try HRT. The improvement for me has also been virtually instant and will likely keep improving over time. And yet sadly many end up suiciding or just suffering in an horrific state for years.

If I hadn't been through it myself I don't think I'd fully get it. I've been through the relentless suicidality, involuntary and extremely horrific intrusive thoughts and absolute extreme distress. it is nothing like other types of anxiety and depression and has a very unique profile.

I hope Narc H might reflect a bit. At least, as you say, he will probably stop giving you menopause advice that is insensitive. I just wish for a more humane and caring society where we seek to understand instead of judge people. Women suffering through menopause can be treated with a kind of derision, and you can see why women choose to suffer in silence rather than be socially ostracised and ridiculed.

Anyway, I'm so glad you are seeing improvement! 🙏

[Eagle Ray]

Dear Fiatlux,

Just letting you know I did reply to you several hours ago but it hasn't appeared. It will probably appear sometime belatedly. I agree, the experience of your mother-in-law sounds very much like menopausal effects and what has happened to a lot of women.

Having a rougher day today the longer I'm off the progesterone. Have sunk down a lot and lost my spark. Obviously it really helps me. If this is the usual pattern it will mean spending half the month feeling great and half feeling terrible. It's not usually prescribed continuously until out of perimenopause and into menopause where I'm not quite at yet. Trying to find some answers today with research. It's so strange to go from feeling awful to feeling really incredible well, calm and healthy to feeling awful again.

Hope you are having a lovely weekend 🙏

[Fiatlux]

On a much lighter note… Kaftans!

I now get it… loose fitting clothes, batwings, mu mu’s and beautiful flowing fluttering kaftans.

When the hot flushes hit, I often felt like ripping off my clothes… even in winter and jumping under a cold shower. Once the flush was over, I felt cold again. It was awful. My entire torso was on fire. As I go through this, I can now recognise the symptoms in other women. The menopause sisterhood support club, is a club I would like to join.

I already owned a few kaftans which I only wore in summer but now they are my go to for every season. Naughty me, I have just ordered a few more. I can’t let a less than half price deal go. And they’re 100% Cotton. So hard to find cheap cotton kaftans.

Today I started a new HRT product as the one I was taking was out of stock. I have a 4 week supply and if this works well for me I will stay with this product.

I am now starting to understand menopause coping mechanisms… 🙏🏼

[Eagle Ray]

Hi Fiatlux,

My posts to you from Saturday have finally appeared after being caught in the system.

I have never owned/worn a kaftan but they look flowing and comfortable. I can understand owning a few because there are so many beautiful patterns and designs to choose from! The hot flushes sound awful. I had only a few (like just 3 or 4) in about 2018/2019 and they really were just s brief rush of heat through my body. What you went through sounds worse. I am fortunate I don't have night sweats either. For me it has been horrific anxiety and depression and an ability to sleep.

I hope the new HRT product works well for you. It is definitely a trial and error thing isn't it!

I was brilliant for 12 days but because one of the components of the HRT is cyclical and I have to come off it for 16 days, I've plunged back into horrible anxiety and depression again. It was clearly making all the difference. I told my GP I thought this would happen based on the research I'd done and that I'd be better on a continuous rather than cyclical regime, but he said to go cyclical. I'm seeing him today and I'm going request doing a 25 on, 3 day off regime which I have read has resolved the horrific distress some women crash back into on a cyclical regime.

During the first 12 days everything in my body was fixed. Anxiety and depression just went. My bones and muscles felt strong. I slept beautifully. My brain felt sharper and clearer than I think it had ever felt and I was highly motivated but also very calm. It was like the best mental and physical health I think I've ever felt. Now that has just all gone again because of coming off the progesterone component. I want to go back on it straight away rather than endure another 2 weeks of cycling off it, which I'm not sure I can go through in this horrible state.

It is so frustrating when you intuitively know the answer but the doctor advises you against it. You then have to suffer terribly and convince them you were right in the first place. And you have to present them with a rational argument for your case when you are feeling terrible and having trouble functioning. For me it is about my survival because I am spiralling back into a dark place. I at least know exactly what the hormonal driver is now. Other women on the community app I've been on have described the same thing - plunging back into feeling awful and no sleep, and it was solved by the continuous option. So I think I'm just going to do that regardless of what the doctor says today.

So little is understood about female hormones in the medical profession. There has been a lack of clinical research to establish evidence around things like perimenopausal and menopausal depression and much of the info doctors have is out of date and, in some cases, plain wrong. It is the work of people like Dr Louise Newson and Professor Jayashri Kulkarni that has finally provided the info I desperately needed. I think without this info I may have not been here much longer as I couldn't have continued to live like that.

So right now I feel desperate and horrible but trying to remember that I can feel really better again once back on the hormone I've cycled off. I can't help thinking of all the women who suffer terribly in this way and never get any help. I really look forward to feeling better again.

I hope you are having a good day and that you have a great week ahead 🙏

[indigo22]

Hi ER,

Sorry to hear you have spiraled since you started the cyclic stage. If you are not needing prescription for HRT, I agree you should go with your gut again if your GP disagrees with you. I wonder also if the professor you mentioned who has a clinic in melb might do telehealth appointments as she sounds better suited to your needs in this area. Just keep reminding yourself that the way you feel right now is only temporary and you will feel better when you are on a more appropriate routine with the HRT.

You are doing important work for all middle aged women by writing about this, the silence has gone on long enough, too long in fact.

You may or may not deal with hot flashes when in menopause, I did, so perhaps find some loose fitting clothing just in case you need it.

Let me know how you went with your friend.

indigo

[Fiatlux]

Hi Eagle Ray,

I hope you are coping with that desperate feeling of wanting to feel better again.

I spent most of last year feeling absolutely terrible most of the time. I didn’t leave the house. The night sweats had me jumping out of bed stripping off my nighty. Even during cold winter nights. The times that meds helped me sleep through it, I would wake with my hair soaking wet. It was exhausting. I barely functioned during the day.

Since only starting HRT in November and needing to renew my prescription last week, I went into a panic when I was told that my HRT meds were out of stock. The pharmacy phoned my GP to get authorisation to provide me with a different Brand. I understand that desperate feeling. I wasn’t going to leave without a resolution. I too am scared about what will happen if I am without my HRT.

You truly are brave to speak up with your doctor. I told mine, ‘give me something now or else’. I wasted a lot of money on over the counter stuff. They were ok but may have had a placebo effect for a short time.

Sleeping on a frozen jell pad under my sheet was when I was at rock bottom.

Stay strong and keep us updated on how you are feeling. 🙏🏼

[Eagle Ray]

Thank you kindly indigo 🙏

I'm about to head off the the doctor. Basically I can stay on the same prescription but it would be just adjusting how I take it. So the gel daily as I have been but taking the pill component on a 25/3 pattern (1 per night) instead of a 12/16 pattern (2 per night). So fortunately I don't have to get him to write me another script.

Yes, I had thought about the professor with the clinic in Melbourne and Telehealth. I expect she is in extremely high demand. But I will definitely look at other options if my doctor doesn't agree with me today. I want to go back on the progesterone from tonight but not sure if my body will get too confused, yet I feel like it actually might be the right thing to do rather than go through another 2 weeks of hell.

I improved instantly on the HRT in every area of my mental and physical health. Then I relapsed immediately as soo as the cyclical component was removed, immediately back to fractured sleep and waking with significant anxiety. I would say I have had lifelong issues with dysregulated hormones and my body just thrived once it got what it has desperately wanted for years.

Yes, I will see how I go with regard to hot flushes. If I am on HRT I may not even experience them again, and when I did before they really weren't bad, just weird. But I realise they could come back worse. But given I felt just fantastic on those first 12 days, I feel like everything can balance with the right hormonal treatment, which can be adjusted over time as need be.

Things went well with the friend actually. I think I've established something of a boundary. I am definitely getting a lot better with boundaries. There are some people you just need to permanently get away from. Then there are people with good qualities and you care about the friendship, but they also have some exploitive traits. Such traits often come from their own trauma pattern. If you can establish a boundary it often sets things straight and they have to learn they either respect your boundary or you will just separate from them. You basically put the ball back in their court. So I can tell it has made her a bit ambivalent now and she will have to decide whether she likes the new status quo or not. She can tell I still care about her but I also have limits and boundaries and I'm not in any way going to take responsibility for her, as her tendency is to get others to parent her. It's quite challenging these things but I'm definitely getting wiser and stronger when dealing with them.

I hope all is well with you indigo 🙏

Hugs,

ER