No laughing matter
Q: How many (peri)menopausal women does it take to change a light bulb?
A: Oh, change it yourself — and stop bugging me with your stupid questions!
Christiane Kuntz, a family physician who treats patients referred to the mood disorders clinic at Ottawa’s Shirley E. Greenberg Women’s Health Centre, keeps a binder in her waiting room that’s full of jokes and cartoons such as the one above. There’s no shortage of them — the furious, hormone-crazed woman has long been an object of humour; meanwhile, a popular YouTube clip these days shows two “menopausal women” melting down in fits of road rage.
Yes, humour is a great coping mechanism. But for women hitting their mid- to late forties who find their moods suddenly fluctuating wildly, it’s no laughing matter. Many of us have lived our lives keeping our anger pent up, and putting other people’s needs before our own. The small irritations we used to respond to with a weary sigh, rolled eyes or a mild, under-the-breath curse now make us so furious that we want to (and often do) scream. Or cry. The patience we once had when dealing with spouse, children and co-workers seems to have evaporated.
Four years ago, at age 45, I couldn’t seem to shake this constant, ramped-up irritation and anxiety. Domestic squabbles were becoming more frequent; slammed doors were a common sound in my home, as was myself yelling — I didn’t like the sound, and neither did my partner. I finally decided I had to do something about it when I found myself reacting to an officious letter from the Canada Revenue Agency by ripping it up, flinging it across the room and screaming. I stopped short of banging my fist against the kitchen wall, but only just. We all have our occasional flare-ups, but this was different. I had a sick feeling that with anger this over-the-top, I could do some damage to myself or someone else. My outburst brought my partner running down the stairs to see what was going on — and, like any smart animal sensing an oncoming tsunami, quickly retreating to the higher ground of his home office until my tantrum subsided.
Mad woman in the attic
Such frequent bursts of anger are exhausting and, ultimately, counterproductive. Once you’ve lashed out and alienated family and friends (but more often than not, family), you may find yourself alone in an empty room, with nothing to show for the ruckus you’ve caused but a pounding headache, a raw throat, and even more raw feelings of confusion and remorse. Relationships can be damaged. “Women feel tremendous guilt over this, especially with their children,” says Kuntz. They may even begin to feel a kinship with the “mad woman in the attic,” that stock character who haunts Victorian novels, and wonder if the best thing to do is to hole up in a secluded room, place a sign on the door that says “Sorry! Out of Estrogen,” and stay there until age 55, when the severe storms of menopause are likely to have passed.
It helps to know, and to have a doctor who knows, what’s going on. And it turns out that the rapid decline in estrogen levels is one of the key culprits in mood swings. In fact, research is accumulating to indicate a strong link between estrogen fluctuations and the changes in brain chemicals that can lead to mood disorders — the most common symptom is depression (reported by a staggering one in five women from puberty to post-menopause), which can manifest itself as PMS, pregnancy blues, postpartum depression and perimenopausal mood changes. A depressed mood can typically descend after age 65, and this can occur regardless of sex as the brain ages and hormonal production declines.
