Tuesday, January 26, 2010 karma asks

Q: Should a therapist know if you are suffering from hormones or mental illness?

I just found out I am suffering from severe perimenopause symptoms (depression, lots of crying, weight gain, etc).

Prior to getting this diagnosis, and feeling concerned that I could not control my moods, I made an appointment with a therapist. I had just gotten out of a toxic relationship and assumed the stress had put me into depression.

My therapist, without saying exactly these words, allowed me to believe I was having a mental breakdown. My question is....given my age and symptoms, should she have at least QUESTIONED whether hormones were having an influence on my mood??

And now that I know the main cause of my behavior, would it be wrong of me to suggest that maybe I put off therapy (mostly dealing with childhood issues) until some of these symptoms subside? It just seems like a bit much to deal with both challenges at once.

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Answers (1)

Dorian Martin, Health Guide

1/27/10 12:18pm

Hi, Karma,

I'm so sorry to hear you're going through all of this. I guess my first question is whether your physician prescribed anything (drugs, exercise, etc.) to control the perimenopause symptoms? And if so, is what he/she prescribed working?

It also sounds like you have a lot on your plate. Based on my limited participation in therapy, I think it has a lot of good things to offer by having an objective trained listener help a person sort through issues. However, I don't know whether your therapist is taking a holistic view of your issues (which would include the perimenopause symptoms), but that doesn't totally surprise me considering how fragmented our health care system can be.

I'm not a medical doctor, so please know that I'm coming at this from a layperson's perspective. My suggestion is that you may want to talk to your therapist about what your doctor has found concerning perimenopause and then discuss a therapy schedule that would take both your medical issues as well as your mental health into consideration.

Take care and keep us posted!

Dorian

karma

1/27/10 1:43pm

Thanks so much for the reply.

My primary doc suggested I should start taking anti-depressants, but I told her I wanted a month or two to work on it without drugs. She then told me her other patients use a supplement call Sam-e, which I am using along with a black cohosh mixture and my other daily supplements. I have also been trying to get more sleep (which is helping).

I currently exercise twice a day, and plan to increase the duration/exertion of these workouts. It can only help my mood and weight.

karma

1/27/10 1:46pm

It has only been 3 days....too soon to know if exercise and supplements will do the trick.

Dorian Martin, Health Guide

1/27/10 2:33pm

Thanks for the reply. So I'd suggest maybe scheduling your next appointment with the therapist in a month or so. Also, I've noticed that as I've entered perimenopause, I become much more moody the week right before my period. I don't know if it's the same for you, but if so, then maybe avoid that week for your next therapy appointment.

Take care!

Dorian

Sandy Greenquist, Health Pro

2/15/10 6:01pm

Hi Karma,

I see you've been getting good response to your questions but wanted to add a bit. First, I'm glad you put off the anti-depressants and are trying other approaches first. SAM-e is a good choice as is black cohosh. Exercise is an excellent way to improve mood and sleep as well as decrease hot flashes if you're having them. The other thing to keep in mind if these more natural approaches are not quite enough is that mood and sleep issues in perimenopause are related to progesterone decreasing. I find that my patients often do very well on progesterone (Prometrium) either 2 or 3 wks a month. That may be enough to keep you quite balanced for quite a long time.

As to whether a therapist should know if it's mental illness or hormones...unfortunately they do not and many other practitioners and doctors do not either because they are not trained to think in terms of hormones. It seems like an easy connection when you have these symptoms in a woman-of-a-certain-age, but the earlier writer is correct. The system is way too fragmented and not wholistic.

I'm glad you're on the right track,

Sandy Greenquist, nurse-midwife and menopause clinician

karma

2/15/10 9:33pm

Thanks, Sandy! You are absolutely right...the Sam-e has been a LIFESAVER. I pulled out of my depression immediately. I almost feel normal again.

I did buy a black cohosh supplement, but don't seem to need it just yet. I've been doing Same-e, vitamin D and omega 3's every day. I gave up alcohol and I'm working on caffeine. Haven't lost a pound....but at least I'm not crying anymore.

Again...thanks to all of you for your input. I don't have anyone I can speak to about this stuff, so I really do appreciate you being here.

Q: Should a therapist know if you are suffering from hormones or mental illness?

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