Indian Write-Ups

Psychological Symptoms

Mood disturbances:

• Irritability,
• Easy crying,
• Feeling of unhappiness, futility, frustration, loneliness,

Loss of interest in surroundings, listlessness, diminished libido.

Attention seeking.

Hypochondriasis.

Obsessive compulsive behaviour.

Depressive thoughts, rarely suicidal ideation.

Management

Having understood the problem, a clinician can help the women in the following ways:

First fulfil the prerequisites- A careful history, thorough examination and necessary investigations are the first steps to ascertain that there is no physical illness.

Short term pharmacotherapy to give symptomatic relief – which is so necessary to build trust and rapport.

Emphasis on regular exercise and good nutrition towards general fitness. Convince the patient that a fit and trim body harbours a sound mind.

Judicious use of anti-depressants/anxiolytics to hold the patients to tide over the 'mid-life crisis’, and to contemplate other options.

A careful inquiry about patient’s hobbies, interests, skills, capabilities of the past and the present, her educational qualifications, her aspirations and ambitions which may have been thwarted.

Encourage her to revive any such activity, to turn a new leaf, to begin anew. Counsel other members of the family to ensure their cooperation and support.

The options are innumberable. The choice has to be made by the patient. She may take up teaching, singing, painting, sewing, embroidery work, cooking, yoga etc. She may start further education. Facilities for diploma courses are available. She may take up a part-time or full-time job; even self-employment pursuits like a small-scale business.

She should spend at least a few hours outside her house in a productive way, rather than ‘stew in her own juices’ or she may start a cottage industries right in her house. Opportunities to interact with different people, to earn money, to win accolades for excellent work, to gain recognition, will go a long way to build up her self-esteem by providing the necessary ‘positive strokes’.

As the patients takes tentative steps towards this goal, her symptoms slowly disappear and requirement for medications and even counselling becomes less and less. When the patient creates her own niche, she does not need ‘secondary gain’- sympathy or attention. This results in total resolution of the ‘menopausal syndrome’. This well-adjusted, balanced person, can even face true menopause valiantly, because for her ‘life begins at forty’.