With menopause, there’s no rite of passage, and often, women aren’t sure what to expect. If you’re troubled with frequent mood swings and bouts of anxiety, you may suspect it’s more than just menopause.
And, you could be right — even if doctors have been unable to pinpoint the problem. Like menstrual cycles, menopause is not the same for every woman, but ongoing panic, anxiety and depression are not the norm.
Psychiatrist Lilian Gonsalves, MD, answers key questions about how anxiety and panic attacks relate to menopause. She also offers some advice on how to treat these challenges.
A: Yes, the fluctuation in estrogen and another key hormone, progesterone, can cause anxiety or depression.
Frequent, troubling high anxiety or panic attacks, however, are not a normal part of menopause. Some women develop a panic disorder during menopause.
A: You’ll notice sudden, intense feelings of doom or anxiety. Physical symptoms sometimes include:
A: Not necessarily. Those with panic disorder have frequent panic attacks. And, in between, they worry about when the next one will strike. They also try to adjust their behavior in the hope of heading off another one.
But a single or a few isolated panic attacks don’t automatically mean you have a panic disorder.
No. “It’s treatable and it’s not forever,” Dr. Gonsalves says.
“Relief may come after menopause ends and hormones level out,” she says. But she urges women to talk to their doctor as soon as possible to start the right treatments to manage both menopause and panic disorder.
A: Along with hormone therapy and other treatments for menopause symptoms, your doctor may prescribe medication for anxiety. Counseling also helps treat the psychological symptoms.
Along with medical treatment, a healthy lifestyle can help ease the menopause transition and cut down on panic attacks. “Women should make sure they eat well, cut out the caffeine, quit smoking and cut down or avoid alcohol,” Dr. Gonsalves says.
A: Some symptoms, such as anxiety, sweating and palpitations, mirror those that many women have during perimenopause and menopause.
Even when a woman is quite sure something else is going on, she may see several specialists but not get the right diagnosis.
For example, heart palpitations could lead a woman to a cardiologist, but exam results often show a normal reading. A neurologist may find no cause for dizziness or headaches.
But, just because a panic disorder is not easily diagnosed, doesn’t mean that it doesn’t exist or that you can’t treat it.
A: Women who were prone to anxiety in the past or who had postpartum depression are sometimes more likely to have a panic disorder during menopause. But any woman can develop one, says Dr. Gonsalves.
Menopause is a natural stage in most women’s lives, but ongoing panic attacks aren’t a normal part of the process. Your doctor can combine treatments to help you feel more like yourself again.