Sri Sri College of Ayurvedic Science & Research Hospital, Sri Sri University, Cuttack

The incidence of anxiety and depression in postmenopausal women is more common in nuclear family rather than combined family: A hypothesis

The incidence of anxiety and depression in postmenopausal women is more common in nuclear family rather than combined family: A hypothesis

Menopause is defined as the permanent cessation of menstruation at the end of reproductive life due to loss of ovarian follicular activity, which occurs naturally or induced by surgery, chemotherapy or radiation therapy. Menopause is not only the cessation of monthly menstrual cycle but it is transitional phase of life and body from reproductive stage to the non- reproductive stage in which Serum FSH level are elevated  and Serum estradiol level are highly decreased, which reflects as menopausal symptoms and collectively called as menopausal syndrome.

The age of menopause ranges between 45-55 years. Post menopause is the phase of life that comes after the menopause. Due to increased life expectancy especially in affluent society, about one-third of life span will be spent during the period of estrogen deficiency stage with long term various symptomatic and metabolic complications. There is wide variation in menopausal symptoms which includes symptoms with acute sub acute onset, vasomotor, urogenital, psychological, skin and hair, locomotor, gastrointestinal and others. Psychological symptoms include anxiety, headache, insomnia, irritability, dysphagia and depression. Women may also suffer from dementia, mood swings and inability to concentrate.

At the time of menopause, a woman must adjust her life from the reason that has been physiologically stimulated by estrogen and progesterone production to one devoid of these hormones. The loss of estrogens causes marked physiological changes in the function of the body, which includes

(a) “Hot flushes” characterized by extreme flushing of the skin

(b) Psychic sensations of dyspnea

( c) Irritability

(d) Fatigue

(e) Anxiety

(f) Occasionally different psychotic states

(g) Decreased strength and calcification of bones throughout the body

These symptoms are of sufficient magnitude in about 15 per cent of women to warrant treatment. If there is no counseling, daily administration of estrogen in small quantities usually reverses the symptoms, and by gradually decreasing the dose, postmenopausal women can likely avoid severe symptoms.

Depression is an important contributor to the global burden of diseases and people of all communities are affected across the world. Today depression is likely to affect more than 350 million people. Depression is a common mental disorder that presents with depressed mood, loss of interest, decreased energy, and feeling of guilt, disturbed sleep, and poor concentration. Women are 70% more likely than men to express depression. Anxiety and depression are projected to form the second most common cause of disability by 2020. WHO report stated that depression and anxiety intimidate to be the world’s most common illness by the end of the century especially in women. An estimated 73 million adult women worldwide undergo a major depressive episode each year. Indian studies showed that middle aged women reported more psychological distress, more medical problems and lower morale than man. Anxiety and depression disorders are among the most common psychiatric disorder in the community however most patients with this disorder go unrecognized.

Women who are going through or who have just gone through menopause particularly suspected to depression. Estrogen influences the action of certain neurotransmitter such as serotonin which is responsible for regulating mood. Therefore low estrogen level after menopause leads to depression. Once depression is diagnosed it can be treated via several different approaches.

Families are the most important part of an individual. From an early age a child is taught to the importance of family. Living in a joint family or having more social interaction can help to reduce anxiety level, improve memory, and overcome the effect of chronic stress. Post menopausal women may find solace in menopause support groups where women going through the same thing can share experiences and tips. Talk therapy is a good medication for depression. Even talking with friends and family who won’t judge can have a therapeutic effect. Now a days we have a trend of nuclear families and this could be the one of the reason for the increased anxiety and depression level as there is no one for counseling of post menopausal depression.

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