美国国家公共电台 NPR In The Lead Up To Menopause, Depression And Anxiety Can Spike

 

RACHEL MARTIN, HOST:

There's a day in every woman's life when she hasn't had her period for 12 consecutive¹ months. That day is when she starts menopause. But there are years leading up to that point. For some women, it can take as long as a decade. Those years are called perimenopause. And during that time, hormones² fluctuate, periods get irregular, women can experience hot flashes, changes to their bodies, emotional ups and downs. But for many women, some of the symptoms don't stop there. Perimenopause can bring on severe anxiety or clinical depression.

NPR's Rhitu Chatterjee has more.

RHITU CHATTERJEE, BYLINE³: About a decade ago, when Teri Hines was in her mid-40s, her period started to change.

TERI HINES: It increased in frequency, it increased in intensity⁴, and it increased in duration.

CHATTERJEE: She had hot flashes, gained weight, and her energy levels took a nosedive.

HINES: I just did not have the energy to do the things that I wanted to do.

CHATTERJEE: Like the morning walk she loved to take with her dogs. At the time, Hines lived alone in Philadelphia, where she worked as an assistant principal at a school. She struggled to get out of bed and go to work and began to withdraw from her friends.

HINES: I would prefer they come to me. I would prefer to stay home rather than meeting up with everybody for an evening out.

CHATTERJEE: Looking back, she remembers feeling foggy and isolated⁵. But she didn't realize that she might be depressed⁶. Even though she'd struggled with depression before and had sought treatment for it, she knew her symptoms, her triggers - usually it was a big change in her personal or professional life. This time, though, she says, she was just focused on her body changing.

HINES: The physical nature of menopause consumes you and is what we're taught is what you have to pay attention to.

JENNIFER PAYNE: Perimenopause is a whole host of physical changes but can also lead to emotional changes.

CHATTERJEE: That's psychiatrist⁷ Jennifer Payne. She directs the Women's Mood Disorders⁹ Center at Johns Hopkins University. She says most women experience mood swings. They might feel blue, irritable¹⁰ or anxious, but women who have a history of mental illness like Hines, they're likely to experience more serious symptoms.

PAYNE: Women who have a previous diagnosis¹¹ of major depression or an anxiety disorder⁸ are going to be at a greater risk during the perimenopausal time.

CHATTERJEE: There's also a higher risk for women going through major life upheavals¹² - changes in career, a divorce or children going off to college. Payne says women who are really struggling need treatment.

PAYNE: If you're having serious depression and your functioning is affected¹³, or you're having suicidal thoughts, or you just feel completely hopeless, that is a major depressive episode that absolutely needs treatment.

CHATTERJEE: That treatment, she says, can be in the form of talk therapy and/or medication.

PAYNE: Antidepressants can, you know, help a woman get out of a major depressive episode. Antidepressants also can be very helpful for anxiety symptoms.

CHATTERJEE: But getting a diagnosis and treatment, she says, can be an uphill battle.

PAYNE: It's a very common situation for many women, and doctors are not keeping up with that.

CHATTERJEE: That's because most physicians, even OB-GYNs, get little education about perimenopause. Hines learned this the hard way. When she first noticed her changing period, the weight gain, her falling energy levels, she mentioned it all to her doctor.

HINES: I think she might have said, yeah, you're about the age when you will begin to have these symptoms; you will begin to be perimenopausal.

CHATTERJEE: But, she says, her doctor offered no treatment or even further information, not even the fact that perimenopause can last up to 10 years. Hines did eventually realize that she might be depressed, but it took her several years of struggling with her symptoms.

HINES: That's when I made an appointment with my doctor and said, like, here's what I'm thinking. Here's what I'm feeling. And I think I might be depressed.

CHATTERJEE: This time, her physician prescribed her an antidepressant.

HINES: The minute I went on it, it felt like I had the energy to tackle those other things that were ongoing¹⁴.

CHATTERJEE: Hines also started seeing a therapist, who gave her coping skills to better manage her symptoms. Hadine Joffe is the vice¹⁵ chair of psychiatry¹⁶ research at Brigham and Women's Hospital in Boston. She says women need to be direct with their providers about their mental health problems, like Hines was.

HADINE JOFFE: Just the same they would - if they had a rash, they would go in for an extra appointment. And that's the first thing they say, is I have a rash.

CHATTERJEE: Another tip she gives women - start tracking your symptoms as soon as you notice them.

JOFFE: Knowing that information, somebody can say, well, over the last six months, I only had two periods, or I had hot flashes almost every day, or my mood was bad as it gets, you know, a third of the time.

CHATTERJEE: Joffe says most of the time, women don't do this and just try to tough it out because they're used to dealing¹⁷ with physical discomforts¹⁸ and emotional struggles. But, she says, seeking help is important.

JOFFE: I want people to have permission. I want people to feel that they owe it to themselves and the people around them that they aren't suffering.

CHATTERJEE: Because with the right tools and treatment, they don't have to suffer during this time of transition. Rhitu Chatterjee, NPR News.

1 consecutive   

adj.连续的，联贯的，始终一贯的

参考例句：

• It has rained for four consecutive days.已连续下了四天雨。
• The policy of our Party is consecutive.我党的政策始终如一。

2 hormones   

n. 荷尔蒙，激素 名词hormone的复数形式

参考例句：

• This hormone interacts closely with other hormones in the body. 这种荷尔蒙与体內其他荷尔蒙紧密地相互作用。
• The adrenals produce a large per cent of a man's sex hormones. 肾上腺分泌人体的大部分性激素。

3 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

4 intensity   

n.强烈，剧烈；强度；烈度

参考例句：

• I didn't realize the intensity of people's feelings on this issue.我没有意识到这一问题能引起群情激奋。
• The strike is growing in intensity.罢工日益加剧。

5 isolated   

adj.与世隔绝的

参考例句：

• His bad behaviour was just an isolated incident. 他的不良行为只是个别事件。
• Patients with the disease should be isolated. 这种病的患者应予以隔离。

6 depressed   

adj.沮丧的，抑郁的，不景气的，萧条的

参考例句：

• When he was depressed,he felt utterly divorced from reality.他心情沮丧时就感到完全脱离了现实。
• His mother was depressed by the sad news.这个坏消息使他的母亲意志消沉。

7 psychiatrist   

n.精神病专家；精神病医师

参考例句：

• He went to a psychiatrist about his compulsive gambling.他去看精神科医生治疗不能自拔的赌瘾。
• The psychiatrist corrected him gently.精神病医师彬彬有礼地纠正他。

8 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

9 disorders   

n.混乱( disorder的名词复数 )；凌乱；骚乱；（身心、机能）失调

参考例句：

• Reports of anorexia and other eating disorders are on the increase. 据报告，厌食症和其他饮食方面的功能紊乱发生率正在不断增长。 来自《简明英汉词典》
• The announcement led to violent civil disorders. 这项宣布引起剧烈的骚乱。 来自《简明英汉词典》

10 irritable   

adj.急躁的；过敏的；易怒的

参考例句：

• He gets irritable when he's got toothache.他牙一疼就很容易发脾气。
• Our teacher is an irritable old lady.She gets angry easily.我们的老师是位脾气急躁的老太太。她很容易生气。

11 diagnosis   

n.诊断，诊断结果，调查分析，判断

参考例句：

• His symptoms gave no obvious pointer to a possible diagnosis.他的症状无法作出明确的诊断。
• The engineer made a complete diagnosis of the bridge's collapse.工程师对桥的倒塌做一次彻底的调查分析。

12 upheavals   

突然的巨变( upheaval的名词复数 )； 大动荡； 大变动； 胀起

参考例句：

• the latest upheavals in the education system 最近教育制度上的种种变更
• These political upheavals might well destroy the whole framework of society. 这些政治动乱很可能会破坏整个社会结构。

13 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

14 ongoing   

adj.进行中的，前进的

参考例句：

• The problem is ongoing.这个问题尚未解决。
• The issues raised in the report relate directly to Age Concern's ongoing work in this area.报告中提出的问题与“关心老人”组织在这方面正在做的工作有直接的关系。

15 vice   

n.坏事；恶习；[pl.]台钳，老虎钳；adj.副的

参考例句：

• He guarded himself against vice.他避免染上坏习惯。
• They are sunk in the depth of vice.他们堕入了罪恶的深渊。

16 psychiatry   

n.精神病学，精神病疗法

参考例句：

• The study appeared in the Amercian science Journal of Psychiatry.这个研究发表在美国精神病学的杂志上。
• A physician is someone who specializes in psychiatry.精神病专家是专门从事精神病治疗的人。

17 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

18 discomforts   

n.不舒适( discomfort的名词复数 )；不愉快，苦恼

参考例句：

• Travellers in space have to endure many discomforts in their rockets. 宇宙旅行家不得不在火箭中忍受许多不舒适的东西 来自《用法词典》
• On that particular morning even these discomforts added to my pleasure. 在那样一个特定的早晨，即使是这种种的不舒适也仿佛给我增添了满足感。 来自辞典例句