Life Transitions: Treating Anxiety and Depression

By: Joseph Baskin, MD • Posted on May 24, 2019

How Change Can Create Stress and Anxiety

We humans are geared towards maintaining equilibrium. When our stability is threatened, stress levels rise and stress coping strategies are tested. Sadness and anxiety can flare at such times of change. Prolonged stressors and anxiety, especially when mixed with hormone deficiencies and other medical problems can lead to depression.

Symptoms of being out of balance, out of your natural equilibrium can include:

Feeling blue
Losing interest in activities
Feeling on edge
Excessive worrying
Difficulty concentrating

Perimenopause: Anxiety and Depression

When the duration of these symptoms extends into weeks, it can become a diagnosable medical condition. Even those persons without any prior history of mental health issues can experience an emergence of such symptoms around peri-menopause. Dramatic, hormonal upheaval may lead to previously unexperienced sadness and anxiety. If you have had prior postpartum depression or severe PMS/Premenstrual Dysphoric Disorder, you may be more at risk for depression at midlife. Conversely, some women at midlife, freed from child-rearing responsibilities, feel energized and take the time to focus on themselves - pursing new activities, hobbies, work and/or volunteering.

Menopause: Anxiety and Depression

Psychologically, menopause can herald other changes. Some women put careers on hold in order to raise children and/or their main career has been entirely focused on their children. Now, with the children grown and the house empty, possibilities that seemed tantalizing at the time, can now feel overwhelming for some. Finding meaning anew can become challenging. Another danger that accompanies the consummate caregiver - that special woman who provides all of herself to those she loves - is that she may grieve when her children are all grown and there is a risk of feeling bereft of support when she is looking to get her own needs met.

Therapy and Activities to Help With Depression and Anxiety

If symptoms of depression or anxiety persist you can seek out your primary care doctor, Ob/Gyn or a psychiatrist to discuss medication options, and if you are midlife, then menopausal hormone therapy. If your goal is to avoid medications, then psychotherapy: both group and individual therapy can be equally as helpful for symptoms of depression and anxiety. If you are developing panic attacks, you need to seek evaluation and treatment. If you feel like life isn’t worth living, you need to contact suicide prevention resources as soon as possible.

If your symptoms are mild and you are the “self-help only type”, activities that improve stress tolerance include:

exercise
meditation
yoga
healthy eating

These activities can all be very beneficial and help improve your well-being.

In addition, altruism, the act of doing for others without concern for personal gain, is a healthy outlet to build self-esteem, feel productive, and develop pride in oneself.

My Take Home Messages

To kick start any program of psychological change and life transition stage:

Learn how to truly be in touch with what you want. Many of us have a tendency to bury those thoughts out of fear or out of not getting our needs met.
Vocalize what your needs are to those closest to you.
Pursue those goals even when you hear "no". Those who are persistent are more likely to get some of their needs and life goals met!

No one gets everything they want, and getting through life transitions can take time and work. But if you're advocating for yourself, you're in the game and have a far better chance of achieving your objectives and reaching a healthy equilibrium. Positive action beats passive resignation, especially when it comes to avoiding learned helplessness.

This positive action will help improve your sense of well-being and detour you from the road to depression that can occur at midlife or at major life transitions.

Be Strong. Be Healthy. Be in Charge!

- Joseph H Baskin, MD
Cleveland Clinic Lutheran Hospital

Dr. Baskin is a psychiatrist for the Cleveland Clinic. He blogs for Psychology Today, at suicidefrontlines.com and is the author of two novels available through amazon.com.

women's health, anxiety, sadness, depression, menopause, perimenopause, dr. Joseph baskin, psychiatry, life transitions

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