Menopause is the period of time before and after menopause in women, including the period beginning with clinical or sex hormone levels showing signs of ovarian function decline and lasting until one year after the last menstruation, i.e., the menopausal transition plus one year after menopause. Menopausal depression refers to a series of disorders in which anxiety, depressed mood, fatigue and even self-injury and suicide are the main clinical manifestations in women during the menopausal stage due to the decline or even disappearance of ovarian function, often accompanied by clinical manifestations such as irregular menstruation, decreased libido and vegetative nervous disorders.
The detection rate of depressive symptoms in menopausal women is 36.2%. According to the sixth census, the proportion of the population aged 60 and above increased by 2.93% and the proportion of the population aged 65 and above increased by 1.91% compared with the fifth data. The above data show that the aging process in China is gradually accelerating, and the social group of menopausal women is gradually becoming larger. The social problems brought about by the rapid economic development in China have also increased the social and family pressure on menopausal women. Women are prone to depressive mood disorders during menopause, and depressive mood disorders can lead to a significant reduction in their social functioning. Therefore, this paper mainly analyzes the psychological characteristics, causes and influencing factors of menopausal depression in women, and puts forward relevant suggestions to improve the health and living standards of women with menopausal depression.
1.Psychological characteristics of menopausal depressed women
1.1 Characteristics of depression and anxiety
Due to their special physiological and social stages, menopausal women are prone to depression and anxiety due to social pressure, poor family relationships and illness. A survey of Cao Yang and Cao An streets in Shanghai showed that the proportion of depressed subjective feelings was higher among female menopausal residents in the community, and those who were introverted, sentimental, timid, sensitive, emotionally unstable, easily agitated, conformist, and all-rounders were more prone to tension, anxiety, or depression than those with other personalities. In addition to personality traits, the disease often presents with neurological and psychiatric symptoms associated with menstrual disorders, i.e., the characteristic triad of low affect, slow thinking and reduced willpower. Somatic symptoms are often manifested as insomnia, especially early awakening insomnia is the most characteristic. The most important mental symptom is depressed emotionality. Patients are often listless and depressed all day long, often sighing or blaming themselves, ashamed to see others, and not interested in things. In mild cases, they have the desire to seek treatment, while in severe cases, they are pessimistic and anxious, refuse treatment, or even have suicidal and homicidal thoughts and behaviors.
1.2 Interpersonal relationship characteristics
Interpersonal relationship refers to the psychological relationship between people in the process of interaction, including kinship, friend, classmate, teacher-student relationship and employment relationship. Good interpersonal relationships are an important factor influencing the onset of depression in menopausal women. Women with menopausal depression often show interpersonal relationship disorders, which are mainly caused by negative emotions such as introversion, sentimental personality, low mood and crying easily, and shyness to meet others. Li Shuxing et al. concluded that good interpersonal relationships play an important role in maintaining the psychological health of menopausal women, and that the necessary help and support given to perimenopausal women by their families or society have a positive effect on reducing the incidence of menopausal symptoms and depressive symptoms.
The modern society is not fully aware of depression, and depressed patients cannot get sufficient understanding and support from the society. Meanwhile, menopausal depressed patients do not recognize themselves correctly as suffering from depression, and mostly believe that they only have menopausal symptoms, and they and their surrounding relatives and colleagues cannot treat depression correctly, which leads to interpersonal problems such as hostility, isolation and reduced self-identity in menopausal depressed patients.
1.3 Self-perception characteristics
The degree of self-perception of menopausal depressed women determines the onset of depression during menopause, the speed of progression and the degree of prognosis. The severity of symptoms of hot flashes and sweating, insomnia, agitation, fatigue, palpitations, depression or suspicion, abnormal sensation, and vertigo were lower in menopausal depressed patients with positive and frank attitudes than in those with negative attitudes, while the above symptoms were more severe in menopausal depressed patients with negative attitudes. Therefore, mood regulation for women with menopausal depression is an effective way to relieve the somatic symptoms of menopausal depression.
Currently, menopausal women are not well aware of menopausal depression and have weak self-care awareness. Gu Lei et al. conducted a survey of 935 menopausal women in a community in Shanghai, and the results showed that 39.8% of menopausal women did not pay attention to mental health care, 48.1% said they would adjust themselves if they felt depressed and did not need professional help, only 20.2% chose to obtain menopausal knowledge through doctors, and the majority of menopausal women chose to obtain mental health knowledge through non-medical means, and through this method The vast majority of menopausal women choose to obtain mental health knowledge through non-medical means, and this method of obtaining menopausal mental health knowledge is often mixed with commercial components, which makes menopausal women follow blindly and endangers their mental and physical health.
2. Causes and influencing factors of depression in menopausal women
2.1 Estrogen levels
Decreased estrogen levels lead to reduced brain function and changes in the concentration of neurotransmitters such as 5-hydroxytryptamine (5-HT) in patients. The “estrogen withdrawal hypothesis” suggests that a decrease in serum estrogen levels is the main cause of menopausal depression or patients with depressive potential. ) levels is similar to the results reported by Wang Shanfeng et al. Therefore, the presence of emotional and somatization symptoms in women during the menopausal phase may be related to estrogen withdrawal.
2.2 Family and social factors
Women during menopause are vulnerable to family and social influences, and they are an integral part of the family and society. Guo Xinping’s study concluded that the level of depression in menopausal depressed women was highly negatively correlated with social support and subjective support, but not with support utilization. This suggests that social support is one of the important factors affecting the psychological well-being of menopausal women. The family, as the back-up of menopausal women, also bears the psychological support of women and has a role in the psychology of menopausal women. Family social factors such as intra-family and social support, personal occupation, personal situation of partner and children, marital status and marital relationship, housing situation and neighborhood relationship all influence the onset and progression of menopausal depression in women. Due to the differences in the sample size and the level of education and family income, the results of the reported surveys are not consistent. Clinical understanding of family and social factors should be emphasized, and guiding patients to adjust their family and social environment is an integral part of the treatment plan.
2.3 Disease factors
Menopausal syndromes and the presence or absence of the disease can cause psychological changes in menopausal women. Menopausal syndrome is a group of syndromes caused by fluctuations or decreases in sex hormones around menopause in women, mainly due to dysfunction of the autonomic nervous system, accompanied by neuropsychological symptoms. Menopausal syndrome is a risk factor for the development of menopausal depression. According to the results of a stratified survey of menopausal women by Su-Lan Chen, menopausal syndrome is the most influential factor for menopausal depression compared with other social and family influences. Also the presence or absence of illness was associated with the occurrence of menopausal depression in women. Strengthening disease prevention and control and regulation of somatic symptoms are necessary to improve the psychological and somatic health of menopausal women.
4. Measures to improve the health level of women with menopausal depression
4.1 Self-improvement
The prognosis of menopausal depression is determined by the correctness of women’s own perception of the disease. Firstly, women with menopausal depression need to recognize the existence of their disease, treat depression correctly at the early stage of the disease, and take the initiative to regulate and treat all aspects of the disease. Secondly, patients with the disease need to integrate various methods of treatment for menopausal depression, not rejecting medication, psychological counseling and sports, actively participating in social and family activities, improving their confidence level, expanding their social circle and improving their interpersonal relationships.
4.2 Family support
Family factors are important influencing factors in the onset and prognosis of menopausal depression in women. Good family relationships are an important factor in reducing the incidence of menopausal depression in women and improving the quality of life and disease prognosis during menopause. It is crucial for family members to have a deeper awareness of menopausal depression, and family members need to treat menopausal depression correctly. Unlike general physical illnesses, this disease afflicts menopausal depressed patients at both the mental and physical levels. Family members should treat women with menopausal depression in an emotionally warm and understanding way, encourage them to communicate with others, encourage them to share and face various problems in their lives with their family members, and should not reject their personality traits such as introversion, sentimental personality, low mood and tendency to cry, and shyness to meet others, and should listen patiently and answer warmly to their frustrations in life.
4.3 Treatment options
Due to the differences in the study population and the degree of depression in menopausal depression, the findings of estrogen replacement therapy for women with menopausal depression are not consistent, but most studies have concluded that estrogen replacement therapy is effective. Zhu Soyu et al. applied fluoxetine + hormone replacement therapy to treat female menopausal depression, and the results showed that fluoxetine hydrochloride + hormone replacement therapy was more effective for female menopausal depression, and this treatment plan can be recommended for patients with moderate or severe menopausal depression. At the same time, Chinese medicine has also been studied in depth for menopausal depression in women, and its efficacy is confirmed. Patients with menopausal depression and their families should choose a reasonable treatment plan that takes into account their own characteristics and actively cooperate with the doctor in the treatment of the patient. Patients who are resistant to medical treatment should be reasonably induced to reduce the degree of depression and anxiety through physical exercise and psychological guidance, so that patients can recover as soon as possible.
4.4 Physical exercise
Exercise can pleasure the mind and body and improve symptoms such as somatization disorder and depressive psychological disorder. Zhao A-Meng et al. selected 64 menopausal women for 16 weeks of standardized exercise prescription training, and the results showed that the members effectively improved and enhanced the psychosomatic state of menopausal women after training, especially in anxiety level and sleep quality (P<0.05). According to the study by Yongmei Zhu, a comparison of self-rated factors between menopausal women who practiced taijiquan and those who did not found significant differences in somatization, paranoia, and anxiety factors (P<0.05), and highly significant differences in depression factors (P<0.01). Therefore, participation in sports in menopausal depressed women can help them recover from their psychological depression, and participation in sports can treat both mind and body, improving their basic diseases and enhancing their physical fitness while regulating their psychological state.