DEPRESSION
One of the most common reasons women reach out to us at The Surmeno Connection is because of their emotional turmoil post operatively. Losing your ovaries affects every aspect of your body and in many cases, your identity and life. These sudden shifts and changes can leave an imprint on your emotional wellbeing. In more severe cases, women in Surgical Menopause become suicidal and feel completely alone in the world.
The Science of Post-op Depression
While Natural Menopause and Surgical Menopause both involve similar symptoms and changes in biochemistry; women in Surgical Menopause tend to struggle more with depression than their counterparts in Natural Menopause. Mood changes are directly linked to the drop in estrogens and androgens in the body, and because women in Surgical Menopause lose all their hormones abruptly as opposed to slowly over time, the quick onset of depression and anxiety can hit hard and feel overwhelming.
First and foremost, the body is trying to recalibrate post surgery. Surgery is a major trauma. The sudden loss of the ovaries and hormones is a violent jolt that reaches every part of your body. Withdrawals from hormones can cause aches and pain, fatigue, insomnia, weight gain, food aversions, racing heart, and the infamous Menopause signature, hot flashes. Anxiety and stress also put a great strain on your already overloaded body. Your emotional wellbeing is fragile after such a life disrupting surgery. Feelings of isolation and loneliness can be heightened. Mood disorders and depression frequently follow.
Surgery Is Not Just Physical, It’s Emotional
It is important to keep in mind that there are two aspects to Surgical Menopause: the physical but also the emotional. In addition to the multitude of hormonal changes women experience after their surgery, women can struggle with feelings of both loss and grief for their former self and their former body. This is especially true of young women who have their ovaries removed prior to having children. For women who have not yet reached a menopausal age, the removal of ovaries translates to a loss of fertility. Loss of fertility is a complex issue, because it can stir up feelings of being less feminine as well as being unable to fulfill a dream or life’s purpose of having children. Some women feel their identity as a woman is tied up in the role of motherhood and in their ability to conceive and have children of their own; therefore being physically unable to do so can most certainly lead to depression.
Another aspect of this surgery that triggers depression is that it can potentially alter one’s lifestyle due to the chronic health problems it can cause. Some women simply no longer feel well or have vitality following surgery, and they are unfortunately unable to resume their life as it once was and have difficulty keeping up with the rigors of their job, relationships, and home life. In some cases women are forced to leave their job or cut back on their hours because of their physical health limitations, which can lead to financial and thus family stresses. Women in Surgical Menopause may also have to rely more heavily on their partners or others for help and assistance depending on the extent to which this surgery has disabled them. It is devastating to struggle through life battling chronic health problems, debilitating fatigue, or feeling ill; and many doctors don’t prepare women for the possibility that they may not be one of the fortunate ones who can function or feel good post operatively. Losing your identity and being vulnerable due to feeling unwell and unable to participate in the things you love and enjoy can have a big impact on mood and certainly leads to depression.
Lastly, body image can be something women struggle with after surgery. Women standardly gain 20lbs from Surgical Menopause, though it can be more or less depending on the individual. Women who never had weight issues in their life can find themselves struggling to fit into their clothes or even feel comfortable in their own skin. It is essential not to underestimate the value we place on our appearance, and understanding how we can love and accept ourselves and our bodies through this change is an essential part of overcoming depression associated with Surgical Menopause.
Treatment
Women are already twice as likely than men to experience depression. One in four will suffer in their lifetime. Genetics, hormonal disorders, illnesses, medications, trauma, on top of Surgical Menopause puts you at greater risk for depression. If you have a previous history with anxiety/depression the risks increase even more.
There are many treatment options available to women in Surgical Menopause suffering with depression and mood disorders. The primary treatment options include balancing your hormones with HRT, therapy, psychiatry, and in some cases, SSRI antidepressants. SSRI’s are often stigmatized in our society, but public perception shouldn’t undermine the seriousness of mental health and the need to treat it effectively.
These potentially life-saving medications increase serotonin (neurotransmitter) in the brain. Serotonin maintains mood and balance in your body. Estrogen helps regulate neurotransmitters so when estrogen is lost or too low as the result of Surgical Menopause, depression becomes an inevitability. When depression gets so severe and overwhelming that there is no joy in life, SSRI’s can help lift your mood so you can better handle your emotions.
Getting Help
Untreated depression is the number one cause of suicide. There is no shame in seeking help. You are worthy of a fulfilling life. Depression is more than not feeling well, it’s a person being stripped of hope, peace, wellbeing, and their sense of connection to the outside world. This isn’t a test of personal will or strength, so please do not suffer in silence. Depression is an imbalance and misfiring of information in the brain. These intricate structures and nerves aren’t operating like they should. This often leaves your emotions in extreme states or feeling completely desensitized. Imagine a computer crashing. Getting the help you need to deal with your depression is the best thing you can do to get back "online" and on the road to recovery.
If you are feeling suicidal please reach out to the following places:
-National Institute of Mental Health at 1-866-615-6464.
-National Suicide Prevention Lifeline 1-800-273-8255
-Your nearest ER to see a mental health crisis professional.