Understanding is the Foundation
Understanding the causes and outcomes of menopausal depression correctly, recognizing its clinical manifestations, preparing psychologically in advance, laying a good foundation for preventing the occurrence of this disease, and being able to identify depression symptoms timely, unleashing subjectivity, cooperating actively with treatment timely, so as not to feel nervous, anxious, and at a loss.
Emotional Guidance is Key
For early mild depressive emotions, emotional adjustment can be achieved by diverting attention. Cultivating interests and hobbies appropriately, such as tending flowers and plants, painting, singing, etc., increasing social activities, enhancing exercises, such as square dancing, jogging, practicing Eight Pieces of Brocade, etc., not only can increase the fun of life but also maintain good brain function, regulate physical and mental health, beneficial for emotional guidance.
Patients with moderate to severe depression that cannot be self-regulated need medication under the guidance of a specialist physician.
Currently, western medicine treatment mainly includes supplementing estrogen, antidepressants, or a combination of both. Literature reports that hormone replacement therapy (MHT) to a certain extent can improve the depressive state of menopausal women, but long-term use can increase the risk of endometrial cancer, breast cancer, ovarian cancer. Commonly used antidepressants include sertraline, escitalopram, venlafaxine, mirtazapine, etc. When using antidepressants, start with small doses and gradually increase the dosage. In addition, the onset of drug action requires a certain amount of time, and some patients in the outpatient department reject taking antidepressants due to concerns about side effects and stop taking medication on their own when feeling uncomfortable. We need to know that most drugs have a slow onset of action, require a sufficient duration of treatment, generally show effects in 2-4 weeks, therefore, enough patience is necessary. Follow the medication regimen under the guidance of a doctor, avoid stopping medication arbitrarily.
Traditional Chinese Medicine Understanding
Traditional Chinese medicine has certain advantages in treating menopausal depression. Traditional Chinese medicine classifies this disease based on symptoms as “Yu syndrome” and “pre- and post-menopausal symptoms.” The “Yellow Emperor’s Inner Canon” says: “Girls reach the age of 14 and they get their menstrual periods, which come on time… at the age of 49, the Conception Vessel is weak, the Great Rushing Vessel is declining and weak, the menstrual period ends, and the Earth Channel is obstructed…” Menopausal women are at the age of “49”, with kidney essence deficiency and the depletion of menstrual blood being the basic characteristics of their physical functions. The relationship between the liver and kidneys reveals that if the kidney water cannot nourish the liver wood, on the basis of kidney deficiency, it can develop into liver blood insufficiency, namely liver-kidney yin deficiency. “The Liver uses Yin to aid Yang,” liver blood insufficiency can lead to a loss of liver dispersing function, which can lead to liver depression over time. Therefore, the fundamental cause of this disease lies in kidney deficiency and liver depression, and the imbalance of yin and yang. Differential diagnosis strategies can be used with medicines like Xiao Yao San, Chai Hu Shu Gan San, Liu Wei Di Huang Wan, and Zishi Qinggan Yin to play the role of soothing liver, resolving depression, nourishing Yin, and supplementing the kidneys.
In addition, non-pharmacological traditional Chinese medicine therapies for treating menopausal depression are diverse, such as acupuncture, moxibustion, massage, etc. By using differential diagnosis and treatment, choosing acupuncture points reasonably, and employing appropriate techniques, they can enhance essence, tonify the kidneys, soothe the liver, resolve depression, and nourish the heart and calm the spirit.
Due to the complex etiology, long duration, and high recurrence rate of menopausal depression, combined traditional Chinese and Western medicine intervention is recommended. The use of Western medicine to improve mood in the acute phase of depression, combined with Chinese medicine treatment, helps enhance the therapeutic effect, alleviate the physical discomfort of the patients, and reduce the adverse reactions of Western medicine. For patients in the stable phase of depression, persisting in combined Chinese medicine treatment helps improve remaining symptoms, promotes the reduction of antidepressant drugs, shortens the course of treatment, and effectively stabilizes emotions through comprehensive regulation, preventing recurrence.
In addition to medication, psychological therapy can be combined, mainly including health education and psychological intervention. Health education involves understanding menopause and depression, the importance of drug treatment, adverse reactions, and guidance on diet, lifestyle, and behavior. Psychological intervention includes cognitive-behavioral therapy, family therapy, marriage counseling, interpersonal psychological therapy, etc., providing psychological comfort and support to patients throughout the treatment process, identifying the root causes of depression, providing individualized treatment for patients, enhancing their confidence in overcoming the disease, making patients optimistic and actively cooperate with treatment, adapting to family and social environments, and improving their quality of life.
Understanding and Support are Important
Not only the patients themselves need to pay attention to and understand this disease, but also the understanding and support from family, relatives, and society are crucial. Menopausal women are experiencing both physical and mental double trials, if they do not receive help from family and society, it will undoubtedly make things worse. Family members need to understand the psychological characteristics of women with menopausal depression, patiently listen to the patients’ psychological feelings, do not deny the patients’ discomfort symptoms, provide understanding and support, actively accompany, care for, and comfort them; at the same time, learning from female friends who have experienced menopausal depression can help build confidence in healing, achieving better results.
