Psychological therapies for early menopause

The fact that I wouldn’t be able to have children was up there with wanting to survive [cancer] and I thought, ‘If I don’t – If I can’t have kids, I don’t want to survive. I would actually rather have died from cancer than be alive now dealing with the fact that I’m a woman who feels I was born to have a child and can never have one.’ Now I have a counsel- a psychologist at the hospital and we’ve discussed that. I understand it might sound a bit harsh to people but for me that was my meaning for life and my purpose and goal that I was working towards to. So now we’re now we’re trying to make some different goals. For example, I’m looking at fostering and perhaps surrogacy down the line. (…) So, I had a relationship with a psychologist before this but I actually decided to choose to go and meet the one at the oncology department because she meets women like me. And she’s great because she’s able to tell me that I’m not the only one feeling these things and I leave feeling far less isolated and far less hard done by, you know, less sorry for myself. Not better, I don’t feel happier or better but just… I’m not the only one and she’s able to help me know that my feelings are common amongst other women.

I’m really lucky because I’ve had an amazing therapist who’s helped me from the word go to get through the losing of our pregnancy, the diagnosis of premature menopause, and all of the bits and bobs over the last five years. So, when I’m feeling like I need a bit of extra support, I go and see my therapist and I just have to recommend that to anyone. I like to think about it like if your electricity’s gone, you call an electrician, when your plumbing’s broken, you call the plumber, and when you need some mental health issues, you should go and see a psychologist. And they have really helped me talk in a really open and honest space about where I’m at in a way that maybe I wouldn’t be able to talk to friends and family for the fact of worrying about upsetting them or scaring them in some way about how I was feeling. So my biggest thing is still about working through my body image issues that have come up through perimenopause.

There was some counselling offered and you do speak to people about that. And, you know, counsellors, they offer great insight and good advice and from a rational perspective – it all makes sense. You know, “You’re not just a mum and there’s all these different roles you play,” and lah, lah, lah, lah, in a family. But when you have that idea that you won’t be able to be a mum – and you never really sort of – and I never did. I always thought I’ll have plenty of time.

So when you think like that it becomes difficult to then say, you know, “Okay, well, I’m not going to, that’s not going to be a role that I’ll ever play naturally. So everything else that I am doing or have done or will do is my contribution to, you know, family.” And culturally family’s a big part of who we are and it’s a massive part of your identity as a female. And so when you’re – when that is removed, that idea of naturally being able to have children, it becomes difficult to reconcile. So rationally and logically, from a counselling perspective, all of that made sense. But reconciling it in my heart and the emotions that are associated with those roles, it’s not as easy; it hasn’t been as easy.

The only thing that really was an issue when it started happening were the hot flushes that happen during my sleep, which kind of either woke me up or at one point I wasn’t sure what was happening, but I was waking up almost quite regularly every hour or two hours. (…) – it just kept continuing for a few months. I can’t even remember when it was, but it was distressing because I kept saying, ‘What’s going on? I’m not getting a full night’s sleep, I’m not going to be able to function tomorrow,’ and, you know, it was just strange. And I just thought it is because I was linking so many things. I said, “okay, this like obviously it’s not going to help me with my memory.” It’s already, you know, I’m already so stretched at trying to function as normally as I can at work and I just feel that this was kind of depleting what was in my tank. [laughing].

But there was, I guess, there is no clear pattern in terms of what happens and that was really distressing. So it distressed me in that I was waking at all times of the night and I just couldn’t sleep back and then my memory, you know, some days seemed better, my multi-tasking kind of took a while to come back. And so, I was kind of in this loop where I just couldn’t tell what was the cause, what was the effect, what were the things that I could intervene or, you know, what changes could I make because it was just a very, you know – it was just a mess and I just couldn’t pull it apart and figure out which were the ways to attack it and things like that.

Yeah, so that was probably the biggest. And so because of that then I started spiraling to sort of feel really lousy and then I couldn’t figure out whether I was being lousy – I was feeling lousy because I couldn’t sleep? I couldn’t sleep well and, you know, I wasn’t functioning as well as I could or was it because physiologically my ovaries were just acting up? And then, every now and then I’ll go back, when I see my medical oncologist and then she said, “Well, it is really what we’re doing to you through the ovarian suppression.” I said, “Are you sure? You know, if you tell me that, that’s fine. You know I just don’t want to have an underlying mental health issue that I’m not addressing and, you know, and things like that.” She said, “No, it’s really that.”

And – but in the last six months, I think, we really started having more discussions about my mental health and whether I wanted to take another medication which is EFEXOR [venlafaxine] … just help stabilise things. And I was pushing it back because … I said, “Oh, another thing to take and another stigma,” and she looked at me and she said, “No mental health is not” – I said “I feel it.”

And I finally, I think in February this year, I really hit rock bottom and that’s when I said this is, you know, I just couldn’t get out of it every day waking up, it was just heaviness on me. The colours are grey and more grey, like even through the darkest days of cancer treatment, I know I could still find things to be cheerful about; I could still smile, I could still laugh. You know, I mean there were days when like I don’t look forward to it, but you know through the day you know there was – there will be something that could just kind of turn my focus and attention.

But yeah and the last like month, about two months I think from Feb to April this year, where it was just – it was just hard, it was just heavy and then and I said – then they say, you know, it’s really not worth struggling so much and then when I look at the signs of depression I was starting to tick all that and I said [laughing]. And so I said, “okay, you know, and ever since they gave me that is really literally changed my life around.” I say when I wake up I don’t have this heaviness. It’s not the first thing that I feel when I wake up and, yeah, I can function. I mean even though, you know, I still face a lot of stressful situations, but you know I can still smile, I can still laugh, you know, there’s a bit of black humour, there’s you know, I can be cynical, be anything except flat and grey.

At the time of the surgeries and following that, or at the time you went to the GP to get the diagnosis, was there any talk of counselling or psychological support that you should seek…

No. No. Not at all, which is kind of counter-intuitive, because I’m going through this huge change and suddenly they’re going, “It’s all medical.” It’s not looking at me as a complete human being. It’s just looking at, “We’ll fix this problem; you’ve got problems with your uterus, your ovaries, we’ll deal with that.” It wasn’t, well, you know, “You’re going to go through a huge change. You might want to go and talk to someone about it.” So, yeah, there was none of that. And I think it was a huge falling down in their part of not actually referring me to someone to go and talk about it. Instead I had my partner and that was great, but he really didn’t need to know some of the things I was going [laughing] so, yeah…

So you didn’t go and find someone?

No. That’s it, no. No. Instead I wrote a lot in my diary [laughing] and, yeah, just worked through it. That’s it. I sort of went on the opinion of ‘better in than out.’ And as long as it was down it doesn’t matter so… [laughing] I can laugh about it now but oh my goodness.

I had a particularly good surgeon as well who just had the best sort of caring bedside manner. She’s the one that did my big surgery and she was actually pregnant which was just bad timing because it was quite traumatic for me to be around pregnant women when I was going through that. But, you know, when I saw that she was pregnant and it was showing, I said to her, “Congratulations” and she just looked at me and just shook her head, you know. She was very aware of the loss involved, yeah. She was a very beautiful person. Someone told me that when you’re this sick, you have angels that come into your life, just in the sense of people that you might not expect. They’re an unexpected surprise and you do, you do have people that come and give you strength and support.

I haven’t done any counselling or something. But probably, like, my mum and my sister are the main people who I talk to. And it’s actually kind of good. My sister has done like a counselling course so she’s quite good with all that kind of stuff. [laughing] And, yeah, I’ve had some really good chats with her. She’s the one I go to if I really need to talk to somebody.

But I think fortunately apart, I mean, obviously I, like you said, have quite a supportive family and that’s helped a lot. But I think my sort of just natural mindset has helped quite a lot as well. Just that, I don’t know, I’m a stubborn little [laughing] thing that was just, like, “No, I don’t want to be down in the dumps. I want to do something and live normally.” [laughing]

Besides my lack of period I just felt unsteady in myself emotionally, and I couldn’t work out why. And sleep, so that’s been a predominant problem since I was 40, since I was diagnosed. Just your sleep, you don’t realise how much you should appreciate it when you’re younger, yeah, so sleeping became hard. And just, I just didn’t feel myself.

So I think that’s one of the tricky things about this. Besides sleep, I don’t think I was an anxious person before, but it’s something I have to kind of manage a lot. And I do really see that that’s a brain chemistry thing in many ways that I do feel more anxious since I’ve gone through this. But it’s really hard to get a good sleep, and I hear that with you know lots of women.

Did you seek any kind of therapy or anything around the emotional side of it?

No, I treat myself. I do see so much that it’s – it feels like a brain chemistry thing, but yeah, I’ve got ways I try and cope with it. And doing some meditation, or using my support network and my family and things does really help. And I’ve used, like, I’ve tried to use Melatonin – I use occasionally to help my sleep, which then helps me cope with everything better when you can sleep better. I guess I could probably go and get a better assessment of, you know, what can I use occasionally, but that works for me and I don’t use it very often.

Sometimes I think I have less energy than I had and I’m also a grandmother and that takes a lot of energy [laughing], I do lots of care. But yeah, I don’t have the same amount of energy that I had before, and managing kind of worries about things is something I have to do every day.

I probably had the counselling in the lead up to the IVF because that’s standard thing. I don’t think I ever felt that I did need it. I think again, I think I was fortunate the way things, in which things – my journey was all a bit backward I was getting all the things and then that all pointed towards the menopause which was finally confirmed as opposed to out of the blue, guess what. And then dealing with everything that flowed, so it was almost like a slow unfolding for me as opposed to a, you know, line in the sand and here it is your life’s changed forever.

Certainly knowing we couldn’t have a second child was again because of the difficulty in having our first one, I suppose again that wasn’t completely surprising either. Disappointing and sad, but not completely shocking either. And look, I have had friends say, you’d know they’d be mortified if they couldn’t have a second child. They would be devastated. I’m like, “Really?” I didn’t understand that because for me it was upsetting but it wasn’t life. It wasn’t like life being over sort of thing. And again that might just be me, everyone’s different but I know that I possibly felt better equipped to deal with that reality than maybe, maybe friends would have or people in the same situation.

I don’t think I ever thought about even seeing a counsellor come to think of it. I think I just was focussed on myself, my path, my daughter, the support that I did have and yeah, and just doing the best I could and I think part of that was, yeah know I didn’t have to be, you know, perfect. That whole discussion that always comes up with women and feeling like they need to be and I think I just felt, well you know, maybe this is good enough. And going back to that yeah, I think you’ve done pretty well considering the circumstances and stopping to acknowledge that and then you’re just not so hard on yourself and you just think, well you know that’s pretty good that you got dinner on the table or whatever it might be, so, well done you! [laughing]