Today’s blog post is about “female stuff”.  I thought about warning men they may want to skip this one, but after doing my research I think this topic is important for them too…maybe even more so.  Women have to go through a lot of hard stuff.  Fortunately though, I have always been blessed with amazing friends who I have been able to wade through the gory details of womanhood with. 

I remember the day I got my period.  I was in 8th grade and feeling completely left out because I was one of the last of my friends to get it.  My best friend and I had been sent out in the hall by our PE teacher for being a little too social and right there in the hall it happened.  I knew exactly what to do because my friends and I had talked incessantly about every detail regarding this momentous day in our life.  I was ready.

Then came trying to get pregnant, being pregnant, and labor and delivery.  Again, it’s all we talked about.  I could always find someone experiencing what I was going through or a story of what to prepare for and this camaraderie got me through.  I was ready.

Next came female problems of another sort.  Ablations, hysterectomies, D&Cs, birth control…anything to get that mess down there fixed up and healthy.  Obviously not everyone could relate, but the ones that could shared their experiences and put me at ease.  I knew what to expect.  Again, I was ready.

Now the start of a new phase and for the first time, I’m not ready.  Finally a topic my friends aren’t talking about and I’m not sure why…perimenopause and menopause.  Of course we talk about the hot flashes, the insomnia, and the weight gain.  Some of us even talk about the mood swings.  And if we are lucky enough, we have someone to talk to about the depression, loss of libido, and affect on our marriage and family.  But mostly there is silence.  I’m wondering if it’s because everyone feels as lost as I do.  There was no question I had my period or I was pregnant or that I needed a hysterectomy but now I’m questioning this…am I in perimenopause or am I just crazy?

First, a brief health lesson.  I started researching this topic for my own sanity and came upon my life line.  A blog called The Perimenopause Blog (yes, people are actually blogging about this!)  In her post titled Symptoms of Perimenopause  Symptoms of Menopause (http://www.theperimenopauseblog.com/symptoms-of-perimenopause-symptoms-of-menopause/) Magnolia Miller explains it this way.

Perimenopause is a transitional period a woman goes through where her estrogen and progesterone levels are fluctuating until she becomes fully menopausal.  During perimenopause, her ovaries will produce less and less progesterone and estrogen until she no longer has a menstrual cycle.  A woman is said to be menopausal once she has gone twelve consecutive months without a menstrual cycle. Once a woman reaches actual menopause (the average is four years but it can take up to ten!!), her ovaries are no longer producing enough progesterone and estrogen to support monthly menstrual cycles. While most women find menopause to be a wonderful, peaceful time of life, the low estrogen levels common in menopause can put many women at a higher risk for a number of health issues such as osteoporosis, bone and joint degeneration, and chronic depression.

But there’s a lot more going on.  The author of the blog says she started blogging about this because the anxiety and emotional turmoil she was experiencing made her truly believe she might be going crazy.  She goes on to say, “It’s difficult to explain to others who have not been through it, what perimenopause feels like.  It’s especially difficult to explain to our husbands who can’t begin to understand or even remotely connect to the female experience. Not only is this frustrating but it can add to the feelings of isolation and vulnerability.”

It seems from my research, the medical field agrees there are about 35 symptoms you might experience during perimenopause.  Obviously you will not experience all of these things (thank goodness!) and some of you many never experience any of them.  Personally, I was able to identify at least 15 symptoms on this list I am experiencing or have experienced at some point.  No wonder I feel crazy!

35 Symptoms of Perimenopause

• Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling
• Irregular heart beat
• Irritability
• Mood swings, sudden tears
• Trouble sleeping through the night (with or without night sweats)
• Irregular periods; shorter, lighter periods; heavier periods, flooding; phantom periods, shorter cycles, longer cycles
• Loss of libido
• Dry vagina
• Crashing fatigue
• Anxiety, feeling ill at ease
• Feelings of dread, apprehension, doom
• Difficulty concentrating, disorientation, mental confusion
• Disturbing memory lapses
• Incontinence, especially upon sneezing, laughing; urge incontinence
• Itchy, crawly skin
• Aching, sore joints, muscles and tendons
• Increased tension in muscles
• Breast tenderness
• Headache change: increase or decrease
• Gastrointestinal distress, indigestion, flatulence, gas pain, nausea
• Sudden bouts of bloat
• Depression
• Exacerbation of existing conditions
• Increase in allergies
• Weight gain
• Hair loss or thinning, head, pubic, or whole body; increase in facial hair
• Dizziness, vertigo, light-headedness, episodes of loss of balance
• Changes in body odor
• Electric shock sensation under the skin and in the head
• Tingling in the extremities
• Gum problems, increased bleeding
• Burning tongue, burning roof of mouth, bad taste in mouth, change in breath odor
• Osteoporosis (after several years)
• Changes in fingernails: softer, crack or break easier
• Tinnitus: ringing in ears, bells, ‘whooshing,’ buzzing etc.

But what I am finding so fascinating in my research is the profound psychological and emotional changes that go hand in hand with the physical changes during this time.  As I googled menopause, article after article came up about the effects of menopause on a marriage.  Did you know that over 60 percent of divorces are initiated by women in their 40s, 50s or 60s — the menopause years — according to a recent survey conducted by AARP Magazine.  Other articles put that number as high as 70%.

Why you ask?  Obviously it could be many, many reasons unrelated to menopause, but I was interested in learning more about the correlation between menopause and marriage.  What I found out is summed up best by Lori Phillips, BellaOnline Marriage Editor, in an article called Menopause and Marriage (http://www.bellaonline.com/articles/art1379.asp).  She explains it this way.

Studies show that early in life when women’s estrogen levels are high, they feel a sense of maternal nurturing. To ensure the survival of the family, they become the peace-makers and caretakers. As menopause ensues, estrogen levels drop while testosterone levels rise. A woman suddenly feels less inclined to be the pleaser. The increase of testosterone makes her more prone to thinking about her own needs. A lot of women suddenly think, “I’ve put everyone first in my life. There are things about him and our marriage that I don’t want to put up with anymore.”  It leads many women to re-think their lives and their newfound sense of self compels them to break away from old priorities—child-rearing and husband-caretaking--and embark on new paths that allow them to pursue personal goals.

I am in no way saying that menopause causes divorce.  A struggling marriage was probably struggling way before menopause and a strong marriage will survive it just fine.  But it does shed some light as to why some women find themselves disconnected at this time in their life.  I am not divorced or planning to get divorced but I have certainly felt this disconnect myself.

It also helps to know I’m not alone in everything I’ve been feeling lately…that I’m really not crazy.  In fact, I’m more normal than I ever knew.  I’ve been to several doctors looking for answers to what’s wrong with me and I’m not alone there either.  I read comment after comment of women describing going from doctor to doctor looking for answers.  Some quit their jobs because the symptoms were so severe, while others thought they were dying.  And in the end, they were all found to be “healthy” and “just perimenopausal”.  All said the emotional changes are far worse than the physical changes as there seems to be more help and acknowledgement of the physical stuff, but they felt very alone in this new emotional turmoil they feel trapped in. 

I can promise you it’s not “just perimenopausal” when you are going through it but there is help!  Treatment varies from lifestyle changes to hormone replacement therapy.  Go see your doctor!  Take this post if you need to!  Highlight your symptoms!  Advocate for yourself!  Don’t settle for …”you are fine.”  And let’s start talking about this!  Nothing is as scary when you realize you’re not alone.

Imagine this...

Your husband has a disease.  It not only affects his life, but the lives of everyone in your family.  Your friends and family provide you with an abundance of support.  They fix dinner for you, they offer to take him to doctor appointments to give you a break, they have a fundraiser to help pay for medical expenses your insurance won’t cover, and they call to ask how he is…how you are.  You feel loved.  You don’t feel so alone.

Or imagine this...

Your daughter has been victim to a terrible trauma.  The side effects from this trauma have been life altering for her, as well as everyone in your family.  Your friends and family show up with food.  They take you out to talk and hear how things are going. 
They offer support to your daughter as well, understanding it takes a village.  They spread the word your family needs support and your community rises to the call. 
You feel relief.  You don’t feel so alone.

Most of us can imagine this because we have been on the giving or receiving end of a loved one suffering from cancer, or a heart attack, or a car accident.

Let’s take it a step further though.  Your local high school has “green night” at the basketball game. They are selling green t-shirts to support people struggling like your husband and daughter.  
 
They are having…MENTAL ILLNESS AWARENESS NIGHT.  

At half time they recognize your husband for living with bi-polar disorder and depression.  They recognize your daughter for overcoming her substance abuse and
finding the right medicine and treatment for PTSD (Post Traumatic Stress Disorder) after returning from Iraq.  They recognize the care givers of those who are mentally ill and promise more research and better treatment with the money they raise.  Again, you feel your community’s support.  You don’t feel so alone.

Can you imagine the last scenario?  Probably not. We only talk about mental illness when it’s to place blame.  When are we going to start recognizing mental illness as the crippling disease it is? When are we going to start supporting our brothers and sisters suffering from depression the same way we support those suffering from cancer? 
When is raising money for the research and treatment of schizophrenia going to be as important as the research and treatment for heart disease?  When will feel comfortable discussing our substance abuse the way we discuss our diabetes?  Don’t tell me it’s because people die from physical illness but not from mental illness.   Read the paper.  Watch the news.  We are a country suffering from an epidemic of mental illness that is
going to ruin this country.   People are dying every day from the affects of mental illness and the funding just keeps decreasing as the need is increasing at lightning
speed.

How many more are going to be killed?  

Miriam Carey, who drove through a White House barrier and engaged Capital police in a
high speed chase with her one-year old in the car, was suffering from postpartum
depression and psychosis.  She is just one of a string of mentally ill people who have been killed or killed others in the recent past.  These include Aaron Alexis who reportedly believed he was being controlled by electromagnetic waves when he killed 12 people at Washington Navy Yard in Washington, D.C., Adam Lanza who killed 26
people at the Sandy Hook Elementary School in Newtown, Connecticut and James
Holmes who killed 12 people at the premier of a Batman movie in Aurora, Colorado. In my own hometown, Seung-Hui Cho, who killed 32 people and injured 17 more in the Virginia Tech massacre, was suffering from a severe anxiety disorder and major depressive disorder. And just this week in my home state, Virginia Senator Creigh Deeds was stabbed multiple times by his alleged mentally ill son who has been turned away from a psychiatric hospital the day before due to lack of beds.

There is a stigma that comes along with mental illness that prevents people from
getting help and like any other kind of illness, untreated mental illness only gets worse, not better.  According to the National Institute of Mental Health (NIMH), an estimated one in four adults suffers from a diagnosable mental disorder in a given year. I think about all those Americans suffering while both society and the health care industry do very little to alleviate their suffering.  Health care companies provide incentives to lose weight or stop smoking, but most offer nothing when it comes to mental illness.

Victoria Brownworth summed it up best on a blog post written for The Huffington Post dated October 7, 2013. The article called Crazy Every Day: America's Mental Illness Epidemic which describes living with her mentally ill mother concludes this way…

“Nearly 60 million Americans suffer right now from some form of mental illness, be it psychosis like Carey or schizophrenia, depression, anxiety, bi-polar disorder, an eating disorder. Many of those people are compliantly taking medications and others are wandering lost in America, unmedicated, hearing voices, thinking paranoid delusional
thoughts and literally going out of their minds.

How many families have to be devastated by the impact of this disease before we make mental illness a priority in this country? One in four is sick. If it were influenza, it would be an epidemic. Let's start acting like mental illness is illness first, mental
second. It's a public health crisis in America. And until we address it, there will be more Miriam Careys, more Aaron Alexises, more mothers like mine and so much untreated suffering, we might all go crazy from the pain.”

I don't want to go crazy from the pain.  How about you?

I’ve started this week’s blog post about five times and I keep hitting the delete button.  I’m just not feeling it this week.  I’m in a funk.  Everything I write feels blah because I feel blah.  I’m tired and cranky and overwhelmed and moody (yes, poor Todd!).  I’ve not been as productive as I want to be because I’ve been having too much fun being the guest of honor at my own pity party.  I want to climb in the bed and stay…for days.  Everything feels hard and I’m resentful because everything “seems” easy for everyone else, although I know it’s not.

I have nothing witty to say, no great lesson to cast upon you, I’m just showing up.  And you know what?  That’s ok.  Sometimes just showing up is the best we can do.  Although we don’t want to burden others with our sob stories, sometimes it’s nice to know that others have these kinds of days.  A kind of day where my hair feels too short, my thighs feel too big, my house feels too messy, my laundry feels too overwhelming, my job feels too scary, my kids feel too old, my friends feel too distant, my blog feels too insignificant, my heart feels too heavy, my diet feels too boring, my moods feel too manic, my smiles feel too absent, and my guilt feels too consuming because I have no “good reason” to feel all these things…I just do.

Here’s the thing.  I showed up today and I’m going to show up tomorrow…and the next day and the next.  Because that’s what we do.  We keep showing up until our gloomy days feel sunny again.  And they will.  That’s the beauty and irony of life…nothing is permanent.  Whatever you may be experiencing in this moment, know that this too shall pass.  It will, I promise.

I posted this quote on my LimitlessLessons facebook page this morning and I love it. 

I’ve written about being brave in a previous blog post and I sincerely believe that one of the most courageous acts is just showing up. I love the fact that we get the gift of a new day…a new beginning…a fresh start.  So, as Ralph Waldo Emerson so perfectly said, “Finish each day and be done with it. You have done what you could. Some blunders and absurdities no doubt crept in; forget them as soon as you can. Tomorrow is a new day. You shall begin it serenely and with too high a spirit to be encumbered with your old nonsense.”

See you tomorrow!  Maybe even with a new blog post and a smile on my face!

I have this “friend”. I tell her everything.  Recently though, I’m realizing she is not a very good friend.  In fact, she’s the worst friend I have.  Here is a sampling of some of our conversations…

Me:  I lost a pound this week.
Friend:  A pound?  Seriously? You’ve been drinking spinach like someone is paying you by the leaf and getting up at some ungodly hour every morning to work out and you only lost one pound???  That sucks!  I’d give up on that!

Me:  I forgot the one paper I needed for my meeting today.
Friend:  How can you be so stupid and forget that?!
 
Me:  Catie didn’t have what she needed clean for volleyball this morning. I feel bad.
Friend:  You should feel bad!  You are lazy and unorganized and you really need to figure out how to get your shit together!!  Other working parents get it done…why can’t you?

Me:  How do I look? (after getting ready for an evening out)
Friend:  Tired and old.  The 40’s have seriously not been kind to you.  I’d ask for a do-over.
 
I know what you’re thinking.  You are thinking why in the world would I have a friend like this and why would I ever let someone speak to me this way.  I’m wondering the same thing.

The saddest part of this story is that this “friend” is me.

If you follow LimitlessLessons on Facebook you know I post a lot of quotes.  Some have a very personal meaning to me, others I just love the message, while a handful stick with me and speak to me in a very profound way. This one stuck with me…

It’s a simple quote but I couldn’t get it out of my head.  As those who know me are well aware, I think A LOT.  I have been known to create stories in my head that could win an Academy Award.  I tend to think I know what others are thinking and feeling when in reality I have no idea.  I have a hard time having relationships with people who don’t communicate well because if you don’t tell me what you are thinking or feeling, I’ll just make it up in my own head.

I’ve actually gotten much better about this, but what I have not gotten better about, is how I talk to myself.  I would never tolerate anyone else talking to me the way I talk to myself sometimes.  If someone spoke to my child or mother or best friend the way I speak to myself, I’d be outraged.  So why is it ok for us to treat ourselves in ways we would never allow others to treat us?

It’s not.  And I know I’m not alone out there.
 
Throughout the day, our thoughts race at a hundred miles an hour, jumping uncontrollably from one self-diminishing thought to the next without consciously registering as such. If someone else was to put us down, our senses would immediately awaken and we would probably defend ourselves. However, there is no such self-defense mechanism with negative self-talk. All this negativity is blindly absorbed and becomes that much more toxic to our lives and particularly the relationship we have with ourselves.

What are the unsupportive thoughts you hear playing on repeat in your mind right now?  What self-defeating, abusive and limiting statement is your brain trying to convince you (or have convinced you) to be true?  Here are some of the more common ones…

I’m not good enough.
I’m ugly.
I’m too fat/tall/short/young/old.
I’m stupid.
He/she’ll never love me.
I am not lovable.
I am a bad parent.
I am a horrible person.
There is something wrong with me.
I never have enough time.
I don’t deserve …
I can’t …

Again, Don’t believe everything you think.

So how do we change this?  The first step is to be aware…really pay attention to the internal voice you communicate with.  Take note of every time you say something negative to yourself. I think you’ll be surprised how often it is.  Next, start to counter those thoughts with the reverence you would give your best friend. Speak to yourself
with kindness and love.  Be the kind of friend to yourself you want others to be to you. 
Remember, you teach others how to treat you so treat yourself with all the respect, love, and compassion you deserve!  If you don’t, who will?

For most of the world, March is about March Madness.  For me, I’m calling it March Sadness.  This weather is killing me.  I hate the cold and the older I get, the worse it’s becoming.  It’s taking a toll on me physically and mentally, but the mental part is the worst.  I’m like a bear in hibernation.  Some days it’s hard for me to even get out of the bed.  I feel the chill in my bones…I can’t seem to ever get warm.  Every day at work, someone asks me if I’m sick because of the layers of clothes I have on, including my winter coat sometimes, and I’m still cold.  I don’t want to go out, I don’t want to spend time with friends, I don’t even want to shower.  I sleep more, I eat more, and I exercise less.  I’m depressed.  I know it’s the weather, because on that beautiful Saturday a few weeks ago, I felt the old me come back.  I worked in the yard, I took a long walk, my husband and I met friends out…I was happy.

In a previous post (What Do YOU Have to be Depressed About?), I mentioned a depressive disorder called Seasonal Affective Disorder (SAD).  SAD is a type of depression that occurs at the same time every year.  Most commonly, it begins in the late fall and continues through the winter months.  Less often, it causes depression in the spring or early summer months.  Symptoms include depression, anxiety, loss of energy, social withdrawal, oversleeping, loss of interest in activities you once enjoyed, appetite changes (especially a craving for carbs), weight gain, and difficulty concentrating.  Many people (including myself!) brush off the feeling as a case of the “winter blues” or just a “cold weather funk”, but it could be more than that.  If you feel down for days at a time and you can’t seem to get motivated to do the activities you normally enjoy, you may want to consider seeing a doctor.

The causes of SAD are unknown, but there are some factors that may contribute to it.  The reduced level of sunlight in fall and winter may disrupt your body’s internal clock which lets you know when to sleep and when to be awake.  Reduced sunlight can also cause a drop in serotonin (a brain chemical that affects mood) and that may trigger depression.  Also, the change in season can disrupt the balance of melatonin in your body which plays a role in sleep patterns and moods.  It is diagnosed more in females and the further you live from the equator, the more prevalent it is.  As with all depression, if there is a family history, you may be more likely to have it.  Treatment for SAD may include light therapy, medication and psychotherapy, but there are some lifestyle changes you can make as a place to start.  

        Make your environment sunnier and brighter…open blinds, trim trees that block sunlight.

        Get outside…take a walk, eat lunch at a nearby park or simply sit outside in the sunlight.

        Exercise regularly…physical exercise helps relieve stress and anxiety, both of which can increase SAD symptoms.

        Eat a healthy diet…focus on protein and limit your carbs and sugar that will eventually make you feel even more lethargic.

I’m following my own advice for once.  I’m getting out of town for the kids’ spring break.  I’m heading south for more sunlight, warmer temperatures, and long walks.  And when I get back, March Sadness will hopefully be far behind me and April will be the start of happy months to come!  Do you battle the winter blues?  What works for you?

Just living is not enough... one must have sunshine, freedom, and a little flower.  ~Hans Christian Anderson

You finally find the courage to confide in someone.  You explain how sad you feel, how lonely you are in a room full of people, how overwhelmed you’ve become.  And the response?  What do YOU have to be depressed about?!?  So the depression deepens and the isolation grows because they are right.  You have a great life…healthy kids, a loving husband, a good job, money to put food on the table and take care of your kids…what DO you have to be depressed about? 

Well stop.  Depression is not a choice.  Just like cancer, depression does not discriminate.  It doesn’t matter how many friends you have, how rich you are, how beautiful/skinny you are, how great your kids are, or what kind of job you have.  It’s just there.  An uninvited guest that can show up anytime, anywhere.  You become a prisoner in your own head, unable to escape the thoughts of helplessness and hopelessness and feeling guilty because you know others have it worse than you.  You are not alone, you are not crazy, and most importantly, it’s not your fault. 

Most experts are still not sure what causes depression but it seems to be caused by a combination of factors, such as the person's genes, his biochemical environment, his personal experience and psychological factors.  An article in medicalnewstoday.com states that an MRI has shown that the brain of a person with depression looks different, compared to the brain of a person who has never had depression. The areas of the brain that deal with thinking, sleep, mood, appetite and behavior do not appear to function normally. There are also indications that neurotransmitters appear to be out of balance. Neurotransmitters are chemicals that our brain cells use to communicate. However, imaging technology has not revealed why the depression happened. We know that if there is depression in the family a person's chances of developing depression are higher. This suggests there is a genetic link. According to geneticists, depression risk is influenced by multiple genes acting together with environmental and others factors.

All of us get sad.  Many of us experience “situational depression”, meaning we might go through a period of sadness when we experience something awful.  Some of us might even have SAD (Seasonal Affective Disorder).  This is when a person develops a depressive illness during the winter months but the symptoms go away during spring and/or summer.  Some of us may have experienced postpartum depression after the birth of a baby. And some of us have a daily battle with depression, no matter what the circumstances.

I am not a doctor and certainly no expert on the facts surrounding depression.  There are plenty of places you can read all about the symptoms and treatment for depression (and you should…it is one of the most treatable illnesses!)  I am writing as someone who overheard the above conversation and it broke my heart.  I am writing as someone who has experienced mild depression (mostly situational and SAD) and someone who has friends experiencing depression.  I am also writing as a professional who is seeing more and more anxiety and depression and seeing it in kids as young as kindergarten (I’ll save that for another post!)  If you are experiencing depression, find a friend who will listen and not judge.  Don’t isolate yourself and don’t feel guilty.  Treat your depression as you would a physical impairment…talk to your doctor and get treatment.  There is nothing to be embarrassed about.  If you don’t know where to go for help, email me.  I can steer you in the right direction.  You are not alone.