The Pitfalls of Over-Prescribing Antidepressants

As a women's health support practitioner, I have heard firsthand the complex journey that many women navigate during perimenopause. Just in the short time I have been studying to work in this field of healthcare, including my client practicum, women have confided in me that when discussing their symptoms with a general practitioners (GP), the immediate and consistent response is to presecribe SSRIs.

In an article by reporter Maya Oppenheim written for The Independent, the author explores a recent study revealing that more than a third of women presenting menopausal symptoms to their GPs are being prescribed antidepressants instead of hormone replacement therapy (HRT).

Also known as selective serotonin reuptake inhibitors, SSRIs, are widely prescribed to treat mental health conditions, including but not limited to panic disorders, eating disorders, anxiety disorders, and obsessive-compulsive dircorders. These are bona fide disorders classified as such in the medical field. Perimenopause is not a disorder. It is a natural and normal process that evey woman who lives long enough to reach this stage will go through.

So, while medical interventions can be beneficial, the over-prescription of antidepressants to treat perimenopause has become a concerning trend.

In this post, I will explore the potential negative effects of such prescriptions and the importance of women advocating for their own bodies.

The Perimenopausal Challenge:

Perimenopause, the transitional phase leading to menopause, brings about a multitude of physical and emotional changes. Hormonal fluctuations during this time can lead to symptoms such as mood swings, hot flashes, and sleep disturbances. Unfortunately, these symptoms are commonly and incorrectly hastily met with a prescription pad, often for antidepressants.

In recent years however, new research is revealing that perimneopause is a brain health phenomenom but the literatuer on this is still so fresh, doctors will be playing catch up for years to come before it is well understood and, in turn, treat their patients accordingly.

For more on menopause and brain health, listen to my recent All Things Menopausalpodcast episode with Dr. Fiona Lovely who talks about trauma, hormones and the brain.

Pill Pushing:

1. Masking Hormonal Imbalances: Over-reliance on antidepressants may mask underlying hormonal imbalances that contribute to perimenopausal symptoms. It's crucial to address the root cause rather than merely treating the surface-level manifestations.

2. Side Effects and Dependency: Antidepressants come with their own set of side effects, ranging from weight gain to sexual dysfunction. Moreover, dependency on medication may hinder women from exploring alternative, holistic approaches to manage their symptoms.

3. Incomplete Mental Health Assessment: Perimenopause is a nuanced phase where emotional and physical well-being are deeply interconnected. A comprehensive mental health assessment, considering hormonal fluctuations, is essential to tailor interventions effectively.

4. Gaslighting: Women may pretend, avoid or supress her menopause experience and keep it hidden for fear of being shamed, blamed or questioned by her GP into thinking she does not know her body well enough or that her symptoms related to her psycological state. This form of emotional abuse is more often used as a diversion from the fact that GP's simply aren't extensively or properly educated in menopausal health.

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Self-Advocacy:

1. Informed Decision-Making: Women must actively participate in their healthcare decisions. Educate yourself about perimenopause, its symptoms, and potential treatment options. This knowledge empowers you to engage in informed discussions with healthcare providers.

2. Open Communication: Establish open communication with your healthcare team. Discuss concerns, preferences, and inquire about the rationale behind proposed treatments. A collaborative approach ensures that your unique needs are taken into account.

3. Exploring Holistic Approaches: Embrace holistic approaches to complement medical interventions. Lifestyle modifications, such as nutrition, exercise, and stress management, can significantly impact perimenopausal well-being.

4. Seeking Second Opinions: If you feel uncertain about a prescribed treatment plan, don't hesitate to seek a second opinion. Different healthcare professionals may offer diverse perspectives, helping you make more informed decisions.

5. A Menopause Doula Can Help: A menopause doula offers support by being a compassionate listener, providing valuable resources and credible information for informed decisions, empowering you to take control of your health and body. Additionally, she can attend medical appointments with you and advocate on your behalf if you feel unheard or disrespected.

Conclusion:

While antidepressants may play a role in managing some perimenopausal symptoms, their over-prescription poses risks that must not be overlooked. Women must actively advocate for their bodies, engage in open dialogue with healthcare providers, and explore holistic approaches. In doing so, we pave the way for a more personalized, comprehensive approach to women's health during the challenging phase of perimenopause. More importantly, we send a resounding message that the inequalities in the appraoch toward women's health will no longer be tolerated.