[naia]

Not sure if this is the right place to put this, but I've got a session tomorrow & am wondering how to bring up this topic. My T is a guy & we haven't talked about this type of thing before. I have been different lately, under a lot of stress, but when woke drenched in sweat, I just thought it's time to bring it up.

I have a general idea that menopause affects moods. I'm kinda a tomboy, plus had an operation didn't know I was going through this until I had lab tests this summer. I'm seeing a Chinese doctor for supplements.

Meanwhile, my T has thought my moods are all over the place & has thought maybe something else was going on. I'm wondering if it is change of life stuff, not mental health stuff.

I don't want to challenge him. We've been a bit rocky over the summer so I'm trying to work on making it smoother, but still. I mean if I seem more emotional or moody or irritable, maybe it's hormones not some sickness.

[SallyBrown]

I'm still a couple decades from menopause, but I also have a male T and have also recently gone through the hormonal wringer of pregnancy. He was very open to talking about it -- I do think it makes a difference that he was male, but overall, he's your T and should be able to talk about whatever it is you're going through. And whatever he can't comment on, he should be assisting you in finding support for.

I do get that you don't want to challenge him if you guys are generally having a hard time. Been there. But, I really don't think this should be overly challenging -- if it is, I'd kind of question his usefulness to you.

I can tell you that my mom went through a LOT mood-wise during menopause. She and I struggled an awful lot during that time, and were fighting constantly (which, although she and I are often at odds, it was really only during that time that we FOUGHT). So it's not out of the question, at all, that it's affecting your mood. (Things are about a million times better between us now that she's past it.)

I do have a female pdoc who is only a few years older than me, so she is often both well-educated medically on women's health, plus she has the personal experience . You could always think about seeing a female T who specializes in women's health, if you think that will help you, just temporarily to talk about this stuff.

Finally, I've found this website to be very helpful: https://womensmentalhealth.org/speci...usal-symptoms/

[WrkNPrgress]

Is it possible that you're assuming he won't understand or that you fear judgement?

You should never feel like you have to censor or alter your expression or subject matter to accommodate your therapist. You're the client. You should feel like you can talk about whatever you need to talk about.

Mind and Body are connected. Hormones are a real thing. They affect how we feel. Our bodies impact our mind as well as the other way around. Any psychologist or therapist should understand this or the field of psych meds wouldn't exist at all.

So yeah, tell him all about it, I'd say.

[Pennster]

My therapist is a guy and we talk about the effect of my hormones on my mood all the time. I always keep him really informed because I often need help in knowing whether it's likely to be monthly blues or something else- sometimes I forget when I'm in the midst of these things that it's the hormones, not the fact that the world is terribly cruel, that is entrapping me in feelings of despair and hopelessness.

I would imagine most therapists would appreciate a client bringing additional insight into their problems. That would be a drag if he saw this as challenging - I would definitely bring it up.

[Argonautomobile]

I'd bring it up. It's clinically relevant and I wouldn't think he'd take it as a challenge; I would expect he'd appreciate the additional information because it would help him do his job better. Change of life stuff can definitely have an effect on mood.

If you feel awkward talking about lady issues with a male T (I know I do) you don't have to talk about it in detail. A heads-up "It's possible my mood issues of late are related to menopause and I thought you ought to know" would get the job done.

Good luck!

Asking me about my cycles and perhaps hormonal influence on my mood was like one of the first things my therapist and my pdoc brought up with me and took into possible consideration -- both men. In fact, we did reach the conclusion that my heading into perimenopause probably very definitely was a factor in why things went so awry for my at that particular stage of life. Not the only factor (plenty of other factors), but probably a reason things changed so much more at that particular point in time. Interestingly enough, as I've gotten further along into the aging process, those problems have started to level off. This might also be a good conversation to have with your medical doctor.

[naia]

Thanks for the responses. I did bring it up, but I don't think it went that well, not sure though. He gave me broad generalizations, asked when my last period was when he knows that I had an operation so don't have them any longer. Frustrating because we've worked together a long time. Plus he is an MD so seems like he should know that hormones affect women's moods. And his wife is a midwife so...go figure.

I have a trauma history and am experiencing some things like that now (caregiver fatigue, DV, losses of different kinds), but my T seems to not be open now to any external factors. He now wants to put me on lithium, thinks I'm bipolar I guess.

I know I'm not bipolar, don't have the history or symptoms. I actually have nothing against it, just know it's not me. And think it is diagnosed too often, just because someone seems to be moody, irritable, or whatever. Like my sleep patterns are off and am late so feel not put together, which I guess looks like mania? but why?

If I wake up at all hours, drenched in sweat. Or am late because I am care giving around the clock so have to deal with all the responsibilities, the shopping, cooking, cleaning, laundry, etc., why is that mania? why isn't it just life and life changes?

I don't want to fight about diagnosis; I can't win. But I don't want to have the reality of my body and life circumstances be completely dismissed and told that everything has to be due to some sort of disease when menopause is natural.

Not sure what to do. I don't want to leave him because we have had good experiences. He also is having a lot of stress at home so I get that right now he is very distracted, not really himself.

I may sound like I'm making excuses, but I'm trying to take in the larger picture, testing out how it sounds, just throwing out ideas and feelings.

[Argonautomobile]

I don't think you sound like you're making excuses. I think you sound very reasonable and self-aware. I'm sorry the conversation didn't go well and that your T is not quite himself right now. I've always tended to just go with my care team's recommendations--you're right, it's not really an argument you're in a position to win, and, anyway, it's not like all docs are quacks and meds are the devil. But I've never had reasons as compelling as yours to disagree.

I guess you'll just have to agree to disagree for while. Sorry this is happening.

[SallyBrown]

Jeez, that sounds pretty dismissive of him. I'm really sorry it went that way. The stuff you're describing sounds a lot like it could be attributed to menopause plus life stress, to me. Especially those night sweats. Got them while pregnant. Yech.

A few thoughts:

- Re: lithium... that's not exactly a little thing. I think you are entitled to seek a second medical opinion about it before doing that. That's not "fighting", that's taking care of your body.

- Re: pushing the mania diagnosis... I get the impression he's been implying that it's something like that for a while? I wonder if he is doing the (very human, but pretty damaging when you're an MD but I see it all the time) thing where he doesn't want his "professional opinion" to be contradicted, and isn't really thinking about this new information you're giving him? Or whether he ought to be referring you out to someone with more expertise? I don't want to make any judgments based on so little, but I do wonder.

- Re: not wanting to leave because of the good stuff... I really, really hear you on this. Really. Is there some intermediate step you can take -- are you able to see a second T/pdoc in the meantime who has more knowledge in this area, or at least doesn't have a history with you that may cloud their judgment? Depending on your insurance situation, you don't have to quit your current T. Maybe for "second opinion" on the lithium, you can look up a pdoc who has a special interest in women's health, and you can kill two birds with one stone -- consult about the lithium/BP diagnosis, and get some feedback on menopausal mood symptoms.

- Re: his home stress... I think it's cool that you're considering the human dimension of being a T. In the end, he's a person doing a job, and sometimes personal stress makes it harder to do that job. BUT. When your health is at stake, there's no excuse to phone it in. If his home stress is preventing him from doing his best work, he's got to take responsibility for that. Also, and this is not a criticism of you or your T, but how do you know he's experiencing a lot of stress at home? Is this something you spend a lot of time on in therapy? My T sometimes tells me if he's under a lot of stress, but only because I can tell when he's under a lot of stress and it will bother me and make me worry if he's frustrated with me, so he just tells me it's not me. But we don't get into detail, since the therapy hour is something that's for me.

[naia]

Thanks. Many things. I agree that lithium is not a small thing at all. I have known people who were put on it and though it helped them, they ended up with kidney disease, even shunts and dialysis. Not saying that would happen to me, but it is a heavy metal and does do harm. Plus I generally don't take meds if there are alternatives. Ironically, my T also generally does not want to put people on meds but get them off meds. So even though an MD, he does therapy primarily. That he is pushing pills is not like him.

That brings me to the stress in his life. He told me because it was affecting the way we work. I know him well, knew something was different, got upset at lots of changes in scheduling, availability, rules, etc. so he finally took out a session (which he didn't charge me for) to explain a family medical emergency.

While I am trying to be understanding of that, it also really sucks that it is happening when I have all of this going on and it is affecting our work and his judgment. He is sorta turning toward meds I think because he can't put in the therapy hours like before. Still, it's not right and hard to confront him about it.

I have asked him for referrals, but he has given me people in his close circle, who I sometimes see when he is away and are not really affordable. I did see someone else for a while for extra support, thought it was covered for DV compensation, but then I had to stop because my claim was denied. The police came, but they never filed reports so the letter I got said there wasn't evidence. Kinda stuck there. I can't take on the police either, but really don't get how they could come and not make reports?

Anyway, my T does have lots of experience so it's not that he doesn't know what he is doing. It is that he is getting it mixed up and not taking in all the external factors. I can't really afford to seek out a second opinion right now. I've lost a huge amount of money being a caregiver and don't make enough to replenish that loss. I'm just making ends meet, sorta day to day, and things are tight.

I did request a new physician due to menopause and DV, but don't see her till March. Unfortunately, I think that I have to just wait this out.

[SallyBrown]

You are dealing with SO much right now. I'm amazed at how pulled together you are about all of it -- many kudos to you.

I also don't get why there'd be no report on file by the police. But I don't really know much about how this stuff works -- hopefully someone who knows more can chime in -- but it never ceases to amaze me how much people who are victims of DV are left out in the cold, when they are so damn vulnerable. Makes me mad.

I get why you wouldn't want to confront T about your suspicions regarding why he's suddenly pushing meds. While I think your suspicion is perfectly reasonable, and makes a lot of sense, it's really hard to accuse someone of such a thing, especially when you're unsure. Hopefully you can tell him you want to wait on the meds since that would be a big change, and then drag that out long enough for you to finally talk to this physician in March.

Aside from them being expensive and money being tight, I also probably wouldn't see someone in his inner circle just because you run the risk of someone not wanting to go against his judgment because they have a personal connection. It's stupid that that's how this can work, but I think we all know that that's how it is sometimes.

I've also had issues with my T (of 9 years) at points in his life where something personal was getting in the way of his judgment as a therapist. Obviously I like him a lot and do think he helps me if I've been seeing him that long! But it's added an extra dimension of pain and frustration when there's this THING on top of whatever else I'm dealing with. I even left for a few months when things got really bad -- but I lucked out with great insurance coverage for that.

And it's pretty crappy that you have this part of your life -- menopause -- that's clearly affecting you and affecting the way you are in therapy, that you feel you can't talk about because he's not accepting it. I hope you can occasionally bring it up and maybe he'll come around when things clear up more for him. I had a similar experience around a miscarriage... talking about it with my T went really badly at first, which was like a punch in the gut.

I'm sorry that seeing someone else is just not an option by now. I hope you're able to ride it out -- but I also hope that if it gets really bad you aren't in any way inhibited by fear of not finding another T that works well with you. That's never a good reason to stay.

Sending good vibes your way.

[catnip123]

Menopause affected my mood a lot. I ended up having to use a hormone replacement patch to get stabilized again. I hate it, but it (along with other meds) help keep me going.

[naia]

Thanks again. I guess I don't realize how I sound. It is a lot though now that I put it out there so I guess I'm dealing though it totally sucks. And waiting till March feels so long...

I do see a doctor trained in Chinese medicine. He has given me supplements after running a lab test of his own. I also am taking supplements for problems with adrenals, basically replacement hormones. That is also due to stress most likely. And it was confirmed by an ultrasound. So even though this doctor in Eastern medicine might be seen as too alternative, all of his findings have been backed up by Western tests. I trust him. He actually knows quite a number of the people involved in this situation and is very supportive. Not a therapist, not really a friend, but has helped a lot. He too is someone I can't afford to see that often now, but I will see him the week after next.

Speaking of supplements, need to take some and have an early lunch.

[Lauliza]

If your T is an, MD he should know that your lack of sleep and mood swings can be due to menopause. Most would look to those factors before settling on a bipolar diagnosis. In the DSM it even states that other possible causes (physical or social) should be ruled out as a cause before a final diagnosis is made. It sounds to me like you are very insightful - hormonal changes plus all that added stress is a lot to handle. If you don't want to take it I would push back on his advice to take lithium. It is your treatment and if he doesn't listen to your concerns, which make a lot of sense, it isn't a bad idea to get a second opinion. If that's not an option, at least you have the new doctor you see in March. If you agree with what she has to say perhaps she would be willing to speak to your T for you.

[naia]

Thanks. I have told him clearly that I would not take lithium even though he keeps raising it. What I did was sorta fib a bit and say I'd be willing to take something else, like a mood stablizer, if he felt there was an issue. That was just to put it off though. If anything I'm the opposite of manic. I'm totally exhausted and sometimes really down, but with the bipolar thing in the air, I don't have a chance of getting anything for possible depression.

It's really frustrating and hard to deal with. We almost did stop. I mean he has seen me cry, which I don't do that easily. He has seen the bruises and pictures too. He has heard parts of the fights. Well, he did hear before his own stuff made him cut back almost all calls and lots of time off. He doesn't even have someone cover him anymore.

I'm hoping that the new doctor will be willing to talk to him. March does seem far, but I do have good medical coverage so can go to others in the clinic if something comes up before then.