As one 49-year-old woman recently put it, "Is it normal to be a complete witch for two weeks out of every month?" Well, um, yes.
Solution: Just because your mood swings are a normal part of menopause doesn't mean you -- or your family and friends -- have to just stand by and take it. First off, start marking on the calendar which days of the month you're a complete hellion. Is it the week right before your period? Two weeks before? Or both? Then analyze the emotion -- or emotions -- you're experiencing. Is it anxiety? Depression? Anger? Are you oversensitive, feeling hurt all the time; or overreactive, freaking out over everything in sight?
The reason for compiling all this data: Mood-altering medications come in many varieties, and it's not a one-size-fits-all situation, though far too many doctors treat it that way. If your primary emotion is anxiety, even paranoia, a short-acting benzodiazepine like lorazepam (brand name: Ativan) may be much more effective and have fewer unwanted side effects than an SSRI (selective serotonin reuptake inhibitor), like Prozac or Zoloft.
If your mood problems come primarily in the form of irritability and anger, an antidepressant might help, but making time for regular yoga or dance classes or a strenuous walk can do just as much to relieve stress and that horrible sense of feeling overwhelmed. And if middle-of-the-night, mind-racing insomnia is your main symptom, then taking an herbal supplement such as valerian or chamomile might get you back to sleep without the need to be on a drug full time. (Several midlife women we talked to keep a simple chewable homeopathic remedy called Calms Forté in their nightstand drawer for such moments.)
It's not that antidepressants are bad per se, but going on one can cause additional issues, such as loss of libido. So if you can take care of your symptoms without a systemic solution, there's less chance of complications. If you do go on an antidepressant, many women swear by citalopram (brand name: Celexa); in fact, a recent study found that citalopram was the most effective SSRI, and even more effective for women than for men. Research at Massachusetts General Hospital showed a surprising additional benefit: Celexa reduced women's hot flashes by 50 percent. Another tip: Start with the lowest possible dosage your doctor thinks might be effective and work up from there. With citalopram, for example, studies have shown just 20 milligrams to be as effective -- and to have fewer side effects -- than the more common starting dose of 30 milligrams.
