I think the impact of women’s hormones throughout the life cycle & their role in different mental health presentations in general is a massively under recognised & under researched area. Largely down to outdated patriarchal psychiatric practise where polypharmacy seems to be the predominant model of treatment. Don’t get me wrong antipsychotics, antidepressants & mood stabilisers all have their place & save lives on a regular basis. (Mine included).
But the reluctance to listen to the patient’s experience, the automatic discounting & rubbishing of the possibility of hormonal issues in mental health, is huge.
Louise Newson is doing work educating psychiatrists on the impact of Peri & Meno on MH & advocating they test hormone levels, proper vitamin/thyroid/B12 levels (not the shitty ones the GP’s do) & history taking of stage of life more seriously, as part of their assessments.
And where safe & clinically indicated - to consider a hormonal trial of HRT as part of/before/instead of any treatment.
Which would be huge if she were to get any traction. It’s a start at least.
As for direct evidence of menopause causing psychosis I’m sure the increased stress as a result of peri/menopause in those of us clinically vulnerable could certainly contribute to a person’s vulnerability to psychosis (& any other MH condition for that matter) & exacerbate existing conditions. Surely women deserve holistic health care to optimise all our systems in the body & brain which she says are hugely sensitive to fluctuations in oestrogen.
Including antidepressants & psychiatric drugs. Sorry to sound like a Newson devotee but apparently if you’re not properly “oestrogenised” certain antidepressants won’t work optimally. And some antipsychotics & mood stabilisers contain certain hormones that can mess up an already messed up mix of hormones during peri & meno.
Rather than being put on more (let’s be honest pretty toxic & horrific to withdraw from) drugs or a stronger dose - when you see your GP or psychiatrist as you feel your medication is no longer working, Newson advocates them making sure you’re fully oestrogenised first, (if in peri or menopause) otherwise your psychiatric medication may not have the best efficacy.
I really hope we see a move towards integrating peri & menopausal health into MH care, but I won’t hold my breath. It all sounds so good in theory but finding the correct dose, type & mix of HRT that even works for you is a challenge in itself.
And in those sensitive to mood fluctuations anyway, the impact of HRT could have very significant effects on mood & possibly require MH supervision & input even to get stabilised on the right dose.
So it’s a challenging area but not one that should be just swept under the carpet any more.