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TO CONTENTS |
Depression and Agitations in Both Sexes Extracted from CHANGE OF LIFE IN MEN AND WOMEN by MARIE CARMICHAEL STOPES Putnam, London, 1936 |
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If one filters out the frequent references to thyroid extract which seems to have been viewed as a cureall for the climacteric - much as estrogen later became - the text below describes symptoms and situations which are very familiar to anyone knowledgeable about perimenopause. Of prime interest is the fact that they are attributed to both sexes, rather than being at worst the fault of the female, at best hers alone to suffer. The recommendations for dealing with them may be over sixty years old but they are still well worth considering - even the thyroid testing. |
| Depression in both Sexes | |
| All is not lost. | The healthy man who maintains his health, like the healthy woman, need experience none of the distresses of the climacteric. In him, too, should be seen the fine flowering of the human intellect at and after the climacteric |
| Gloom caused by thyroid problems? | Nevertheless, in the world as it is to-day, the mere will to health, valuable as it is, is not enough to secure it without physiological knowledge, and a physical depression is sometimes felt at the climacteric by men and women alike with no apparent illness. This may be so deeply rooted that even a joyous event happening on a bright day cannot wholly overcome it, and the climacteric man or woman feels "Ah, let others enjoy life who can, for me life is over-" Such a one, whether man or woman, is probably suffering from a thyroid deficiency. Hence very many such overcast lives can be helped most easily, for thyroid is easy to administer in simple capsules which can be swallowed. Thus readily can be overcome a fundamental gloom and the colour of the inner sky of the mind changed from grey to blue, by a suitable amount of thyroid extract. In the alchemy of modern physiology the thyroid may truly be described as an elixir of life. If it is deficient in amount not only the sex potentiality but many other functions suffer. Lethargy and weariness overtake one erstwhile active, and gloom hovers over the sleepless hours. Hence too, unreasonable dissatisfaction with everything composing the daily life is sometimes a feature of the climacteric both in men and in women. |
| Thyroid may or may not fix it. | Sometimes if the man or woman has already lived a full life and has behind him or her a rich experience, all will be well with just enough thyroid to set the well-balanced mechanism in gear again. But, on the other hand, if the life has been narrow and deprived of experience, it may be wise to take a few months of complete change if this be possible. It may chance that a married couple are so timed both in years and in physiological age that they may pass through the climacteric simultaneously. Unless they realised the physical basis of it the personal depression of each would enhance that of the other . |
| Don't break up the home, just travel | No one can advise an individual fully and wisely about this without knowing all the details of their lives. There may be an inherent restlessness due to starvation of experience which should be humoured if it is not at the expense of some lasting family good. For example, if the pair have no children, or grown-up children already established and living in homes of their own, and the home is that unique one the couple came to after their own marriage, so that in reality every stick and stone of it is full of memories and charged with romance, then even though for the time the wife or husband or both may assert they are "sick of it" and find everything wrong some way or other, they should have the good sense not to break up the home in any irrecoverable way . In a few months or a year or so all should be unclouded once more, and they will, as the years go by spend more and more time in the home together till, as Darby and Joan, sitting in its sunlight and the shadow of their own roof tree, they will thank God for the deeply-rooted love of their mutual home. Hence at the climacteric time for them the wise thing would be to travel, or merely let the house furnished, whatever is feasible to effect a change for a few months with the security of a return. |
| Sometimes get rid of the house | On the other hand, where the home is wrapped in no special sentiment, perhaps a hired house in which they have been for enough years for all interest in it to have faded, but not long enough for deep love to have taken root, then, if it can be managed, it may be good to seek an entirely new home and the interest of the new plans and the removal may be beneficial to both. |
| Travel alone may be needed | In other circumstances it is sometimes wise for the one, either man or woman, who is passing through the climacteric, to take a long tour or a journey alone. If a rich man, he may make a world-tour glancing as he passes at whatever of interest offers itself bearing on his business or profession. If a rich woman, a travel cruise, or a long visit to relatives or friends may give her a chance to solve her problems of re-adjustment. If poor farmer-folk, one or both may take seasonal hired service in some distant farm, or if tied wage-slaves of the factory they can at least try varying their week-ends by hiking separately. |
| Least said soonest mended | None of these seem to me to be the course best to be pursued by the ideally sensible, and loving pair, who should, and do in happy instances, want to be together in all the phases of life. But some temperaments require a break in routine at this time to enable them to conserve the precious past and carry on together again after the pivotal phase of the climacteric. They can then live the second halves of their lives together less scarred by the memories of bitter words and unreasonable acts and reproaches than they would have been had they felt themselves absolutely tied by convention not to escape from each other even for a few months. "Least said, soonest mended" is a very wise adage and, as one of the difficulties and failings of the climacteric in both men and women alike, is the tendency to say too much, to reiterate unreasonable reproaches and complaints, a sensible couple whose love is deep but yet not powerful enough to command the situation, would be well advised to take a long holiday from each other, to return at its conclusion, to each other's arms. |
| Not psychoses | Agitations of the climacteric.
These need not be robed in
the terror of the name "psychoses" often applied to them. It is generally
recognised that the period of the climacteric in women may be marked by
various minor agitations of the feelings, ready depression, a tendency
to tears, irritability for no apparent cause with those who are really
loved, a readiness to quarrel with old friends and, it may be, "tantrums"
which need to be sharply pulled up by some relative who can speak with
authority .
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| Affects men too | Climacteric Impatience,
Instability in Man is, though not so generally recognised, quite as
characteristic of man's climacteric.
A loss of generous impulses, a fear of women leading to exclusively male "club-life" and parsimony are not infrequent accompaniments of climacteric impotence. Described by Dr. Marian as a frequent sign of loss of control is " Impatience, becoming easily exasperated. It is a very frequent sign of loss of emotional control in the climacteric man, as in the woman. Many men of uniform and tranquil character throughout life become impatient, irritable, and violent at this age. The usual little cares of the home or profession which before were scarcely noticed, now constitute a torment. This change is readily perceived at home and abroad. The explanation of the phenomenon is always the same, emotional irritability. Naturally the psychic states related directly or indirectly to sexual decadence have a large influence upon the characteristic irritability of some men of this age." |
| Some
would say "normal"
for this period |
Many would consider these manifestations "normal" for the climacteric. Though they are, of course, quite minor troubles they are perhaps somewhat upsetting features of that time. I see no reason why they should occur in men or women whose minds are adult and who can therefore apply intelligence and control to their own manifestations. Many grown-up men and women, however, are never really adults and tend to be always childishly selfish, and lacking in self-control. For such minds, perhaps, it may be conceded that the agitations of temper and temperament of the climacteric are normal . |
| Childishness revealed | Men, as well as women, are often thus childish, and reveal their childishness at their climacteric. Dr. Maranon speaks of "a tendency to melancholia" and "periods of sadness" as being just as much characteristic of men experiencing the virile climacteric as of women. Such minor features are generally transitory and the character reverts to its former trends in a few months or a year or two. Meanwhile, as things can be made very unpleasant for members of the family (especially the wife or husband), it is important that it should be recognised for what it is, a transitory phase which should be controlled, by laughter if necessary, and at the worst must be borne with recognition that it will pass and peace be restored. |
| Sudden tears | Tears relieve a state of tension, both in men and women. Dr. Marian quotes a patient of his own in whom the arterial tension was 19-10, when the patient burst into tears and "a moment later she was calm and the tension had fallen " to 17-9. Men and women with adult minds and normal health shed tears only for some real reason. Disaster, suffering, death on the part of those they love, justify tears even in the most mentally stable and adult members of the community. But when a woman finds herself weeping over the merest trifle, lying awake at night or waking up to sob over some trifling or fancied slight or difficulty which her common sense, even as she weeps, tells her does not justify such a feeling of depression, then she should realise that the tears are a symptom of some functional disturbance. It may be digestive; but it is more likely to be glandular, for nothing is more apt to cause intense and apparently inexplicable depression than an insufficiency of thyroid. This tends to lower the temperature, cause constipation and lead to a chain of other depressing physical conditions which find their outlet of expression in self-pity and tears. |
| Apprehensiveness | Apprehensiveness of risks, fears for the future, and general depression, are also noticeable in both men and women of climacteric age. |
| Men feeling left behind | "Man's Feeling of Being Left Behind Socially, Equivalent to Sexual Melancholy in Women" is the interesting heading of another paragraph on thecritical age in men in Dr. Maranon's book. "But on the other hand, in the climacteric man there is frequently a psychic state which we may consider as equivalent to 'sexual melancholy' in the woman. This is the sense of being ill-used, left behind or prematurely forgotten by the coming generations. This psychic state which embitters the existence of many men in the decline is presented as a plain psychopathic manifestation in varying grades from simple worry, compatible with normal conditions, up to true states of persecutory delirium." |
| Thyroid deficiency? | In my opinion most of such depressions are directly correlated with a deficiency in thyroid action. Such a feeling is characteristic also of the convalescence after certain infectious fevers, and may be rapidly overcome then by the administration of very moderate doses of thyroid extract. In a case I have observed, one grain of fresh thyroid extract daily for a few weeks transformed a sense of gloom and impending disaster into a calm and serene sense of confidence. The thyroid has already been mentioned, and in more than one connection. It is impossible to deal with the climacteric in mankind without frequent reference to the thyroid for it is a gland whose controlling activities are so wonder-working. It will be referred to again in several more sections of this book, so we had better devote a few lines to considering it now. |
| Thyroid overworked during the change? | The thyroid is not only the gland most generally known to the public and most discussed, it is actually of immense importance. On the thyroid falls apparently the major duty of making up for the deficiency or absence of the other genital glands' secretions. If its secretions are kept active and sufficient it stimulates other and distant organs to play their parts properly. Consequently, at the climacteric, the thyroid may have too much to do, and hence be in need of assistance. When this is so it is relatively fortunate for the man or woman, as the thyroid is the easiest of all the glands for us to supplement, and the extract when taken in capsules works effectively. It is therefore easy to make up for any deficiency in the thyroid secretion. When the thyroid works too actively, and too much thyroid extract is being set free into the sufferer s system, it creates a rather more difficult problem, but fortunately this is much rarer than thyroid deficiency. Yet it is important that the public should realise that at the climacteric there is a chance that some of the symptoms currently thought to be due to too little thyroid are in fact caused by too much thyroid. Dr. Maranon in his book The Climacteric (English translation 1929) makes this clear and discusses the condition he calls Climacteric Hyperthyroidism |