What steps are needed towards understanding and managing mental health of women with menopause during Covid-19?
Coronavirus pandemic, by no surprise, is pervasive and most likely to entrench in our society. A study by Weber in May 2020 revealed that women are struggling the most with mental health issues this lockdown and are experiencing increased rate of insomnia, anxiety, loss of appetite and physical activity, aggression, apprehension, and resentment. Most of these issues are already prevalent among women during their menopausal phase. As the menopausal phase demarcates end of the reproductive cycle and is associated with neuroendocrine changes, such issues become quite prominent. Shreds of evidence suggest that stress contributes to hormonal imbalances during this sensitive period. Given this kind of difficult and challenging situations of psychological hardships, it is inevitable that women in the menopausal phase will have considerably more taxing state.
India, being known for collectivistic culture, traditionally prevails the concept of family emphasizing integrity, loyalty, and unity, where one family member has the potential to influence the whole family dynamics. In contemporary times, even though women are encouraged to pursue their careers beyond household chores, they still are expected to adhere to their role as homemakers due to societal stereotypes. For instance, a woman who lives with her in-laws, have teenage children and also working during their menopausal transition, would be subjected to more challenges during the lockdown wherein she has to manage multiple roles at the same time along with the demands of adapting to the changes occurring in her body as well as in the surroundings. All this would become so overwhelming for them to subsist through, as they are put into more intense state. Even though, some recent studies indicate that few women with menopause during this time are having less worries and are euphoric about the lockdown as they get to spend quality time with their families. With the passing time, they reported it turning into more burdensome, stressful, and challenging scenario. All the distresses summed up can affect their behavior and attitude in general, sometimes leading to changes in their personality, which can cause issues in the family, if misperceived. Hence, family members need to understand and respond to situations sensitively. It is important for all of us to realize that, even they need some solitude time and space for themselves, to process and understand the sudden changes occurring in and around them.
Mental health and menstruation are both stigmatized concepts in India where myths, and taboos surrounding both are still prevalent. The cultural connotation given to these concepts determines the approach of people, which is now slowly and gradually undergoing a positive change creating more awareness. It is said that any growth or change should be slow and gradual to have an everlasting impact on mankind. The growth of psychosocial rehabilitation was indeed the same in India. With the prolonged efforts from the government and various mental health professionals, from the post-independence phase of development of Psychosocial Rehabilitation (PSR) in India, a lot of mental health concerns are being managed. Both the pandemic and menopause are prominent in this context, which are beyond our control. Hence, it is important that ample measures are taken to address these concerns. Even though, there are many on-going debates and studies about the post-menopausal hormonal therapy and other medical interventions, the results so far indicates that the symptoms are unavoidable and tends to largely impact the health of women. Considering the inevitable circumstances, there are certain suggestions based on the core principles and values of PSR which even family members can adopt to address and manage the issues faced by women during menopausal transition. This would not only benefit them during this pandemic but also in general times.
To begin with, it is very important that hope and respect are conveyed, with the belief that they have the capacity for learning and growth as it is motivational and most necessarily, to bring about a change. It is of utmost importance to identify their strengths and capacities and help them build on that, based on their unique needs that are consistent with values, hopes, and aspirations they hold. This kind of approach along with the integration of family members and significant others can help them accept the responsibilities, and explore opportunities and possibilities that enables them to identify their roles and adapt to the situation better. It is important to promote self- determination and empowerment among them, as that can help them make their own decisions. This would facilitate their development of personal support networks by utilizing their natural support from family, peer support initiatives, self, and mutual help groups. All of these would lead them to strive to improve the quality of their lives in social, occupational, residential, intellectual, and spiritual aspects. As this is part of their living and inevitable to undergo this transition phase, it is important to emphasize on the practices that promote their health and wellness, encouraging them to develop and use individualized wellness plans through which they can maintain their physical and mental health based on their convenience and resources available. In case, they would seek professional help, support from the family is essential.
With all these, even though the concerns faced by women during this transition can't be eliminated; it surely can help them manage and adapt to the situation better, along with the active engagement and support from the family members and mental health professionals. The challenges posed by this pandemic is scrutinizing and a roller-coaster ride of mixed emotions for everyone, but with unity, love, and care, all difficulties can be sailed through easily. After all, families are meant to stick through each other's thick and thin. In this kind of panicking situation of the pandemic, it is important that everyone realizes this aspect and stand with each other as this would strengthen the relationships and help them sail through the hardships and foster better mental health at home as well as in the society.