Dipl.of Mental Health – CHCPOL003_CHCMHS009 – Assessment: Research Report 1
1. Formulate a ‘research question’ that your research will attempt to respond to:
With the changing hormonal levels in women during pre, peri & post-menopausal states, is there a heightened risk of developing depression?
2. Provide a background to the issue. Your discussion must make reference to epidemiological or trend related data relevant to the issue, historical developments in sector or policy approaches and current best practice:
Taboo subjects remain a challenge to be talked about in ways that are healthy, helpful and supportive. The issue of menopausal stages and hormonal disruptions triggering anxiety, depression or another mental health issues has double the stigma; women aging beyond their reproductive years and mental illness.
Women in the stages of pre, peri and post menopause have been reported to become vulnerable to mental health issues (Jagtap, Prasad, Chaudhury 2016) which brings the correlation between the changes in hormonal environments and depression disorders in older women into the category of exploration and research to help find better management practices of menopausal symptoms and mental health conditions associated or exasperated.
The Australian Menopause Society can be quoted in referring to the transition of menopause as, “has been shown to be one of increased risk for both depression and psychosis in some women” (Australian Menopause Society 2014) which is a clear indication that hormonal disruptions impact an aging woman’s biological environment to the point of distress and potential concern in area’s of mental health.
Whilst mental health has been moving from highly clinical processes to individualized and personally tailored recovery practices, menopause is still regarded as “a highly pathologized process orbiting age, fears of temporary madness, and social attitudes about older women’s sexuality.” (Krajewski 2018)
With a somewhat lacking advancement in the acceptance of the female rites of passage pathway into crone-hood, menopause was also once a diagnosis to be feared as it became weaponized for admitting women into asylums throughout the alarming history of mental asylums and institutions; ‘insane by suppressed menses’ within older females. (Pouba, Tian 2006)
With practices eventually moving away from linking hormonal changes of menopausal transitions with being insane, the modern day movement of developing awareness around the hormonal changes occurring within female bodies and the link to psychiatric vulnerability, creates an opportunity to change not only the way society views aging women, menopause and mental health, but also more inclusive, effective and holistic approaches to better management.
3. Explain why you have chosen to research this issue. Your response must demonstrate understanding of different reasons for undertaking research:
Exploring the correlations of menopause and depression is a way of strengthening my toolkit in women’s empowerment, and, at 46, optimising my understanding of the mental health aspects of transitioning through menopause.
Being well informed on this subject not only supports my personal and practice knowledge base, but also improves my effectiveness in being able to advocate for myself and others in managing pre, peri and post-menopausal transitions.
Identifying what are the current norms and accepted views within aging women, menopause and mental health, is an integral step to alleviate 3 types of stigma that still plague modern day society. Those three types being aging, women and mental health.
It is my understanding that to promote change and healing, unearthing the taboo subjects and creating clear conversations is paramount in the evolutionary process of acceptance and inclusivity of all.
4. Discuss a minimum of three legal, ethical and/or cultural considerations relevant to research on this topic, including duty of care requirements:
Legal Considerations: Privacy and Confidentiality. Maintaining effective records and recording keeping methods. Respecting individuals wishes and only sharing information with referral services if consent is given.
Ethical Considerations: Duty of Care and wellbeing. Providing the best, most effective, positive and support services and referrals to services as possible. And contributing to as much ease when transitioning through the menopausal stages and mental health implications.
Cultural Considerations: Language supporting the cultural backgrounds where communication around a women’s body, reproductive rights and issues, and menstrual cycles may not be as open and forthright as we are in Australia. This points to the potential of wariness and or breaking of foreign countries traditions and taboos. Stigma of mental health issues within that as well. Ensuring that the people being spoken to and language used, are appropriate for that cultural aspect also and that no cultural boundaries are being crossed.
5. Provide an annotated bibliography, reviewing at least 2 scholarly sources of information on your chosen issue that you have read:
Krajewski, S 2019, ‘Killer Whales and Killer Women: Exploring Menopause as a “Satellite Taboo” that Orbits Madness and Old Age’, Sexuality & Culture, vol. 23, no. 2, pp. 605–620, viewed 24 February 2020, https://search.ebscohost.com/login.aspx?direct=true&AuthType=url,uid&db=a9h&AN=136274741&site=ehost-live&scope=site
Killer Whales and Killer Women: Exploring Menopause as a “Satellite Taboo” that Orbits Madness and Old Age.
A fascinating article of intrigue and well-articulated wonder.
Touching on the taboo subjects of ‘old age, madness and menopause, this article is a collective of information from the practical to the enlightening.
Setting out to discover the ‘why’ of our biological ability to reproduce ceasing long before we die, the article formulates a link between killer whales as the only other species on the planet that sees females surviving long after their reproductive years have finished.
In a fascinating comparison, this article pushes the boundaries on the taboos of menopause, implying that comparing whales and women could have positive social implications by shifting the focus from medicalization to empowerment, from illness to wellbeing.
Studying the similarities in killer whales and their social structures, this article bravely points to understanding human menopause rather than treating it like an illness and continuing the power structures and control over women’s bodies that we’ve seen throughout history and into modern day times.
It has a decisive tone in producing the distinctions of social views and taboos coupled with positive adoptable aspects from our whale friends that support the shift of acceptance and embracement of the elder female powers including knowledge, wisdom, experience and enhanced leadership skills.
The article proposes that while menopause is part of a biological aging process, the socially constructed links to menopause benefit those who support the idea of menopause being a socially constructed trigger of illness, discomfort and madness, and remaining in that ideology will continue to perpetuate negative feelings and responses towards older women and their bodies.
Citing the menopausal transition as being deeply embedded in social structures and evolutionary advantage, as explored through the research and theories of Daniel Franks and Darren Croft respectively, we are privy to viewing both the social constructs and evolutionary implications that gives a glimpse into the necessity of ageing women as a strength in survival and the taboo discourse due to “the very essence of being female seems to be attached to being sexually desirable and able to produce offspring.”
The article cites no definitive link between hormonal changes and menopausal depression, but rather, the female struggles in an environment of gendered pathology and taboo discourses would be better served by exploring the reasons for taboo around menopause, who benefits from the madness around it.
Jagtap, B, Prasad, B. S. V. & Chaudhury, S Department of Psychiatry, Pravara Institute of Medical Sciences 2016, ‘Pschiatric Morbidity In Perimenopasual Women’, Industrial Psychiatry Journal, vol. 25, Jan-Jun pp. 86-92, viewed 25 February 2020 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5248425/
Psychiatric Morbidity in Perimenopausal Women
This article is more symbolic of data collection as a result from a hospital based study carried out in India. This study was designed to assess the psychiatric morbidity in perimenopausal women within the age group of 45 to 55 years.
The article refers to a cross-sectional and observational study of 108 women diagnosed to be in perimenopausal states. Excluded from the study were perimenopausal women with a history of psychiatric illness, with a major medical illness, or who had undergone surgical menopause.
It is brief article yet provides a responsible and intellectual look at findings after carrying out assessments with Sociodemographic and clinical data sheets, the Mini International Neuro psychiatry Interview (English Version 6.0.0) and Statistical Analysis.
The article covers the results of the evaluated perimenopausal women which found that out of the 108, 31% of women had major depressive disorder. 7% of women were found to have anxiety disorder and 5% were found to have major depressive disorder with comorbidity.
In this article, relevant statistical data is shared around the sociodemographic findings in relation to differences, of which education, rural living and the age of experiencing the first menstrual cycle.
The article goes on to discuss perimenopause as being a time of vulnerability that may be associated with increased risk of developing a psychiatric disorder, with depression being the main mental health morbidity.
This article shares the statistically drawn data and conclusions, around women in perimenopause affected by psychiatric morbidity were most commonly diagnosed with depression. This article identifies a correlation between perimenopause and depress, confirming a link that supports at least a vulnerably to depression and other mental health issues during the stages of hormonal changes in aging women.
6. A discussion of the recommendations based on your research you would make to a service or individual workers supporting people experiencing your chosen issue to:
Within the context of the research that I have carried out, one cannot necessarily draw definitive conclusions around the risks of hormonal changes and mental health challenges like depression and anxiety.
Given the taboo status of ageing females, menopause and mental illness, conversation around women’s experiences, both with menopausal transitions and mental health, will help to destigmatize the subjects and allow for open and expansive conversations and explorations designed to create knowledge, awareness and understanding.
With a limited scientific encouragement to explore the hormonal changes within women’s bodies without judgment, preconceived views and stigma related limitations, we are left with choosing (1) to believe in what sources of information come our way and navigate the transition of menopause somewhat blindly or medically, or (2) to monitor our own process and feelings, to ignite conversations with our peers, to be in more control of what our bodies, our hormones and in awareness of what our feminine instincts are illuminating for us.
Until there is a true desire to understand pre, peri and post-menopausal changes, conditions and transitions beyond the gendered pathology and taboos, women will be subject to medical control rather than physical, mental and spiritual health and wellbeing.
Industry best practice requires a shift in focus and a shift in perception, to widen the narrow mindedness and stigma in order to expand into the best possible practices that support women’s health and wellbeing in holistic and inclusive ways.
7. Identify at least two aspects or areas relevant to your chosen issue that you will conduct further research on:
The connection between hormonal changes and risks of developing anxiety and or depression, is left somewhat unanswered depending on the source of research. With scholarly sources both discounting and accrediting hormonal changes as a potential risk or increase in the development of depression, the question remains open to further exploration and research.
Do hormonal changes during pre, peri and post menopausal transitions create a risk or exasperate depression?
Or is the link one of discourse and stigmatization of women’s bodies, hysteria, and mental health judgments in aging and older women?
Australian Menopause Society 2014, ‘Mood Problems at Menopause’ 2014, viewed 20/2 2020 <https://menopause.org.au/hp/information-sheets/570-mood-problems-at-menopause>
Jagtap, B, Prasad, B. S. V. & Chaudhury, S Department of Psychiatry, Pravara Institute of Medical Sciences 2016, ‘Pschiatric Morbidity In Perimenopasual Women’, Industrial Psychiatry Journal, vol. 25, Jan-Jun pp. 86-92, viewed 25 February 2020 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5248425/>
Krajewski, S 2019, ‘Killer Whales and Killer Women: Exploring Menopause as a “Satellite Taboo” that Orbits Madness and Old Age’, Sexuality & Culture, vol. 23, no. 2, pp. 605–620, viewed 24 February 2020, <https://search.ebscohost.com/login.aspx?direct=true&AuthType=url,uid&db=a9h&AN=136274741&site=ehost-live&scope=site>
McGuire, T 2020, Research Practices, lecture notes, Diploma in Mental Health CHCPOL003 CHCMHS009, TAFE NSW Taree, delivered 24 February 2020
Pouba, K & Tianen, A University of Wisconsin Oshkosh 2006, ‘Lunacy in the 19th Century: Women’s Admission to Asylums in United States of America’, Oshkosk Scholar, vol. 1, April 2006 pp. 95-103, viewed 20 February 2020 <https://minds.wisconsin.edu/bitstream/handle/1793/6687/Lunacy%20in%20the%2019th%20Century.pdf?sequence=1>
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