Menopause can have a profound effect on a woman’s body. It’s not simply the end of menstruation — it impacts the metabolic system, the cardiovascular system, and mental health. It’s estimated that about 35 percent of menopausal women experience depression, but often clinicians don’t make the connection between menopause and mood disorders.
That’s what happened to Marian Adams. At 52, she suddenly didn’t feel like herself. It took 10 doctors, 22 medications, and even a round of electroconvulsive therapy before a physician checked her hormone levels and was able to guide her toward recovery. In this compelling essay — one of several pieces included in Midlife Private Parts: Revealing Essays that Will Change the Way You Think About Age, out June 24 — Adams talks about her experience with medical gaslighting and her long journey to get the care she needed.
Fingers locked tightly, my husband holds my bony hand as we ride the hospital elevator. Knots tighten in my stomach with each passing floor. Stark fluorescent lights and chalk-white walls greet us on the eleventh floor, along with a stone-faced security guard who enters a passcode, opening a huge steel door. Two white coats and a nurse look up from the long table. The nurse approaches me. “Raise your arms,” she says. With shiny sharp scissors in hand, she cuts the drawstring of my yoga pants, then the laces from my running shoes.
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Welcome to my nightmare. I am in the psych ward.
It’s 2016, and I’m 52 years old. Since the age of 40, I had been the poster child for healthy living. Each morning began with a long run, weightlifting, or Vinyasa yoga. Invigorated and clear-headed, I dove into the tasks and challenges of the day. Each evening, I prepared the night’s Mediterranean dish for my beloved husband and three children. It truly was a wonderful life.
One of the highlights during these years was our family tradition of attending the annual Army/Navy football game. The anticipation was as much fun as the game, packing fleece blankets and roast beef on rye, pulling out the Navy hats, sweatshirts, and thermals. This Navy-loving clan would be there, rain, snow, or sunshine.
But in 2015, I felt as if someone else was watching the game. While I had always marveled at the Blue Angels soaring through the clouds and became giddy as Navy Seals parachuted onto the field, this time, there seemed to be a veil between me and the action. I could not feel the excitement, did not belt out the National Anthem as I did every year before. When my husband bounced back and forth between our seats and those a few rows away where our children sat, I felt paranoid, believing he didn’t want to sit beside me. Caught up in the thrill of the game, no one noticed how frightened I was.
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What was happening to me?
A few days later, while paying for my chocolate almond protein shake, the owner of our local health food store noticed my low energy, the sadness in my eyes, and said, “You’re not yourself today.” I wasn’t.
When my sister-in-law dropped by the house the following month, she seemed concerned by my gaunt appearance and the absence of my smile. I overheard her tell my husband, “My God, she’s a shell of herself.” I was.
Then, one Friday afternoon at the hair salon, I suddenly began to weep uncontrollably. Fleeing to the ladies’ room, I called a friend, begging for a lifeline. She didn’t know what to do.
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I had tried so hard to be strong and pretend everything was fine but could no longer keep up the façade — for myself or those around me. There was something seriously wrong.
Probably the most debilitating aspect of my freefall was my inability to sleep. When my husband’s alarm went off at 5 a.m., as it had every weekday of our married life, I found myself, tortuously, still wide awake since the night before.
Desperate, I began attending the weekday 8 a.m. mass at St. Joseph’s Roman Catholic Church, where I had been baptized 52 years before. On my knees, I’d light a candle for myself and beg the dear Lord, “Please help me.”
And then my hair, which I’ve always loved, began to fall out. It was time to see a doctor. I had no idea it would be the first of many.
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A friend recommended a psychiatrist, who, after a lengthy discussion and questionnaire, told me my serotonin must be very low and that I had a “mood disorder.” Depression. She pumped me full of prescriptions.
After trying 10 different sleep and mood medications with no relief, I went to my long-time internist, doctor No. 2. Down 21 pounds from my last checkup, missing patches of hair on my head, I wept as I told him I couldn’t sleep; I couldn’t function. “A lot of people think they don’t sleep, but they really do,” he responded. “Besides, you can’t be that bad. You’re dressed nicely and wearing your pearls.” He never examined me. No scale, no blood pressure, no urine sample, no stethoscope, no blood test, no EKG. Nothing. But he did hand my husband a card for the best psychiatrist in New York City, the doctor I went to next, who recommended electroconvulsive therapy (ECT), assuring me that 75 percent of patients with severe depression “get their lives back.”
“I think you’ll really like the unit,” doctor No. 3 added.
And so there I was, an inpatient in the psych unit of a top Manhattan hospital. Every other day, I was instructed to undress, step into a sumo wrestler–size plastic diaper, and wrap myself in a hospital gown. Then, seated in a wheelchair, I was lined up with the other five patients waiting for the same treatment.
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The room was always freezing. Just before they put me under anesthesia for the first time, I turned to one of the masked doctors. “Can you please pull the blanket over my foot?” He responded matter-of-factly, “It needs to be exposed so that we can see when it starts shaking; that signals that the seizure we are inducing in your brain has been triggered.”
After more than two weeks of “treatment,” I returned home. Nothing had changed.
Next stop, my gynecologist, doctor No. 4. He took one look at me and said, “I’m worried about you,” and suggested I see his partner, doctor No. 5, to check my hormone balances. When I requested that she do so, she rolled her eyes and spoke to me through her assistant, in the third person. “Tell her to order Cortisol Manager, magnesium glycinate, and Methyl-Guard Plus,” pricey supplements from her new website. She would not test my hormones.
I was beginning to feel hopeless but continued my search for an answer. Doctor No. 6 referred me to a neurologist, doctor No. 7, who ordered a brain MRI and a spinal tap and sent me home with an apparatus of metal discs I had to keep wrapped on my head for seventy-two hours. Verdict? No neurological issues.
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Doctor No. 8 was an Ayurvedic doctor, whose examination consisted of asking me questions and looking at my tongue.
Doctor No. 9, a local female “concierge” internist, was full of condescending speculation. “Maybe it’s not depression; maybe you’re sad because you don’t have any small children to care for anymore. You know, no reason to get up in the morning. Perhaps you should get a job.” I couldn’t get myself into the shower in the morning, and this woman wanted me to “get a job”!
Next, a Harvard-educated psychiatrist prescribed 36 rounds of transcranial magnetic stimulation. Five days a week for seven weeks, I sat in a chair with a helmet apparatus sending constant loud clicking pulses to my brain. He also suggested I take up swimming. Swimming! If I got into a pool in my state, I’d likely drown.
On what felt like my thousandth trip to Walgreens, this time to pick up gabapentin — the same medication my vet once prescribed for my ailing dog — I stared down what appeared to be an impossibly long aisle. I felt like a dead woman walking as I made my way to the pharmacy at the back of the store. I’ll never forget the two female pharmacists, who’d known me when I was “myself.” They spotted me and glanced at each other, and then back at me with disbelief and pity, as if they were saying, “My
God, I can’t believe she’s here again.”
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By this point, I had been prescribed and taken over 22 different medications, including Saphris, Lexapro, Seroquel, sertraline, lamotrigine, escitalopram, clonazepam, aripiprazole, Latuda, gabapentin, Pristiq, nortriptyline, lithium carbonate, bupropion, mirtazapine, zolpidem, tranylcypromine, midodrine, and minivelle.
None of them worked. On the contrary, many, especially in combination, exacerbated my symptoms.
I had lost focus, the ability to concentrate. My mobility was impacted. My family took my car keys away.
At the lowest of lows, I began lying to my husband. “Did you walk today?” he’d ask, hoping to see even the tiniest bit of light. “Yep, mm-hmm. I walked while you were out biking,” I’d say. I didn’t want to disappoint him.
Almost three years since that Army/Navy game, I sat propped up on the sectional at a family gathering. My beautiful mother positioned me at the buffet, where, tongs in hand, I robotically served melon and prosciutto. I overheard a relative raving about a nutritionist he started seeing and asked for her number. Maybe she could tell me what to eat to feel a little better. The last thing I thought I needed was another doctor. But I was wrong. I needed the right doctor. The “nutritionist” I saw was actually an internist/endocrinologist. Dr. Carolina Sierra was doctor No. 10. And she saved my life.
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Two days later, Dr. Sierra shared the results of my blood work. “Marian,” she said, “the reason none of your past treatments or medications helped you is because they target a chemical imbalance in the brain, and that is not what caused your symptoms.”
“You haven’t slept in three years because you have no progesterone,” she went on. “You can’t stop crying and don’t feel like yourself because you have no estrogen, and no testosterone, which women need too. Your thyroid is a disaster. You have no vitamin D or vitamin B, and you did have the Epstein-Barr virus at one point.” Then, with the most sincere compassion, she said, “All together, you fell off a cliff.”
After nearly three years of misery, existing haggardly on the sidelines of my life, I was finally properly diagnosed. At 52, along with a malfunctioning thyroid and several vitamin deficiencies, I was also in menopause, a word that not one of these doctors over a three-year period had ever mentioned. Appropriate, targeted medications and supplements swiftly brought both my mind and body into balance and highly functioning again. Thyroid medication brought me back to a healthy weight, gave me blessed energy, and restored my lustrous locks. Compounded bioidentical hormone cream balanced my estrogen so that I could regain the joy I used to naturally feel. Replacing lost progesterone granted me dreamy, restorative sleep, and testosterone levels normalized. Prescription-strength vitamin D and daily vitamin B12 further restored my energy and mental clarity.
I felt as if I rose from the dead.
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My vibrancy, humor, and health now regained, I sometimes wonder about the precious time lost with my children, husband, and exquisite, dear mother. But I don’t stay there long. Rather, I turn my attention to using my experience to help other women avoid unnecessary, preventable suffering. How much could I have avoided had any of my first ten doctors been properly trained and took seriously the changes and debilitating symptoms that many women suffer when they experience menopause? By sharing my nightmare, I am turning anger into action. Above all, I tell my story to empower women. Equipped with the right questions to ask, women will be prepared to effectively advocate for their health.
“It’s all in your head”? Maybe not.
Excerpted from Midlife Private Parts: Revealing Essays that Will Change the Way You Think About Age, edited by Dina Alvarez and Dina Aronson.
The post One Woman’s Grueling Ordeal With Menopause and Medical Gaslighting appeared first on Katie Couric Media.