https://mcdn.podbean.com/mf/web/jzqiz7/swapnafinal.mp3
EPISODE SUMMARY:
Dr. Swapna Vaidya is a psychiatrist whose vast range of specialties include women’s health and dealing with menopausal symptoms in midlife. In today’s episode, we sat down with Dr. Vaidya to discuss taking antidepressants during menopause, the side effects of antidepressants, if you can take SSRIs and HRTs together, and the increase in public conversations about menopause.
First, we asked Dr. Vaidya why menopausal symptoms are often treated with antidepressants. She explained to us that although menopause and depression are two different diagnoses, menopause can often mimic symptoms of depression. Due to this, doctors will often prematurely prescribe antidepressants to patients whose actual problems are coming from perimenopause or menopause. To figure out whether a woman needs antidepressants or another form of treatment for her menopausal symptoms, it’s important that she find a doctor to go over the chronology of her symptoms. For most women who have no history of depression before menopause, starting with dietary, exercise, lifestyle changes, and hormone replacement therapies can help alleviate their symptoms. However, if the more natural treatments are ineffective, an SSRI or SNRI may be prescribed. When deciding whether a patient is experiencing major depression or symptoms of menopause, doctors will look at the women’s personal and family history. If she has struggled with depression in the past or her current symptoms are influencing her quality of life, a doctor may be more inclined to give her antidepressants to help. While some women are afraid starting a medicine means they’ll be on it their entire life, that isn’t always the case. When it comes to using antidepressants to treat menopause, a woman can stay on the medicine until her symptoms start to alleviate. Afterwards, she can discuss with her doctor weaning off the antidepressant and trying more natural treatments if she wishes.
Side effects are another aspect of antidepressants that make people hesitant to start them, and when asked about it, Dr. Vaidya said that one of the side effects that isn’t discussed often is a lowered sex drive. Since women’s sexual health and desires are considered taboo topics, no one discusses how a woman’s sex drive can be lowered when she starts taking medicine. However, side effects are treatable and can be made manageable. One way to avoid difficult side effects is to make sure you’re taking a medication that’s right for your body. When it comes to antidepressants, it’s important to discuss your options with a psychiatrist to see what sort of medication is most aligned with your specific symptoms. For example, Prozac may make symptoms of anxiety worse, while Lexapro has a more sedating effect. If you have been on a certain antidepressant before, the same medication is likely to work again if you go back on it for menopausal symptoms.
When going through menopause, a woman experiences not only physical and emotional but environmental changes. Referred to as the “sandwich generation”, midlife women are often taking care of both their parents and their children, forcing them to be extremely depended on. Due to this, coping with their own issues can become a challenge. To help, Dr. Vaidya recommended that midlife women keep a mood diary. By writing down their symptoms, issues, and feelings, they can not only release their emotions but also give a more detailed explanation to a doctor about what they’re experiencing to receive the best form of treatment. With both SSRIs and HRTs being forms of treatment, some women are afraid of taking them together. However, Dr. Vaidya assured that the two forms of treatment do not counteract one another. However, it’s important to be aware of your medical history before starting either an SSRI or HRT. Dr. Vaidya also talked to us about how menopause is still something that isn’t often discussed in the medical field. As a psychiatrist, she shares her own experience with menopause in hopes of starting important, necessary conversations about women’s health. As a whole, menopause is steadily becoming more talked about amongst the public. Information and resources are available for women more than they have been in the past, and there are now different websites, organizations, and applications that offer help and education.
Menopause can often feel like an isolating experience, and Dr. Vaidya emphasized the importance of discussing your struggles with family members and friends. She brought up how the way other people respond when you’re going through something can either positively or negatively impact your experience. It’s important to educate others on not only your menopausal symptoms but your personal needs and boundaries. If a family member or friend makes you feel invalidated, you have every right to confront them, for by doing so, you can help further educate them. Others that should be educated on menopause and how it affects a woman’s body and life are employers. Women should be able to have open and honest conversations with their bosses and fellow employees in order to destigmatize menopause in the workplace. While there have been improvements in certain businesses and careers, society still has far to go in terms of helping and validating working menopausal women.
Finally, we spoke to Dr. Vaidya about who to consult about starting antidepressants for menopause. She told us that for those experiencing mild depressive symptoms, seeing a gynecologist before a psychiatrist is a good option. They may not need medication, and a gynecologist can help form a dietary and lifestyle plan to help alleviate symptoms. However, if you have a history of depression or your symptoms are affecting your ability to function in daily life, then you should see a psychiatrist about potentially starting an antidepressant.
Dr. Swapna Vaidya
Swapna Vaidya MD is currently working as a Collaborative Integrated Care Psychiatrist at Microsoft Crossover Health helping to build an inclusive mental health program for the Microsoft Employees. Prior to this she was Chief Psychiatrist for Kaiser Permanente, WA at their Tacoma location. She also worked at Multicare Behavioral Health Network where she served as a Physician Executive. She has demonstrated a long history of working in hospital health settings, inpatient and outpatient in both community and academic settings. She is experienced in working collaboratively among disciplines within behavior health and across medical specialties to achieve improved health system design and healthcare outcomes. She has made significant contributions in quality improvements methods, process improvement and other metric designs and analysis. She has been instrumental in helping standardize processes and streamlining electronic medical records to achieve better outcomes from a patient centered approach.
She completed her medical training in Mumbai, India and did her psychiatry residency at St Luke’s – Roosevelt’s hospital in NYC. She went on to do a fellowship in Consult-Liaison medicine at NYU-Bellevue Hospital and then worked in medical psychiatry for two years prior to coming to Mount Sinai. While at NYU she served as a vice chair for the mayoral city-wide smoking cessation initiative.
She worked as the Director of Transplant Psychiatry for 5 years before being promoted as the Director of Psychosomatic Medicine Fellowship at Mount Sinai SLRH. She is board certified in General Adult Psychiatry and Psychiatry of the Mentally Ill. She has been inducted as a fellow in the Academy of Consultation Liaison Psychiatry (ACLP) because of her contributions to the field both in research and in academia.
She was presented the Resident Education Recognition Award by the Mount School of Medicine for her exemplary dedication and contribution to the education and professional development of residents in Psychiatry.
Her areas of interest include mood and anxiety disorders, women’s health, reproductive psychiatry, psychopharmacology and psychotherapy in the medically ill, cognitive behavior therapy, and mindfulness-based stress reduction (MBSRT). She is fluent in English, Hindi, and Marathi and has beginner level proficiency in French.
In this episode, we discuss…
- [0:01] Bossa Bars
- [0:49] Guest Introduction
- [5:40] Start of Interview
- [6:35] Antidepressants and Menopause
- [11:38] Diagnosing Depression Versus Menopause
- [13:41] Side Effects of Antidepressants
- [19:14] Coping with Symptoms
- [22:29] Taking SSRIs and HRTs Together
- [31:14] The Increase in Menopause Information Availability
- [33:55] Starting Conversations About Menopause
- [38:53] Working While in Menopause
- [43:33] Who to Consult for Antidepressants During Menopause
- [48:19] Closing Thoughts
- [50:21] Outro
Useful Resources:
Dr. Vaidya’s LinkedIn I [https://www.linkedin.com/in/swapna-vaidya-503843a/]
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