美国国家公共电台 NPR How Puberty, Pregnancy And Perimenopause Impact Women's Menta

How Puberty, Pregnancy¹ And Perimenopause Impact Women's Menta

RACHEL MARTIN, HOST:

Last week, I talked with author Ada Calhoun about the unique stresses facing women who are part of Generation X, the generation born between about 1965 and 1980.

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ADA CALHOUN: The pressure on women now to not only be great at work and, you know, great at home but also just, like, to be really exceptionally thoughtful and patient parents - it does feel like it's really high right now.

MARTIN: Her book is called "Why We Can't Sleep: Women's New Midlife Crisis." And in it, she also addresses the physical and emotional stress women face in midlife, not just the social pressures or economic strains. All of that stress is actually compounded by the big reproductive change that happens in that time of life. Yeah, we're talking about menopause, the end of monthly periods and the end of fertility. Here's Ada Calhoun.

(SOUNDBITE OF ARCHIVED NPR BROADCAST)

CALHOUN: I just found it really helpful to know that this is a set period of time, that these years, middle age, have been rough, especially for women, for many, many generations and that it's hard for us. But it's going to be over at some point.

MARTIN: Menopause is the last big reproductive shift for women. There are all the hormonal² changes that happen in pregnant women and after those women deliver babies. Here's Jennifer Ford³ (ph) of Massachusetts.

JENNIFER FORD: It's very hard to admit that, you know, something's not right, I mean, especially when you have a new baby in the house and it's supposed to be this wonderful, happy time. And it's just that's not how it was.

MARTIN: And, of course, the first big change happens in puberty. This is 15-year-old Isatou Barrow (ph). She's from New York and one of the hosts of the podcast Shh! Periods.

ISATOU BARROW: No, I actually suffer from, like, depression. Like, I really get depressed⁴ a lot. Whenever, like - whenever I get depressed, that means, like, my period, like, comes - that's why.

MARTIN: All this week, we're going to be talking about these pivotal moments in a woman's life, what is actually happening biologically and how to manage the unforeseen effects. Our guide through this series will be NPR health correspondent Rhitu Chatterjee, who joins us in the studio now. Thanks so much for coming in.

RHITU CHATTERJEE, BYLINE⁵: My pleasure, Rachel.

MARTIN: So we just heard that very moving tape from 15 year old Isatou Barrow talking about her own depression, what she feels when she's about to start her period. And that is what is so complicated - right? - about these reproductive turning points in a woman's life. There's the physical and also the emotional stress.

CHATTERJEE: Right. And these are times when women's bodies are going through these enormous, big changes, which often involve hormonal changes. And that makes them vulnerable to emotional stress and mood and mental health symptoms. So a lot is changing in the lives of girls and women socially, emotionally, physically⁶. And most women, I think, will experience PMS symptoms, for example, around their periods. And then there are more serious symptoms, like depression and anxiety, that can crop up at these times in life.

MARTIN: And then for women who get pregnant, there's this period around pregnancy postpartum. Talk about what that can look like.

CHATTERJEE: So 1 in 7 women usually develop major depression during pregnancy and postpartum. And among some women, like those who have a history of trauma⁷, the rate is even higher. And the symptoms are usually like that of any major depressive episode. So women get - you know, they feel hopeless. They - getting out of bed is hard. They can feel weepy, and they struggle to get through sort of daily activities taking care of themselves and even their babies in the sort of postpartum period. And some women have heightened anxiety, so they have trouble sleeping. They're hypervigilant, worried about something happening to their baby. And for an even smaller minority of women, things can get as bad as postpartum psychosis. Now, it's rare, estimated in only about 1 or 2 out of a thousand deliveries, most often within the first two weeks of childbirth. But it can happen.

MARTIN: Right. So understanding that it's rare, what does that look like? How does it manifest?

CHATTERJEE: So psychosis is a break from reality. So women can feel delusional⁸. They have hallucinations. They can be hyperactive, unable to sleep. They feel paranoid and suspicious. And a small minority of them can even be suicidal and attempt to take their own lives.

MARTIN: So now and again, it's worth saying we're identifying all these stages because we're going to talk about coping mechanisms⁹...

CHATTERJEE: Exactly.

MARTIN: ...Through this series and how women can deal. But let's talk about menopause because this is something that is confusing to a lot of women because we don't talk about it a lot.

CHATTERJEE: We don't talk about it. And that's something that, in the process of reporting on this, we sort of reinforce just how much of a silence there is around this and lack of information. So menopause is just one day in a woman's life when she hasn't menstruated for a year. And the period most of us think of as menopause is actually what researchers called perimenopause. And we don't realize that that period can last anywhere between four to 10 years when our bodies are sort of changing dramatically to prepare to put a stop to menses - or the periods - which we've spent our entire lives (laughter) getting accustomed to.

MARTIN: But wait. Ten years?

CHATTERJEE: It can for some women. Not everybody - but yep, it's four to 10 years.

MARTIN: It's so interesting - the menopause, the actual moment of menopause - it's just a day.

CHATTERJEE: Exactly.

MARTIN: Wow. So we're going to talk about all this through this series, but we have to acknowledge in this conversation that the very idea that a woman would be mentally or emotionally compromised during reproductive turning points is something that has been manipulated since the dawn of time to diminish women, to oppress women. Those societal stereotypes¹⁰ have been used to push women out of public life.

CHATTERJEE: Oh, I still hear it. You know, when - as a joke, people will say, oh, she's just hormonal. She's just, like, crazy hormonal. And it's still used to sort of belittle¹¹ women to not take them seriously. But what researchers tell me is that women going through these sort of stages of life and times when they are under the influence of hormones¹² that might be affecting their mood, the problem is that they're way too tough and resilient, that they're so used to dealing¹³ with so many of these big changes throughout their lives, they're always trying to sort of tough it out and not take care of themselves, not pay attention to whatever symptoms they're experiencing. And on top of that, take the stigma¹⁴, societal stigma around mental illness in general. And that prevents women from sort of speaking up or even acknowledging to themselves that, hey, I'm not doing that well. And if I don't take care of myself, I'm not going to be able to take care of all the other people in our lives, which is what, a lot of times, women are way too busy doing.

MARTIN: Rhitu Chatterjee, NPR health correspondent. Thank you so much, Rhitu.

CHATTERJEE: Thank you, Rachel.

1 pregnancy   

n.怀孕，怀孕期

参考例句：

• Early pregnancy is often accompanied by nausea.怀孕早期常有恶心的现象。
• Smoking during pregnancy increases the risk of miscarriage.怀孕期吸烟会增加流产的危险。

2 hormonal   

adj.激素的

参考例句：

• Some viral diseases are more severe during pregnancy, probably tecause of hormonal changes. 有些病毒病在妊娠期间比较严重，可能是由于激素变化引起的。
• She underwent surgical intervention and a subsequent short period of hormonal therapy. 他接受外科手术及随后短暂荷尔蒙治疗。

3 Ford   

n.浅滩，水浅可涉处；v.涉水，涉过

参考例句：

• They were guarding the bridge,so we forded the river.他们驻守在那座桥上，所以我们只能涉水过河。
• If you decide to ford a stream,be extremely careful.如果已决定要涉过小溪，必须极度小心。

4 depressed   

adj.沮丧的，抑郁的，不景气的，萧条的

参考例句：

• When he was depressed,he felt utterly divorced from reality.他心情沮丧时就感到完全脱离了现实。
• His mother was depressed by the sad news.这个坏消息使他的母亲意志消沉。

5 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

6 physically   

adj.物质上，体格上，身体上，按自然规律

参考例句：

• He was out of sorts physically,as well as disordered mentally.他浑身不舒服，心绪也很乱。
• Every time I think about it I feel physically sick.一想起那件事我就感到极恶心。

7 trauma   

n.外伤，精神创伤

参考例句：

• Counselling is helping him work through this trauma.心理辅导正帮助他面对痛苦。
• The phobia may have its root in a childhood trauma.恐惧症可能源于童年时期的创伤。

8 delusional   

妄想的

参考例句：

• You became delusional and attacked several people trying to escape. 你产生了错觉并攻击了许多人还试图逃走。 来自电影对白
• He is incoherent, delusional, suffering auditory hallucinations. 他出现无逻辑的，妄想的，幻听的症状。 来自电影对白

9 mechanisms   

n.机械( mechanism的名词复数 )；机械装置；[生物学] 机制；机械作用

参考例句：

• The research will provide direct insight into molecular mechanisms. 这项研究将使人能够直接地了解分子的机理。 来自《简明英汉词典》
• He explained how the two mechanisms worked. 他解释这两台机械装置是如何工作的。 来自《简明英汉词典》

10 stereotypes   

n.老套，模式化的见解，有老一套固定想法的人( stereotype的名词复数 )v.把…模式化，使成陈规( stereotype的第三人称单数 )

参考例句：

• Such jokes tend to reinforce racial stereotypes. 这样的笑话容易渲染种族偏见。
• It makes me sick to read over such stereotypes devoid of content. 这种空洞无物的八股调，我看了就讨厌。 来自《现代汉英综合大词典》

11 belittle   

v.轻视，小看，贬低

参考例句：

• Do not belittle what he has achieved.不能小看他取得的成绩。
• When you belittle others,you are actually the one who appears small.当你轻视他人时， 真正渺小的其实是你自己。

12 hormones   

n. 荷尔蒙，激素 名词hormone的复数形式

参考例句：

• This hormone interacts closely with other hormones in the body. 这种荷尔蒙与体內其他荷尔蒙紧密地相互作用。
• The adrenals produce a large per cent of a man's sex hormones. 肾上腺分泌人体的大部分性激素。

13 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

14 stigma   

n.耻辱，污名；(花的)柱头

参考例句：

• Being an unmarried mother used to carry a social stigma.做未婚母亲在社会上曾是不光彩的事。
• The stigma of losing weighed heavily on the team.失败的耻辱让整个队伍压力沉重。