The husband of a solicitor who took her own life amid struggles with perimenopausal depression has called for it to be recognised as a mental illness in its own right.
Victoria Metcalf-Smith died in March 2021 at the age of 51, having spiralling into depression after entering her perimenopause - the stage immediately before menopause - a few years prior. She had no previous issues with her mental health.
Her husband, Peter Smith, and her mother, Heather Metcalf, were two panellists at a suicide prevention event exploring the links between perimenopause and suicide organised by the Norfolk and Suffolk NHS Foundation Trust.
During the session, Mr Smith called for perimenopausal depression to be recognised as a form of the mental illness in its own right, as opposed to being treated like any other depression.
He said: "The awareness and classification of perimenopausal depression needs to be out there - it needs to be recognised as another type of depression in the same way that postnatal depression is.
"When she died she had become very unwell and we could just not understand what it was. It is heartbreaking - a very sad story."
His calls were echoed by his mother-in-law, who also spoke out about her daughter's illness during the panel.
She said: "She was a remarkable woman who was always calm and confident and was the lynchpin of our family. If this could happen to her it could happen to absolutely anybody.
"In the period of two years before her death she went to her GP and doctors and nobody appeared to think that perimenopause could have been the cause."
Mrs Metcalf-Smith, who died in Norwich, was treated with a range of medication geared at treating her depression, starting with anti-depressants before she was eventually moved onto lithium.
However, her family say none of her treatment was geared at addressing the perimenopausal side of her troubles.
And they argue that were perimenopausal depression to be treated in the same way as, for example, postnatal depression, it could go a distance to preventing others suffering the same fate as her.
Mr Smith added: "I think people being able to get the right help is as important as the awareness and GPs ought to know more about the psychological effects of perimenopause.
"In Vic's case, her mental health was focussed on but the cause went untreated. We will never know for sure but it felt like a very significant factor in her case."
Mrs Metcalf added: "She would have gone on and on taking this same medication and probably would have made no real difference at all.
"There is such an expectation on women to just keep going on - it does not really matter how they feel. The awful thing is women often feel that way themselves, that they have to keep doing their jobs and keep their homes together and the truth is, in the end, she couldn't."
Also part of the panel was menopause specialist Louise Newson, who regularly appears on television to raise awareness of the challenges women face when going through both menopause and perimenopause.
Dr Newson said: "Lots of people think that menopause is just a few hot flushes and nothing more - that is wholly wrong.
"It is also so important that people know they are not alone - this is something that affects 50pc of the entire population directly and probably the other 50pc indirectly.
"We absolutely have to listen to the women that are going through this."
Dr Newson said that typical features of perimenopausal depression include paranoid thinking, decreases in self-esteem and heightened anxiety. It can also lead to weight gain, poor sleep quality and other forms of fatigue.
Liz Howlett, suicide prevention lead at NSFT said: "In more than 20 years working as a mental health professional this is among the first times we have really asked questions about menopause - this has to change.
"We cannot go on saying 'there there' to women going through it then sending them to sit next to an open window."
Where to get support
Support for people going through menopause can be found at the following websites:
Menopausesupport.co.uk
Thebms.org.uk
Menopauseandme.co.uk
Menopausedoctor.co.uk
Themenopausecharity.org
Thedaisynetwork.org
If you need help and support, call Norfolk and Suffolk Foundation Trust’s First Response helpline 0808 196 3494 or the Samaritans on 116 123. Both services are available 24 hours 7 days a week. You can also download the Stay Alive app on Apple & Android
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