Text | Cai Jiaxin
Editor | Tao Ruogu
Until one day, Douban ID discovered a familiar and secret world hidden in her mother's shopping cart-lobular rosewood bracelets for her daughter, stomach-nourishing bread for her husband, woolen coats and down jackets that she failed to order. In Bai's view, these are all traces of her mother's hard work. However, I bought myself a pale pink chiffon scarf, but my mother hanged herself in the bathroom at home. "It is these ordinary details that make your departure so unexpected."
Her post "Visiting Mom's Taobao" stung many people who had similar experiences. Most of them did not expect her mother's death to be so unexpected. In another family, on an ordinary morning, the whole family just wrapped up jiaozi and agreed to take her to the hospital to see insomnia the next day. For her 34-year-old son, it was originally one of countless ordinary days, but a few hours later, her mother jumped from the window of a tall building.
The last straw that crushed the mother pointed to "menopausal depression", medically known as "perimenopausal depression", which was a mental disorder that first appeared in menopause. Wang Xue, a psychologist at Beijing Anding Hospital, said that female menopause usually occurs between the ages of 45 and 55, which means that ovarian function is reduced and hormone levels are reduced, which is the high incidence of depression. It is the first time for a small number of people, and many patients have a medical history in the past, but they may not be taken seriously and have not been diagnosed by doctors. "A person committed suicide, hasn't it changed at all?"
Many people shared with us the course of my mother's "menopausal depression". Grumpy, silent, sometimes fragile and crying, just like a child who needs to be protected, this face of her mother has never been shown when she was growing up-she used to be so strong, omnipotent and even a perfectionist in the eyes of others.
(Note: The "menopausal depression" mentioned in this article generally refers to the mental disorder during menopause. For the convenience of writing, it is called "depression" for short, and related diseases include depression, bipolar disorder, anxiety and so on. Because of the great differences among patients, the cases in this paper are not limited to the first menopause. )
There is no clear time to suffer from "depression" until there is serious abnormal behavior. One day seven or eight years ago, Li Ziyu's mother suddenly cut off the intercom line at home, saying that others would monitor her through it.
From then on, Li Ziyu felt something was wrong: walking in the community, an acquaintance greeted her head-on, and her mother would quietly tell her that the person had a problem with herself from her expression; Li Ziyu's playing ring fell in his father's car, and his mother directly described the details of other women in the car after seeing it. "The obvious feeling is morbid." In retrospect, Li Ziyu, a doctoral student in Japan, found that even before the symptoms of "delusion of being killed" appeared, her mother became irritable and quarreled with her father for a trifle, and anyone who left the key at home would also lose his temper. But no one realized that she was ill. They just asked her, "What are you talking about all day?"
Yunran didn't know her abnormality for half a year, until her mother's weight dropped below 80 kg: she couldn't sleep all night, nervous, and didn't joke. People around don't understand. My husband is an employee of a state-owned enterprise and my daughter works in Beijing. What is anxiety? Yunran also thinks that "I am the one who should be more anxious".
In Guangzhou, 2000 kilometers away, my mother's life presents a seemingly leisurely but unknown blank. Recalling her changes and anomalies, Yunran, who is far away in Beijing, knows nothing. The only thing she can remember is that her grandfather died last year. In the past six or seven years, my mother didn't have a job. She was always at home alone and took care of her sick grandfather every morning. Yunran never thought about what her mother was doing every morning after grandpa left.
Some people simply hide their illness for the purpose of protecting their children. Li Ziyu is an only child. When my elders were sick, my parents quarreled. She kept a secret from me and didn't take part in any disputes. "Just concentrate on your studies." . In order not to affect the college entrance examination, Li Ziyu was sent to her grandmother's house by her father. She didn't know how hard it was for her mother and her family, and even later her mother was sent to a mental hospital. It was several years before she learned from her relatives.
Li Ziyu lives in a second-tier city in northwest China. After six years, the elders in the family are still avoiding this matter. My mother sometimes takes the initiative to mention "I was mentally ill at that time ..." Her voice did not fall, and my uncle quickly interrupted: "Don't talk nonsense." The stigma surrounding depression is also aggravating her "sense of shame".
According to psychologist Wang Xue, like Li Ziyu's family, too many patients and their families have a sense of shame about depression. In the consultation experience, many patients will ask her when they see the diagnosis results: Why should I be diagnosed with depression? The older you get, the stronger your sense of shame becomes. According to Wang Xue's analysis, this may be related to their times and environment. "In those days, mental illness was a shameful title. It' s embarrassing to be old and mentally ill. "
This sense of shame makes them tend to hide their illness. Su's mother, a girl from Henan, was diagnosed with depression four years ago. She was afraid of being called crazy, so she always stopped taking the medicine without authorization and didn't get better. In her hometown village, her mother told her that many women like her were afraid to say, "It's too uncomfortable, still fighting the disease."
In Beijing Anding Hospital, more than half of Wang Xue's outpatients come from other places, mostly in small and medium-sized cities in Shandong, Inner Mongolia, Henan and Northeast China. When she went to Beijing for medical treatment, her condition was already very serious. She analyzed that it may be related to the limited local medical resources-usually there is only one psychiatric hospital, and there is no specialized branch. Depression and schizophrenia mixed together, the experience is not good.
People in big cities usually go to gynecology or Chinese medicine first. Guangzhou once conducted a survey on 500 menopausal women. Among them, 76% people think that they should go to obstetrics and gynecology when they encounter emotional disorders, and less than 20% people choose internal medicine or psychiatry. A mother in Chongqing stopped menstruation at the age of 49. She couldn't look up at the ceiling for a long time and couldn't lift her left arm. She chose to go to neurology and was diagnosed with autonomic nervous dysfunction, so she summed herself up as "menopausal syndrome". She told her daughter, "There are many women waiting in line, all of whom are menopausal syndrome, which is more serious than me." Later, he came to the city mental health center and was diagnosed as "moderate depression+mild anxiety".
Patients often ask Wang Xue, "Why can't this menopause pass?" She introduced that at present, the recognition rate and treatment rate of "menopausal depression" in China are low. Because its early symptoms overlap with menopause, it is usually considered as a necessary normal physiological phenomenon for women. "Fortunately, I was recommended by other doctors to seek treatment in the psychiatric department."
Even if a diagnosis is made, some children will think that "there seems to be no danger." When my mother had a general checkup, Yunran was afraid it was a malignant tumor. She was relieved when she found that mental problems caused her weight to plummet. In fact, the suicide rate of depression is between 4.0%- 10.6% (note: the data comes from the White Paper on Depression in China (20 19)). On the contrary, menopause will become a mask, which will turn "depression" into an invisible killer.
This killer took away the mother of a Douban netizen in September 2020. "I'm leaving" (ID) wrote in the post that during the summer vacation, my mother mentioned "poor sleep and lack of strength", but she didn't care, just reminded me to go to the hospital for a general examination. After school started, I was busy studying. One day, I sent a WeChat to my mother and didn't reply. "I thought she was working." That morning, my mother committed suicide by jumping off a bridge.
As soon as she got the news, she knew that her mother was ill and had not been to work for more than a week. How did mom spend that time? She doesn't know. "My mother's insomnia must be very painful. Why didn't I insist on accompanying her to the hospital? "
In order to "cheat" her mother into the psychiatric department, Liu Ling, a girl from Shenyang, took her classmate's mother as an example to talk about similar diseases and the progress of treatment every other month. After using it for three months, my mother finally sat opposite the psychiatrist. But I still held back and kept repeating "I have suffered for so many years anyway"-for ten years, Liu Ling's mother didn't like anything, complaining about taking the bus, going to the supermarket, walking the community and going to the hospital. The body will go down every three or five times, and almost every detail of the whole body has been checked. I have seen respiratory department, brain department, digestive department and orthopedics department. Some doctors suggest seeing a psychologist. Liu Ling's mother is going crazy. "How is that possible?"
Finally, the psychologist asked: Aunt, do you feel wronged? Liu Ling saw her mother's tears immediately fell down-she was strong all her life, but she cried because of one sentence.
Wang Xue often meets such strong-willed patients in outpatient clinics. "I'm afraid of this hard support. They have been trying their best to play the role of daughter, wife and mother all their lives, and they are too tight. "
She once came into contact with a 53-year-old patient, her second daughter. She worked hard to carry water for farming since she was a child, and her in-laws were ill in bed for five years, waiting on her and taking care of her son's study and her husband's life. She is also an excellent teacher at work, and tries her best to be perfect in whatever she does. Once she was ill in bed and had no time to cook, her husband accused her: Why are you so unfilial? From this moment on, depression broke out. These women are usually under great psychological pressure. Wang Xue said, "When they are treated unfairly, they can't stand it at once."
Many sick mothers used to be perfectionists in the eyes of others. Sue's mother used to work in Beijing with her husband. She goes back to her hometown to take care of her children every two months, and then goes back to Beijing to take care of her husband. "I really want people around me to praise her." Later, when her husband retired, she was still trying to make money, but she felt very wronged. She couldn't hold it any longer, so she said to Sue, "I don't want to live, I just want to jump from the upstairs."
When you encounter depression in menopause, the process of seeing a doctor is like an endless cycle of "pain, seeking medical treatment, no illness and pain", which constantly aggravates the patients' physical anxiety and gradually makes them lose the trust of their families.
Many husbands think that "depression" means "thinking too much" and "pretending". Wang Xue's 53-year-old patient suddenly couldn't get up after onset, and acupuncture didn't work. Her husband thought she was pretending to be ill and didn't want to work. After another woman was diagnosed, the doctor told her not to stimulate her too much, but when there was a contradiction, her husband would still accuse her face to face-"mental derangement."
In the home of Lu Lin footballer, a girl from Chengdu, the mother complained more than appreciated her father. My mother was born in a cadre family and was famous for her beauty when she was young. A year after marriage, a pilot came to propose. Married to an ordinary worker, she always complains that her husband is incompetent and can't make money. Sometimes I call my daughter twenty or thirty times a day and scold my husband crazily.
It was not until her mother was diagnosed with bipolar disorder that Lu Lin knew her mother's psychological trauma for many years: she had undergone three operations for uterine fibroids and was afraid of death and cancer-but her powerful mother didn't help when she was sick, and her husband didn't know anything, so her daughter fled to other places to study. This is the other side of the mother that Lu Lin footballer doesn't understand: helplessness.
Later, my parents divorced, and my mother began to complain that I was afraid at home alone. In Lu Lin footballer's view, "She doesn't really have a life of her own. All her life is given to her family. If you are dissatisfied with life, you have neither the ability to make life better nor the ability to accept reality. " This is the case of many middle-aged and elderly women, who control and rely on their families, even if they are separated from their husbands.
"The loss of values is a factor in the high incidence of depression," said Wang Xue. Whether at home or at work, many people feel that their lives are out of control. "They need a sense of existence, respect and recognition."
Retirement is also one of the landmark events. Chen Xue, a psychiatrist in the Fourth Affiliated Hospital of China Medical University, said that there used to be several nurses in her hospital. Half a month after retirement, she suddenly rushed to take the bus. When she arrived at the hospital, she remembered that she had retired. "You suddenly don't know who you are and what you want to do, and you are particularly lost."
When Li's mother reached the age of 53, a young leader was suddenly transferred to her post to supervise her work progress every day. Mother had to adjust and change the pace of work that had been maintained for more than 30 years, but she still couldn't keep up with the speed of young people. In Harbin, she calls her daughter in Qingdao every day and cries. Even if the steamer forgot to put in water and was burnt, she would cry and blame herself. "I feel that my brain is poor and useless." My mother has been strong all her life, as if she could do anything. She contracted everything at home, even changing light bulbs and repairing electrical appliances.
These powerful mothers often make people ignore the gentle and lovely side. After his mother fell ill, Lv Lin remembered something. Her mother once bought a sex education book and put it on the shelf at home, secretly observing it all day. Finally, she couldn't help reminding Lv Lin to read it. "Your grandmother never taught us this."
In medicine, the pathogenesis of depression is neurotransmitter disorder, and the main clinical feature is significant and persistent depression. Common symptoms include mental retardation, inattention, poor sleep, loss of appetite, weight loss and low self-evaluation. For children, the process of observing and accompanying their mothers is like a gray net, and they can't escape.
Sick mother always stares out of the window quietly. She used to speak the most standard Mandarin, but she was only willing to speak the most rustic dialect when she was sick. Grandma is here and doesn't want to see her. Her father has a canteen at work, but he goes home to have dinner with her every noon. When Li Ziyu came home from vacation, her mother leaned against the door and watched her play computer quietly.
Facing this strange mother, Li Ziyu couldn't help complaining, "Why is my mother like this?" Until one day, grandma called and said, "Call your mother quickly. She kept crying and asked me to go to the university with her to find you. " Li Ziyu realized that her mother had been missing her very much since she went to college, and she tried her best to control her personal feelings. She didn't interrupt to oppose her leaving the northwest for the south, going to Japan to study for a master's degree and doctor's degree, and only talking to her once a week.
Many people intuitively saw the explosion scene of "Parents Are Dead". When Lu Lin footballer's mother gets sick, she will pour her anger on her daughter at any time. Her shoes will be stained with mud, and her clothes will not be cleaned. At the first sign of trouble, she will start hitting people, cursing people and even throwing things, "like a demon on earth". In addition, this bomb will explode at any time.
At this time, Lu Lin footballer also fell into collapse and despair. A sick mother has many faces, and sometimes she suddenly becomes a different person. Reflecting on the previously controlled education, Lu Lin footballer had to switch back and forth between different modes-standing on the same side with her to speak ill of her father, or buying her something to ease her mood. "I want to escape but I can't," Lu Lin footballer said, because if I don't get her response, my mother will hurt other family members. "This means that the whole family is suffering from this disease."
There are many posts on social networks that record children's pain, and they write about how mothers with "menopausal depression" impose their emotions on themselves. Because of her mother's pessimism, she has no self-confidence and feels inferior than anyone else. At the most painful time, Lu Lin footballer even thought, "She is dead, and everyone in our family is relieved." This kind of negativity and depression will in turn anger and hurt the mother, and the family relationship will fall into a vicious circle.
The diagnosis of depression depends on the patient's expression, family observation and doctor's consultation. "Different from medical and surgical diseases, the existing medical detection methods can't find a clear focus of depression, and it is difficult to directly identify it as depression from the examination results. It is necessary for doctors to determine the comprehensive clinical manifestations, mental examinations and auxiliary examination results. " Wang Xue said.
Most of the children who can find the mother's abnormality early and take it to the hospital live in first-tier cities such as Beijing and Shanghai, and have a full understanding of depression. However, my mother still thinks this disease is disgraceful. Except for children, she never lets her friends accompany her to see a doctor. Most of the children are in their twenties and thirties, and they are at an important stage of their career development, facing enormous work and economic pressure.
My mother divorced in middle age and got depression. For Liu Huihui, this is a heavy burden that she can only bear alone. On the one hand, Liu Huihui will be involved in her mother's depression and asked to ask how her divorced father is doing. "She always stressed that she couldn't make my dad feel better." . At the same time, she has to treat her mother. They live in Beijing and Chongqing respectively. When her mother was ill, Liu Huihui often asked for leave to go home, which delayed her work.
"I didn't know how difficult the word' company' was until I was sick." Liu Huihui said that she finally decided to bring her mother to Beijing for illness. But it's not easy. Just renting a house will cost you more than half of your salary every month. For Liu Huihui, the uncertainty of her future, such as her mother's unauthorized withdrawal of drugs and capricious depression, made her feel uneasy and tired.
This is an accompanying problem for patients with depression at present. Depression is like a black hole, which not only sucks patients in, but also "eats" people around. Suicide tendency is the focus of family members' concern, and doctors will advise family members to accompany patients all the time and observe their words and deeds. A Guangzhou girl resigned and stayed at home with her mother. She can only sit by the bed from morning till night, listening to her negative thoughts. Observe and pray, and I will be comfortable when she is comfortable. Because of this, girls have no income and often follow their mothers to the hospital in the middle of the night. "It's too difficult to be negative and pretend to be optimistic."
In Wang Xue's view, as long as patients can receive treatment. Many patients ask her to prescribe drugs for insomnia, accepting that it is a physical problem and an emotional problem, but not necessarily accepting that she is depressed. "It is difficult to change a person's mind, so it is good to receive treatment. As the treatment progresses, the patient's understanding of the disease may change. "
Now, Lu Lin footballer has found a way to deal with her mother. Live separately, but if you buy things at home, you have to mail them every month. This way, my mother will feel, "You have this home in your heart and you are still relying on her." Once her mood came, Lu Lin footballer pretended to be ill and complained about her life. At this time, her mother will be transferred because she is worried about her. The roles of two generations seem to be reversed, and mothers are at a loss. Only when you see your children can you feel protected and show peace of mind.
However, for a long time, Lu Lin footballer himself was seeing a psychological counselor. Her expectations for the future are not too high. "As long as it doesn't touch her bottom line, it's not too bad. Let's do it now. "
(Except,, and Su, all the other characters in the text are pseudonyms. )