Latest / Cortisol Coach / Hormones and Depression in Women Over 40: The Signs You Need to Know with PA Jessica Crespo

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Hormones and Depression in Women Over 40: The Signs You Need to Know with PA Jessica Crespo · Cortisol Coach

0:03
Welcome to the Cortisol Coach Podcast. If you're exhausted, gaining weight,
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losing your hair, your anxiety is through the roof, or the depression and emotional
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overwhelm have completely consumed your life, or maybe you're not showing up
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as the wife and mom you want to be.
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You've spent years never feeling good enough, taking care of everyone else while
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you quietly fell apart, and your body has been keeping score of every single bit of it.
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The chronic stress, hormonal shifts, perimenopause, menopause,
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whatever season you're in, cortisol is making all of it worse.
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And until you heal the root, nothing changes. But this show here is about to change that.
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I'm your host, Christine Marie, Holy Spirit-led Biblical Mindset Coach,
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and I have helped thousands of women heal their hormones and cortisol levels.
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Every week, I bring you leading experts, doctors, and coaches who will help you heal your body,
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mind emotions and your spirit so
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that you can step into every kingdom purpose that god
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has planned for your life so go grab your cup of coffee and let's
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jump in there is a woman listening to this right now who has become really really
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good at holding it all together she's the one that everyone leans on the one
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who keeps going no matter what and absolutely nobody knows how broken and empty
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she feels inside. She wakes up exhausted.
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She goes through the day. She takes care of everyone around her.
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Then she goes to bed. She does it all over again.
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And if you asked her if she was depressed, I'm guessing she would say no.
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She would say, I'm just tired, just stressed, just busy, just a mom,
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just a wife, just somebody who has a lot going on right now.
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But what if tired and stressed and empty and disconnected and going through all of the motions?
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What if that is depression? And what if the woman who keeps everyone else afloat?
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Is quietly drowning. And what
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if nobody ever told her that her hormones were at the root of all of it?
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My guest today is Jessica Crespo, a physician assistant with nearly 26 years
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of clinical experience spanning some of the most dynamic,
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demanding environments in medicine, cardiology, emergency medicine,
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psychiatry, and over a decade in primary care. That combination is rare.
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Most providers specialize and then stay there, but Jessica has seen the full
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picture of what happens to a woman's body and mind when something goes wrong,
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which is exactly why she sees what so many others are missing.
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She is known for building deep, trusting relationships with her patients,
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creating a space where women finally feel heard, not rushed,
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not dismissed, and actually heard.
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But what makes Jessica truly unique is that she's not just a clinician.
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She's a woman who firsthand knows what it feels like to put everyone else first
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and then lose herself completely in the process.
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She has rebuilt her life from the ground up, and that journey lit a fire in
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her to help other women do the same.
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Jessica, I am so excited to welcome you to the Cortisol Coach podcast.
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I am so excited to be here. Thank you so much for inviting me.
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I feel very, very honored to be here today.
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Oh my gosh. The honor is mine and I cannot wait for our listeners to hear everything
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that you have to share. But let's start with the woman you see in your practice.
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Because I think most women over 40 would never describe themselves as depressed.
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So what are they actually saying when they come to you? You are so correct when you say that.
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I think most women just feel like they're going through the normal day-to-day.
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Errands and things that they have to get done and just going through life,
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going through the motions.
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When I tell you, it was the same story over and over again of these women that
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would come in and complain of all the same symptoms.
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And they didn't think that they were depressed. But when we would go deeper
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into it and I would ask more of the important questions, it would come out that
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there was a degree of depression.
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So what does that, what is depression? Because I'm guessing with a high-functioning
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woman over 40, which truly describes our listeners. What does that look like?
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I feel like so many women are so, they're driven, just high-functioning women,
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women that just do it all.
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You know, they run households, they work full-time jobs, they're constantly
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going and doing things for everyone else.
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And so I feel like they become numb and they just think it's normal to go about things that way.
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But what happens is when you typically look at depression, people look at it
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like, oh, in bed crying, can't get out, can't function, can't do that.
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But there's what I call a low-grade mood, low-grade depression,
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which is what affects a lot of women that don't realize it.
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And that looks as simple as being more irritable, snapping at the kids maybe
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more often, or your spouse.
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Sometimes it can be as simple as just not having as much patience as you once had.
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And then when you go deeper into it, it's difficulty focusing.
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It's feeling more anxious, less able to handle stress the way that you normally would.
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Things that you would normally be able to handle with no problem,
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all of a sudden you feel like you can't, almost like there's a loss of control over things.
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What about the physical sides of depression that people don't talk about?
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So physical side of it is when you've ignored the emotional side to it.
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It starts, your body's not able to process it anymore. So it starts to come out
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physically with things like headache. The number one thing I would see is a fatigue.
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You know, a lot of women complain of just extreme fatigue, muscle,
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joint pain, feeling run down, always getting sick.
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Those are the type of physical complaints that I would hear of.
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I've struggled with anxiety my whole life, but I've definitely experienced periods
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of depression as I've walked through hard situations in life.
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And I just remember feeling empty. Yes, that is a very, very common symptom
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women would get. You feel lonely.
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You almost start to isolate just because things, you know, you get invited to go out to dinner.
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You may say yes and be excited to go and then last minute you kind of change
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your mind and you end up canceling.
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So it's things like that. At the time you're excited, you want to,
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but then when it comes to actual getting ready and going out,
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a lot of times you cancel plans.
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And a big one is feelings of guilt.
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That was a big one I would say. Feeling like you're not a good enough mom,
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a good enough wife, let's say, and just being very hard on yourself.
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I remember one thing for me is I noticed that the chores around the house started piling up.
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So it was not being able to push through the day, but then it was also more
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like, I just didn't care because I was so sad and so empty.
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Exactly. And part of that is the lack of motivation that you have. And that's all related.
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You start to lose motivation. Also, when you were once motivated and focused,
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you can get all these things done. But as you lose that motivation and you're
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not able to focus, that's when things kind of fall to the wayside.
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So why do you think that high-functioning women would miss these signs?
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I think because high-functioning women are used to just doing it.
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They're used to hustling.
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They're used to getting it done. They're used to pushing.
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They take responsibility for everyone. They put themselves last.
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They just go, go, go, go.
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And they ignore it and say, you know, I just have to try harder.
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I just have to do more. I just have to wake up earlier.
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I just have to do this. And so they just keep pushing. I think that was it for
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me, especially, you know, we fostered 77 kiddos in 10 years because I was,
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there was no, no slow down moment for me. I don't know how you could. Wow.
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I don't know how it, how it all happened, but truly like how we made it through
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it, but truly like once we were no longer foster parents,
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That's when I stepped into that period of depression because when you are constantly
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going, you don't realize how tired you actually are.
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Yeah, your body just crashed because you have cortisol that keeps pumping through
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you elevated. And that's what keeps you go, go, go, going.
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And so when now you don't have the responsibilities and things slow down,
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your body crashes. your cortisol, like it's not able to sustain anymore and
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you feel everything all at once.
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I absolutely did. And I'm glad that you brought that up because that was the
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next question I wanted to ask you is this is not just a mental health conversation.
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This is a hormone conversation and every part of our body is connected.
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But can you help us connect the dots in a way that our listeners are going to
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more easily understand, which is what's actually happening in a woman's body
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over 40 that might actually drive depression.
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I'm so glad you brought that up
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because, you know, when it comes to mental health, it has such a stigma.
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And what I really want to drive home today, my big message is it's that it's
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not our fault because there are actually things that are changing in your body that's leading to this.
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And so things like estrogen and progesterone, It's not just reproductive hormone.
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They also play other roles with our body.
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For instance, estrogen. It supports things like serotonin and dopamine.
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These are two neurotransmitters that make us feel good. It makes us feel happy.
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So for estrogen, let's say, and this can be due to postpartum.
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It can be due to perimenopause. Even when there's a change in our cycle,
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you know, the week before a woman gets her menses, you start to feel that shift.
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And the reason why is because estrogen plays a huge role with supporting,
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like I said, the serotonin and dopamine.
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So if estrogen is low, then guess what happens?
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Your mood is down, your motivation is down, and that's when you become more emotional.
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The emotional stability changes. That's you have an increase in anxiety.
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You feel more irritable, just not yourself.
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As far as progesterone, that's the other hormone. That's what helps you feel
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relaxed. That's what helps calm you.
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So now if that's low, then what happens is you feel more on edge And that's
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when you feel like you're not able to handle the things the way that you used
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to. So there's a direct link there.
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And it's interesting because when I just had my blood work done recently,
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I didn't even realize I was in menopause.
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I thought I was in perimenopause. And then when I saw my lab work and my estrogen
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was basically had left the building, there was such a huge dramatic difference
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for me now that I'm on estrogen.
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I feel so different.
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And so I can truly see how just the hormonal shifts in a woman's body can make
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a huge difference on mental health.
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Yeah, it really does. I would see it all the time.
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Women who are in post-menopause, perimenopause just coming in,
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that would be what they would say. I just feel off.
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I don't feel right. I don't feel like myself.
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Something you said to me before we started this recording, I have not been able
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to stop thinking about it because not only have you studied depression and helped
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women navigate through depression. You've also lived it.
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Can you share with us a little bit more about your personal experience?
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Absolutely. So this is something I've never shared. Only, you know,
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a few close friends and family know about it.
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I've experienced it in two different ways.
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Being that high-functioning, overachieving mom, I pushed and pushed for years,
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doing all the things and just pushing through.
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And it was years of working, paying the bills, doing the grocery shoppings,
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running to the kids' sports, doing everything.
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I ran myself ragged.
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I put myself last and made sure everyone else was good, but I never,
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took care of myself. I thought it was a good thing to do. I thought it was a noble thing to do.
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In the end, I was a shell of myself and I couldn't even recognize myself anymore.
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Not realizing it at the time, I had a lot of these symptoms,
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extreme exhaustion, difficulty focusing.
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Feeling anxious, feeling very lonely at times, very isolated,
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but they were mild, you know, and I thought it was all normal.
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I said, this is part of just being a mom, you know. Then in a different way
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was when my daughter was about three years old, I was pregnant and I was pregnant
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with twins. It was about nine weeks.
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And at first, of course, it's exciting, nervous.
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You know, it was natural. I hadn't gone through treatments. It was a natural pregnancy.
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They were twins in the same sack. What the doctor explained was that I could
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have carried them up until the 38th, 39th week, and then I could lose them spontaneously.
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So it was a high risk situation.
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Pregnancy. And so when I had gone back for the follow-up visit, there was no heartbeat.
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So I had to schedule a DNC. So DNC was scheduled.
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And the day after, I crashed in such a hard way where I cried. I just felt so sad.
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And it felt like, okay, this is normal part of the loss that we just experience.
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But it was bad. I couldn't get out of bed. It got to a really bad place.
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And what I realized it was, when you get pregnant, your hormones are in,
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they're doubling, tripling, they're increasing so rapidly in the beginning.
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And then when you have that TNC, your hormones, they just come down and you crash.
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So I said, wow, this is really such a big thing to experience,
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to go from such a high to just crash that way.
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And what I realized was it took about six months.
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My menses were not regular at all.
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And finally, when it came to the sixth month and I started to regulate, I was completely fine.
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My mood was completely back to normal. I'm so thankful that you were transparent, open to share that.
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And I'm so sorry for such a huge loss.
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I think there's a lot of listeners who can connect with you on this.
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What for me hit me is I would imagine you would be so grief stricken after the loss of any child.
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But I wouldn't naturally think postpartum depression after a DNC.
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Is that normal that people wouldn't assume that?
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I didn't assume it. It never dawned on me, and I don't know why.
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You think of postpartum after you deliver a healthy baby, but I never looked
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at it as a postpartum because it's the same thing. It's your hormones.
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It's such a change. After you deliver the baby, your hormones start to decrease
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rapidly. And it's the same thing after a D&C.
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So again, I never considered that.
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So it was really, you know, eye-opening for me to say, wow, like it was literally the next day.
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And you think of the woman who just experienced the loss of her child,
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or maybe she is that woman who is the high-functioning mom and wife like you just talked about,
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because you've had several experiences with depression, and you think, well,
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I'm just sad, I'm just going to stay in bed.
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But how do you, what would you say to that woman right now who's listening to
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this and saying, it's fine, this will pass.
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I'm just going through a moment. I'm just going through a time.
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What would your encouragement be to her right now? To not ignore the signs.
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Really be open and honest with yourself. If you have support,
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talk to whoever that is, whether it's your spouse, parents, sibling, friends.
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And for me, thank God I had the support of my parents. They were there because
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you get into this negative loop of thinking and everything is negative. And it's all linked.
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You don't feel good enough. You feel lonely. You feel like a burden.
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You feel you want to self-isolate because you don't want to bother anyone.
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And so I would say don't ignore the signs and don't feel bad that you're feeling
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that because it's not your fault.
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It's important that once you recognize that it's a possibility, talk to someone.
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Talk to your medical provider. Start that conversation.
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And I also feel like so often as women, for whatever reason.
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Your thoughts get very dark. Yes, very.
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And if you are having thoughts that you wouldn't even repeat to your significant
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loved one, that's especially the point when you need to say,
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I need to take this bold step and I need to schedule a doctor's appointment,
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even though maybe I'm not caring about myself.
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I need to do this and see and find out what's actually going on.
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I am so happy you brought that up.
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That is so important that people realize is that when you have those type of
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thoughts, that's part of the effects of the hormones that are not balanced.
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And so again, it is not your fault. It is because these hormones are low.
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They're not balanced right now. So if you were to correct that,
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let's say I gave you that, you know, if I can just snap my fingers and balance
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those levels and they were back to normal, that would go away.
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That feeling would go away.
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It was interesting. My husband and I had a conversation actually last night,
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and he was asking me, we had a very significant event in our marriage,
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and he was asking me, he said, you seemed like you were different.
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Like a different person after this happened. And he said, what do you think it was?
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Well, the difference was I was put on an SSRI. And I said, it balanced me.
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For the first time in my life, the spiraling thoughts stopped.
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So I was a different person because my body was balanced.
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There's the other forms of depression that it's genetic or it's hereditary,
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or maybe you have genetic mutations that are causing long-term,
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lifelong depression where you need a medication help like I did.
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I remember being a young child, even in my teenagers, that I just never felt
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quite at peace and at rest in my body, and I didn't know why.
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And so I think that that's the piece where there's such a big difference between
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when your body is balanced and who you are and when it's not. Absolutely.
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So after I had the DNC and the next day I crashed, I tried to just give myself
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a little bit of time, but it was pretty bad.
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And so at that point, I decided also to go on a medication, which was an SSRI.
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Within days, I felt so much better. And so it confirmed exactly what I was thinking, what happened.
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So once I got on that, it was about six months, like I said,
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because of my menses, it was not regular.
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So about six months it took to finally get regular again. Once it got regular,
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I stopped the medication. I was fine.
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I felt I was back to myself without medicine. That's awesome.
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Well, and then there's people like me, which I will be on medication for the rest of my life.
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And then there's people who just need assistance for maybe a short period of
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time or maybe a longer period.
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And I talk about this often. There's no one-size-fits-all.
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Everyone is so different. Again, like you had mentioned, you know,
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there's genetics with this.
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There's other maybe medical issues you may have, medications you may be taking.
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It's important to just look at the whole picture. You know, we do have medications
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and they can be life-saving.
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I am definitely not against medications. I took them myself and it helped. It helped me.
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I could function again. I can be there for my daughter, you know,
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and be the mom I wanted to be. So there's a lot of options out there,
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figuring out what's best for you and doing that with your provider.
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You might not have to go on medication, but if you need it, there's nothing
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wrong with that. And you don't have to be on it lifelong.
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It can be a short period of time. There are treatments for hormone replacement.
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You know, if that is something that's needed, if these symptoms are so severe
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where it's interfering with your quality of life, then that's something that
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you can look into as an option.
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There should be no judgment. This is your body. This is your life.
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And it's up to you to decide what is the best course? What do you feel comfortable with?
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I love that. And so let's give the listeners a first step.
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So let's imagine she's listening to this. She's identifying with so many of
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these symptoms that you are describing or struggles.
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And she's thinking, okay, let me just have a conversation with my doctor.
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Let me take the first step and schedule an appointment just to see if maybe this is truly what it is.
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What could she say to her doctor to start the conversation?
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First, I would make sure to just keep it very focused.
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If this is your appointment, make sure that this is what you're focusing on
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because there's a lot to cover when it comes to something like this.
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It's not just a, I have a sore throat type of thing. This is you want to get
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your symptoms across so that they understand what you've been feeling.
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Make that list. Have that list of everything that you've been feeling and let
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the doctor know. Let them know what type of stress that you have.
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It could be, let's say, the loss of a loved one, the loss of a job,
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or the stress of being a mom, a working mom, doing things, just life.
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Let them know what is behind the scenes. And then from there,
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I would definitely get at least a baseline set of blood work just to rule out anything else.
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Because, for example, something like an underactive thyroid,
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known as hypothyroidism, can sometimes give you symptoms of depression.
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So if you have an underactive thyroid, that can be corrected and then those
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symptoms can be corrected as well and you can feel better.
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So I would definitely go in there with a list of everything you've been feeling.
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I request if you can have, if you can be sent for a full thorough set of blood work. I love that.
22:57
So one thing that you had mentioned that you were going to give the listeners
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today was a checklist of symptoms so that they could fill out the sheet and
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take it to their doctor just to begin the conversation.
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And I will include Jessica's information on how you can connect with her in the show notes.
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Because hopefully that can make the conversation a little bit easier.
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So Jessica, if you were to say one thing to the woman who listened to this whole
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episode and is still thinking, I'm probably just fine, what would you say to her?
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I would say sit down with yourself, take some alone time, and really go through the symptoms.
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If you feel irritable, if you feel like you snap at the kids a lot.
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That you don't have too much patience that, you know, for things that you used
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to, if you're feeling exhausted, look at those mild type of symptoms.
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And if you're feeling anything, then maybe talk to your family,
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too, because a lot of times people around us notice a lot better than we can actually recognize.
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And that's a big one. We think we're doing good. We think we're pushing along.
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We think we're doing all the things.
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But believe it or not, people pick up on your moods, your personalities,
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on the things that they're seeing. They know you.
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And so if there's any kind of change, they're going to recognize it.
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So if you have that conversation, say, hey, you know, talk to your,
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let's say your spouse, you know, do you feel like I've been different the last
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couple of months or whatever it is?
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And you may be surprised to find, you know what, I'm glad you brought this up,
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but you haven't seen yourself, you know, in the last couple of months.
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You haven't been yourself in, you know, so many years, however time, you know, it is.
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But they can help you realize that maybe you're not doing such a great job as
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what you realize, you know.
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That is so great. I know for me, especially, you know, I had asked my husband
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and I had asked my kids because especially the people who are living in the
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house with you. Exactly.
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They're picking up on it.
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Exactly. And especially for me, knowing that if I'm not being the best possible
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mom that God intended me to be.
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I wanted to reach out. And there's a huge difference. And I'll just be really
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honest. I was completely against medication.
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So when my doctor said, let's try a medication, I wasn't comfortable with it.
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But now I'm at the point that I say, I don't like the version of me without
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the medication because I feel peaceful in my body now.
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And so if that's the piece, but I didn't know anything different beforehand.
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Right, right. And you get so, and that's so common, and you don't have to take medication.
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There's other ways around it, you know, to get your mood up.
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But some people do need it, and there's nothing wrong with that.
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But there are a lot of people that are against that. And like I said,
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you know, you don't have to take medications, but you have to look at the quality of your life.
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If you're barely functioning, then you have to really consider that because
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you don't have to suffer. You don't have to go through life being so depressed
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where you're not even, you know, you're not living.
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I love that. And you are so right. There are so many amazing things that you
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can do for your mental health.
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For me, I know I like to walk outside for 45 minutes every single night after
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dinner because that helps with my mental health tremendously.
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So there's a lot of options. I know you ride your bicycle. Yes. Yes.
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Get in the sunshine. There's so many things you can do that will help and especially
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sleep, good quality sleep, and maybe it's sleep hygiene before bed every night.
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So that's really, you don't have to go to your doctor necessarily to have a
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medication conversation.
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Connect with Jessica, get her checklist, work through the questions,
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ask your family, if you have a spouse or loved ones, that you can have them
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look at the list if this is something that's concerning to you.
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Because friend, you were meant to live the most incredible life and God has big plans for you.
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So if there was something in this episode that made you pause,
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I really want you to pay attention to that.
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Because God did not design you to disappear.
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He did not call you to pour from an empty cup until there was nothing left of you.
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He called you to be whole. He called you to be present.
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You matter. Your health matters. And asking for help is not weakness.
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If Jessica's checklist resonated with you, I want you to head over to her Facebook
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page and connect with her to get that.
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It is the first step that you can walk through to really take a look at,
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is depression possibly affecting me?
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The link is in the show notes. and I'll see you later.
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Friend, I am so thankful that you were here today. I pray this episode blessed you big time.
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And if it did, would you do me a favor and leave me a review on Apple Podcasts?
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It helps more women just like you find the show and it may be the very reason
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that somebody else gets the answers that they need.
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I would also love to connect with you personally on Instagram.
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You can find me by searching cortisol underscore coach. That's where I show
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up every single day and send me a DM. I would love to connect with you. I'll see you next time.
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We'll see you next time.