My story: Losing my wife – an avoidable tragedy?

This story is a very hard-hitting account from a husband who lost his wife by suicide. Pete wants to tell others about Victoria’s experience to raise awareness of how suddenly and severely mental health can deteriorate during the perimenopause. What happened to Victoria is rare and there is effective treatment for low mood related to the menopause. However, it is a tragic fact that suicide rates for women peak between the ages of 45-54 years, and much more needs to be done to recognise and treat the problem of changing hormones on a woman’s mental wellbeing.

There are sources of support and information throughout and at the end of the article.

“In April this year my wife Victoria took her own life. I am sharing our story because as a family, we not only want to understand how Vic came to this tragic end but hope that by sharing our truly awful experience we might just prevent it happening to another woman and her family. My family and I are struggling to come to terms with this terrible event and it is unimaginable just how unwell Vic must have felt to leave the family and her children that she loved so much.

“Vic and I had been together for almost 24 years and had been married for over 21 years. We have 3 wonderful children now aged 16, 18 and 20. We had always had a happy and close marriage. We had a fantastic life with our children, having great holidays and trips and spending many happy days with our friends and family. Our plan was to spend the rest of lives together bringing up our children and then enjoying our retirement.

“Vic’s troubles started in the spring of 2019 at the age of 49. She had never had any mental health issues prior to this. She was warm, kind, incredibly bright but also humble and giving. Vic was an Oxford educated lawyer and a qualified teacher. She was strong and capable and the most organised person I knew. Vic made many good friends wherever she was, and we have been overwhelmed by messages of love and support, all expressing complete disbelief over what has happened. Many of them are in shock as this was so out of character for Vic and the last person in the world they could ever imagine would end their life when she had so much to live for.

“I remember in early 2019, Vic saying something like “I just don’t feel right”. She had recently been promoted as an associate at the law firm where she worked. When she first started to feel extreme anxiety, we initially put this down to work-related stress. She was signed off work and the first trip to the GP resulted in a prescription for antidepressants. As she failed to improve, we negotiated her leaving her job in the hope this would alleviate any further worry and stress. Far from improving, she continued to worsen. Her anxiety and panic meant she started to have almost completely sleepless nights. Her normally sharp brain became muddled and confused. Our GP made 2 further prescriptions of antidepressants before suggesting she needed specialist psychiatric help. By this time, she had also been prescribed diazepam to calm her increasing anxiety.

“During these first visits to the GP, Vic did mention the possibility of menopause, but it was soon discounted as her mental health rapidly deteriorated. I had no experience of dealing with any serious mental health issues and, like most men, I had absolutely no knowledge at all of menopause, never minding knowing the term ‘perimenopause’.

“With no NHS psychiatry available for some time, we sought a private psychiatrist who diagnosed agitated depression. He prescribed an antipsychotic drug as Vic appeared to be suffering with paranoia. She continued to worsen and after a second trip to A&E when she was very distressed and I was unable to calm her, she was admitted to a psychiatric ward for a 72-hour assessment. This ended up being a voluntary 4 month stay. Vic continued to worsen, staying in her room for days at a time, confused and lost. She refused to see me on many visits, believing she would never be discharged. I attended every weekly review with the ward psychiatrist and nursing staff. I remember being quite direct at times, questioning what exactly was happening to Vic. We raised the issue of menopause again in these discussions. Vic had started to bleed heavily and almost continuously, but this was put down to a side effect of sertraline which she was taking at the time. I was clutching at straws, suggesting bipolar or early onset dementia, but these were all dismissed. The consensus at hospital and throughout, was that Vic was suffering a severe form of clinical depression. All the many health professionals who saw her over a 2-year period dismissed the perimenopause as a likely cause. Vic recovered sufficiently enough to be discharged from hospital in time for Christmas 2019.

“Through 2020 Vic functioned but was just not herself. She continued on her meds protesting that they were not improving things for her. Being as bright as she was, she began researching to look for answers herself. She wrote a detailed letter to her Community Mental Health Nurse stating she believed her condition was due to perimenopause. We received no reply at all to this. She questioned everything about herself. She would ask me if she’d been a good mother and wife, to which I of course told her she had been the best. She took no joy in anything despite all our efforts to improve her spirits. I began to realise that nothing I could say or do would make any difference at all to her. We talked endlessly and took long dog walks, but I could tell how much she was still struggling.

If you’re suffering, speak to someone about it and see your GP or nurse. There are effective treatments for menopause related low mood and anxiety. Contact the Samaritans at any time by calling 116 123 or visit www.samaitans.org

“Vic felt the close relationship she had always had with our children had disappeared and she struggled to feel warmth, affection and felt she lacked any empathy. All of these traits she now perceived were in fact the polar opposite of who she really was. We sought the help of a private psychologist who helped her through the summer but by the Autumn of 2020, Vic made the first of 3 attempts on her life.

“While there was superficial interest from the mental health professionals, they just didn’t seem to understand what an awful state Vic was in. They seemed intent on treating the symptoms rather than diagnosing what was causing her underlying depression. Her sisters came to help support us and along with her parents, we provided 24/7 care for Vic up to Christmas 2020, as we felt it wasn’t safe to leave her on her own.

“By early 2021 Vic had seen a consultant gynaecologist and tests showed she had a thickened uterus caused by a hormonal imbalance. She commenced HRT and was fitted with a Mirena coil. I never understood if there was any joint discussion between the gynaecology and mental health teams to review the many medications Vic was taking. We had asked for a gynaecologist who specialised in depression around perimenopause. We were informed that there wasn’t such a consultant at our local hospital.

“Vic seemed to be functioning OK through early 2021 and she did everything she could to keep busy, volunteering for a local group, picking up shopping and prescriptions for the vulnerable during the pandemic. Her actions often seemed robotic, but she could present the very best version of herself around friends. She would never let her guard down in public, and she promised me in private that she had no intent to harm herself anymore.

“By now she was also taking Lithium as a last option to tackle what the professionals now called ‘treatment resistant depression’. She quickly put on almost 3 stone. She still exercised and started couch to 5K, but nothing shifted the weight caused by her medications. She had always been slim and fit and loved her clothes. She was distraught at the weight gain and wanted a review of all her medications as she felt no improvement in her spirits.

“Vic had 2 job interviews the week before her death and was offered both positions. We had a relaxing Easter weekend with our 3 children and a beautiful walk on Easter Sunday where I took my last photos of Vic. She left the house Tuesday morning for a routine appointment, but never arrived.

“Following an internal review by the local Mental Health Trust it appears they recognise that there were failings in Vic’s care and that the menopause may well have been the root cause of her deterioration. The questions I continue to ask myself and to our local NHS Trust are ‘why was Vic never correctly diagnosed?’  ‘When all of the numerous medications had little or no effect on her wellbeing, why weren’t the health professionals asking why?’ Vic had insisted throughout that the medication was making no improvement at all, and conveyed this to all the professionals treating her. She reluctantly took her meds, often at my insistence, as I believed that eventually something may help her get better. I now realise she was correct and that nothing was working. You can see from her emails and notes that here was a woman trying to understand what was happening to her and she was desperate to find a way to get better.

I recently sat through the two-day ordeal of Victoria’s inquest. Two of the NHS psychiatrists were questioned as witnesses. Upon the question of perimenopausal or hormonal depression they confirmed their dismissal further. One stated that perimenopausal depression was a ‘Red Herring‘ and the concerns regarding this were ‘baseless’

The other quoted that the WHO made no differentiation between clinical and hormonal depression and there was no difference in their treatment plans.

We were astounded at this as it clearly illustrated the lack of awareness in 2 experienced male psychiatrists. The report from their own employers stated ‘this view is potentially outdated, two-dimensional and not in keeping with current research and theory…’ Is it any wonder this was never given serious consideration in Victoria’s case.

We also noted through our research that hormonal depression and perimenopause are not found when searching the NHS website. Why is that?

“I am not sure that hindsight is a great thing. I have so many regrets and am greatly troubled that we couldn’t get Vic through her problems and ultimately save her life. However, we saw 6 psychiatrists over 2 years – 3 of whom were female – and all of them dismissed hormone related depression out of hand. Out of all the mental health professionals Vic saw, not one seriously considered that the perimenopause had a significant part to play in her declining mental health. Why is that? The work done by Dr Louise Newson and TV programmes such as the Davina McCall documentary, has started to raise the profile of menopause. I have now read a great deal about perimenopause and gained a small understanding of how this can affect women. It seems Vic did have an extreme case of hormonal depression and anxiety and had this been recognised when symptoms started and she got the right help and type and dose of HRT, it may never have progressed so drastically. Sadly, the insistence on conventional antidepressants over 2 years blunted her emotions, changing this wonderful woman into a hollow version of her former self.

“It seems there is a complete lack of awareness and understanding surrounding the menopause and this must change. For any family the first point of contact is usually your own GP. If a woman in her mid-to-late 40’s presents with anxiety and depression – especially when she has no prior history of mental health issues – surely the first question must be ‘is there a link to perimenopause?’ Why is this not the case?

“It is difficult to talk about the woman you love with any subjectivity when most of the time I am consumed with grief and regret. I would urge any woman reading this to encourage their partner to also read it. I still know so little about perimenopause, but it appears a large proportion of mental health professionals also know very little. The only positive my family and I could gain from this awful tragedy is if we can raise awareness and prevent other women suffering a demise similar to Vic’s.

“I can’t even begin to express the grief we are experiencing. I know my life will never be the same without this special woman. I implore women, men, health professionals, employers and anyone who reads this to think about the women around you. Empathise, listen, try to understand what may be happening and help them seek the appropriate help. It could save someone’s life.

If you’re suffering, speak to someone about it and see your GP or nurse. There are effective treatments for menopause related low mood and anxiety. Contact the Samaritans at any time by calling 116 123 or visit www.samaitans.org

Severe deterioration in mental health due to perimenopause or menopause is rare and improvements can be made with the right type and dose of hormone replacement therapy, as well as talking therapies and support from family and friends.

Balance has several articles, podcasts and videos covering menopause related depression, and mental health and wellbeing. Visit our Menopause Library and refine your content by selecting ‘Mental Health and Depression’.

NHS Support:

Find psychological therapies here

For urgent mental health advice visit here

Listen to Pete episode on the Dr Louise Newson Podcast here