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Perimenopausal Depression

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Are you suffering from hot flashes, night sweats or cranky moods? Feeling hopeless, apprehensive or deep sadness for prolonged periods? If so, you may be suffering from perimenopausal depression.

Depression is more common among women than men. Biological, life cycle, hormonal and psychosocial factors that women experience may be linked to women's higher depression rate. Researchers have shown that hormones directly affect the brain chemistry that controls emotions and mood.

Perimenopausal symptoms may be the cause of depression, and for some, it may even be clinical depression.

According to the North American Menopause Society:

A depressed mood --This is a normal, brief period of feeling blue or sad that is commonly experienced and rarely requires treatment.




Depression as a symptom - This type of depression may be due to a wide variety of medical or psychological problems, or to intense reactions to life events (such as divorce, losing a job, death of a loved one). It is usually short-term and most often does not require treatment, although it can progress to clinical depression.




Clinical depression -- This is a pathologic disorder believed to result from a chemical imbalance in the brain. A clinical (major) depression requires treatment.

Women who had severe PMS in their younger years may experience more severe mood swings during perimenopause. There are many factors that can cause an increased risk for depression from your genes, to having a prior history to taking certain medications. Certain endocrine disorders, such as hypothyroidism, or other illnesses, such as chronic fatigue syndrome, are also associated with depression.

Signs and symptoms include:

  • Persistent sad, anxious, or "empty" feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness or excessive sleeping
  • Over eating or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

Mild depression -- feeling blue or sad -- can be dealt with cognitive therapy, psychotherapy, meditation, yoga, getting enough sleep, a positive outlook, healthy eating, incorporating appropriate supplements, acupuncture and exercise. Exercise boosts your endorphins and can lift your mood. Engaging in new activities may help, such as taking yoga or a pilate's class, or getting out and trying new things, all while enlisting the support of your family and friends.

If you have lingering or worsening symptoms, you may need medication. Depression can be a malfunction of your neurotransmitters, particularly serotonin, which is the "feel good" neurotransmitter. Medicines can be enormously helpful, although you will want to incorporate lifestyle changes as well.

Dr. Wendy Klein, menopause expert and co-author of The Menopause Makeover:

If you are still feeling very stuck and sad, talk to your clinician so you can get a referral to a good psychotherapist. If you need medication, in the broader context of menopausal symptoms, there is some evidence that hormone therapy can augment treatment and help people who are on anti-depressants feel even better. That is a decision for you and your clinician.

According to the Study of Women's Health Across the Nation (SWAN):

The risk of major depression is greater for women during and immediately after the menopausal transition than when they are pre-menopausal.

If you suffer from depression whether mild, moderate or clinical, get support and visit your health care provider to discuss your options.