Menopause can be a complicated experience for many people. Hormonal changes within the body can lead to a range of effects, including physical and emotional symptoms. More research is needed to fully understand the impacts of menopause, but it is widely understood that going through menopause can increase the likelihood of a person experiencing depression. However, that does not mean that everyone who experiences menopause will become depressed. It can be helpful to understand the relationship between menopause and depression, as well as treatment options. Hormone replacement therapy, yoga, meditation, mindfulness, and therapy may all be helpful. A licensed therapist can provide you with the support you deserve in person or online.

What is menopause?

For a person with a uterus, menopause can be defined as the time in their life when their reproductive hormones begin to naturally decline, and they may stop menstruating. In general, a person is officially considered to be in menopause if it has been 12 months or longer since they last experienced a menstrual period. This life milestone typically happens between the ages of 45 and 55 for most women and people with uteruses. 

Menopause is typically preceded by a transitional period known as perimenopause, which can last from seven to 14 years. It can also be marked by a range of hormonal fluctuations and changes, and it can have similar symptoms to menopause.

Perimenopause and menopause symptoms

Perimenopause and menopause symptoms may include the following:

• An erratic and unpredictable menstrual cycle: a heavy flow one month, skipped periods for several months, etc.
• Hot flashes, usually defined as a sudden feeling of intense warmth that can be experienced all over the body, but is typically concentrated in the face, neck, and chest area
• Sleep disturbances, including insomnia or excessive sleepiness
• An increased risk of infection in the bladder or vagina
• Mood symptoms, including mood swings, general moodiness, and irritability
• Changes in vaginal lubrication production levels
• Weight gain
• Thinner skin, potentially leading to more instances of bruising and bleeding
• Shifts in sex drive, including increased or decreased libido levels
• Muscle definition loss
• Headaches
• Trouble remembering events, as well as other cognitive impacts
• General body aches and pains
• Heart palpitations (a much less common symptom)

What is depression?

Depression typically refers to a mental health condition defined by a persistent feeling of sadness or hopelessness that lasts for a certain period of time. The word “depression” can be an umbrella term for a variety of mental health disorders related to the condition, including major depression, seasonal affective disorder, and dysthymia. 

While sadness is usually the defining characteristic of depression, depression is often about much more than simply feeling “mopey” or “down in the dumps.” In general, to receive a depression diagnosis, several physical, behavioral, and emotional symptoms must occur. Symptoms of depression can seriously impact a person’s life and their ability to function. Some depression symptoms may even overlap with other symptoms of physical conditions, including menopause.

Physical and behavioral symptoms of depression

• Difficulty concentrating, feeling less capable of making decisions, problems with memory, and other cognitive impairments
• Shifts in appetite and eating habits that can lead to weight changes
• A sense of exhaustion and lethargy 
• New or increased substance use
• Restlessness
• Significant changes in sleep schedule: sleeping all day, staying up all night, or some other form of sleep disturbance
• Isolation from other people, particularly formerly close and important relationships 
• Less attention paid to personal hygiene
• Slower speech, potentially slower movements
• Nervous behavior (pacing back and forth, handwringing, etc.)
• Spending more time alone
• Absences from work or school
• Pain and achiness

Emotional symptoms of depression

• Consistent feelings of sadness without any clear cause
• Decreased self-esteem
• Feelings of emptiness, guilt, or worthlessness
• Blaming oneself for situations that are out of one’s control
• Irritability 
• Disproportionate reactions to stressors
• No interest in hobbies or other activities that used to bring joy
• A bleak outlook toward the future
• Heightened sensitivity, especially to criticism
• Becoming agitated easily
• Relationship problems with friends or family members, potentially due to emotional outbursts or withdrawal
• A belief that one’s life will never improve and there is nothing worth living for
• Thoughts of self-harm, death, or suicide*

The connection between menopause and depression

For people with uteruses, there are multiple phases of life in which estrogen levels may fluctuate, rise, or fall. Examples can include pregnancy, immediately after giving birth, and right before a person experiences their first menstrual period. 

What are the treatments for depression experienced during menopause?

During all these phases, depressive symptoms can be more common, indicating there may be a connection between estrogen levels and the likelihood of experiencing depression. Menopause can be a particularly long phase of changing estrogen levels, so hormone replacement therapy may be a viable treatment option for those experiencing depression related to menopause. 

Hormone replacement therapy (HRT) for depressive symptoms

Hormone replacement therapy can be used to treat a variety of health conditions, including menopause. When used to address menopause symptoms, HRT is often referred to as “estrogen therapy,” as estrogen is the hormone typically being replenished.

Hormone replacement therapy usually refers to administering synthetic or organic forms of estrogen into the body to combat menopause symptoms, including depression. Estrogen administration can take place in the form of a pill, a gel, a patch, or a vaginal ring.

Sometimes, estrogen therapy may be prescribed alongside an antidepressant treatment medication. For both hormone replacement therapy and potential antidepressant intervention, it’s vital to consult with a doctor, as therapists normally cannot prescribe medication. 

Yoga, meditation, and mindfulness

During menopause, a person’s body tends to go through a lot of changes. Practices designed to enhance a person’s awareness of themselves, their minds, and their bodies may help to understand those changes and cope with them more effectively. 

Mindfulness, or being aware of the present moment and observing one’s own thoughts and feelings, may give a person a sense of agency over their own emotions, which may help to combat the symptoms of depression. 

Yoga and meditation can both be helpful ways to incorporate mindfulness into your life, with yoga potentially facilitating a stronger connection to your body and meditation possibly doing the same for your brain. Studies frequently show a link between practicing yoga and the reduction of depression- and mood-related symptoms in people experiencing menopause.

A healthy diet for menopausal depression

Having a healthy diet also plays a role in alleviating the symptoms of depression from menopause. Try to consume a variety of nutrient-rich foods to support hormonal balance. Incorporate whole grains and lean proteins into your meals as they can bolster your energy levels. Try to eat mood-enhancing foods such as leafy vegetables, berries, and fish.

Join therapy to improve your mental health

When you are experiencing significant changes in your life, it can be helpful to talk to a therapist. If you are having difficulties with depression symptoms during menopause, it can compound an already complicated period of life. A therapist may help you process your feelings and alleviate mood-related menopause symptoms.

Benefits of online therapy

Common symptoms of depression can include exhaustion, lethargy, and feeling as if even small tasks are daunting. If menopause-related depression is making it hard for you to leave the house, you may want to consider online therapy. Online therapy through a platform like BetterHelp can connect you with a licensed therapist with whom you can meet from the comfort of your own home. 

Effectiveness of online therapy in managing the symptoms of menopause and depression

Scientific research has indicated that accessing therapy online may be just as effective as attending a traditional in-person therapy appointment. One study found that completing an online course of cognitive behavioral therapy often helped relieve menopause symptoms, including psychological symptoms. If you are encountering difficulties with emotional distress and depression during menopause, connecting with an online therapist may be beneficial.