Are Depression And Menopause Related?
Menopause is a major milestone in the lives of many women. From puberty and menarche to pregnancy and childbirth, our bodies undergo numerous changes over our lifetimes. The last transition, menopause, is just as significant as the rest; as such, it requires sensitivity and recognition so that those experiencing it are as comfortable as possible. Menopause can affect women’s health in many ways. In addition to having an impact on your physical health, menopause can also affect mental health and can even increase the risk of depression.
Depression and menopause
For many people, depression is a common symptom during the time leading to menopause. This can be uncomfortable not only for the individual experiencing menopause but also difficult for family members who are concerned. Symptoms can have a significant effect on a woman's life, so it's crucial to understand the symptoms (especially when taken within the context of menopause) and to know the potential options available for antidepressant treatment. Some common symptoms of depression include:
- Irritability
- Low mood or persistent feelings of sadness
- Feeling empty, hopeless, or guilty
- Difficulty making decisions
- Loss of interest in previously enjoyed activities
- Withdrawing from loved ones
- Difficulty concentrating
- Having thoughts of suicide*
*If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available 24/7.
What is menopause?
Symptoms and risks of perimenopause
The transition into menopause, also known as perimenopause, lasts between 7 and 14 years and is often characterized by a number of symptoms, such as hot flashes, that develop due to hormonal shifts. Symptoms occur in response to physiological and reproductive hormones changing in the body as it goes through the transition to menopause. Hormonal shifts that occur can increase one’s risk of developing certain health conditions, such as heart disease. Major depression is a common symptom of both perimenopause and menopause, but it is by no means the only symptom. Some other symptoms of menopause include:
- Hot flashes
- Fluctuations in or absence of the menstrual cycle
- Changes in vaginal lubrication
- Increased potential for vaginal and bladder infections
- Sleep problems such as insomnia, sleep disturbance, or poor sleep
- Changes in sex drive; there can be an increased or decreased libido in the status of sex after menopause.
- Mood swings (moodiness and/or irritability)
- Body changes: weight gain and muscle loss, thinner skin, and achiness are all common
- Memory problems
- Headaches
- Heart palpitations (in rare cases)
Understanding depressive symptoms and mental health during menopause
Anxiety and depression symptoms are frequently observed in people who are experiencing the transition to menopause as well as those who have already gone through the transition and are now officially menopausal. Unfortunately, the connection between depression and menopause isn’t very well studied yet, even though it is an undeniable part of perimenopause and the beginning stages of menopause for many people. Although not much is known about why most women experience depression during this time, there is plenty of information available on how to treat it and maintain emotional health.
What's the connection between menopause and depression?
There is a well-established connection between depression and menopause, but the actual causes are highly variable. The most propagated theory relates to the effects of dropping estrogen levels. Throughout life until menopause, the body produces estrogen to start menstruation, encourage physical development, manage sex drive, manage the growth of the uterine lining during pregnancy, and control weight gain and metabolism. At the onset of menopause, estrogen production dramatically drops, which can lead to a variety of symptoms.
How hormonal shifts relate to depression during perimenopause, postpartum, and menarche
In fact, hormonal shifts that occur during perimenopause and menopause are similar to those that occur during the postpartum period and that contribute to postpartum depression. At certain stages during and after pregnancy, or right before menarche (the start of menstruation), many people experience similar (though often less dramatic) symptoms. This demonstrates the connection between a decrease in hormone production and depression during the first stages of menopause.
Dealing with menopause and depression blues
For those experiencing this, having the “menopause blues” is normal. Feeling somewhat more irritable, sad, or melancholic than usual is to be expected. However, some people experience more noticeable symptoms that negatively affect their ability to function and get through the day. No matter the severity, depression can be very uncomfortable. It’s important for individuals experiencing menopause to be aware of their symptoms as well as resources that are available to them so that they can get treatment they need.
Treating menopause and depression
Depression during menopause can be the result of a number of different things, not only dropping estrogen levels. For example, sleep troubles, changing body image, changes in physical appearance, and changes in sex drive can all be causes for symptoms as well. While the overall symptoms are often attributed to hormonal changes, symptoms can arise from multiple sources. Here are some of the most effective ways to treat menopause-related depression symptoms:
How exercise can improve mood and mental health during menopause
Exercise is an incredibly important part of any treatment plan for depression, especially for those who are entering menopause. When you exercise for 20 minutes or longer, performing continuous, moderately strenuous movements, your body releases endorphins that can lead to feelings of happiness and calm. Maintaining a regular exercise routine not only increases the “happy hormones” in your body but can also create a sense of routine in your schedule that can in and of itself be reassuring during the transition to menopause. If you exercised before, try to keep up your old routine or modify it to suit your changing needs. Although it can be difficult to start or continue an exercise routine when you’re experiencing depression, it can make a huge difference in your mood.
Yoga and meditation to manage menopausal symptoms and mood
Establishing a regular yoga or meditation practice (or even a combination of the two) is a powerful way to reconnect with your mind and body as you’re going through the transition to menopause. If you’re feeling symptoms of depression, meditation can allow you to “get away” for a period of time so that you have an opportunity to gain perspective and enjoy a few moments of peace. Plus, because your body goes through changes during menopause just as it did during menarche, practicing gentle movements like yoga can help you relearn your body and practice working with it in new ways.
Exploring herbal remedies and dietary changes for menopause symptoms
For thousands of years in China and India, people who started perimenopause visited traditional acupuncture or Ayurveda practitioners for advice. Some practitioners of these medical methods would offer specific herbs to women and propose very particular dietary changes to help them manage the symptoms of the transition to perimenopause and menopause. Even in the West, it was at one time common for herbs and diet to be used to manage perimenopause and menopause symptoms for those experiencing them. Today, these traditional therapies are making a comeback. If you’re interested in natural remedies for treating menopause symptoms, contact a specialist so that you can get high-quality, personalized information for your unique situation.
Hormone replacement therapy as a treatment for depressive symptoms during menopause
For those entering menopause, hormone replacement therapy (with either organic or synthetic hormones) can be a viable and popular treatment. This treatment involves the administration of extra estrogen during perimenopause in order to reduce the problems associated with decreased hormone levels, such as the symptoms of anxiety and depression. The estrogen may be self-administered either as a pill, a patch, a gel, or a special vaginal ring. Contact a hormone replacement therapy treatment specialist for more information if this treatment option appeals to you.
How therapy can help with menopausal mood and symptoms
While the symptoms of depression are most commonly caused by something physiological, that doesn’t mean that therapy can’t help those experiencing it. For example, therapy for the symptoms of depression can help perimenopausal people to reflect more consciously on their mood and its correlation with their physical symptoms. For many people experiencing menopause, being able to discuss the changes in mood, feelings, and appearance is a major key to being able to successfully overcome the symptoms of depression. While not all the symptoms may go away with only therapeutic treatment, therapy can be a viable addition to any menopause treatment plan because it offers support and reassurance during this life change. This support can be particularly crucial for individuals with aging parents or those struggling with substance use during this period.
Online therapy and BetterHelp
If you’re considering therapy to help navigate the complicated side effects of menopause or to address other life challenges, the mental health professionals at BetterHelp can give you the support you need. BetterHelp is an online therapy platform that provides a team of licensed therapists who can help you manage symptoms of depression and other mental health concerns. Online therapy can be a discreet and flexible way to find the tools and guidance you need. Although depression can make it hard to get out of bed, you can still get care from the comfort of your home by utilizing online therapy.
The effectiveness of online therapy treatment
Online therapy can be a powerful tool for treating depression and other types of mental health disorders. One study found that internet-delivered psychotherapy significantly reduced symptoms of depression. Those who had never utilized online therapy before saw even greater improvements in their symptoms. However, results were consistent across gender, income, and physical health status, speaking to the efficacy of online therapy for people from all backgrounds.
Takeaway
What is the best treatment for menopausal depression?
Typically, treatments for menopausal depression involve a combination of methods depending on the severity of symptoms. For some people, antidepressant medications paired with cognitive behavioral therapy (CBT) are the most effective strategy. Others suggest hormone therapy methods like low-dose oral contraceptives or estrogen patches paired with progesterone pills are more effective. For those who require non-pharmaceutical or hormonal treatments, CBT paired with mindfulness-based interventions (MBI) has been proven to “significantly improve anxiety and depressive symptoms in menopausal women.”
When paired with therapeutic strategies, certain lifestyle habits like regular exercise, quality sleep, a nutritious diet, and stress management can help ease depressive symptoms in menopause. The best treatment for depressive symptoms associated with menopause depends on the individual and their body. Be sure to talk to your primary care doctor or obstetrician/gynecologist about the best treatment for you.
Does menopause cause depression?
Menopause doesn’t directly cause depression, but it can be associated with an increased risk of depression for some people. One of the primary links between menopause and depression lies with hormonal changes, particularly a decrease in estrogen levels, that influence neurotransmitters like serotonin, which play a key role in mood regulation. Other factors that might contribute to an increased risk of depression during menopause include:
- Effects of physical discomfort: Common symptoms such as hot flashes, night sweats, sleep disturbances, and fatigue can affect mental health, leading to feelings of irritability, anxiety, or depression.
- Significant life changes: Life changes that sometimes occur during midlife, such as children leaving home, aging parents, loss of loved ones, or changes in relationships, can contribute to stress and emotional strain, increasing the risk of depression.
- History of depression: Although it isn’t the case for every person, individuals with a prior history of major depression or anxiety are at higher risk of experiencing depressive symptoms during menopause. This includes a history of postpartum depression or depression associated with menstruation (premenstrual dysphoric disorder).
What are the natural remedies for menopause depression?
Naturally based complementary and alternative medicinal (CAM) treatments for menopausal symptoms can fall into a few categories, including:
- Mind-body practices like hypnosis, CBT, relaxation techniques, aromatherapy, meditation, and biofeedback
- Natural products such as vitamins, minerals, herbs, and dietary supplements
- Whole-system treatments like traditional Chinese medicine, acupuncture, homeopathy, and reflexology
If you are considering natural remedies for treating your menopausal depression symptoms, it’s imperative to collaborate closely with your healthcare provider. This is particularly so if you’re considering using a dietary supplement, as meta-analyses indicate that “evidence is mixed concerning the efficacy of natural products, and there are some safety concerns.”
How long does menopause sadness last?
Menopausal symptoms, including sadness, may last anywhere from seven to 14 years depending on several factors like physical health, family history, race and ethnicity, or smoking.
Why do I feel so bad during menopause?
There are several factors associated with menopause that may heavily influence physical and mental well-being. Hormonal changes in the body are among the most commonly cited causes. These changes can cause:
- Sleep disruptions
- Weight gain
- Low mood or anxiety
- Night sweats
- Hot flashes
- Vaginal dryness/pain during sex
- Loss of interest in sex
- Urinary incontinence
Hormonal changes in the human brain during menopause can also affect the ability to store information and other cognitive processes, leading to distress and frustration. Environmental factors can also influence how you feel during this stage in your life. For example, grown children leaving home, caring for aging parents, and transitions in careers or retirement can be stressful.
What calms menopause?
Several strategies might prove effective in helping manage symptoms of menopause. What works best typically depends on factors like physical and mental health and the types of symptoms, so speak to your healthcare provider. They can help tailor a solution that works best for your unique situation. Some common methods for reducing symptoms of menopause include:
- Hormone replacement therapy
- Antidepressant medications
- Psychotherapeutic interventions like CBT
- Relaxation and stress-reduction techniques
- Healthy lifestyle habits
- Vitamin, mineral, or dietary supplements
How do you fix menopausal depression?
“Fixing” menopausal depression might take time, effort, and perhaps some trial-and-error to find a combination that works for you. With the right intervention strategy, it is possible to reduce or eliminate symptoms of menopausal depression. Here are a few suggestions:
- Psychotherapy: CBT and other forms of therapy can be effective in treating menopausal depression. These types of therapy focus on identifying and restructuring negative thought patterns and behaviors that contribute to depression.
- Mindfulness-based interventions: Techniques like meditation, journaling, mindful breathing, grounding techniques, progressive muscle relaxation, yoga, and tai chi can improve mood and reduce stress.
- Stay active: While it isn’t an antidepressant therapy by itself, regular exercise has been shown to significantly improve mood and alleviate symptoms of depression associated with menopause.
- Eat a nutritious diet: Numerous studies suggest a link between diet and menopausal depression. While the success of a dietary intervention depends on your unique situation (consult your doctor or a nutritionist), a diet featuring foods that promote overall nutrition, like fruits, vegetables, whole grains, and lean proteins, can be beneficial.
- Get enough sleep: Poor sleep can exacerbate symptoms of depression. Establish good sleep hygiene with a consistent bedtime routine, a comfortable sleep environment, and avoiding screens before bed.
- Consider medication: In some cases, antidepressants or hormone therapy might be necessary to help manage severe symptoms of menopausal depression.
- Do things that make you feel good: Treating yourself to a massage, spending time in nature, and engaging in creative activities are all examples of self-care activities that can help manage depression.
- Stay social: Spending time with friends and loved ones can help distract you from unpleasant symptoms, but a support system can also provide perspective and encouragement to help you cope.
What is the best diet for menopause depression?
People in menopause have an increased risk of developing diet-related health conditions like osteoporosis, obesity, cardiovascular disease, and metabolic syndrome. Studies also suggest a multi-directional connection between dietary habits, menopause, and depression. Nutritional counseling is recommended for people who want to manage their menopause and depression symptoms with dietary support. While the best diet for menopause depression might be different from person to person, here are a few key findings:
Some people who eat more fruits and vegetables experience fewer menopausal symptoms
Some people who eat more whole grains and less processed foods have less severe menopausal symptoms
Diets high in omega-3 fatty acids, like those found in fatty fish and seeds, are associated with better health and a reduction of symptoms during menopause
Dairy products containing tryptophan (like yogurt, cheese, and milk) are associated with better sleep, essential for overall menopausal health and for managing menopause-related depression
Why do I cry so much during menopause?
Crying is a natural part of being human, but if you’re experiencing menopause and crying a lot more than you used to, it could be due to a decrease in estrogen and progesterone levels. These hormones are closely linked to mood regulation, and their fluctuation can lead to increased sensitivity and episodes of crying.
Significant life events that occur during this phase of life, like children leaving home, changes in work life or relationships, and caring for or the loss of aging parents, can contribute to sadness and increased crying. Physical disturbances during menopause, like night sweats, insomnia, hot flashes, and fatigue, can be stressful, heightening emotions and making you more prone to sensitivity and crying.
Can menopause cause a mental breakdown?
Menopause can contribute to severe emotional and psychological distress and lead to cognitive changes that might feel like a mental breakdown. Speak to your doctor or women’s health specialist, or find a therapist experienced in treating people with menopause if you’re experiencing symptoms like depression, anxiety, irritability, overwhelm, mood swings, and trouble with memory and concentration.
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