Menopause is diagnosed after going for 12 consecutive months without periods. The period spanning the time from the first manifestations of hormonal changes leading to menopause and the first year after the cessation of menstruation is called perimenopause. Normally, this occurs between the ages of 45 and 55, with the median age being 51. Some women can go through menopause earlier or later due to certain factors such as genes, comorbid diseases, lifestyle factors, etc.
Due to hormonal fluctuations, women in menopause experience a range of physical and emotional symptoms, including hot flashes and mood changes. Studies show that41.8% of women in perimenopause and postmenopause have symptoms of depression. So, does that mean there’s a link between menopause and depression? If yes, what is the treatment? Here’s what you should know.
Can Menopause Cause Depression?
Studies show there’s a link between menopause and depression. Also, some studies reveal that women were four times more likely to experience depressive symptoms and 2.5 times more likely to be diagnosed with major depressive disorder (MDD) during the menopausal transition as compared to when they were in the premenopausal stage.
However, this doesn’t happen to everyone. The risk factors include:
- Having a history of depression, especially during PMS, menstruation, and pregnancy.
- Surgical menopause.
- Stressful life events.
- Negative attitude toward aging and menopause.
- Frequent and distressing hot flushes.
During perimenopause, the woman’s body starts producing less estrogen and progesterone, the two hormones that play a huge role in fertility. Estrogen also increases serotonin, a neurotransmitter that affects mood and happiness. Against this background, the synthesis of serotonin in the brain also decreases. That’s why some women feel depressed during menopause.
Symptoms of Menopause Depression
How would you know if you’re going through menopause depression? First, identify the signs of the premenopause stage. If you’re over 40 years, you may start noticing signs like:
- Irregular menstrual cycles. Anything can happen, from missed and longer periods to heavier and lighter ones.
- Hot flashes. It’s a sudden heat that spreads through your body and may include sweats and chills.
- Insomnia. You may find it difficult to fall and stay asleep at night. This could be due to hot flashes and mood swings.
- Vaginal dryness. Due to low estrogen, vaginal tissues may become drier and less elastic.
The above signs indicate you’re in the premenopause stage. In addition to these signs, you may start having mood swings, such as anxiety and irritability. Physical symptoms may exacerbate feelings of depression. If depression co-occurs with perimenopause, the two can be linked together.
Menopause depressive symptoms and their extent may vary according to the stage of the menopausal transition and age of menopause. Here are common signs of menopause depression:
- Feeling sad, worthless, and hopeless.
- Changes in appetite, leading to weight gain or weight loss.
- Lack of interest in activities you once enjoyed.
- Feeling tired.
- Irritability.
- Sleeping problems.
- Difficulties maintaining focus, remembering, and making decisions.
- Physical pain such as headache and stomachache.
Even though hormonal changes are the main reasons women at menopause get depressed, other factors can also contribute to or worsen the condition. These include stressful life events, relationship problems, financial difficulties, chronic illness, and substance abuse.
Treatment for Menopause Depression
If left untreated, depression can take a toll on your life. It can adversely affect your physical and mental health, career, and relationships. In the worst cases, suicidal thoughts may increase and significantly degrade your quality of life. Fortunately, you can overcome depression by seeking professional help.
Depression treatment often involves a combination of medication and therapy. Additionally, making lifestyle changes can also help cope with it. Here’s what you can expect in a treatment plan.
Medication
Depression can be treated with many types of medications. Your doctor will select the best drugs based on your medical history, symptoms, and responsiveness to previous treatment. The most common options are antidepressants of the SNRI and SSRI types:
- Selective serotonin reuptake inhibitors (SSRIs) such as Zoloft (sertraline) and Prozac (fluoxetine)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Effexor (venlafaxine) and Cymbalta (duloxetine).
Both of these types of drugs work by changing the levels of neurotransmitters in the brain to regulate a person’s mood. Most people respond well to SSRIs, making them the most common antidepressants. But in rare cases where the individual doesn’t respond well to SSRIs, the doctor can recommend a different drug. Sometimes, combining a few medications may be more effective.
Hormone Replacement Therapy (HRT)
HRT can regulate hormones and relieve symptoms, such as mood swings and hot flashes. Moreover, it may improve the response to antidepressant treatment. HRT may be a viable option for women in perimenopause who are not taking hormonal contraceptives. However, the use of HRT should be based on individual risk factors and medical history. There are potential risks associated with HRT. Your gynecologist will evaluate all the benefits and risks of HRT individually.
Therapy
Medication isn’t enough to deal with depression. It only provides relief from symptoms but usually doesn’t affect the root cause of the condition. So, therapy is necessary for long-term improvement. The best thing about talk therapy is that it helps identify the cause of the problem before finding solutions. Remember, besides hormonal changes, menopause depression can also result from a person’s attitude and environmental factors.
Therefore, talk therapy, such as cognitive behavioral therapy (CBT), can help identify negative thoughts and replace them with positive ones. Talk therapies are also ideal because they allow you to express yourself without fear. A professional therapist or mental health specialist doesn’t judge you or disclose your secrets to anyone. Additionally, talk therapies don’t have any side effects like the case with drugs.
Lifestyle Changes
In addition to medication and talk therapy, you can improve your condition by making a few lifestyle changes. Some techniques work regardless of the cause of the depression. For instance, exercising regularly can help improve your mood. It relaxes your mind and makes you physically tired, which can help you sleep better. Also, if falling asleep is a serious problem, you may be recommended to reduce or avoid caffeine.
Improving your diet can also help. Eat more fruits, vegetables, and whole grains. Avoid alcohol, artificial sweeteners, and highly processed food. You can also find stress-relieving techniques such as meditation and yoga to be effective. And finally, seek support from family and friends. Instead of spending your free time alone, spend it with people who care about you.
Conclusion
Menopause is a natural aging process that leads to biological changes which can significantly impact a woman’s physical and emotional health. Research shows there’s a link between menopause and depression. The risk is highest during the perimenopause period when women experience hormonal fluctuations.
Also, women with previous cases of depression, especially during pregnancy and menstrual cycles, have a higher risk of developing menopause depression. Fortunately, menopause depression ends 2 to 4 years during the postmenopausal period.
But before then, it’s essential to seek treatment for depression because it can significantly degrade your life’s quality. Treatment involves using medications like antidepressants and talk therapies. Making a few lifestyle changes can also accelerate your recovery. If you have menopause-related depression, you can get your life back on track by seeking depression treatment.