Menopause and Depression: Causes and Treatments

An estimated 8 – 15% of all women experience symptoms of depression during menopause.  Unfortunately, problems are often misdiagnosed, because many of the symptoms of depression mimic those of normal menopause. Increased fatigue, appetite and sleep disturbance, difficulty concentrating, and increased irritability are symptoms of both clinical depression and peri-menopause (the 8-10 years prior to full menopause) or menopause.

Extended periods of sadness or melancholy, accompanied by feelings of hopelessness or helplessness, call for medical intervention, as clinical depression may be present.  Untreated, depression can lead to a host of emotional and physical problems, and, in extreme cases, even suicide. Several recent studies point to an increased risk of depression in menopausal women, even those without any history of the disorder.  One study, published in the Archives of General Psychiatry, found that women were four times more likely to develop depressive symptoms in peri-menopause than prior to its onset.

Causes of menopausal depression

The most frequent culprit in the development of women’s midlife depression is the significant drop in estrogen levels that accompanies the onset of menopause.   Emotional changes associated with low estrogen levels include depression, anxiety, and increased irritability. With the loss of estrogen, other hormones and neurochemicals become imbalanced as well.  In particular, those affecting stress and mood, such as cortisol and serotonin, may be disrupted.  Low serotonin levels are frequently associated with the development of depression.

The stress caused by other menopausal symptoms can also contribute to feelings of depression.  Insomnia, night sweats, mood swings – symptoms such as these can make the most emotionally balanced person feel out of kilter.  An individual who is biologically more prone to depression may find such menopausal symptoms to be a trigger for a depressive episode.

Finally, age-related stressful life changes and events may coincide with menopause, such as the loss of fertility, “empty nest” syndrome, occupational changes, parental care giving, and marital strife.  These stressors may contribute to feelings of depression.

Women more likely to suffer menopausal depression include those with a history of depression and those who experience a surgical menopause, due to the sudden loss of estrogen.

Menopausal depression treatment

Menopausal depression can be treated successfully, with significant symptom management. The most common form of treatment is hormone replacement therapy.  Often used to manage menopausal symptoms such as hot flashes, estrogen therapy has also been found to reduce depressive symptoms. A study reported in the American Journal of Obstetrics and Gynecology found that 80% of menopausal women reported positive mood changes as the result of oral estrogen doses.

Antidepressants can also provide benefit to women with menopausal depression.  Those which help the body raise its serotonin levels are particularly effective.

Psychotherapy has also been found to be an effective treatment method. Trained professionals can assist individuals in learning how to re-frame negative thoughts and reduce stress levels.

A focus on appropriate self-care is helpful for any woman facing menopause. Many symptoms can be managed through practicing such strategies as vigorous physical activity, stress management exercises, good sleep habits, and healthy eating.

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