• Malin Andersson

Understanding depression during menopause

Updated: Oct 4

Before we look at the complex and often isolating experience of menopause-related depression, consider taking a long, deep breath. Really – take a breath and hold it for a few seconds. Depression can be a heavy topic. Taking care of yourself, your body, and your mind is always #1.


Alright, exhale now if you haven’t already. Everyone brings their own personal suitcase of experiences and history to the discussion of depression. It’s a topic full of twists and turns of many varieties – but you are not alone.


Anxiety, depression, and other mental health challenges often accompany the changes that come with menopause. They can feel frightening or discouraging – especially if you keep these thoughts and feelings strictly to yourself. Though it can be intimidating, seeking help from a healthcare professional or sharing your current experience with a friend, community, or partner are great first steps in seeking the care you deserve.

young women looking thoughtful
Depression during menopause can feel isolating but no one is alone.

Is it common to experience depression during menopause?

What causes depression is highly individual. Like menopause, every path is personal.


What continues to be clear anecdotally and through research, however, is that the transition of perimenopause can increase a woman’s chance of experiencing depression – even if they haven’t experienced it before.


Women in perimenopause are 2 to 5 times more likely to experience depression disorders than women in their late premenopausal years. But this increased risk will not last forever. Studies have shown that a woman’s vulnerability to depression seems to decline 2 to 4 years after her final menstruation.


The common assumption has been that hormone changes during menopause can lead to depression. Although this connection is strong and likely has a decent effect, it isn’t the only factor at work here.


Hormone changes, history of depression, and stress are all factors that can lead to depression – though they do not guarantee it.


What are the symptoms of depression?

Mood is one of the primary aspects of daily life that is impacted during menopause. Along with experiencing mood swings or feeling generally down, many women will report more anxiety and fatigue in the months or years surrounding their final period.


For many women, however, disruptions in mood may become more frequent and severe, interfering with day-to-day life. Perimenopause – the time leading up to the final period – has been studied as a time in which women appear to be more vulnerable to experiencing depression.

About 18% of early perimenopausal women and 38% of late perimenopausal women experience symptoms of depression. Though a majority of perimenopausal women do not develop depression, it is important to recognize that this is a time of increased risk – specifically the 24 months surrounding your last menstruation.

To feel any variety of depressive symptoms can be upsetting. Recognising the thoughts and emotions you’re going through can be an important step in finding relief.

Symptoms of depression include:

  • Depressed mood (eg, feeling sad or hopeless)

  • Decreased interest or pleasure

  • Weight change (greater than 5-percent of body weight per month) or change in appetite

  • Sleep disturbance (insomnia/hypersomnia)

  • Fatigue

  • Feelings of worthlessness or excessive guilt

  • Difficulty concentrating

  • Psychomotor agitation or slowing (relating to how brain processes affect movement)

  • Recurrent thoughts of death

Though the symptoms on this list are associated with depression, their existence alone cannot guarantee or diagnose clinical depression. Many depressive symptoms overlap with symptoms of menopause which can make the root of the feeling difficult to assign. For example, trouble sleeping, mood swings, sadness, and irritability are associated with both.

Vasomotor symptoms like hot flushes and night sweats have been strongly correlated with menopausal women experiencing depressive symptoms. Many women who report depression often also report severe vasomotor symptoms. However, though they are often correlated, they are not predictive.

Your experience is valid and real. No matter the variety of your symptoms, you are always highly encouraged to reach out for help – especially if your symptoms are interfering with your quality of life.

woman holding head
Symptoms like sadness, fatigue, and difficulty concentrating are often associated with depression and menopause.

So, what exactly causes depression?

Unsurprisingly, the cause of depression is not a clear-cut path. It’s more of a winding combination of underlying factors and experiences.


Navigating the maze can feel never-ending. Understanding what builds the maze as well as knowing and being patient with yourself can hopefully make it less intimidating.


To put it simply, there is a lot happening inside your body during menopause. With this in mind, much of the research on the connection between depression and menopause is focused on the biological side of things – like hormones and genetics.


When oestrogen and progesterone levels fluctuate, it is possible that the threshold for depression to emerge may be lower. Mood regulation, cognition, and stress response can be affected, making depression more common. In several studies, lower levels of oestrogen in postmenopausal women have been linked to a higher risk for depression.


There is also a potential link between genetics and depression that is still being researched but can be helpful to connect in your own life. If you are able, talk to those in your family who have gone through menopause before. You might learn a thing or two.


It may not be easy to pinpoint one specific cause of depression, but it is helpful to understand how each factor might play a role in your own life.


Past experiences with depression

One of the most common questions is how a personal history of depression influences depression during menopause.


Research has shown that women with a history of depression are nearly 5 times as likely to develop it again than women who have never experienced it before. However, women without a history are still at risk – although the risk of depressive symptoms lowers 2 or more years after their final period.


However, if you’ve had depression before in your lifetime, you are not pre-determined to face it again during menopause just as many women experience depression for the first time during menopause. There are many ebbs and flows during this journey.


Experience with premenstrual syndrome (PMS) has also been linked to depression, especially for its relation to hormone shifts and mood swings. Menstrual cycle irregularity during perimenopause as well as a history of smoking can influence depression in midlife.


Social, economic, and circumstantial stress are other components at work. Just as the major life change of menopause can play a part, the effects of life’s other factors can influence an individual’s experience with depression. Your past and present are both important in your mental health journey.


Depression can heighten loneliness or the sense that something within you is defective. It’s important to acknowledge that you are not the first person to experience menopause-related depression. There is a wealth of information, support, and help if you gather the courage to pursue help.


Neither depression nor menopause are cookie-cutter experiences. And that’s okay.

Two friends hugging
Reaching out to friends, family, and professionals can be a good first step in finding relief.

Seeking relief

Now that we’ve sorted through all of that information, take another deep breath. Hold it for a moment and just let yourself be.


Okay, go ahead and exhale. Depression can feel heavy and unnerving, yes, but there is also great potential for help. Talk to your doctor or a trusted friend. Learn about the resources available to you. Be patient with yourself.


Though self-care is far from a “cure,” take some time to be kind to your body and mind. Explore lists of self-care. Find what’s best for you.


Even though menopause and depression can be highly personal and unique, you are not alone. Your feelings are valid and deserve real care. By learning about your body, hopefully, you can acknowledge your capability of weathering the storm.


Disclaimer: This website does not provide medical advice. The information, including but not limited to text, graphics, images, and other material contained on this site are for informational purposes only. No material on this website is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen. And never disregard professional medical advice or delay in seeking it because of something you have read on this website.


References:

  1. "Depression and its influence on reproductive endocrine and menstrual cycle markers associated with perimenopause." https://doi.org/10.1001/archpsyc.60.1.29. Accessed 14 June 2022.

  2. "Depression and the menopause: why antidepressants are not enough?" https://doi.org/10.1258/mi.2009.009021. Accessed 14 June 2022.

  3. "Depression During and After the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease." https://doi.org/10.1016/j.ogc.2018.07.007. Accessed 14 June 2022.

  4. "Depression in the menopause transition: risks in the changing hormone milieu as observed in the general population." https://doi.org/10.1186/s40695-015-0002-y. Accessed 14 June 2022.

  5. "Menopause and depression: is there a link?" https://doi.org/10.1016/j.maturitas.2014.05.014. Accessed 14 June 2022.

  6. "Onset of the menopause transition." https://doi.org/10.1016/j.ogc.2018.07.002. Accessed 14 June 2022.

  7. "Risk for New Onset of Depression During the Menopausal Transition: The Harvard Study of Moods and Cycles." doi:10.1001/archpsyc.63.4.385. Accessed 14 June 2022.

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