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Menopause and Depression

It’s estimated that 20% of women suffer from depression during the time leading up to menopause (perimenopause) and throughout menopause itself. That means for every five women aged approximately 40 to 65, one may be suffering from menopausal depression.

What are the Signs of Menopausal Depression?

Everyone goes through extended periods of stress, which can often lead to temporary mild depression. When those emotions continue past a reasonable time frame, however, intervention may be necessary.

If you find some of the following signs have remained for prolonged periods during menopause, they may indicate depression. These are:

  • Absence of motivation
  • Fatigue
  • Low energy
  • Memory lapses
  • Excessive sadness
  • Aggressive behavior
  • Restlessness
  • Irritability over minor occurrences
  • Frustration
  • Sudden outbursts of anger
  • Irrational paranoia
  • Anxiety
  • Difficulty focusing or concentrating on everyday tasks
  • Unpredictable mood swings
  • Feelings of low self-esteem
  • Unwarranted feelings of guilt
  • Constant tension
  • Agitation
  • Apathy towards previously enjoyed activities
  • Difficulty making decisions
  • Crying jags or exaggerated emotional reactions
  • Difficulty sleeping or sleeping too much
  • Appetite changes (over-eating or not eating enough – possibly leading to eating disorders)
  • Experiencing unusual pain without medical basis
  • Feelings of deep despair

Sometimes I Feel Like I’m Going Insane! Why is This Happening?

Rest assured that you’re not alone. Menopausal depression is only partially, but not completely linked to hormonal changes within the body. As your ovaries age, they get tired and stop producing estrogen and progesterone, which are responsible for enabling fertility, menstruation and good reproductive health. Other parts of the body go into overdrive to try and make up for the loss. Fat cells, adrenal glands, and the hypothalamus struggle to make up the difference, but aren’t very efficient, causing internal balance disruptions.

The situation is similar to a substitute teacher taking over a class for a week while the regular one is off sick. She does her best but lacks familiarity with both the students and their curriculum. Though the class survives the temporary disruption, it does not function at an optimal level.

The Scientific Whys of Depression

In your body’s case, the hypothalamus and pituitary glands produce more luteinizing hormone (LH) and follicle stimulating hormone (FSH) than normal to nudge additional estrogen production, but can’t quite pump out enough to maintain normal levels. Thus, serotonin and norepinephrine, which affect mood don’t get their regular dose of estrogen. Additionally, plummeting progesterone can cause sleep disturbances and erratic mood swings.

Most women can get through menopause with minimal discomfort, but for others whose side effects are much more dramatic, menopausal depression can have a psychological ripple effect when combined with the following occurrences:

  • Empty nest syndrome
  • Fear of aging and facing one’s mortality
  • Death of family members or friends
  • Hot flashes, palpitations, headaches and night sweats causing interrupted rest, full-blown insomnia, exhaustion, irritability and/or loss of focus and memory
  • Declining physical health
  • Negative body changes from aging, resulting in lowered self-esteem
  • Lowered libido resulting from vaginal dryness and sexual pain
  • Caretaking responsibilities of elderly relatives
  • Lack of emotional support from friends and family leading to feelings of isolation and aloneness
  • Divorce or job loss
  • Exposure to environmental pollutants, or sensitivity to chemicals or synthetic hormones found in foods

Who is More Likely to Suffer From Menopausal Depression

Any woman can experience depression during menopause, but some are more predisposed. Extreme menopausal depression can lead to social isolation, relationship breakdowns, and even thoughts or attempts of suicide, especially for women who:

  • Have a family history, or they themselves suffered from depression, Premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), or postpartum depression
  • Have undergone surgical menopause (oophorectomy) or a hysterectomy
  • Feel devalued or non-essential due to their age
  • Regret never having children, whether by choice or circumstance
  • Resent impending infertility and losing their childbearing abilities
  • Are alone, or lack moral and emotional support from family and friends
  • Are unemployed, are of low income, or are experiencing financial stresses
  • Dread aging, menopause, or have low self-confidence
  • Have poor overall health, or have family members suffering from poor health, especially if they are caretakers of the latter
  • Received minimal education
  • Feel multiple regrets regarding past life choices
  • Smoke
  • Do little or no exercise
  • Are unhappy in their relationships
  • Have a sexual abuse history
  • Live extremely stressful lifestyles
  • Take or have taken antidepressants in the past
  • Suffer from significantly more hot flashes than average

What Can I Do to Feel Better?

There are many lifestyle changes you can make to find relief. Some are:

  • Get at least a half hour of regular exercise five days a week
  • Try to get at least 8 hours of sleep.
  • Try relaxation methods such as Tai Chi, massage, yoga, meditation, etc.
  • If you smoke, quit
  • Join or create a support group for women with similar menopausal complaints
  • Avoid alcohol, tranquilizers, recreational drugs, and caffeine-especially near bedtime
  • Find a calming hobby such as painting, gardening, coloring, etc.
  • Find short-term projects that can give you a sense of satisfaction and achievement
  • Avoid isolation. Reach out regularly to family, community, and friends
  • Volunteer to help those less fortunate than yourself
  • Don’t sweat the small stuff: Prioritize and concentrate on what needs your attention now. Break up chores into smaller manageable time frames and declutter your environment
  • While you’re feeling this way, don’t make any life-changing decisions, you may regret later

Are There Any Natural Remedies That Can Help?

Eastern cultures rely heavily on diet and herbal and holistic medicine for many ailments, including menopausal depression. In China, for instance, only 10% of women suffer from different menopausal discomforts compared to 85% of American women. Western medicine recognizes the value of many of these time-honored and effective remedies. Today, many doctors work in tandem with these ideas, incorporating them into their modern day treatments, and recommending different formula combinations which may contain the following:

  • Ginseng
  • Dang kui
  • Sichuan lovage (chuan xiong)
  • Cordyceps (dong chong xia cao)
  • Red sage root (dan shen)
  • Angelica Sinensis (dang gui)
  • San-Qi ginseng (shen-san-qi)
  • Safflower flower (hong hua)
  • Trifoliate orange (zhi-ke)
  • Achyranthes (huai-niu-xi)

A healthy diet rich in protein, vegetables, fiber, and whole carbohydrates is also essential in warding off depression during menopause.

Other Natural Herbs and Supplements Include:

  • St. John’s wort (Hypericum perforatum)
  • B complex vitamins
  • Chromium
  • Omega 3 containing EPA and DHA
  • Magnesium
  • Vitamin D
  • Herbal teas containing hops
  • 5 HTP

Depression is Treatable

Depression is treatable. It is also encouraging to note that, though many women suffer from depression before and during menopause, once the transition is complete, with proper care, the depressive symptoms decrease and often disappear.

Your depression could be menopause-related, but there can also be other reasons for your symptom. As stated earlier, menopause itself does not cause depression, but it can contribute to it hormonally. You should always discuss your issues with your doctor to rule out any other physical or psychiatric disorders.

What if Nothing I Do Helps?

If your depression continues despite all your attempts, you may need medical intervention in the form of short or long-term antidepressants, estrogen replacement therapy, or the additional help of a therapist to discuss your problems.

How Can Cherokee Women’s Health Specialists Help Me?

Cherokee Women’s Health Specialists is a broad-based OB practice consisting first and foremost of three doubly accredited urogynecologists holding certification in OB/GYN and Female Pelvic Medicine and Reconstructive Surgery (FPMRS), a highly coveted credential approved only under the most stringent criteria set forth by the American Board of Medicine (ABM).

Along with these specialists, additional gynecologists, urogynecologists, obstetricians, nutritionists, and experts in holistic medicine and diet, are available for any and all female health-related disorders, concerns, and problems, providing you with the best possible care.

For a consult with one of our gynecologists to discuss depression during menopause, call 770-720-7733.

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