Perimenopause is a transition females go through prior to menopause that brings changes in their menstrual cycle patterns, such as abnormal menstrual periods, erratic fluctuations in hormone levels, and insomnia. For many it can also cause unpleasant hot flashes. Several studies have linked perimenopause to depression, as well as worsening of existing depressive symptoms.
Signs and symptoms of Perimenopausal Depression
Signs of depression that perimenopausal women often exhibit include:
- Fatigue or loss of energy
- Restlessness and irritability
- Emotional flatness
- The desire to disconnect from people
- Crying for no reason
- Decreased interest or pleasure in activities
- Changes in appetite
- Changes in sleep patterns
- Difficulty concentrating
- Feelings of guilt or worthlessness
- Thoughts of suicide
Risk factors for Perimenopausal Depression
Research has identified the perimenopausal stage as a time of increased risk for both depression and psychosis. There are a number of factors, including hormonal changes, physical changes, and overall health that can all bring on depression.
Stressful life events such as a divorce, job loss, or the death of a parent—which are all common occurrences for women in this stage of life—can trigger depression during this time. Because the risk for depression is high, it is a good idea for women in perimenopause to keep an eye out for these symptoms and to recognize when it’s time to seek help.
Hormones and mood
Declining estrogen levels during menopause can make women feel like they are in a constant state of PMS. When hormone levels decline, as they do in the months and years leading up to menopause, the production of mood-regulating chemicals such as serotonin and endorphins change. This can result in mood swings, depression, and an emotional roller coaster of highs and lows.
Depression and its effect on Perimenopausal Women
The signs and symptoms of Perimenopausal Depression overlap with the symptoms of depression unrelated to perimenopause, but there are some unique elements including physical, psychological, and life changes that can all be contributing to the depression you’re feeling.
Management of Perimenopausal Depression
Perimenopausal Depression can be managed with psychotherapy and other non-drug interventions. If drug treatment is need, it will most likely involve hormone replacement therapy, an antidepressant, or both.
The psychological and social impact of menopause may also affect mental health. Although some women feel that menopause is a positive event, others may feel as though it has fundamentally changed their social role. Psychotherapy can help with identifying these feelings and the other social factors contributing to your depression, and help you understand and manage your thoughts and emotions.
Drug or “biological” treatments
Antidepressants can help correct the chemical imbalance caused during the perimenopausal stage. Many women will show a noticeable improvement with antidepressants and will experience relatively few adverse effects. Antidepressants can be most effective when used in combination with psychotherapy. Estrogen also has been shown to significantly improve mood in some women during perimenopause. The two therapies may also be used in combination if one alone proves insufficient.
Home remedies for dealing with Perimenopausal Depression
Many women seek out a variety of ways to help themselves calm and comfort their perimenopausal symptoms. A few popular remedies include:
Women experiencing Perimenopausal Depression may find relief through walking, jogging, biking, swimming, or any other exercise that they enjoy.
Sleep disturbances increase during the menopausal transition, with the most common complaint being waking up at night. Try to maintain a healthy weight and diet, avoid nicotine, caffeine, and alcohol, and reduce stress as much as possible because anxious and stressful thoughts can make it harder to fall asleep.
Mindfulness practices, such as deep breathing and staying focused in the present, may help ease symptoms such as hot flashes and stress that often accompany perimenopause.
Some women find relief from hot flashes by taking valerian root during perimenopause, but there is little scientific proof that it works.
Research has indicated that some B vitamins can be helpful for relieving physical and psychological symptoms during the perimenopause phase, and that a deficiency in these vitamins during this time of transition can lead to adverse health outcomes.
The physical symptoms of menopause often present themselves later than the psychological symptoms, making the diagnosis of Perimenopausal Depression difficult. It is important for your health professional to consider whether you are experiencing depression related to your perimenopausal hormone fluctuations or as an exacerbation of a previous depressive issue.
The outlook for most women who experience Perimenopausal Depression is good. While treatment cannot always make your depression go away completely, it can usually make your symptoms much more manageable.
Perimenopausal Depression FAQ
Perimenopause is the transition women go through prior to menopause that brings menstrual cycle changes and hormone level fluctuations. It can also bring on depression, and make any existing depressive symptoms worse.
When women go through sudden hormonal changes during perimenopause they’re at a higher risk for depression. Approximately 70% experience irritability, and 20% suffer with significant anxiety and depression.
Brisdelle, a low-dose SSRI, is currently the only antidepressant that’s FDA-approved to help with the hot flashes and night sweats that are experienced by a majority of women during their menopausal transition.
There is no one way to prevent perimenopausal depression, but several studies suggest that hormone therapy may improve depressive symptoms for women during this time of transition.