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Menopause Depression (Yeah, it’s a Thing)

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You’re not alone — and there’s lots you can do about it.

Women going through the menopausal transition were four times more likely to be diagnosed with depression than at any other time in their life, according to a 2014 study.

Hot flashes, weight gain and low libido — to name just a few of the most common symptoms of menopause — provide plenty of reason to feel down in the dumps. But what few women realize is that grappling with depression due to hormonal shifts during menopause is far more common and treatable than you might think.

A study published in JAMA Psychiatry in 2014 found that women going through the menopausal transition were four times more likely to be diagnosed with depression or experience a depressive episode than at any other time in their life if they had never suffered from depression. If they had experienced depression before, that number jumped to 13 times more likely to develop depression.

“It’s a window of vulnerability,” says Sheryl Green, Ph.D., an assistant professor at McMaster University in Hamilton, Ontario, a clinical health psychologist at the affiliated Women’s Health Concerns Clinic and a Phenology Scientific Advisor.

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Photo by Jason Leung on Unsplash

Menopause & Depression

From a medical perspective, shifts in estrogen during perimenopause and menopause can cause mood swings, decreased levels of energy, lowered libido, weight gain and disrupted sleep patterns, all of which make you more vulnerable or likely to develop depression, says Shera Raisin, MD, a board certified family medicine doctor and lead physician at The Lanby, an integrated medical center in midtown Manhattan, New York.

“If someone is a highly functioning person in their 20s and 30s and has never been prescribed anti-depressants, then I would think it’s menopause until proven otherwise,” says Dr. Raisin.

And while menopausal depression may have different triggers than standard depression, the way doctors diagnose it — the symptoms they look for — are the same: “Feeling down or sad for most of the day for at least two weeks; no longer feeling pleasure from things you enjoy for at least two weeks; experiencing associative symptoms like low energy, change in appetite, excessive feelings of worthlessness, sleep disturbances and passive suicidal ideation,” says Dr. Green, who is also a coauthor of "The Cognitive-Behavioral Workbook for Menopause."

How To Treat Menopause Depression

Once you’ve determined that you might be experiencing depression, how can you treat it?

“The most common treatment experts recommend for menopausal depression is antidepressant medication and, when severe, it may be combined with hormone replacement therapy,” says Dr. Joanne Frederick, PhD, a licensed mental health counselor in Washington, D.C.

But many women prefer to avoid hormones and can see significant improvements by making lifestyle adjustments, like changing their diet. The Mediterranean diet, which includes plenty of leafy greens, legumes, lean protein and healthy fats from olive oil and nuts can help balance blood sugar and regulate mood. Other naturally-powerful mood regulators include saffron and genistein, a combo that, consumed as part of a daily regimen as in this daily supplement routine, can reduce stress and anxiety, support positive mood and better sleep, and reduce frequency and duration of hot flashes.

There’s also cognitive therapy for women who don’t want to go on antidepressants (though Dr. Green says cognitive behavioral therapy, CBT, can help even if you are on medication). Dr. Green encourages patients to try to reframe some of the symptoms they’re experiencing — like thinking of hot flashes as “tropical moments” instead of humiliating sweat fests. A woman having a hot flash during a meeting might say to herself, “They are going to see me sweat, so what? I’m still competent and have something important to say.”

It also helps for women to know they aren’t alone in having to contend with menopausal changes. Talking about your struggles can also dispel the stigma associated with both depression and menopause — and help you get back to feeling like yourself, faster. “We have to remind ourselves that every other woman goes through menopause and it’s really hard,” she says.

Tatiana Boncompagni
Tatiana Boncompagni is a writer, group fitness instructor and mom of three based in Manhattan. She has written about health, wellness, food, fashion and beauty for dozens of publications, including The New York Times, Wall Street Journal, Financial Times, Marie Claire, Vogue, and InStyle.

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