Depression in Menopause

The Perfect Storm – Stress, Hormones and Midlife

Depression in Menopause is often caused by hormone changes, stress and midlife. This creates the perfect storm and results in feeling the “blues”.

Most women have occasional episodes of depression, and menopause is no exception. Actually, women often experience their first episode of this illness during perimenopause.

Here you will find information about the different aspects of depression in menopause and things you can do to get help for your symptoms.

If you have thoughts of suicide or of harming yourself in any way, seek the help of a health care provider immediately!
What is Depression?

Unfortunately about 25% of women are affected by depression at some point in their lives. Women are much more likely to suffer from this illness, almost twice as likely as men.


But how do you know if you are just feeling “blue” or if you have clinical depression? Here is the difference:

  • It is normal to feel sad and anxious when we experience difficult situations. Most women are also familiar with occasional feelings of sadness and anxiety, even despair. But most of the time these episodes disappear after a couple of days.


  • When severe symptoms appear out of the blue and without reason, it may be clinical depression. Also if your feelings of sadness and despair persist for a long time and impair the function in your daily life, it is time to get help.


  • Certain risk factors make it more likely to develop this illness. A family history of depression and other mental illness, major life events in the early years and ongoing major stress are all factors that predispose a person to depression. (And menopause is certainly a time of heightened stress).

There are other medical reasons for depression such as thyroid problems or certain medications.

The cause of major depression is still not fully understood. More than likely, several factors (genetics, chemical imbalances) work together and cause the symptoms.

The neurotransmitters serotonin, dopamin and norepinephrine play a key role. Depression alters the structure of the brain and affects the those areas that are critical for mood and hormone regulation (hypothalamus, pituitary and adrenal system).


Reasons for Depression in Menopause

Major hormonal events often trigger this illness (i.e. Post-partum depression, premenstrual dysphoric disorder (PMDD)). Doctors have long known that depression in menopause is linked to the major hormone changes.

The reason for this connection is the activity of the hypothalamus-pituitary-adrenal axis which regulates many body functions (including our body temperature). (The link will take your to Wikipedia for more information about this important system. It will open in a new window).

The hormones released by this system are also highly involved in causing menopause symptoms. This is the reason for the common symptoms of depression and menopause:

  • Fatigue
  • Problems concentrating
  • Sleep Problems
  • Anxiety

Newer research has revealed some very interesting facts:

  • Women with major depression were 20 % more likely to experience early menopause. The more severe the symptoms, the higher the likelihood.
  • The risk of developing symptoms of depression greatly increases during perimenopause. This is true even for women who never had any mood disorder problems before the menopause transition.

For hormone imbalances play a major role and can cause depression in menopause.

If women never had problems with depression prior to peri-menopause, the symptoms usually disappear postmenopause. For those women, hormone therapy during the years of menopausal transition can greatly alleviate the symptoms. Sometimes antidepressant medication is prescribed as well.


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