Perimenopause Depression

Updated: Mar 26

The menopause transition is accompanied by a number of challenging physical and mental symptoms. Changing hormone levels not only gives rise to commonly known menopausal symptoms including hot flashes, irregular periods, and night sweats, but there are other symptoms that are not as well known. Perimenopause depression is a common symptom of perimenopause, yet many women don’t talk about it because depression and perimenopause are considered taboo subjects. However, nothing is taboo here on the Perry blog so let’s get to the bottom of perimenopausal depression.

Why does menopause cause depression?

Women in perimenopause and menopause are much more susceptible to depression. Recent studies suggest that roughly 1 in 5 women will experience a major depressive disorder (MDD) at some point in their lives. Most commonly, a woman will experience depression during a time of fluctuation in hormone levels such as in postpartum and perimenopause periods. While there is undeniably a connection between perimenopause and depression, clinical trials have not found concrete evidence that perimenopause causes depression. Current theories suggest that hormonal imbalance may be the catalyst for women that are predisposed to depression.

There are certain factors that can predispose a woman to depression with perimenopause. Factors that can affect a woman’s likelihood of developing perimenopausal depression include:

Biological - Your reproductive hormones, your genes, and the combination of your genes and your environment can impact your likelihood of depression.

Health-Related - Your physical condition, symptoms you experience with any health conditions you may have, your health behaviors (exercise, sleep, diet, etc.), and overall functioning play a role in if you will have depression and its severity.

Psychosocial - Your socioeconomic status, social support, your experiences and exposures, and stressful life events can affect your depression.

What does depression feel like?

Depression is a term that is used in social, public, and medical contexts. The term generally refers to a general unhappy psychological state that has varying degrees of severity. Sometimes, the term is thrown around loosely, such as someone saying the day’s rainy weather is making them depressed. However, depression can lead to extreme psychological and physical distress and can even lead to thoughts of suicide.

The Diagnostic and Statistical Manual of Mental Disorders (The DSM-5), which is the primary tool used by psychologists and psychiatrists to diagnose mental illness, provides a list of symptoms and behaviors identified with depression. Symptoms include:

  • Decreased mood (sadness, hopelessness)

  • Decreased interest or pleasure

  • Sleep disturbance such as insomnia (Also a perimenopause symptom)

  • Fatigue (And another peri symptom)

  • Weight change (...And another peri symptom)

  • Feelings of worthlessness or excessive guilt

  • Difficulty concentrating

  • Psychomotor slowing or agitation

  • Recurrent thoughts of death

One of the more common feelings that women with perimenopause depression describe is an inability to enjoy life like they used to. While depression is one of the 34 symptoms of perimenopause, it can be one of the most debilitating and should not be ignored.

How to fight perimenopause depression

Yes, studies show that women are more likely to experience depression in times of hormonal and endocrine imbalance. And, it is a symptom of perimenopause. But that does not make depression normal and something that you should shrug off and muddle through. If you have any symptoms of depression or you are asking, “is it depression or perimenopause?” talk with your doctor about your mental state. Depression is becoming more commonplace, in part because it is talked about more frequently than it used to be. Therefore, medical providers are more adept at treating depression through a variety of practices.

Try as you may, sometimes there is little you can do on your own to change the course of depression. Most medical practices provide screening tools for all patients, especially females, during routine medical visits. This is to help identify and treat depression as early as possible.

Treatment of depression can include using hormone replacement therapy, antidepressants, and behavioral modifications including exercise and sleep patterns. If you have experienced current and past traumas, early stressors in life, or significant adversity, you may benefit from psychotherapy, cognitive behavioral therapy, or therapy for trauma. Reach out to your doctor if you are feeling depressed and contact the National Suicide Prevention Hotline if you are thinking about suicide or ending your life.

Sometimes, finding community and support from other women going through the same thing can make a big difference in your quality of life. We at Perry are here for you from the first sign that you are in perimenopause. Join our Perry community to connect with other women in perimenopause and perimenopause experts. From hot flash remedies to using antidepressants in perimenopause, we discuss all things perimenopause (with a pinch or two of humor thrown in). You can join the Perry community here.

Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.

Meet the Author

Perry Babe Julia ( RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations.

Much of her education and clinical experience are related to educating women on women’s health topics ranging from lifestyle improvements, disease management, and general health education.

Find Julia's Perry community profile right here.

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