Depression and Menopause


Depression has an effect on up to 25% of women during some point in their lives. This is a much higher percentage than men. It is a disease that can drain a person, limiting their daily activity. Research has shown that many women begin having signs of depression during their 20s or younger. It is unusual for women to experience depression for the first time after menopause, when all menstruation has stopped. However, there is a transitional period in mid-life that is known as perimenopause. Perimenopause is a period when a woman’s menstrual cycle slowly lightens and does not happen as often. The length of perimenopause can last anywhere from a few months to a few years. During this time, women are more susceptible to depression.

During perimenopause, it is common for women to experience minor mood swings, insomnia, and hot flashes. There are some women whose symptoms result in a more severe mood disorder known as major depression. Women who have a history of depression or who had postpartum depression are at a higher risk of being diagnosed with major depression. Major depression is a type of mood disorder that causes a person to experience abnormal mood states. They are a biological illness that is thought to be caused by changes in brain chemistry. It has been found that physical or emotional stress can cause these biological changes that happen during depression. The hormonal changes leading up to menopause could also cause these changes, especially in women who may be more apt to get depression due to underlying brain chemistry or family history. Symptoms of major depression include the following:

  • Depressed mood most of the day for almost every day for two weeks or longer
  • Loss of interest or enjoyment in activities that you normally enjoy
  • Tiredness or no energy
  • Restlessness or feeling slowed down
  • Feeling guilty or worthless
  • Having a hard time concentrating
  • Difficulty sleeping or sleeping too much
  • Experiencing recurring thoughts of death or suicide

There have been many theories comprised to help explain the increase in depression during perimenopause. One traditional point of view is how the “empty nest syndrome” or other events during middle age lead to the feelings of loss and sadness. Another viewpoint looks at the biological effects of hormonal fluctuations on mood because this perimenopause is the time when the ovaries start to produce less estrogen. Estrogen intermingles with chemicals in the brain that can affect mood. For some women, a decrease in estrogen during perimenopause can cause depression. Restlessness and hot flashes during perimenopause can also cause emotional distress.

How to Cope

If you are experiencing mild to moderate depression during perimenopause and/or menopause, consider following these lifestyle changes recommended by the National Institute of Mental Health.

  • Break down big tasks into smaller ones, set a few priorities, and do what you can when you can.
  • Take part in activities that could make you feel better such as exercise, attending a ballgame, or participating in religious or social activities.
  • Be patient. Expect your mood to get better slowly, not right away. It takes time to feel better.
  • Do not make important decisions until your depression has lifted. Before you make a decision about a significant transition, talk to others who know you and who will have a more objective view of what is going on.

One other way to help you cope with depression is by using Transcranial Magnetic Stimulation (TMS). This is an alternative way of dealing with depression if you do not want to take medication. GatewayTMS in the St. Louis area is one of the leading providers of TMS and have many years of experience. If you are interested in TMS, contact us at (314) 909-8487 to get more information and to talk with one of our experts to see if this is the right treatment for you.