An unpredictable hormonal fluctuation plus stress, body image, sexuality, infertility, and aging. Any one of these factors, or a combination of several of them, can be a great source of emotional stress that results in mood swings , or in more severe cases, depression. That is why it is very important to recognize the causes and impact of menopausal depression.

There are 3 types of depression

“Depressed” and “depression” are words used to describe three conditions with very clear differences:

1. Depressed mood

This is a short, normal period of sadness or blueness that is commonly experienced and rarely requires treatment. The medical term is dysphoria .

2. Depression as a symptom

Sometimes called an adjustment reaction, this type of depression can be caused by a wide variety of medical or psychological problems, or by intense reactions to life events (such as divorce, loss of a job, death of a loved one). 

It is usually short-lived and most of the time does not require treatment, although it can progress to clinical depression. The medical term for depression that occurs for most of the day, most days, for at least 2 years, is dysthymia .

3. Clinical depression

This is a disorder that is believed to be the result of a chemical imbalance in the brain. A clinical (major) depression requires treatment and proper monitoring.

How hormones affect mood

In clinical trials, no connection was found between menopause and these three conditions mentioned above. But many women experience very abrupt mood swings during perimenopause. At one point they are energetic and happy, but that happiness soon turns into tears. 

Joyful times followed by moody days. These mood swings are believed to be related to fluctuating levels of ovarian hormones during this transition to menopause. Also, if a woman does not sleep well due to night sweats, her mood will undoubtedly be affected as well.

Women who had severe PMS in their youth may have more severe mood swings during perimenopause . Additionally, women who have suffered from clinical depression appear to be particularly vulnerable to menopausal depression. Whether you suffer from a mild case of sadness or something more severe, no one should suffer their mood swings in silence . You always have to get help.

How to treat menopausal depression

For mild to moderate depression, herbal remedies such as St. John’s wort and the following lifestyle changes, recommended by the US National Institute of Mental Health , may help:

  • Break large tasks into smaller sections, set some priorities, and do what you can.
  • Participate in activities that can make you feel better, such as light exercise, going to the movies, a ball game, or participating in religious, social, or other fun and group activities.
  • Give yourself time. Wait for your mood to improve gradually, not immediately. Feeling better takes time.
  • Put off important decisions until the depression is gone. Before deciding to make a meaningful transition – changing jobs, getting married, or getting divorced – talk to other people who know you well and have a more objective view of your situation.

For perimenopausal mood swings, some experts recommend a low-dose oral contraceptive (OC), even if contraception is not desired. These estrogen and progestin pills provide continuously stable hormone levels and can control mood swings. 

In addition, they provide other health benefits, such as regulating uterine bleeding and reducing the risk of uterine and ovarian cancer . Smokers over the age of 35 should not use oral contraceptives.

If menopausal depression is severe

In severe menopausal depression, the psychiatrist may prescribe antidepressant medications to correct the chemical imbalance. Although it generally takes several weeks to experience the full effect of a drug, most women experience marked improvement with these drugs and relatively few side effects. 

Some antidepressants have also been found to relieve hot flashes. Antidepressant medication is most effective when used in combination with counseling or psychotherapy .

Many primary care providers are not specifically trained in the management of mental health disorders, including clinical depression. Consultation with a mental health professional may be appropriate, and an expert opinion may be reassuring.

However, as information, the antidepressant medication can be considered as an aid, but the best remedies that we can use for depression are herbs, good habits and proper exercise, with them we can ensure that depression will not be a conflict for us.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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