What are the symptoms of depression in menopause – and how can you tackle them?
When it comes to menopause everyone is an individual. You may have symptoms in common with friends or family members, but you’ll probably all experience them with varying degrees of severity, in different ways, and at different points along the perimenopause and menopause journey.
Psychological symptoms can be the most troubling – anxiety, feeling low, and lacking in motivation and energy, for example. These also happen to be some of the symptoms associated with depression, so what is going on? Is your menopause causing depression – or is something else happening? And, whatever the cause, what can you do to ease the symptoms?
Triggering the symptoms of depression
Menopause doesn’t cause depression but it does trigger physical and mental changes that can lead to depressive-type symptoms. The point at which your oestrogen levels begin to drop marks the start of the journey. Changes in hormone levels affect your body, mind and emotions.
So, you might start to feel sad or anxious. But we all experience different feelings and shifts in emotion to some degree, at some point, depending on what is happening in our lives. In menopause, these feelings may affect you more often and more intensely, causing bewilderment or frustration. You won’t necessarily feel low, sad, anxious or tired all the time; you may find these feelings fluctuating, with good days as well bad days.
It is only when these feelings take a permanent grip that you might begin to wonder if you are suffering from depression. Depression (and it takes various forms) comes with a range of symptoms, the most common of which include feelings of helplessness, loss of interest in daily activities, appetite or weight changes, sleep changes or insomnia, anger or irritability, loss of energy, low self-esteem or self-loathing, reckless or extreme behaviour, lack of concentration, and random aches and pains.
You’re menopausal but what else is happening in your life?
The point at which many women move into full-blown menopause (the average age is 45) often coincides with major changes in their lives. Ageing parents often need more care or help; children are becoming more independent and may have left home and, although the divorce rate in England and Wales is dropping, the average age at which women in opposite sex couples divorce is 43.5.
Any or all of these life events are bound to have a profound effect on the way you feel; no wonder that so many women’s emotions take a nose-dive during menopause.
It’s also worth thinking back . . . have there been other times in your life when you have experienced depression or depressive-type symptoms? Did you suffer from post-natal depression? When you were having periods, did you have pre-menstrual tension (PMT)?
Do your emotions take a dip in the winter? Have you been diagnosed with seasonal affective disorder (SAD)? If so, you may be more prone to depressive feelings during menopause.
Is your lifestyle helping – or making things worse during menopause?
There’s probably no more over-used word in the English language than ‘stress’ but, as we mentioned, your menopause may well have collided with one or more of life’s more stressful periods. In addition, you’re running a home, holding down a job . . . you are doing a lot of juggling. The chances are that you are not looking after yourself, as well as you should.
- Are you eating well or healthily? Are you snacking too much, or relying on fast food or junk food to keep you going?
- Are you able to take as much exercise as you would like, even just walking every day?
- Do you find yourself reaching for a glass of wine when you get home? Are you drinking more than you should? (Do an internet search for ‘wine-o’clock’ and you’ll find over 28 million references – that’s almost as many as there are for ‘menopause and depression’.)
- Are you struggling to get to sleep or not getting enough sleep?
All of these factors can make depressive-type symptoms worse. While you can’t alter some aspects of your life, you can take steps to alter your lifestyle (see below) and the results are often encouragingly swift.
What should you do if you’re menopausal and have symptoms of depression?
Make a list of your symptoms and any questions you may have and book an appointment with your GP, who can check your general health and your hormone levels.
Depending on the results, she or he might prescribe hormone replacement therapy (HRT), an anti-depressant, or possibly a talking therapy called cognitive behavioural therapy (CBT).
Many women choose HRT and do well but it is not suitable for everyone – if you have a history of breast, ovarian or uterine cancer, for example. Similar cautions apply to anti-depressants. Don’t feel under pressure to make a decision about treatment there and then; make sure you ask those questions, discuss any concerns you may have, and then you can make a more informed choice.
Lifestyle changes to lift depressive feelings during menopause
If HRT or medication is not appropriate for you, or if you prefer to explore alternative approaches, here are our some of our tried and tested recommendations. Even if you are taking prescription medication, by introducing positive lifestyle changes, such as healthy eating, exercise and creativity, you are helping your overall health and well being.
(Always consult a qualified health practitioner before taking supplements or herbal remedies such as those listed below, especially if you are taking other medication.)
- Exercise, especially aerobic exercise, which increases your heart rate, can lift your spirits as well as making you fitter. Researchers at Duke University, North Carolina, found that regular aerobic exercise was as effective in reducing symptoms of depression as a leading anti-depressant.
- Never underestimate the mood-lifting qualities of being outside in the open air – as any keen gardener will tell you! Try a regular lunchtime walk or visit a park, woodlands, the countryside or coast whenever you can.
- The Mediterranean or rainbow diet, especially when it includes oily fish, has been shown to reduce the risk of depressive episodes by 25 per cent. If you don’t eat fish, try a vegetarian or vegan omega-3 supplement. Eating well, together with regular exercise, also helps to keep your body weight at the right level and avoid obesity (another contributor to depression).
- Make alcohol an occasional treat, not a daily habit! In recent years, women’s drinking rates in England and Wales have soared, especially for professional and middle-aged women. Alcohol is a major trigger for depression and many other serious health conditions and illnesses. It makes sense to treat it with caution and respect.
- The herbal route: Hypericum – or St John’s Wort as it is more commonly known – has been shown to be effective in easing mild depression.
- Think about a SAD light box if your mood dips in the winter. These are medically proven to treat the cause of seasonal affective disorder – the lack of sunlight.
- Discover the joy of mindfulness and creativity. Calming activities that help you to focus are an easy but effective way to lighten your mood. Make a little time to enjoy a favourite art or craft or try an adult colouring book or a meditation CD.
Live Better With Menopause has a great range of books, products and supplements that can help to ease depression-type symptoms.
Find support and practical tips in the Live Better With Menopause community forum.
Find out more about CBT here: https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/
HRT – the pros and cons: https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/
Anti—depressants – the pros and cons: https://www.nhs.uk/conditions/antidepressants/considerations/