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The Link Between Menopause and Depression

Depression is a common symptom during the perimenopause stage, which is the first stage of menopause. However, there is no proven research. A review done in 2014 stated that depression is a common symptom during menopause.(1) The risk gradually decreases in 2-4 years following someone’s last period.

Why depression is a symptom of the perimenopause period is not known, nor is there much evidence supporting it, but it is believed to be due to physiological and psychological factors.

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The Link Between Menopause and Depression

The Link Between Menopause and Depression

Depression is a mental health condition that can affect a person’s feelings, behavior, and thoughts. It can lead to the below-mentioned symptoms:

  • Fatigue or lack of energy
  • Losing interest in any kind of activity
  • Change in appetite, weight gain
  • Difficulty in sleeping or oversleeping
  • Slow movement or speech
  • Difficulty in concentration and making decisions
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Depression is of several types, the most common being major depressive disorder. A review shows that people going through menopause are more likely to develop a major depressive disorder.

How Does Menopause Lead to Depression?

Why menopause leads to depression is not certain, but there are many factors that can lead to depression during the menopause period.

Physiological Factors

During the menopause period, there is an unpredictable change in the hormone levels in the body. There may be a fall and rise in the estrogen level before they decline completely. This causes a change in the brain’s chemistry, structure, and function.

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Estrogen enhances the effect of neurotransmitters such as norepinephrine and serotonin and helps regulate mood. A decline in estrogen level affects the balance of these chemicals.

A few people are more affected by hormone-related mood changes. A study showed that clinical depression is more common in people with:(2)

Psychosocial Factors

There is also a psychosocial and social impact of menopause that may affect mental health. Some people can feel menopause or aging as positive while a few others may take it as:

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  • Negative thing
  • Less youthful or womanly
  • Stressful that may affect the ability to work
  • Lack of social support during the symptoms
  • These feelings may affect mental health.

Some cultures favor youth while others favor age and experience. A review noted that people from several cultures that favored older age reported lesser menopausal symptoms.(3)

Gender roles and expectations influence people and how they experience menopause. Despite of increasing gender roles and more women working, in heterosexual relationships, women have to do the most. Along with managing work and home, the responsibility of caring about children also falls on them.(4) All these responsibilities, as well as menopausal symptoms, may lead to stress.

Women may also have a role as caretakers in the family. As children leave home and older relatives begin to need care due to their illness or disability. Any of these things may lead to stress or depression.

Other Health Factors

Other than menopause, there are other health conditions that may contribute to depression during menopausal years.

  • Chronic Health Conditions: A person with chronic health condition may be a risk factor for depression in midlife. It may coincide with menopause.
  • Lifestyle: There are studies showing the association between depression and certain behaviors particularly smoking and physical activity.
  • Surgical Menopause: Someone who has undergone surgery to remove ovaries, enters menopause more quickly. The procedure itself may lead to stress and depression.

Treatment for Depression During Menopause

Depression can be treated with a combination of anti-depressants and psychotherapy. Selective serotonin reuptake inhibitors may be suggested by doctors for menopause-related mood changes. These medications may lead to changes in the neurotransmitter levels and thereby reduce the symptoms of depression. The medication may also make a person well enough to begin psychotherapy.

Psychotherapy helps in identifying the factors causing depression. Also, a therapist can help understand and manage stress. A study done in 2018 noted that the Food and Drug Administration does not approve estrogen therapy to treat perimenopausal depression.(5) This therapy may also help in reducing hot flashes, sleep disturbances, and other symptoms that affect mood.

Complementary Therapies

The role of alternative therapies in treating postmenopausal depression is less known. There are a few steps that can be adopted to reduce the symptoms of menopause. These include:

There are studies that link postmenopause and depression, but links do not show clear evidence. People become more vulnerable to depression due to hormone fluctuation. A person can take the help of the various interventions available to manage stress.

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