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The link between menopause and depression isn’t fully understood. There are a number of theories posited as to why women in perimenopause and true menopause are at higher risk for depressive illness. It’s estimated that more than 10% of women develop depression during this time. This condition may be due to one or more of the following: decline in estrogen and progestin levels, increased stress of undergoing uncomfortable menopausal symptoms, the significance of the change that menopause represents, and cessation of the monthly cycle.
A connection between menopause and depression that is often made is that declining female hormones influence the way the brain produces neurotransmitters like serotonin. This can lead to dysregulation in mood, and might account for the very common symptom of sudden shifts in mood that most women undergoing menopause experience. It’s suggested that, in some cases, ability to produce helpful neurotransmitters is significantly impaired by hormonal shifts, and this can cause real depression.
Ostensibly, this theory sounds plausible, but there are a few problems with it. Most notably, treating women with hormone replacement therapy (HRT) doesn’t usually fully resolve depression, and other treatments like antidepressants are still typically needed. Additionally, many women now avoid HRT because it elevates risk for cancer.
Another suggestion is that menopause and depression occur together because the symptoms of menopause in total are difficult to deal with. Mood changes, hot flashes, vaginal dryness, and others can be simply too much and result in feelings of hopelessness. From a physiological perspective, the poor sleep many women experience may create a connection. Medical researchers are clearly establishing that insomnia or simply reduced levels of sleep greatly increases risk for depression.
Some doctors believe that the link between menopause and depression is due to the profound change that the cessation of menstruation represents. It is the end of the childbearing years — a time of great transition. This can bring on identity or existential crises, which could fuel a depressive episode.
An additional explanation is that many women have partly defined their lives around their menstrual cycles. Sadness, grief, or a sense of being out of step might occur, as this marker of time, this essential rhythm of womanhood, slips away. Alternately, experts in this area may argue there are so many interrelated elements between menopause and depression that it’s impossible to fully determine how one impacts the others.
Some women have greater risks for developing depression during menopause. A few risk factors are high stress lives, raising small children, or previous mood disorder problems. Understanding an elevated risk might help women undergoing menopause better recognize symptoms of depression. Getting help sooner may lead to quicker resolution of the illness.
Women should get help immediately if they feel hopeless or suicidal. There is no reason to wait until symptoms are severe, and those of sadness, negative thoughts, difficulty controlling emotions, headaches, and poor sleep shouldn’t be ignored. Depression, at any time of life, can frequently be effectively treated with medication and psychotherapy.