What is Perimenopause?
Perimenopause is a transitional phase that women go through before they reach menopause. During this phase, women under a series of physical and mental changes that are nothing to raise concern over as it is a natural process.
What is Perimenopausal Depression?
There have been numerous studies that associate perimenopause with depression, in addition to the depreciation of existing depressive symptoms.
According to the studies from the early 2000s, that were published in the Archives of General Psychiatry, it was documented that women undergoing the transition to menopause were twice as likely to be diagnosed with major depressive disorder (MDD) than the ones who did not enter this phase yet.
In the same batch of studies, it was found that perimenopausal women were four times more likely to develop depressive symptoms than those not going through perimenopause.
Hot Flashes? You’re More Likely to Experience Depression
Those women who have had constant hot flashes were reported to have an increased likelihood of depressive symptoms. Other women who are at a higher risk for depression include those who:
- Have been having antidepressants
- Haven’t given birth
There are even more studies that have determined the link between perimenopause and depression.
Perimenopausal Depression Signs And Symptoms
Even though MDD is a grave condition, it is possible to manage it with the right treatment. Whether you’re going through perimenopause or something else, the symptoms of the disorder may include:
- Reduced cognitive function
- Lack of energy or fatigue
- Decreased interest in hobbies or other activities
- Feelings of helplessness, hopelessness or worthlessness.
Other symptoms associated with perimenopausal depression may include:
- Tearfulness or crying without reason
- Mood swings
- Intense despair
- Elevated anxiety
- Night sweat or hot flash-related insomnia
What about Anxiety During Perimenopause?
Some people may have no mental health symptoms at all before menopause, while there are some who may experience depression.
However, anxiety is also a normal reaction to changing hormones as well. You can learn more about that here:
Learn more about Anxiety and Depression During Perimenopause
Risk Factors for Depression Before Menopause
There are some studies that one of the risk factors of depression include the fluctuation of the female hormone estradiol. But, there are various other factors that result in perimenopausal depression.
In 2010, several studies concluded that perimenopausal women with no previous history of depression were two or four times more likely to develop depression than women in the premenopause phase.
Other symptoms in the review included impact on sleep patterns and hot flashes.
During the perimenopause phase, women go through a number of common stressful life events such as job loss, divorce or the death of a loved one. As such, these events serve as triggers to depression.
Numerous other factors that are associated with perimenopausal depression may include:
- A previous history of violence or sex abuse.
- A family history of depression
- Severe menopausal symptoms
- Negative feelings regarding menopause and aging
- Social isolation
- A sedentary lifestyle
- Sadness in not being able to have more children
- Low self-esteem
Mood And Hormones During Perimenopause
Lots of perimenopausal women experience a slew of mood swings during their phase and can be linked to fluctuating hormone levels.
For instance, when the estrogen fluctuate, the brain’s norepinephrine and serotonin levels are affected. Dopamine, serotonin and norepinephrine are essential brain chemicals that have a direct affect on your mood. They can reduce anxiety, make you happy, improve your sleep and more.
When the chemicals are balanced, you experience a general state of calm and well-being.
Hormone imbalances, like when your progesterone levels are falling whereas estrogen is rising can limit the ability of norepinephrine and serotonin to function as effective neurotransmitters.
Eventually, this leads to mood swings that result in depression.
The Effect Of Depression On Perimenopause
The relationship between depression and perimenopause is complex at best.
Apart from the effects of perimenopause causing depression, a 2003 study revealed that depression itself can lead to an early start to perimenopause.
The study showed that women with certain symptoms of depression in their late 30s and early 40s have an increased chance of entering perimenopause before their 45th birthday than women without any prior depressive symptoms.
However, the research could not conclude whether early perimenopause led to early menopause, or if it simply extended the duration of perimenopause.
In both perimenopause and menopause, lower estrogen levels are linked to other health risks such as:
- Heart attack
- Impaired cognitive functioning
According to the study, women who took antidepressants were three times more likely to enter early perimenopause than those who did not.
Find out more about Perimenopausal Depression
Other Side To Antidepressants and Perimenopause
Even though antidepressants are associated with an early start to perimenopausal depression, they can also help relieve one of its most uncomfortable symptoms.
According to a 2011 study, escitalopram (Lexapro) lowered the severity of hot flashes as well as their occurence by half compared to a placebo.
Escitalopram belongs to selective serotonin reuptake inhibitors (SSRIs), which is a group of drugs.
Lexapro, according to the study, is three times effective for relieving depressive symptoms as compared to hormone replacement therapy (HRT). Also, only 31% of women who received HRT, were said to have been relieved of their hot flashes while there was a 56% relief for those who took lexapro alone.
This finding brings a positive light for those who were worried about the 2004 study that found HRT increases the risk of stroke and heart attack.
Even though it is not known why escitalopram works, the findings reported no “serious adverse effects” on the woman who participated for the study.
Side-Effects of Antidepressants
Still, antidepressants have their own side-effects, like:
- Stomach problems
Home Remedies for Perimenopausal Depression
Other than antidepressants, various home remedies and lifestyle changes may help deal with perimenopausal depression.
It is crucial to get an appropriate amount of sleep between 7-9 hours. So be sure to adopt good sleeping habits such as going to bed at the same time in a cool, dark and quiet room. Also, avoid using electronics or they will keep you from sleeping.
Regular physical activities or exercise can release endorphins and serotonin into the body.
When these chemicals increase, they can help those who currently have depression or prevent it before it takes a hold of you.
The valerian plant has also been very useful in dealing with perimenopausal depression. It may reduce hot flashes and also help you sleep better.
Mindful breathing exercises like meditation or yoga can help reduce anxiety. One of the most useful techniques involve being attentive about your body’s response to natural relaxation as you breathe in slowly from the abdomen and then exhale.
Doing this routine for 15 minutes a day can reduce your stress levels.
B vitamins are essential for the emotional and mental well-being of perimenopausal women:
- B-1 (thiamine)
- B-3 (niacin)
- B-5 (pantothenic acid)
- B-6 (pyridoxine)
- B-9 (folic acid)
- B-12 (cobalamin)
There are some studies which show some promising results for supplements to help deal with symptoms related to fluctuating hormones during perimenopause.
You can lear more here: Supplements to Take During Perimenopause.
Top 5 Natural Remedies for Depression
Perimenopause and Depression: Have your Say
Have you experienced depression during perimenopause? Leave a comment below and let us know about your experience.
Tammy Ford is the resident expert for all things Women’s Health (vaginal discharge and infections, perimenopause, menstrual cycles and more) and is also a chief tester of all things eco-friendly period products. She has a Master of Science in Nursing (MSN) and specializes in reproductive health.
You can contact her via email: [email protected]