Menopause and Depression: the Low-Down

woman with depression against sunset
Medically Reviewed
July 14, 2021

Are you on the menopause and depression roller coaster? Does it seem like that roller coaster has flat-lined or just keeps going downhill? You are not alone. Many women hit an emotional low during perimenopause and menopause. That’s why paying attention to your emotional health during perimenopause is crucial.

To stay healthy, there’s a balance between self-nurturing and your obligations to others that you must maintain, and it isn’t easy.

Even if you can identify and describe the sources of tension and stress in your life, it may still be challenging to take time for yourself. Yes, change is happening, but you will get through it. And you don’t have to do it alone. There is help out there if you are willing to ask for it.

Menopause: Clarifying the Terms

What we know as menopause actually is three different things: perimenopause, menopause, and post-menopause. Perimenopause is the time leading up to menopause. It can last up to 13 years. During this time, your hormones begin to fluctuate, your periods get crazy, and the most uncomfortable symptoms occur.

Menopause is the day that marks the end of your period – it occurs 12 months after you bled the last time.

The post-menopause phase takes up the last portion of your lifetime.

Perimenopause brings with it a whole host of symptoms. Symptoms, and the intensity of symptoms, can differ with each woman. These include:

  • Brain fog
  • Hot flashes
  • Night sweats
  • Difficulty concentrating
  • Insomnia
  • Anxiety
  • Fatigue
  • Weight gain
  • Depression

You’ve probably heard about many of the other symptoms, but were you surprised to see depression on the list? It’s not uncommon for women to experience some form or duration of depression during midlife. In fact, a woman in midlife is twice as likely to suffer from depression as a man at the same age.

How to Know That It’s Depression

We all have downtimes – times when we feel sad or have low energy. The difference between those times and depression is the extent and duration of symptoms. The symptoms of perimenopausal depression look the same as the symptoms at any other point in life.

  • Feelings of hopelessness or pessimism
  • Persistent sad, anxious, or “empty” mood
  • Irritability
  • Decreased energy or fatigue
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Moving or talking more slowly
  • Difficulty concentrating, remembering, or making decisions
  • Feeling restless or having trouble sitting still
  • Difficulty sleeping, early-morning awakening, or oversleeping
  • Thoughts of death and suicide or suicide attempts
  • Changes in appetite or weight
  • Pain, headaches, or digestive problems, or cramps that have no apparent cause or that are not alleviated with treatment

If you have been experiencing any of these nearly every day for most of the day for at least two weeks, it’s time to see a doctor.

The Underlying Causes of Depression During Menopause

Women who are going through the change experience all kinds of internal and external shifts. Some that they can control, others that they cannot.


The hormones that regulate your menstrual cycle also influence a brain chemical called serotonin. Serotonin promotes feelings of wellbeing and happiness. When your sex hormone levels drop, your serotonin levels also fall. The decrease in serotonin contributes to increased irritability, anxiety, and sadness. That’s why you may reacting so wildly to things that usually cause you no problems.


One of the common perimenopausal symptoms is insomnia. Insomnia could be caused by nighttime hot flashes, night sweats, anxiety, or any variety of other things. Unfortunately, lack of sleep can increase your risk of becoming depressed tenfold.

Midlife Situations

Perimenopause typically comes about when you hit your 40s. Although many women seem to come into their power in their 40s, it can also be a stress-filled stage of life. Emotional health can be negatively affected by:

  • Dealing with aging parents
  • Career pressures
  • New health problems
  • Kids flying the nest

These situations can trigger depression and make mood swings more extreme.

A History of Depression

If you have a history of depression, your risk of having an episode during perimenopause increases.

Many women feel much better after they hit menopause, but for those with major depression, you may experience postmenopausal depression as well.

Treatment for Menopause Related Depression

Frequent mood swings and other symptoms of depression can ruin life as you know it. Your doctor can be a wellspring of information, resources, and solutions. Three of the most common are hormone replacement therapy, diet/lifestyle changes, and antidepressants combined with therapy.

If your depression is caused by a hormone imbalance, that imbalance can easily be treated. After confirming the imbalance with blood tests, your doctor can prescribe the hormones your body is lacking and work with you to bring the balance back.

Diet and lifestyle changes are always a good bet when you have health problems. Examples include practicing healthy habits like eating a nutritious diet, exercising regularly, limiting caffeine and alcohol consumption, and good sleep hygiene. These can support you and ease the symptoms of perimenopause and menopause.

Antidepressants coupled with talk or cognitive behavioral therapy can also be an effective treatment for premenopausal women who suffer from depression.

Menopause, depression, and the Nava Five

Treating depression requires an integrative approach. It’s necessary to get to the root of the issue to reap real, long-lasting results. Our Nava Method uses your family health history, individual health concerns, personal health goals, and blood work results to generate a personalized treatment plan of integrative treatments. We won’t just be handing you a bottle of pills. Our treatment plans address the Nava Five – the key areas Nava focuses on to help our clients achieve optimal wellness:

  • Hormone Balance and Sexual Health
  • Stress Management & Life Balance
  • Restorative Sleep
  • Inflammation Control
  • Healthy Weight & Digestion

Are you ready to feel your best again? Contact us for a consultation!

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It's Not Just Your Menopause and Depression
Hormones, insomnia, and midlife situations can all contribute to depression during perimenopause and menopause. But an integrative approach to treatment can help you achieve optimal wellness. Learn more.