Q: I am perimenopausal and feeling extremely depressed during the holidays. I feel blue for no reason at all, and cant snap out of it. Is depression a symptom of menopause?
A: Most perimenopausal women do not experience major depression, but many have symptoms of feeling depressed, stressed, and anxious. If you are experiencing menopausal symptoms such as severe hot flashes and lack of sleep from night sweats, it may be causing you to feel depressed. Many people, menopausal or not, feel depressed over the holidays, so you are not alone.
The most common signs of depression are feeling sad, feeling worthless and losing interest in the things that normally engage you. Other symptoms include the loss of libido, changes in appetite too much or too little feeling very sleepy and fatigued, or having insomnia, not being able to sleep. A common sign of depression is a change in your normal habits.
A more serious symptom of depression is sustained loss of interest in things that you just cant seem to break out of, which is called dysthymia. Things seem really bleak. If it lingers or if you have thoughts that are scary, such as wanting to give up or wanting to hurt yourself or even suicidal thoughts, you must talk to your clinician because there are things that can be done to help you.
Depression is multi-factorial. There are many factors that can cause an increased risk for depression. If you have depression in your family, a prior history of depression, and even some medications can cause an increased risk of depression. Certain endocrine disorders, such as hypothyroidism, or other illnesses, such as chronic fatigue syndrome, are also associated with depression. Depression is an illness that can be triggered by the chemicals in your brain. Serotonin regulates your moods. It is the feel good hormone. When serotonin levels drop you can experience extreme episodes of depression.You also want to look at lifestyle stressors a change in relationship, finances, loss of a loved one, caring for parents and consider the many modalities of treatment that are available to help you.You approach depression in menopause the same way that you would approach depression at any other time: you first want to rule out other medical causes, or other medications that might be contributing.A number of options are available, including psychotherapy, and antidepressants and can assist you if you are suffering from depression.There are degrees of depression. Mild depression, feeling blue or sad, can be dealt with cognitive therapy, psychotherapy, meditation, yoga, eating healthfully, and exercise. We know that exercise does boost your endorphins and can lift your mood. Also, engaging in new activities may help, such as making yourself take classes, making yourself get out and do things, and enlisting the support of your family and friends.
If you have lingering or worsening symptoms, you may need medication, because we know that depression can be a malfunction of your neurotransmitters, particularly serotonin, which is the feel good neurotransmitter. Medicines can be enormously helpful, although you will want to incorporate lifestyle changes as well.If you are still feeling very stuck and sad, talk to your clinician so you can get a referral to a good psychotherapist. If you need medication, in the broader context of menopausal symptoms, there is some evidence that hormone therapy can augment treatment and help people who are on anti-depressants feel even better. That is a decision for you and your clinician.Wendy Klein, M.D., is co-author of the book The Menopause Makeover and a national leader in womens health. She is Associate Professor Emeritus of Medicine, Obstetrics & Gynecology at Virginia Commonwealth University School of Medicine and cofounded the VCU Institute for Womens Health.Staness Jonekos is an advocate for women's health, wellness and empowerment. An award-winning television writer, producer and director, she is also the co-author of The Menopause Makeover.
