Menopause Depression: Causes, Symptoms, and Treatment

Feeling down, irritable, or not enjoying the things you used to love? If you’re in menopause—the 12 months after your last period—and experiencing these kinds of emotions, it might be menopause depression.

While women are twice as likely to be affected by depression in their lifetime, the menopause transition is an even more vulnerable time for these kinds of emotions. Fluctuations in hormones, other menopause symptoms, and independent risk factors can all contribute to menopause depression.

If you’re experiencing challenging emotions during this period, you’re not alone. Here’s what you need to know, and ways to find relief.

What is menopause depression?

Menopause depression is a mood disorder characterized by persistent feelings of sadness, loss of interest in activities you once enjoyed, and changes in sleep and appetite. It’s important to note that menopause depression differs from occasional mood swings, which are also common during this period; menopause depression is more of a prolonged change in emotions versus more rapid fluctuations.

Common symptoms of menopause depression include:

• Feeling down or sad most of the day nearly every day
• Loss of interest or pleasure in activities you once enjoyed
• Significant changes in weight or appetite (either eating much less or much more than usual)
• Difficulty sleeping or sleeping too much
• Restlessness or feeling slowed down
• Feeling worthless or guilty
• Difficulty concentrating, making decisions, or remembering things
• Recurrent thoughts of death or suicide (If you are experiencing these thoughts, please seek help immediately. You can call the Suicide and Crisis hotline at 988.)

Causes of menopause depression

What causes these difficult emotions? The main culprit is the shift in hormone levels during menopause.

As you enter perimenopause, your estrogen and progesterone levels begin to decline in preparation for the end of your menstrual cycle. These hormones play a critical role in regulating different physical, emotional, and even mental processes. 

>>MORE: Perimenopause vs. Menopause: What's the Difference?

Studies show that variability in estradiol, the most prevalent form of estrogen in the body, has been associated with depressive symptoms. Estrogen levels change a lot from perimenopause into menopause, which can therefore lead to menopause depression.

There are other factors that can affect whether you experience menopause depression, including:

• Previous history of depression: If you’ve experienced depression before perimenopause, this can lead to an increased risk of menopause depression. However, women with no previous depressive episodes are still two to four times more likely to experience menopause depression compared to premenopause. 
• Other menopause symptoms: Some researchers suggest a cascade effect of other menopause symptoms leading to menopause depression. While this is not always the case, symptoms like hot flashes and night sweats can lead to fatigue, poor quality of life, and depressive symptoms. 
• Independent risk factors: Factors like poor sleep, stressful or negative life events, lack of employment, and smoking can put you at higher risk for developing menopause depression.

Menopause depression treatment: How to find relief

The good news is that menopause depression doesn’t have to last forever — there are ways to improve your mood, get back to enjoying your favorite activities, and sleeping and eating as normal. Both lifestyle changes and medical interventions can offer relief.

Menopause depression natural remedies

Lifestyle changes can help combat the side effects of menopause depression. 

• Healthy habits: Eating a balanced diet, exercising regularly, and getting enough sleep can all improve your mood.
• Stress management: Techniques like yoga, meditation, or deep breathing can help you manage stress and improve your overall well-being.
• Social connection: Staying connected with loved ones and engaging in social activities can provide support and combat feelings of isolation.
• Therapy: Talking to a therapist can be an effective way to understand and manage depression symptoms. For example, cognitive behavioral therapy (CBT) is one type of therapy that can help you identify and change negative thought patterns that contribute to depression.

Menopause depression non-natural remedies

Non-natural remedies for menopause depression provide treatment in two different ways: addressing underlying hormone factors and addressing depression symptoms. 

• Hormone replacement therapy (HRT): Because menopause depression is often a result of changing estrogen levels, HRT offers a way to help combat these changing levels by supplementing your body’s hormone production. HRT comes in many forms depending on the type of hormone you’d like to supplement (estrogen-only or combined hormone therapy) and the way you’d like to take the therapy (pills, gels, creams, etc.). Be sure to consult with your doctor before you start HRT to discuss the qualifications, benefits, and risks.
• Antidepressants: Antidepressants can help treat depressive symptoms by increasing neurotransmitters in your brain that improve mood, like serotonin. Again, be sure to consult with your doctor before starting any medication to discuss benefits and risks.

Menopause depression: the bottom line

Menopause depression symptoms can be difficult and frustrating, but you don’t have to go through it alone. By understanding the symptoms and treatment options, you can take charge of your mental health and find relief. Talk to your doctor about your specific situation and develop a personalized plan to manage your mood and improve your overall well-being during menopause.