Menopause & Depression: Is There a Link?

Disclaimer: This information isn’t a substitute for professional medical advice, diagnosis, or treatment. You should never rely upon this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Just thinking of the symptoms of menopause—hot flashes, night sweats, vaginal dryness, and insomnia, to name a few—can be depressing. And that’s without actually trying to navigate through this new, potentially turbulent phase in life.

For those wondering if there’s a connection between this phase of women’s lives and depression and anxiety, the answer (in short) is yes.

The longer answer is that there are links between depression, anxiety, perimenopause, and menopause, however, the majority of women will progress to their postmenopausal lives without living with a major mood disorder (which includes clinical depression and anxiety), according to the North American Menopause Society (NAMS) (1). And while women may experience mood swings, those are different from clinical depression and anxiety.

Let’s dig a little deeper into the connections and what they may mean for you or a loved one.

Menopause (and perimenopause) and mood swings

“It’s important to know that mood swings, where you can be happy one moment and then crying the next, is not the same as clinical depression and anxiety,” says Dr. Melynda Barnes, MD, Clinical Director at Rory.

According to research cited by NAMS, as many as 23% of perimenopausal and postmenopausal women experience mood changes (1) due to fluctuating hormones and a number of other factors. Some of the reasons they cite as contributing to changes in mood?

  • Life stresses
  • Sleep issues
  • Night sweats
  • Infertility
  • General aging-related issues

Women who experience greater mood swings during PMS may be more susceptible to fluctuations related to perimenopause, according to NAMS (7).

Menopause (and perimenopause) and depression

According to the Anxiety and Depression Association of America (ADAA), one in eight women will experience depression during their lives—that’s twice the rate that men experience the condition (2). And the transition to menopause is one of the times that they’re more likely to experience depression (2).

The reason being that perimenopause carries with it a greater risk for depression—with that risk increasing from early to late perimenopause and dropping during postmenopause, according to a study on depression and menopause (3).

But why do women’s chances of experiencing depression rise during this time? Here are some of the contributing factors:

1. A decrease in estrogen: The transitional time known as perimenopause, which generally lasts three to five years, can bring with it a lot of the symptoms you’ve likely heard of before—such as hot flashes, insomnia, and pain during sex. What these symptoms all have in common is one thing: dropping estrogen levels. And as estrogen decreases, hormones fluctuate, explains the ADAA (2).

Estrogen is believed to have mood-boosting benefits, according to the Cleveland Clinic (4), so losing out on estrogen means losing out on some of the feel-good effects of the hormone.

2. The symptoms of menopause: Some of the symptoms of menopause (such as those described above) can also contribute to feeling low, which can lead to clinical depression.

3. A history of depression: Women with a history of depression are up to five times more likely to have a major depressive disorder (MDD) diagnosis at this stage (3).

4. Life circumstances: According to multiple experts on menopause and depression, the following life experiences can contribute to depression during perimenopause (1, 3, 5):

  • Issues related to the loss of fertility
  • Feeling the loss of an “empty nest”
  • Being part of the sandwich generation (juggling taking care of kids along with caring for aging parents)
  • General aging-related issues
  • Feeling as if you’re stretched too thin
  • Discomfort related to other symptoms of perimenopause
  • Loss of sex drive

While some may experience depression as a result of perimenopause, most women transition to menopause without being affected by depression.

Menopause (and perimenopause) and anxiety

Researchers of a 2013 Menopause study found that there is a link between perimenopause, menopause, and anxiety (6). The study’s authors found that this differs based on if women experienced anxiety prior to perimenopause or not:

  • Those who had never experienced anxiety (or had only experienced low levels) before the transition were more likely to experience anxiety as a result of menopause.
  • Those who had experienced anxiety prior to menopause had no greater risk of anxiety due to menopause. These women may be considered chronically anxious, unrelated to menopause.

Symptoms associated with anxiety include(6):

  • General anxiety (overwhelming, uncontrollable worrying)
  • Irritability
  • Tension/nervousness
  • Feeling fearful for no reason
  • Heart racing or pounding
  • Panic attacks

“If you are feeling any of the symptoms above, it is important to discuss these potential signs and symptoms of anxiety and depression with your physician,” says Dr. Melynda Barnes, MD, Clinical Director at Rory.

Getting help for depression and anxiety related to menopause

If you’re experiencing any of the above signs of depression or anxiety, please talk to your doctor. If you’re having suicidal thoughts, please reach out for help immediately by contacting the National Suicide Prevention Helpline at 1 (800) 273-8255.


References

North American Menopause Society. Depression, Mood Swings, Anxiety. North American Menopause Society. Accessed on March 13, 2019. View resource

Anxiety and Depression Association of America. Perimenopause and Depression. Anxiety and Depression Association of America. Accessed on March 13, 2019. View resource

Clayton AH, Ninan PT. Depression or menopause? Presentation and management of major depressive disorder in perimenopausal and postmenopausal women. Prim Care Companion J Clin Psychiatry. 2010;12(1):PCC.08r00747.

Cleveland Clinic. Is Menopause Causing Your Mood Swings, Depression or Anxiety? Cleveland Clinic. Published June 3, 2015. Accessed on March 13, 2019. View resource

Bromberger JT, Kravitz HM. Mood and menopause: findings from the Study of Women’s Health Across the Nation (SWAN) over 10 years. Obstet Gynecol Clin North Am. 2011;38(3):609-25.

Bromberger JT, Kravitz HM, Chang Y, et al. Does risk for anxiety increase during the menopausal transition? Study of women’s health across the nation. Menopause. 2013;20(5):488-95.

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