Is something wrong with me or is it just hormones? This is a question I, and many other women, have asked themselves throughout their lives. Hormone fluctuations can lead to dramatic changes in mood and overall sense of well-being. This can include mood swings, irritability, forgetfulness, decreased quality of sleep, appetite changes, and others. When experiencing puberty, getting pregnant, during the postpartum period, and monthly menstruation cycles, most women experience symptoms of hormone fluctuations. Menopause is another period when this can occur.
What Is Menopause?
The National Institute on Aging defines menopause as a time 12 months after a woman’s last period. The years prior to this point, when women experience symptoms such as hot flashes, changes in their monthly cycles, and others, is called perimenopause. This transition often begins between the ages of 45 and 55 but can begin earlier or later. This period of transition can last from 7 to 14 years. Surgery to remove ovaries or the uterus can lead to early onset of menopause.
Mental Health Challenges During Menopause
Due to significant changes in hormones that can affect our moods like estradiol and progesterone, women entering and going through menopause can experience an increased risk for depressive symptoms. Decreased levels of estrogen, specifically, lead to the physical and mood symptoms that can accompany this period in a woman’s life.
When our hormone levels fall, this can cause serotonin levels to decrease as well. Decreases in serotonin can cause irritability, feelings of sadness, and anxiety. Decreases in estrogen and progesterone can also cause mood fluctuations that decrease the ability to cope with stressors. You might feel like things that have previously not caused distress are harder to let go of during this time.
A systematic review of 22 studies about menopause and mood changes found that women have an increased risk of developing depressive symptoms during this time. Researchers also noted that other psychosocial factors present during this life stage can increase the risk for depressive symptoms. These can include life events and transitions and family and career stressors.
An article published by Harvard Medical School in 2020 found that the incidences of depressive symptoms doubled during this time. Additionally, women who have struggled in the past with depression or anxiety might see a resurgence in symptoms.
The Journal of Clinical Endocrinology & Metabolism published a study that found an increase in depression symptoms during perimenopause due to the fluctuation of two hormones: progesterone and estradiol. Researchers also noted that the link between Major Depressive Disorder and hormone fluctuations is not yet clear.
To summarize, multiple studies with thousands of women have found an increased risk for depressive symptoms during menopause, while the link between developing Major Depressive Disorder due to hormone fluctuations has not been well established.
It can be helpful to know the why behind what we are feeling or experiencing along with labeling the feeling to decrease distress related to the discomfort.
How to Cope:
When going through a period of physical, hormonal, and mood changes, it’s important to think about ways to take care of ourselves to support our overall well-being. The following list might help ease the symptoms experienced during this period and address mood changes.
- Check-in with your physician if you are noticing symptoms. Ask your doctor about ways to alleviate any symptoms you are experiencing.
- Track or monitor your mood. I find the app How We Feel to be helpful for mood tracking and thought reframing. Use this tracked data in discussions with healthcare providers.
- Increase self-care with things like more sleep and rest time, increased exercise or movement, drinking plenty of water, and making sure you are getting enough nutrients during the day. Studies have found that just 30 minutes a day of physical activity, 3 to 5 days a week, can improve your mood and decrease anxiety.
- Reach out to connect. Connecting with others during this transitional period can help alleviate some of the mood symptoms that can occur. Whether it’s a regular call or meeting with a close friend or speaking to a mental health practitioner, having support and feeling less alone during this time can be incredibly helpful.
- Be mindful and compassionate. Utilize free mindfulness meditations available online, including self-compassion meditations and thought reframing meditations.
A couple of my favorite meditations are:
Leaves on a Stream Meditation - This cognitive diffusion exercise leads you through the practice of separating from your thoughts which can be helpful when experiencing feelings and thoughts of sadness and anxiety.
Loving Kindness Meditation - Loving-kindness and self-compassion meditations have been shown to increase an overall sense of wellbeing and decrease feelings of judgment toward the self and others.
Progressive Muscle Relaxation - Progressive muscle relaxation can help to alleviate feelings of sadness through increased connection with the body and rewiring of the brain.
Lastly, if you are experiencing symptoms of depression like fatigue, loss of pleasure, or enjoyment in things that have previously been enjoyable, appetite changes, irritability, and sadness, contact a doctor or mental health provider. If you are feeling hopelessness and a desire to end your life, please contact your local emergency services and seek treatment immediately.
