Is Menopause Causing My depression?

Menopause can cause depression in normally healthy women

Many women suffer from depression during menopause. Hormonal changes that occur with perimenopause increase the chances of a woman suffering from depression.

‘I did not call you because I thought that menopause was setting in. I thought it was going to pass after a while.’ My father told me. I wanted to scream at him for allowing my mother to stay home when she was clearly showing signs of being unwell. I could not. 

I sat on the couch feeling helpless. I watched my mother hallucinate, pace up and down the house. She would lift her hands and place them on her head after which she would kneel next to me and ask me to help her. I did not know how to help her.

Raindrops became footsteps. Every time it rained, my mother kept saying that people were marching towards the house to take her.  My mother had not slept for more than 10 days. It was clear to me that this was a mental breakdown. How my father interpreted it to be menopause was beyond me. A part of me did not want to question my father. 

Perhaps he was right after all my mother had gone through a hysterectomy a couple of years back. Maybe that was masking or amplifying her menopause phase.  My mother was diagnosed with depression. However, having gone through a hysterectomy, we have not yet been able to establish if menopause caused it.

Defining menopause and the symptoms

Menopause defines the time marking the end of a woman’s menstrual cycle. It’s characterised by the absence of one’s period for 12 months consecutively. Menopause is a normal phase of ageing and happens after the age of 40.

In some cases, premature or early menopause can happen as a result of surgery, that is if ovaries are removed in a hysterectomy. Another cause of early menopause is damage to the ovaries due to chemotherapy.

As a woman starts nearing menopause, they start having hot flashes, sudden feelings of warmth that will spread to the upper body and sweating. These can range from mild to severe and varies between individuals. 

Other signs of menopause include;

  • Irregular periods. 
  • Vaginal dryness
  • Mood and emotional changes
  • Sleep problems
  • Dry skin
  • Fatigue
  • Depression
  • Weight changes and slow metabolism
  • Changes in libido

How does Menopause contribute in causing Depression?

Menopause does contribute to depression. The period leading to menopause can cause drastic hormonal changes to your body and affect your mental health. Sudden hormonal changes that occur with perimenopause increase the chances of a woman suffering from depression. The risk is even higher among women who have suffered from depression at some point in their lives. 

Hormonal Fluctuation.

When a woman is going through the perimenopause phase, their period becomes irregular, shorter, heavier and lighter. This inconsistency is caused by the fluctuation of hormones (oestrogen and progesterone) in the body that are associated with menstruation. 

Oestrogen is known to influence serotonin, the feel-good hormone. This hormone is key in stabilising moods, happiness and the feeling of wellbeing. It is also responsible for regulating sleep, anxiety, appetite and digestion.

If there is not enough serotonin in the brain, it can lead to depression. Oestrogen helps in stimulating its production and transportation throughout the body as well as prevent its breakdown.   Therefore, a decrease in oestrogen also means reduced levels of serotonin which results in increased irritability, anxiety and extreme sadness.

Sleep Disorders

Night-time hot flashes are one of the major causes of insomnia during menopause. This increases the likelihood of suffering from depression by ten times. When one is about to get a hot flash, the temperature rises, your face gets red and flushed then you break out in a sweat. 

If it happens during the day, it causes discomfort. At night, the flashes disrupt one’s sleep and can also be called night sweats. The reason is because the individuals sweat a lot causing their bedclothes to become wet waking them up and disrupting their sleep.

Other sleep disorders such as sleep apnea may arise from the decline or loss of reproductive like oestrogen and progesterone.  Poor sleep patterns make it difficult for the body to regulate emotions leaving one vulnerable to depression. 

Lifestyle changes

Life begins at forty is a common saying that is thrown around. At forty, a lot of lifestyle changes occur. Changes that cause stress in one’s life and hence affecting one’s mood increasing the susceptibility to depression. 

Aging parents can be a leading cause of lifestyle changes especially if the parent needs round-the-clock care, change of diet or needing expensive medicines. This will cause a huge adjustment.

Career changes, health problems, being outgrown by children are more factors that will throw one off majorly. Since perimenopause occurs when a woman is in her 40s, these external pressures can worsen mood swings and/or trigger and increase depression.

Previous History of Depression

If you have suffered from depression earlier in life, it is more likely that you will experience an episode as you approach menopause.  It is important to be in sync with yourself to note any changes or a return of previous symptoms.

If you notice a return of the symptoms, please talk to your doctor as soon as possible. Some common symptoms of depression include;

  • Persistent feelings of sadness or irritability.
  • Disrupted eating patterns that include over eating or decreased appetite
  • Fatigue and lack of motivation.
  • Loss of interest in activities that one previously enjoyed.
  • Difficult decision making
  • Suicidal or self-harm thoughts

There are more symptoms of depression. Be sure to talk to your family doctor when you experience these and more symptoms. 

Treating Menopause-related depression

According to menopause now, there are three approaches to treating depression in menopause. These include lifestyle changes, alternative medicine and lastly, medications and therapy.

1. Lifestyle changes 

Making changes to your lifestyle requires a lot of discipline. The advantage of this is, it involves low risks. It is important to maintain a regular meal schedule that is inclusive of foods rich in healthy fats, complex carbs. 

Foods rich in healthy gut bacteria such as probiotics have been known to reduce depression. Fish, oats, tomatoes, walnuts, chia and flax seeds are also a great addition to your diet.  Do not forget the famous Omega-3 fatty acids as they are known to be effective in treating depression and many mental health ailments.

Eggs, salmon, diet rich in fruits, vegetables e.g. spinach, whole grains and low-fat dairy should be a key component when adjusting your nutrition.

2. Exercise regularly

According to Harvard Health, running for 15 minutes a day or walking for an hour reduces the risk of major depression.  Exercising triggers, the release of endorphins, dopamine and serotonin.

An average of 150 minutes of moderate exercise per week. It is best to combine activities like jogging, dancing, muscle- strengthening workouts as they are beneficial for treating depression. It is important to note that the risk of osteoporosis is high among middle-age women because of hormonal imbalance.

Therefore, take caution and avoid strenuous activities. If you are feeling depressed, the last thing you want to do is exercise. Start slow like a few minutes daily and build up.

 3. Alternative medicine 

Alternative medicine refers to various options that treat menopausal depression by treating the underlying cause, which in this case is hormonal imbalance. One way to do this is to introduce plant compounds that are oestrogenic in nature. These mimic the body’s own oestrogen.

Even though this may alleviate the symptoms, long-term use of it may cause the body to be unable to produce hormones independently. This will result to further imbalance.

Another way is by taking hormone-regulating supplements. These hormones provide the glands with nutrients to stimulate them to produce their own hormones. The advantage of this is that it not only balances oestrogen but also progesterone and testosterone. Another advantage is it will alleviate the symptoms of an imbalance.

4. Medications and therapy

This refers to the use of conventional approaches to treat the depression that are psychotherapy and medications.

Under psychotherapy, Cognitive behavioural and Interpersonal therapy is used. The former that is the most common tries to break destructive thought and behavioural patterns into constructive ones. The latter treats the depression and prevents a relapse focussing on resolving issues that may contribute to the symptoms.

Medications are used to alter the brain chemistry so as to enhance the moods and emotions enabling one to concentrate, regulate appetite and improve sleeping patterns. The most common medicines are antidepressants. Other medicines include mood stabilisers or antipsychotics. Sometimes, these may be taken along with antidepressants. 

If you consider Hormone replacement therapy, which contains oestrogen, progesterone or a combination of the two, the side effects can be serious. A study has revealed a strong link between this therapy and breast cancer, ovarian cancer, breast cancer and stroke. 

In a nutshell, mood fluctuations are treatable and this is a good thing. However, if they affect your normal daily activities, your relationships or work, book an appointment with your doctor. As your body adjusts to the new levels of hormonal and other changes, you will see a remarkable improvement in your mood symptoms.  

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