Feeling sad, sometimes depressed, anxious, or moody? You are not alone. These are very common symptom around the time of menopause.

It has a lot to do with the wide swings of hormones that occur in midlife. The hormones estrogen and progesterone become unbalanced and have a huge impact on mood. That’s why women who have had bad PMS, a post partum depression or a history of clinical depression are particularly at risk for feeling blue around the time of menopause.

Other women may experience feeling very tired, difficulty sleeping, or feeling hopeless and worthless. Some may even have thoughts about suicide.

For most women, these feelings will pass. But if you have these symptoms for 2 weeks or longer, it may be more than just the menopause blues. It may be a clinical depression. That’s the time it’s important for you to talk with your healthcare provider.

Today there are a lot of things in addition to menopause to increase the risk of feeling sad, anxious or moody; social turmoil, the economy, the pandemic, political division, coping with aging parents. These are all extremely important issues and may be made worse by trying to copy with the hot flashes and poor sleep that is part of the menopause experience.

Your healthcare provider may ask you to take a short screening test to see if your feelings are more likely to be due to depression than menopause. A lot also depends on how much your symptoms are affecting the quality of your life, your work and your relationships. It’s important to take care of the SUM of you and not just SOME of you.

5 Treatments for Menopause and Depression:

• Lifestyle changes: Always begin with what is simplest and safest. Eating more whole foods and less sugar, packaged foods and salt. Drink at least 8 glasses of water each day. Exercise daily, even if it’s only for 15 minutes. Exercise can work as well as an antidepressant for mild and even sometimes for moderate depression. Socialize! Talk with friends you like and ditch the “friends” you don’t. Avoid the evening news, go to sleep at the same time each night, and include some things you enjoy into every day.
• Antidepressants: If you have already had a depression and a particular medication worked in the past, that’s probably a good one to try in menopause as well. Some of the antidepressants used for women in and around menopause will also help with lowering hot flashes. Ask about side effects. Some can also cause weight gain or lower libido.
• Psychotherapy: Whether it is talk therapy in the more traditional way or a type of hypnosis known as Cognitive Behavioral Therapy (CBT), psychotherapy can be extremely helpful. Friends are very essential, but they most likely won’t have the level of skill that a mental health professional will. Remember, it doesn’t have to be forever. But it can make a huge difference in the short run.
• Estrogen Therapy (ET): Menopause has a huge effect on the brain and the brain’s chemistry. I discuss this in detail in my best selling book The Estrogen Fix. While estrogen is definitely not an antidepressant, it does improve sleep and increase serotonin in the brain. And both of those things can help to lift depression. Add to that less hot flashes and it’s one recipe for feeling better.
• Complementary Medicine: There are a number of herbal and over the counter remedies that are sold as mood enhancers. The only one that has some support is St. John’s Wort for mild depression, but the NIH reports it doesn’t work for everyone. And it can weaken the effectiveness of birth control pills, antidepressants and several other common medications. Before you depend on these over the counter remedies, revisit the first bullet point above on lifestyle changes and in particular, exercise.