Depression In Menopause

Adapted from Rachel’s book – Magnificent Midlife: Transform Your Middle Years, Menopause and Beyond.

Depression in menopause is sadly not uncommon. That and anxiety can often raise their nervous heads during the menopause transition. It may be just greater overall sadness, but that can also tip over into depression. Especially if you don’t take steps to rectify it.

If you think of premenstrual syndrome (PMS), it’s only natural that as hormones fluctuate more in perimenopause, our nerves may be more on edge. Women can become suffer low mood around this time and are often offered antidepressants by their doctor, when what they really need is help balancing their hormones.

But don’t automatically blame menopause! There’s potentially a ton of other causes that may be making you sadder than usual. You may be suffering the effects of ageism and sexism and all those negative narratives about who you are now, not to mention the global pandemic and the economic and political instability we’ve all been coping with.

How about dealing with teenagers and older parents at the same time? Or the end of your dreams of fertility or an empty nest? There’s so much going on! There’s also the U-curve of happiness which shows midlife as the dip in our lifetime happiness – it generally gets better after this time, I promise!

Antidepressants may help you through a difficult patch, but often, in midlife, it’s more about balancing our hormones and dealing with some of the emotional issues that surface around this time. Like hormone therapy, antidepressants can enable us to function, but they may mask symptoms we need to deal with, whether or not we take medication. Obviously, for some women, antidepressants are essential, but jumping straight to prescribing them for a midlife woman is not really giving her the duty of care required, in my opinion.

Statistics on menopause and mental health can also appear alarming. For example, there’s an unfortunate correlation which keeps being raised in the UK media, between menopause and the age at which there is the highest rate of suicide for women. It’s true that women aged 50-54 exhibit the highest rate of suicide in the UK, but the actual rate is only 7.4 women per 100,000 population. This rate compares with 6.9 women per 100,000 in the 45-49 age range and 6.5 in the 55-59 age range.

Of course, any rate of suicide is awful. But this is a tiny increase between age ranges, and the rate of male suicide is greater than that of women in every age group except 15-19. I think conflating the age at which there is the highest rate of female suicide with menopause is irresponsible, especially without context, and plays on women’s fears about this time. I’ve written more about this and how correlation does not equal causation. I asked the UK Samaritans for their view on these media narratives.

I believe there are many other factors that build up for women in midlife that impact our mental well-being. Sometimes I feel like the great menopause defender: “It’s not her fault!” If you’re experiencing low mood and or anxiety, I encourage you to be curious about what’s going on underneath and how you can deal with it.

There are plenty of things that can help, whatever the root cause. Here are some:

1. Try any or all of the general hormonal balance tips you’ll find at the bottom of this article relating to diet and lifestyle.
2. Remember, if you’re a drinker, alcohol is a depressant, and your body may may not be able to cope with it as well as it once did. I recently took an extended break from alcohol and my mood and anxiety levels both improved significantly.
3. Try Cognitive Behavioral Therapy (CBT) and or a regular meditation/mindfulness practice. This will help ground you and bring you back to living in the moment. Good mindfulness/meditation apps to try are Calm, Headspace, Buddify, and Insight Timer (which is free). CBT is great for getting a handle on runaway thought patterns. Leafyard is a powerful online self-help program for mental health.
4. Exercise and being outdoors are great for low mood and anxiety. Go for a walk in the park (or in a forest, if
   you can find one). Look around yourself and enjoy a bit of nature. Get your heart rate up and enjoy some post-exercise endorphins.
5. Breathe! Box breathing is a great technique to slow things down if your mind is racing. With box breathing, you breathe in for four seconds, hold for four seconds, breathe out for four seconds, and hold for four seconds, all while visualizing moving round the sides of a square.
6. EFT (Emotional Freedom Technique), otherwise known as tapping meditation, can also be very helpful for depression and anxiety. It has been found to be particularly effective for veterans suffering from PTSD. I really like The Tapping Solution app.
7. I discovered essential oils and am finding them very powerful for changing my mood. I’ve been experimenting with blends in a diffuser to help me focus, boost my energy, balance emotions, and calm me down. Click here for some of my favorite blends.
8. Remember that menopause doesn’t make you any less of who you are. You are still the fabulous woman you’ve always been. You know the same stuff and can do the same things. Believe in yourself and your power.
9. If you’re really struggling with depression in menopause and think HRT will help, then ask the doctor about that. But don’t forget you still need to have a healthy diet and lifestyle to thrive in menopause and beyond. You’ll likely also need to deal with any underlying and unresolved emotional issues eventually!
10. If anxiety and low mood have tipped over into depression, be sure to visit your doctor and get whatever help you need. The longer you leave it, the worse it may get.

Hormonal Balance

I’ve written extensively elsewhere about how to achieve better overall hormonal balance. Here’s the quick guide.

1. Balance your blood sugar and sort out your diet. Fluctuations in your blood sugar levels are going to exacerbate the hormonal fluctuations of perimenopause so helping your body out with the right food and not putting in under extra stress makes sense. Stress can be external or what we create in our bodies with how we live, making them think they need to go into fight or flight mode by causing our blood sugar levels to be imbalanced. This happens either because we haven’t eaten when we should have, and blood sugar has dropped, or we’ve consumed the wrong thing that makes our blood sugar level spike. For example, caffeine, alcohol, sugar and refined foods can all cause our blood sugar to spike and then plummet when their effects wears off. Natural plant-based phytoestrogens in the form of flaxseed or soya are also great for balancing out hormonal fluctuations. Jackie Lynch’s book The Happy Menopause is a brilliant guide to nutrition in menopause.

2. It’s expensive, but eat organic if you can for most food types. Pesticides used in agriculture are known to impact our hormones negatively as well as generally not being very good for you. Certain fruit and vegetables have higher proportions of pesticide residues on them than others. So some you don’t need to worry about so much if they’re not organic and others you may want to avoid unless organic. I’m still grappling with this but have printed out the lists of the worst offenders for reference. You can get these lists for the UK at Pesticide Action Network or in the US at the EWG.

3. Consider also what toxins are in your home environment and whether you can cut back on those. Household cleaning products are full of chemicals, some of which are thought to interfere with hormones. Personal products like deodorant, moisturizers, shampoos etc. often come laden with potentially suspect ingredients (there’s still controversy about parabens) – can you identify everything in the ingredients list of your favorite product?

4. Try to lower your stress or improve how you deal with it. Hormone fluctuations are exacerbated by stress and stress makes low mood much worse. Reduce levels of stress in your life, maybe adopt a meditation practice as above, or do some restorative yoga. Both of these will help you lower stress levels overall and potentially reduce menopause symptoms, especially the sadness that seems to affect many of us around this time.

5. Up your exercise. As we age we need more exercise not less and many women swear by exercise to help them manage menopause symptoms. Exercise can immediately improve our mood. Click here to learn why lifting weights becomes so important as we age.

Don’t let depression in menopause ruin your life. Get the help you need!

You may also like: Menopause And Depression – Giving Context To Statistics and Top Tips For Dealing With Perimenopause Anxiety