There can be numerous risk factors for depression, including stressful events, genetic vulnerability, and co-occurring medical problems like diabetes, cancer, or heart disease. Furthermore, women are more likely than men to be diagnosed with depression, and they may face some unique risk factors. For middle-aged women, menopause may increase the risk of depression symptoms. So, is menopause causing your depression? Learn the answer, as well as some coping strategies, below.

The Link Between Menopause and Depression 

There seems to be a link between menopause and depression. One recent study of menopausal women in the Southwest United States found that slightly over half of them felt unhappy or depressed. Feelings of depression were more common among lower income compared to higher income women, but depression was prevalent in both groups. Other depression symptoms, such as feeling tired, having difficulty concentrating, and losing interest in regular activities, were also common among women in the study.

Experts have reported that many menopausal women experience minor mood problems and sleep disturbances, but for some, these symptoms progress to a major depressive episode. Women who have a history of depression or who experienced postpartum depression are at increased risk of developing depression symptoms during menopause; however, some women may show depressive symptoms for the first time during the menopausal transition. 

Some of the following factors can contribute to menopausal depression:

• Life transitions: During middle age, around the same time that menopause begins, women may experience life transitions, such as children moving out of the house. The sadness surrounding “empty nest syndrome” and other midlife changes, such as divorce, declines in sexual functioning, or changes in appearance, can lead to depression.
• Hormonal changes: Beyond psychosocial factors, such as life transitions, biological changes related to hormones can increase the risk of depression during menopause. Decreases in estrogen with menopause can influence mood and lead to depressive symptoms.
• Menopausal symptoms: Specific menopausal symptoms, including insomnia, hot flashes, and changes to the body’s appearance, can also trigger depression for some women. 

Identifying Depression During the Menopausal Transition

Depression is common in women who are going through menopause, with factors like life changes, hormonal fluctuations, and symptoms of menopause themselves likely contributing to low mood. Given this fact, it is important for women at this stage of life to be able to identify depression symptoms, so they can take steps to cope with and treat depression, if warranted. 

The following symptoms may indicate depression, especially if they are severe and/or interfere with daily functioning:

• Depressed or sad mood
• Loss of interest in regular hobbies or activities, or finding regular activities to be unenjoyable
• Feeling hopeless
• Thinking about suicide
• Lacking energy
• Eating more or less than usual (or either gaining or losing weight)
• Changes in sleep habits, which can include either insomnia, or at the other end of the spectrum, sleeping more than usual 
• Feeling worthless or guilty
• Having difficulty concentrating or making decisions
• Changes in movement patterns, which can include either restless movements like pacing, or on the other hand, feeling slowed down, as if movement is difficult 

The symptoms above suggest that it is time to seek professional depression treatment. 

Coping With Menopausal Depression

If you’re experiencing depression symptoms during menopause, the good news is that there are coping mechanisms, resources, and treatments that can help you to manage your symptoms:

• Exercise: Physical activity can be beneficial for women experiencing depression during menopause. One study found that postmenopausal women who participated in an exercise program experienced significant declines in depression symptoms. Women with moderate depression experienced an 18% improvement in depression, and those with severe symptoms experienced a 22% improvement. Beginning a regular exercise routine may be beneficial if you’re struggling with depression. 
• Other lifestyle changes: You can cope with midlife depression by making other positive lifestyle changes. Developing healthy stress management strategies, such as learning yoga or relaxation techniques, can also be beneficial. In addition, following a nutritious diet, joining a support group, and making time for hobbies you enjoy outside of work, can promote mental health. 
• Professional Treatment: Experts generally recommend that women with severe depression during menopause be treated with a combination of antidepressant medications and hormone replacement therapy. Women with mild menopausal depression can be treated with either medications or hormone replacement. Regardless of depression severity, it is often recommended that women participate in counseling or therapy while receiving medication and/or hormone replacement. Desvenlafaxine, an antidepressant medication, has been found to be beneficial for treating menopausal depression. Other medications, including SSRI drugs like citalopram, may also be effective, but researchers have not studied them as widely. 

Self-care strategies like exercise and stress management can be beneficial for treating depression; however, if menopausal depression is severe and makes it difficult to complete your regular activities, it is likely time to speak to a physician about medication or other treatments for depression. 

Where to Turn When Symptoms Don’t Improve

While self-care strategies, combined with interventions like counseling and medication, are often beneficial for treating depression, some women may find that these usual strategies do not lead to adequate symptom improvement. For cases of treatment-resistant depression, transcranial magnetic stimulation (TMS) may be a suitable option. If you’re experiencing depression symptoms during menopause, and other treatment options have not proven successful, you may be a candidate for TMS. 

TMS is a non-invasive treatment modality used in patients who have not had success with other treatment options. It uses a device placed over the head to stimulate areas of the brain associated with mood regulation, via magnetic pulses. Patients can continue to take their medications while receiving TMS treatment, and because the procedure does not require anesthesia, they can also drive and return to work or other usual activities after a TMS session.

Pulse TMS provides services in the Los Angeles area. Contact us today to learn more or to find out if you’re a candidate for our Southern California TMS treatment.