Perimenopause refers to the period when women’s menstrual cycles become irregular, which generally occurs in the late 30’s to early 50’s. The disruption in menstrual cycle may occur many times before menopause. Depression is a disorder that effects a person’s body, mood and thoughts. It causes loss of appetite, sleeplessness, mood swings, and a deep sense of despair. Perimenopause and depression often come hand in hand.
Depression during perimenopause is different from unhappiness or a “down” feeling. It is also not an indication of personal flaws or a condition that can be motivated or wanted away. Persons with this disorder cannot just gather themselves together and get well. Usually, treatment is important and significantly vital to healing.
There are three primary types of depression. Most of these are established by how ominous the signs are. They are:
- Major depression – This is the most serious type of mood disorder based on the number of signs and austerity of symptoms.
- Bipolar depression / Manic depression – Bipolar depression involves both high and low mood swings. It also indicates other major symptoms not found in other depression types.
- Dysthymia depression – identifies the low to moderate level of depression that continues for about two years and sometimes longer. Though the symptoms are not as serious as a major depression, they more lasting and defiant to healing. People with this type develop a major depression for a moment when depressed.
Studies showed an increase in new onsets of depressive illness in association with hormonal changes in the body during the menopause transition years. It is known to be linked with a decrease in estrogen levels. However, some doctors believe symptoms are caused by a decrease in progesterone and resultant rise in estrogen.
Moreover, a perimenopausal woman has higher risk of recurrence of major depressive episodes, and the risk is greater if she has a previous history of premenstrual syndrome or postpartum depression (can range from temporary “blues” following childbirth to serious, unbearable and emotional depression). Changes in valued life styles associated with motherhood, family, fertility, or physical rigor and attractiveness may also precipitate depressive mood changes in predisposed or vulnerable women.
The symptoms of depression during perimenopause are varied and the severity changes with time. Here is a checklist of symptoms related to pre menopausal depression: gloomy, unshakable sadness, loss of interest and pleasures, fatigue, loss of vigor, extreme restlessness and irritability, memory loss and lack of concentration, loss of self-respect and self-confidence, extreme guilt, lack of self-worth, overwhelming hopelessness accompanied by pessimistic feelings, thoughts of suicide, insomnia or an increased need for sleep, and increased or decreased appetite.
Other common symptoms of depression during pre menopause are:
- Anxiety, read more about anxiety in anxiety attacks in menopause and perimenopause.
- Loss of energy, a slowing down of metabolism, and activity levels.
- A sense of helplessness along with an increasing inability to focus and indecisiveness.
- Inexplicable weight loss or weight gain. Triggered by loss of appetite or eating binges.
- Brooding and suicidal inclinations.
- Physical afflictions like headaches, digestive disorders, and chronic pain for no particular reason.
- Being apart socially.
If that is what you are experiencing, you have a few options including: anti-depressant medicines, psychotherapy, as well as lifestyle changes. In extreme cases electroconvulsive therapy or light therapy are prescribed. Other options are the traditional Hormone Replacement Therapy (HRT) and new alternative medicine that include herbal remedies, dietary supplements such as 5-HTP, or something called Bioidentical Hormones.
Medication generally gives a person with chronic depression a feeling of euphoria and well being. Medication works, but it only works if you use the correct amount all the time, at the right dosage. These drugs are a great tool to stimulate positive thoughts and an ‘I can do it’ attitude. But unfortunately these drugs only last for a short time and the side effects can be devastating. Along with the feeling of the withdrawal symptoms by removing the drug, you can sink to an even lower level of depression than before. This will happen very quickly and can sometimes be very dangerous to your well being.
In some women, certain dosage of antidepressant such as fluoxetine in combination with estrogen replacement therapy may reduce symptoms of depression. A reduction of hot flashes and some other perimenopausal symptoms is also noted in some cases (Read also about controlling hot flashess and night sweats). Progesterone may increase depressive symptoms in women who have a previous history of depression. Estrogen or progesterone hormone replacement should be given in consultation with a gynecologist or primary care physician who can monitor the development of any untoward effects on the uterus, breast, or cardiovascular system.
Talking to a professional therapist could be the answer for some people. A therapist is trained to listen and they do understand how you feel with chronic depression. Prepare to spend a lot of time with your therapist, so find one that you can trust. It will always feel better to talk about your pre menopausal depression to someone that you can trust. But like a drug the withdrawal symptoms of stopping your therapist visits can be just as disastrous. Those negative feelings return again.
Other things you can do to prevent perimenopause depression and support yourself through perimenopause are:
- Exercise, do a little every day
- Learn to manage your stress carefully so you do not get overwhelmed
- Promote good sleep by avoiding things that stress you out and indulging in things that relax you like hot baths
- Eat a well-balanced diet, avoid refined sugar and high carb foods
- Make time to do something you enjoy EVERY day
- Be realistic about the expectations you put on yourself
Perimenopause can be time of great change and depression may play a factor for some women. Take matters in hand and erase negativity from your mind. Try to relax, meditate, and enjoy music, movie, ballgame, family outing, picnic, or trek. Start new activities that absorb your time as well as interests. Go out and meet people and participate in group activities. Be positive, self confident, and have faith in yourself. And be sure to get help if you need it.
Perimenopause depression that goes untreated can become “clinical” and requires professional treatment. If you think you are “clinically” depressed, do not hesitate to get help from a therapist or doctor. He will give you a thorough examination to rule out physical causes for depression as well as any underlying medical problems. Then if required he will recommend that you consult a psychiatrist or psychologist.