Perimenopause and Clinical Depression

Marcelina Hardy, MSEd, BCC
Perimenopause and Clinical Depression

Perimenopause and clinical depression are becoming much more common during this period in a woman's life. Perimenopause is the transitional period before menopause., which is marked by a one-year cessation of a woman's menstrual cycle. During perimenopause, hormones change drastically and some women feel a change in mood, anxiety and depression.

Symptoms of Perimenopause and Clinical Depression

Some symptoms of perimenopause are similar to clinical depression. During this period of transition, women begin to think about their accomplishments up to this point. Women often view this time as a turning point. Not only are perimenopausal women scrutinizing their life thus far, they are experiencing hormonal changes that are affecting them physically. Many of these physical symptoms can mirror depression symptoms.

Physical and Psychological Symptoms of Perimenopause

Estrogen plays a huge role in the cause of perimenopause symptoms. When perimenopause begins, estrogen begins to decrease slowly until menopause is complete. This loss in estrogen affects women in the following ways:

Symptoms of Perimenopause
Hot flashes Mood swings Decreased mental function
Night sweats Memory problems Insomnia
Irritability Anxiety Depression

Specific symptoms and the degree a woman experiences them varies between individuals. Some women only suffer from one of these symptoms and others can endure all.

Symptoms of Clinical Depression

Many women show signs of clinical depression on the onset of perimenopause. Some women have their first episode of clinical depression during this time. Estrogen and the natural reflection of this transitional period play a role in this onset of clinical depression. Many women who feel that this change is a positive stepping-stone in life are able to get through it with less depression symptoms. Someone with clinical depression may experience the following symptoms:

  • Loss of energy
  • Loss of pleasure in activities
  • Change in sleep (too much or too little)
  • Change in appetite
  • Inability to concentrate
  • Emotional or crying spells
  • Thoughts of suicide

Risk of Clinical Depression in Perimenopause

A study reported by USA Today has found that women who experience hot flashes during perimenopause are more likely to become clinically depressed. Another predictor of clinical depression during perimenopause is prior diagnoses. Genetics can predispose someone to clinical depression as well.

Treatment for Perimenopause and Clinical Depression

Remember the feelings you are experiencing are due to these hormonal shifts and treatment is available for you. If you have been on psychotropic medications or psychotherapy in the past, your doctor may ask you to continue. If the medication and therapy do not seem to be helping during perimenopause, your doctor may refer you to a gynecologist who can speak to you about estrogen therapy.

Psychotropic Medications and Psychotherapy

Many psychotropic medications can help you with your depression symptoms. Doctors often prescribe fluoxetine (Prozac) because this medication has shown to help with the physical symptoms of perimenopause as well as the psychological symptoms of anxiety and depression. Proxetine or Paxil and Velafaxine (Effexor) are two other psychotropic medications that have been shown to relieve symptoms of clinical depression in women during perimenopause.

The conjunction of psychotropic medications and psychotherapy is the best treatment for clinical depression especially during perimenopause. This phase in life can be difficult and therapy can help a woman sort through issues she is facing. Therapy can help change the thought patterns of a woman who is feeling depressed about this transitional period.

Estrogen Therapy for Perimenopausal Depression

Sometimes psychotropic medications and psychotherapy is not enough to help a woman in perimenopause. When this occurs, the psychiatrist will often refer the patient to a gynecologist so that the woman can discuss alternatives such as estrogen therapy. This type of oral medication will provide a woman's body with additional estrogen, which can impact depression, anxiety and mood swings. There is debate about the benefits and risks of estrogen therapy so discuss these with your doctor.

Perimenopause and Clinical Depression