Menopause and Depression

Hunter Bennett

Menopause is considered to be a time of great change. A time where the body undergoes a myriad of physical and physiological alterations – all of which essentially indicates the end of the reproductive cycle as we know it.

However (as I am sure you know), menopause can come with a number of unwanted side effects – including physical discomfort, alterations in sleep, and even feelings of lethargy.

But did you know there is evidence to suggest that it may even contribute to the onset of depression?

What is menopause?

As I have already touched on briefly, menopause is a time of change.

In this manner, it is an entirely normal condition that all women undergo as they transition through middle age, representative the end of their reproductive cycle. As a result, the term ‘menopause’ simply refers to the numerous changes that a woman experiences when she stops menstruating for good.

What Causes Menopause?

While many simply associate getting older with menopause, its onset isn’t actually driven by the aging process – but rather as a result of exhausting their natural supply of eggs.

Females are born with only a finite number of eggs stored within their ovaries – subsequently, the duration of their reproductive years are ultimately dictated by the number of eggs that they are born with.

As such, the onset of menopause simply occurs when this supply of eggs is exhausted, and the ovaries no longer have the capacity to release an egg every month (as there are no more eggs to release.

During this process, the reproductive cycle finishes, and menstruation ceases for good.

Related Article: Menopause and Sleep

Who does menopause affect?

I have already stated in detail that menopause is a completely normal part of getting older. With this in mind, it most often occurs in women between the ages of 45 and 55 years – although there can be some individual variances within this range.

It is also important to note that menopause can occur early in certain situations. This most commonly happens as a result of surgery (for example, from a hysterectomy), or in response to physical damage to the ovaries (for example, during chemotherapy).

In any scenario where menopause occurs before the age of 40 – natural in onset or not – it is known as premature menopause.

What are the hormonal changes that occur during menopause?

One of the main reasons as to why menopause wreaks so much havoc with the body comes down to the fact that it causes some pretty substantial alterations in hormone levels (Lehan, 2017).

You see, as well as being the main site of reproduction, the ovaries are also where the key sex hormones estrogen and progesterone are both made and secreted. Interestingly, just prior to the onset of menopause, women tend to see a very sharp decline in the secretion of these two hormones.

Given that these key hormones actually play a key role in the normal maintenance of mood and wellbeing, it stands to reason that their decline can have a significant impact on depressive symptoms – something that has been proven repeatedly (Llaneza, 2012).

Depression and Menopause

You see, these reductions in hormone levels have demonstrated two large implications for the mental health of those women going through menopause (Llaneza, 2012):

Firstly, a global reduction in mood is observed. It appears to have a direct association with the menopausal declines in hormone secretion discussed above. This can lead to sad and depressive thoughts and feelings. Both are known to contribute to the onset of depression.
Secondly, these alterations in hormone levels can also cause wild fluctuations in mood throughout the duration of the entire menopausal period. These uncontrollable fluctuations can create a sense of helplessness within the individual. They may feel incapable of controlling their emotions. As I am sure you can imagine, this can further promote the development of depression.

Now, if you think that these hormonal changes are bad enough, it’s important to remember that they are occurring at the exact same time as a myriad of other uncomfortable physical symptoms – such as lethargy, hot flushes, and nausea.

All of which creates a perfect storm for depression.

What are the symptoms of depression?

With all of this information, you might be wondering how you can actually identify the onset of depression? And it can be a little bit more complex than what you might have first thought (Clayton, 2010).

You see, while depression is typified by an overwhelming and unshakable sense of unhappiness, there are other key symptoms that need to be considered. These symptoms can be related to changes in mood or behavior, and may even be linked to physical alterations.

These symptoms can include:

Reduced social interactions, and withdrawing from family and friends
A decline in work-related productivity
Reliance on alcohol or sedatives
Feeling overwhelmed, guilty, and irritable
Appearing frustrated and lacking in confidence
Finding yourself feeling unhappy, disappointed, miserable, and sad
Experiencing uncontrollable negative self-talk on a regular basis
Feeling lethargic, tired, and run down
Seeing a rapid loss of appetite

As I said – these symptoms can be broad and varied.

What are the risk factors for depression?

One thing that rarely gets considered when discussing depression in its entirety is the fact that its onset isn’t always dictated by the physiology of the individual – in fact, there are a number of things that can increase depression risk that relate to the circumstances of the individual (Stegenga, 2010; Meng, 2017).

It is these that we would describe as risk factors.

Some of the most common risk factors known to contribute to the onset and development of depression include the following:

Feeling unsafe within your local living community
Having an unsupportive social network
Living alone
Being overweight or obese
Low levels of physical activity
Being in chronic pain
Having high alcohol intakes
Low education status

Considering this, it is important to note that even if you managed to fall into all of these categories, it wouldn’t mean that you are destined to get depression. It only means that you would be at a much higher risk of developing the disease than someone without any risk factors to speak of.

Does depression affect sleep in menopausal women?

Interestingly, there appears to be a very strong link between depression and reductions in sleep quality (Thase, 2006; Nutt, 2008).

In fact, most (if not all) depressive disorders are actually characterized by numerous sleep disturbances, in conjunction with global reductions in sleep quality. At times this can even come with the onset of insomnia.

Now, all of this is because the regulation of sleep is closely linked to the same mechanisms that manage mood.

Amazingly, given this extremely close link, interventions aimed at improving sleep quality have been suggested to act as a potent means to assist in the treatment of depression – which is pretty incredible if you ask me (Howland, 2011).

Considering this, if you want to mitigate your risk of developing menopausal depression as much as possible, then improving your sleep is the perfect place to start.

While there a myriad of different ways to improve sleep quality, we strongly recommend the use of the following tools. They have scientific evidence to support their use, and have been shown to be both safe and effective:

While these are no means the only way you can improve your sleep, they are tools we ourselves have used with great success in the past. I guess you could say that they have our personal tick of approval.

Exercises to prevent and help depression

In my personal opinion (and as an exercise scientist, I must admit that I am a little biased), exercise is the most beneficial thing that you can do for your body.

Period.

It has the capacity to enhance cardiovascular and metabolic health, improve muscle strength and functional capacity, enhance the quality of life, and even improve cognitive function.

Oh, and I should also mention that it has the ability to fight depression.

There is a growing body of research clearly demonstrating that those individuals who participate in regular physical activity are at a significantly lower risk of developing depression than those who do not. Moreover, exercise appears to have a dose-response relationship with depression. This means that, for the most part, the more you exercise, the better off you will be.

With this, you might be wondering what the best exercise to help depression is?

Well, I have some good news for you – it doesn’t really appear to matter.

Both aerobic exercise and strength training appear to exhibit the same beneficial effects on mood, feelings of wellbeing, and of course, depression (Ranjbar, 2015; Gordon, 2018).

So simply pick your favorite type of exercise, and perform it a few times per week. Trust me when I say your body and mind will thank you.

Related Article: 3 Exercise Tips to Prevent and Treat Depression

What are the other natural remedies for depression?

At the moment we have discussed both exercise and sleep enhancement as two completely natural ways of helping treat depression. However, it would be negligent of us not to provide some other avenues that you can pursue to further enhance the results of these two methods.

The following is a comprehensive list of great options that have been shown time and time again to help treat depression. This list includes both treatment activities and natural remedies. It is one of the most thorough lists of scientifically supported depression treatments.

Mediation and mindfulness
Yoga
Increased exposure to sunlight
Cold exposure and cryotherapy
St Johns Wort
Fish oil
Cumin
Probiotic supplements
Melatonin
Magnesium
L-theanine
Zinc
Creatine
Lavender
Berberine

Just to be clear, I am not suggesting that you simply run out and try all of these simultaneously. That would most likely be an absolute disaster (and an expensive one at that!).

However, if you have gotten on top of your sleep and started a solid exercise routine, and still find yourself showing the aforementioned signs and symptoms of depression, then these offer potential avenues that you can pursue further.

Take Home Message

In conclusion, menopause is a seriously stressful time that can wreak havoc with the body, leaving a trail of discomfort in its wake. One of the more damaging side effects associated is severely altered mood, which can even lead to the onset of depression.

However, by following the tips outlined in this article you can help fight menopausal depression. Keep your body and mind healthy and happy!

References

Jehan, Shazia, et al. “Sleep, Melatonin, and the Menopausal Transition: What Are the Links?.” Sleep Science 10.1 (2017): 11.

Llaneza, Plácido, et al. “Depressive disorders and the menopause transition.” Maturitas 71.2 (2012): 120-130.

Clayton, Anita H., and Philip T. Ninan. “Depression or menopause? Presentation and management of major depressive disorder in perimenopausal and postmenopausal women.”. Primary care companion to the Journal of clinical psychiatry 12.1 (2010).

Stegenga, Bauke T., et al. “Differential impact of risk factors for women and men on the risk of major depressive disorder.”. Annals of epidemiology 22.6 (2012): 388-396.

Meng, Xiangfei, et al. “Risk factor modifications and depression incidence: a 4-year longitudinal Canadian cohort of the Montreal Catchment Area Study.”. BMJ open 7.6 (2017): e015156.

Thase, Michael E. “Depression and sleep: pathophysiology and treatment.” Dialogues in clinical neuroscience 8.2 (2006): 217.

Nutt, David, Sue Wilson, and Louise Paterson. “Sleep disorders as core symptoms of depression.” Dialogues in clinical neuroscience 10.3 (2008): 329.

Howland, Robert H. “Sleep interventions for the treatment of depression.” Journal of psychosocial nursing and mental health services 49.1 (2011): 17-20.

Ranjbar, Elaheh, et al. “Depression and exercise: a clinical review and management guideline.” Asian journal of sports medicine 6.2 (2015).

Gordon, Brett R., et al. “Association of Efficacy of resistance exercise training with depressive symptoms. Meta-analysis and meta-regression analysis of randomized clinical trials.” JAMA psychiatry 75.6 (2018): 566-576.

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