Depression comes up quite often when I talk to some of my middle-aged girlfriends. Some have even taken prescription medication for their symptoms. But is depression a part of menopause? And does your chance of having symptoms of depression change depending on where you are in the menopausal transition?
First of all, let's define what we're talking about. The North American Menopause Society (NAMS) describes three conditions that are covered by the word “depression”:
- A depressed mood. Also known as dysphoria, this mood is common, brief in length, and normally doesn’t require treatment.
- Depression as a symptom. This type of depression can be triggered my medical or psychological problems or by intense reactions to the events of life. This type of depression tends to be short term and usually doesn’t require treatment. However, it can progress to clinical depression. Known dysthymia, this type of depression occurs for most of the day on almost every day of the week for at least two years.
- Clinical depression. This type of depression is a disorder that is caused by a chemical imbalance in the brain and requires treatment.
Researchers have probed into the combination of menopause and depression. The NAMS reports that clinical trials haven’t found any link between menopause and the three types of depression. With that said, NAMS also points out that many women experience intense mood swings during perimenopause.
Studies also have found that women have a higher risk of depression as they enter menopause. However, researchers from the University of Pennsylvania School of Medicine took a different angle, instead wanting to determine what occurs after a woman’s menstrual period ends.
This study involved 203 women in Pennsylvania who were between the ages of 35 and 48 and who still had their menstrual period when the study started in 1996. By the end of the study, all of the women had reached natural menopause.
The researchers used the Center for Epidemiologic Studies Depression Scale to gauge the participants’ depression throughout the longitudinal study. The study participants completed a questionnaire periodically during the study, which was then analyzed to determine if they had depression symptoms.
At the start of the study, approximately 40 percent of participants had a high enough score on this scale to be classified as being either mildly depressed or moderately depressed. The researchers found that the number of participants who had high scores on the depression scale dropped from a decade prior to their menopausal period to eight years after that period. Furthermore, the risk of symptoms of depression was found to be higher in the years before the women’s final menopausal period; that risk then dropped in the years after the women the women entered menopause.
However, women who have a history of depression still seemed to struggle. The researchers found that the likelihood of symptoms of depression was more than 13 times greater overall among these women; additionally, these women were eight times more likely to have depressive symptoms after their last period when compared with women who had no history of depression. The researchers said that physicians should not consider depression to be a symptom of menopause in these women.
Women who started experiencing symptoms of depression as they approached menopause actually reported a decrease in these symptoms after their final menstrual period. Furthermore, they had a significantly lower risk of symptoms of depression by the second year they were in menopause.
The researchers also found that participants who didn’t have a history of depression who developed symptoms of depression also had changes in their hormone levels. However, the researchers stopped short of saying that these changing hormone levels resulted in the depression symptoms.
So what should you do if you’re feeling depressed? NAMS recommends herbal remedies and lifestyle changes as a way to deal with mild or moderate depression. A low-dose oral contraceptive also may be helpful for perimenopausal women who don’t smoke.
Severe depression should be diagnosed by a mental health professional. This health care professional can prescribe antidepressants, counseling or psychotherapy.
Primary Sources for This Sharepost:
Freeman, E. W., et al. (2013). Longitudinal pattern of depressive symptoms around natural menopause. JAMA Psychiatry.
North American Menopause Society. (nd). Depression & menopause.
Seaman, A. M. (2013). Depression risk may fall after women’s periods end. MedlinePlus.
Published On: November 15, 2013