10 Tips for Managing Menopausal Mood Swings
It’s the butt of many jokes and cause of awkward conversation silences. But in reality, there’s nothing particularly funny or weird about menopause—it’s a basic life experience for hundreds of millions of women around the world. Still, “changes during and prior to menopause are complicated,” says Cynthia Stuenkel, M.D., a clinical professor of medicine at the University of California San Diego School of Medicine. For instance, mood swings are common during this time—usually related to feelings of anxiety or depression. If that sounds familiar, here’s help.
The first step toward understanding mood swings is self-awareness, says Dr. Stuenkel. “Women who have a history of major depression are vulnerable to a recurrence during menopause or perimenopause,” she says. “Some women may have a history of hormone-related mood symptoms, like premenstrual syndrome or postpartum depression, that provide clues.” If you’ve dealt with these issues before, pay close attention to your mood as you head through menopause, and seek help if you start feeling off your game.
Talk to a Pro
“There is no substitute for professional mental health treatment, whether it’s from a psychologist or psychiatrist,” says Rebecca Thurston, Ph.D., president of the North American Menopause Society in Cleveland, OH. You’d think is goes without saying by the 21st century, but we’ll say it anyway: There is no shame in seeking treatment from someone with expertise in helping women just like you deal with anxiety and depression. You are not alone, and with the help of a therapist, you can come up with a plan to get your emotional health back on track.
Treat Yourself With Kindness
No, menopause isn’t an illness. But it can wreak enough havoc on your body sometimes to make you think it is! “Particularly for women who are starting to have hot flashes, menstrual irregularities, interrupted sleep, and maybe new medical issues, depressive symptoms can occur,” says Dr. Stuenkel. It’s a lot for anyone to deal with, she adds, and “you need to cut yourself some slack.” Don’t judge yourself for feeling down; instead, try to replace every sad thought you have with a positive one, and every worry with a reason to feel confident.
Get a Good Night's Sleep
It sounds like an oxymoron, since sleep is the last thing that comes easy during menopause. Hot flashes and hormonal shifts have a way of messing with quality shuteye. The solution? “If triggers can be identified, eliminate them,” Dr. Stuenkel says. “Cut down on caffeine. Look at alcohol consumption, and per current guidelines, try to keep it to one drink per day or less.” Other tips: Keep the bedroom cool and hit the sack at the same time each night. You can also talk to your doctor about a prescription Rx for hot flashes.
Get Up and Move
Anytime you’re feeling sad or hopeless, exercise helps—that’s true whether you’re dealing with menopause, a death in the family, or just a lousy day at the office, according to research. “Keeping a regular schedule and engaging yourself in activities can offset depressive feelings,” says Thurston. Rather than queuing up another episode of your favorite sitcom to distract yourself when a blue mood strikes, try going for a brisk walk around the block, even for just 10 or 15 minutes. You might be surprised what some fresh air and movement can do.
Taking a walk when sadness strikes is good; but taking one every day, no matter what, is even better. “Regular physical activity is important,” Thurston says. “We know that aerobic exercise, implemented with enough of a dose and frequency, can be as effective as many common antidepressants for treating major depression.” Even for those who find medication provides the relief they need, the addition of regular exercise to their daily repertoire may magnify the feel-good effect. How much should you get? Aim for 30 minutes, five times a week, to improve your mood and your fitness.
Ask Your Doc About Antidepressants
The idea that you should “tough it out” is so last century. “For the most part, treatment of major depression requires antidepressants,” Dr. Stuenkel says. “Your care provider can help get you on track if that’s the case.” Bonus: Some antidepressants have also been approved to treat hot flashes during menopause. Remember, taking medication for your mood swings now does not mean you’ll be taking it forever. Often, women find that their mood stabilizes post-menopause, and they are able to gradually stop medication entirely.
Consider Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a form of psychological treatment used by therapists to help with all kinds of mental health issues, including anxiety and depression. Thurston explains that CBT can help you identify specific thought patterns that are negative or critical. “We work to transform those negative thoughts into more positive ones,” she says. Through practice, CBT helps you to change the dialogue going on in your brain, letting you counteract negative feelings before they spiral into something more serious.
Explore Hormone Therapy
It’s not for everyone and it may or may not help with mood swings, says Dr. Stuenkel. Still, a study in the Journal of the American Medical Association found that estrogen and progestin therapy administered for 12 months helped prevent depressive symptoms in peri- and post-menopausal women. “More data confirming these findings is required before this becomes a standard recommendation for all women,” says Dr. Stuenkel. Nevertheless, if you are having severe mood swings and other approaches aren’t helping, it’s worth talking with you doc about it.
Start a Mindfulness Practice
Mood swings are made worse when negative thoughts start to spiral out of control. To center yourself in the moment, set aside a few minutes each day for mindfulness exercises, such as a daily meditation. “Mindfulness helps us have awareness and control over what’s going on with our thoughts,” says Thurston. “And our thoughts are a really big determinant of our mood.” And remember, as difficult as this time may be, what you’re going through is totally normal and it won’t last forever. And that’s something you can feel good about.
- Treatment Guidelines for Perimenopausal Depression:* Menopause: The Journal of the North American Menopause Society*. (2018). “Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations.” menopause.org/docs/default-source/default-document-library/meno-d-18-00170-final.pdf
- Menopause and Mood: Menopause: The Journal of the North American Menopause Society. (2020). “Taking a fresh look at mood, hormones, and menopause.” journals.lww.com/menopausejournal/Abstract/2020/03000/Taking_a_fresh_look_at_mood,_hormones,_and.16.aspx
- Exercise and Depression: ACSM’s Health & Fitness Journal. (2013). “Is Exercise a Viable Treatment for Depression?” ncbi.nlm.nih.gov/pmc/articles/PMC3674785/
- Cognitive Behavioral Therapy: American Psychological Association. (n.d.) “What Is Cognitive Behavioral Therapy?” apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
- Hot Flashes Treatment: National Institute on Aging. (n.d.) “Hot Flashes: What Can I Do?” nia.nih.gov/health/hot-flashes-what-can-i-do
- Hormone Therapy Study: JAMA Psychiatry. (2018). “Should Hormone Therapy Be Used to Prevent Depressive Symptoms During the Menopause Transition?” jamanetwork.com/journals/jamapsychiatry/article-abstract/2668201