I’ve had my share of low days when I struggle to get out of bed or fester the energy to do some work, so I decided today to cover the oh-so-joyous menopausal symptom known as depression and the question does menopause cause depression? There is, of course, a big difference between feeling down and being depressed, so if you're feeling low and not coping, you need the support of others, so speak to a friend or family member or seek out your GP or healthcare practitioner if you need to. Otherwise, in this article, I tackle the question of does depression affect menopause?
During the perimenopausal period, women are at a greater risk for depression. This risk increases as perimenopause progress before decreasing during the postmenopause years. Apparently, our mental health will return to normal two to four years after the last menstrual period, so those who've already reached this milestone, please let me know if this is true by leaving a comment. Menopausal-related depression is, unfortunately, very common, with around 75% of women experiencing depressive symptoms, according to the British Menopause Society. In addition, women with a history of depression or a family history of depression are more likely to experience it during menopause, as well as women who have experienced early menopause or had surgery to remove their ovaries being at a higher risk too.
Don't suffer in silence, as there are plenty of remedies to try out and find out what works best for you, but always consult your healthcare provider if you're struggling to cope. There are many ways women can support their menopausal-related low moods and depression, such as the following:
Hormone replacement therapy (HRT): Your GP can prescribe HRT to balance hormone levels, which can help alleviate depression and other menopausal symptoms. However, not everyone can take HRT, so if you've tried HRT and couldn't get on with it or choose not to, there are other things you can try. I will write a separate article on HRT, but in a nutshell, it's not the ogre we all thought it was pre-May 2021 when Davina McCall's programme aired explaining it all. Unfortunately, by that time, I was into my twelve-month period free menopause period, albeit I was unaware at the time. So it all seemed a little too late to start HRT at that point.
Exercise and diet: Regular exercise, eating a healthy diet, and getting enough sleep can help alleviate depression symptoms. Yoga, meditation, and mindfulness practices may also help reduce stress and improve mood. Indeed, I can vouch for regular exercise, which seems to lift my spirits in the post-workout hours and meditating and mindfulness certainly puts life into perspective. You just have to find the time!
Alternative therapies: Some women find relief from depression through alternative therapies such as acupuncture, massage and herbal supplements. However, speaking with a healthcare professional before trying any alternative therapy is essential, especially where herbal supplements are concerned, which can interact with medicines and treatments. As my perimenopause stage happened whilst still in the throes of HRT being linked to an increased risk of cancer, my only natural course was the route of herbal and vitamin supplements which I'll cover more fully in a separate article.
Family and friends: Menopause isn't taboo, so seeking support from loved ones and friends and participating in social activities can help us feel less isolated, helping to improve our mood. Sometimes, simply going for a walk can bring my mood up, and being around other people makes me feel less isolated. However, if you really can't turn to friends or family, get online and chat with women in similar situations. Menopause Matters offers an excellent platform for a good chat about how you're feeling, and Mumsnet also provides a section on the subject.
Counselling: Of course, if depression is particularly severe and you're finding it difficult to get out of bed and do your normal day, then speaking with a mental health professional, such as a counsellor or therapist, can help manage menopausal-related depression. Cognititve-behavioural therapy (CBT) is a common form of therapy that can help women identify negative thought patterns and learn healthy coping skills.
I will, of course, start by recommending a healthy balanced diet, and as the professionals say, by eating the right foods, you should get the right amount of vitamins and minerals from your diet. However, as women get older, primarily through menopause, we need a little extra support, so topping up on some of the more menopause essential vitamins may help symptoms. And this is especially so as menopause progresses, where we're more likely to be lacking.
Omega-3 fatty acids: They are a great source of EPA and DHA, which have been shown to help treat hot flushes, depression, and cognitive disorders in menopausal women.
Vitamin B12: There is growing evidence supporting the importance of B12 concerning balancing hormones. Indeed, many of the symptoms associated with an imbalance are also associated with a vitamin B12 deficiency. There are four types of B12, and the version you should look at is B12 Methylcobalamin. It is the most recommended version to help improve cognitive function, which we women know better as brain fog and being able to think, reason, and remember. And it's good for our bones as well.
Vitamin B6: All B vitamins are recommended during menopause, but this particular B vitamin helps make serotonin, which is responsible for transmitting brain signals. As women age, our serotonin levels drop, so getting enough Vitamin B6 to boost levels may help with menopausal depression and lack of energy.
Vitamin D3: For women over 50, the recommended advice is to get 20 mcg (800 IU) of vitamin D daily. Indeed, this vitamin is cited as one of the most crucial vitamins for menopausal women, with studies indicating it can help balance our moods and emotions and ward off osteoporosis (weakening of the bones). It's also advisable to take Vitamin D3 alongside Vitamin K2.
Vitamin E: Stress can cause cell damage increasing your risk of depression. However, research indicates that Vitamin E, an antioxidant that helps fight cell damage, can help ease stress, reduce oxidative stress, and may help reduce your risk of depression.
Magnesium: This is another essential nutrient that becomes even more vital for women as we age is magnesium. It plays an essential role in regulating our moods and brain function, with many studies connecting low levels of magnesium to higher rates of depression and anxiety.
Amino Acids are essential during menopause, including tryptophan, tyrosine, and Gamma-aminobutyric acid. Tryptophan is an essential amino acid converted into serotonin to help regulate mood and reduce symptoms of depression and anxiety. Tyrosine plays a role in mood, motivation, and energy levels. Gamma-aminobutyric acid (GABA) is an important neurotransmitter that plays a role in mood regulation, anxiety reduction, and sleep promotion. During menopause, changes in hormone levels can lead to a decrease in GABA activity, which may contribute to symptoms such as mood swings, anxiety, and sleep disturbances, which can be a slippery slope to becoming depressed. If you eat meat, fish, eggs, dairy, legumes, and nuts regularly, you should be getting efficient amounts of amino acids.
Rhodiola is a traditional medicine that’s been used for centuries to treat many conditions, including anxiety, depression, and fatigue. It is believed to be adaptogenic, which means it can help the body to adapt to stressors and improve mental and physical performance. Research suggests that Rhodiola may improve cognitive function, reduce fatigue, and has antidepressant and anxiolytic effects.
St. John's Wort is shown to be effective in treating mild to moderate depression. For example, one study published in the journal Menopause found that women who took St. John's wort for 12 weeks experienced a significant reduction in symptoms such as hot flashes, sleep disturbances, and depression compared to those who took a placebo. However, this remedy, in particular, can definitely interact with certain medicines, so if you consider using this one, speak with your GP beforehand.
Ashwagandha, also known as Indian ginseng, is also an adaptogen - a natural substance that brings balance to the body. It is commonly used to reduce stress and anxiety, improve cognitive function, and boost energy levels and is believed to work by reducing levels of the stress hormone cortisol, which may contribute to depression and anxiety. Indeed, in recent years, Ashwagandha has been studied for its potential antidepressant effects, with studies in the journal Phytomedicine and the Journal of Alternative and Complementary Medicine finding the extract was effective in reducing symptoms of anxiety and depression in people with generalised anxiety and helping to reduce symptoms of depression in people with chronic stress respectively.
Maca Root is a Peruvian native plant that's similarly been used as a traditional remedy for centuries for a variety of conditions, including anxiety, depression, and other menopausal symptoms. Maca root is believed to work by balancing hormones and improving mood. Indeed, some studies suggest that it may be effective in reducing symptoms. For example, one study published in the journal Menopause found that women who took maca root for 12 weeks experienced a significant reduction in symptoms, including hot flushes, night sweats, and anxiety, compared to those who took a placebo. And a study published in the journal CNS Neuroscience & Therapeutics found that maca root extract was effective in reducing symptoms of depression in postmenopausal women. The participants took maca root extract for six weeks and experienced a significant improvement in symptoms compared to those who took a placebo.
Now, I don't suggest for one moment that you take all of the above at the same time in a veiled attempt to restrict menopausal depression, especially the latter four. However, trial and error worked for me. I've never tried the St. Johns Wort or Rhodiola but found that the Ashwagandha with a small amount of Macca Root was sufficient to curb anxiety levels and depression. And, if you're taking a multivitamin supplement or are happy with your diet, you should get enough vitamins B, D, and E. And lastly, remember, if you are on medications or other supplements, speak to your GP or healthcare provider before adding anything to your regime.
According to NICE guidelines (otherwise known as the National Institute for Health and Care Excellence), HRT should be the first line of treatment for menopausal symptoms, including anxiety and low mood. However, remarkably, it is still common for GPs to talk about antidepressants first, which is fine for those who choose to avoid HRT, as Selective Serotonin Reuptake Inhibitors (SSRIs) can be an effective alternative if you're struggling to boost your mood through natural supplements. Ultimately, your GP should prescribe HRT for menopausal depression unless you can't take it or choose not to.
I know the severity of depression will be different for every woman. However, I would like to put it out there that just feeling the air and the sun's warmth on your face and body can sometimes make things a little brighter. So, if you're struggling and can't move off the sofa or even out of bed, try and make an effort to step outside your door or, at the very least, open the curtains and just look outside! Sending love and support x