Can Perimenopause Cause Anxiety and Depression?

One day you’re content, the next day the world feels like it’s caving in on you. Or you find yourself stuck in a loop of worry, catastrophizing over a minor detail for hours as you lay awake unable to sleep.

Whether you’re just entering perimenopause or you’re deep in the throes of it, it is quite common to experience a sudden onset of anxiety or depression.

Hormones directly affect your mood, emotions, and overall well-being. And perimenopause is all about hormonal fluctuations. Mood and mental health changes are a real part of the perimenopause transition.

Several studies have shown perimenopause elevates the risk of depression and anxiety. This is because estrogen fluctuations affect the delicate balance between serotonin and an important neurotransmitter called GABA. In plain English, mood changes in perimenopause are mostly estrogen’s fault.

Before we dig into this further, let’s go over signs, symptoms, and risk factors for depression. Mental health is as important, perhaps even more important, than physical health. Knowing what to keep an eye out for will help you thrive in perimenopause and beyond.

Signs and Symptoms of Depression

Having a down day, or feeling sad once in a while is totally normal. (Life is hard sometimes.) When these feelings are ongoing and/or disrupting your daily life, it might be depression.

Symptoms to look out for, and that should be addressed, include:

• Unexplained sadness, anxiety, irritability, restlessness
• Feelings of worthlessness, low self-esteem
• Difficulty focusing and concentrating
• Loss of interest in activities and things you typically enjoy
• Sleeping too little or too much/sleep disturbances; having no energy
• Changes in appetite
• Suicidal thoughts or behaviors*

Risk Factors of Anxiety and Depression During Perimenopause

Although estrogen decline is wreaking havoc on your body, there are other factors that can put you at increased risk of experiencing anxiety and depression in perimenopause. These include:

• A prior diagnosis of anxiety or history of depression (before perimenopause)
• Low levels of socialization, feeling isolated or unsupported by those around you
• Increased stress, from work or in your personal life
• Not getting much/enough exercise
• Low self-esteem or negative feelings about aging/menopause

If you’re experiencing any of these signs or symptoms, or are at risk of depression, take note. Shifting hormones and changing estrogen levels can make it hard to know if you’re experiencing true clinical depression or in a hormone-induced funk. (Not that those aren’t tough, too!)

Is It Depression or Hormonal Changes?

Can perimenopause cause depression? While the hormonal changes of perimenopause can significantly impact mood and overall well-being, it’s important to rule out and/or address underlying depression or other mood disorders. A medical professional can diagnose and help determine treatment.

Lifestyle Changes to Treat Perimenopause Depression and Anxiety

Life for people in their 40s and 50s is notoriously stressful. Many women find themselves sandwiched between caring for their children as well as becoming caregivers to their parents. Balancing demanding work responsibilities with life and family can become a lot.

All the while, you’re riding a hormonal roller coaster with drastic perimenopause mood swings. (Or your anxiety is suddenly through the roof, or you might feel like you just…can’t.)

With all that’s on your plate, asking “why am I developing anxiety in my 40s?” is starting to make sense. Lifestyle changes can help you manage mood changes and improve your quality of life in perimenopause:

Sleep:

Hot flashes, a restless mind, and more, can make a good night’s rest feel elusive. But do your best to make quality sleep a priority. Better sleep helps with making decisions and maintaining a steadier mood. Not getting enough sleep has been linked to depression, riskier behavior, and more. Try to:

• Go to bed and wake up at the same time.
• Avoid screens (blue light) for at least an hour before you hit the pillow.
• Try some gentle stretching, yoga, or meditation as you prepare for bed.
• Prep your room: make sure it’s dark, cool, there’s a fan if you prefer it.

Check out this post for more sleep tips for perimenopause.

Nutrition:

Aim for a nutrient-rich diet that supports brain health. A healthy diet makes for a healthy mind! Healthy eating patterns potentially reduce the risk of depression, anxiety, and other mental health conditions.

• Whole foods high in fiber and protein are critical during perimenopause and beyond.
• But also aim to eat plenty of foods high in omega-3s (oily fish, nuts, seeds), whole grains, fruits, and veggies to support brain health.
• A diet full of highly-processed foods and sugar have been shown to increase anxiety.

Exercise:

Get moving! The benefits of regular exercise are practically endless. In addition to keeping your body strong as you age, exercise helps reduce stress. It supports better sleep and can ease feelings of anxiety and depression.

• Menovation has a range of programs, from yoga to strength training to help you stay active in this phase.

Just relax:

Ok, that’s much easier said than done. Try incorporating relaxation techniques, like yoga, meditation, and other mindfulness practices (staying present in the moment, without judgement) into your day. This will help you better cope with stress and anxiety.

• Even practicing mindfulness for just 5 – 10 minutes a day can help manage anxiety, mood swings, improve sleep, and promote self-compassion.
• Studies also suggest mindfulness practices can ease hot flashes and other menopausal symptoms.

When to Seek Professional Help for Anxiety or Depression

Making positive lifestyle changes is always a good thing, but it may not be enough. Also, you can never be too proactive with mental health. There is ZERO shame in getting professional help from a therapist.

If you are experiencing symptoms that disrupt your daily life – for example, sleeping too much, feeling worthless, suffering extreme anxiety or panic attacks – please, please seek out professional help.

Counseling, even for a “check-in,” can be so helpful. From gaining a clearer understanding of your feelings to learning coping tactics to simply having an unbiased ear, a therapist will help you through this experience.

You can find a therapist through Psychology Today or another online directory, talk to your doctor or a trusted friend or family member for recommendations.

What About Medication?

A therapist can also help you understand if medication would be beneficial to your situation. It isn’t unusual to require anti-depressants or SSRIs to help even out the hormonal roller coaster your body is going through.

And going on medication for anxiety or depression DOESN’T mean you’ll be on it forever. Your estrogen levels even out as you get closer to menopause, and you may find it’s possible to wean off it (with the help of a medical professional).

Can Hormone Replacement Therapy Prevent Depression?

Interestingly – and maybe not surprisingly – studies show Hormone Replacement Therapy (HRT) may reduce the need for antidepressants. (Estrogen levels impact nearly every system in the body.)

HRT can be an effective treatment option for anxiety and depression, particularly during perimenopause, because it helps restore hormonal balance. Talk to your doctor about the benefits, side effects, and risks to see if HRT is a fit for you.

How Long Does Perimenopausal Anxiety Last?

It might seem impossible when you’re in the moment, but remember “this too shall pass.” Anxiety is a feeling, and feelings constantly change.

As far as the long-term, every person is different. For some people, perimenopausal-induced anxiety may last a few weeks or months, for others, much longer. Generally, once you’ve reached menopause and beyond, your hormones settle and anxiety, depression, and other mood symptoms tend to stabilize.

How Menovation Can Help Women’s Health

In the meantime, we are here at Menovation to help support and empower you through your perimenopause anxiety issues and beyond. It features exercises, nutrition plans, and education for improved well-being, reduced symptoms, and inspiring self-care for confidence and vitality. Then tell a friend – we are trying to keep the lines of communication about peri(menopause) open, right?

As always, talk to a doctor or mental health professional about your experience. Be sure to reach out to a professional for additional support, especially if you are experiencing severe symptoms, want to explore hormone therapy, or have other health concerns.

Take the “What stage am I in?” quiz here to determine what stage of perimenopause or menopause you are in and receive a free guide to help you feel your best during that time!

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*If you or a loved one is experiencing suicidal thoughts or behaviors, please seek immediate assistance. Call 988, the Suicide and Crisis Lifeline for immediate and compassionate support. The national service available 24 hours a day in the U.S.