How to Deal with Menopause and Depression
Menopause is a turbulent time of transition for both the body and mind. You are at a stage in your life where everything is changing.
You are finally stepping off the roller coaster of hormonal highs and lows you have been riding since puberty—but that in itself can feel like a crazy ride. You also are entering a new phase in your life where you can no longer bear children.
Depression is a common experience during menopause, so you shouldn’t be surprised if you have been feeling down. It is completely expected and normal, and there are quite few factors which could be feeding into the blues.
In this article, I am going to offer up some practical suggestions for how you can deal with depression during menopause. But in order to do that, we need to first learn a bit more about how menopause and depression are (and are not) linked.
Depression and Menopause May Be Correlated … But Not the Way You Think
Menopause and depression do show up hand-in-hand quite a lot. The common assumption is that one causes the other. Surely the dropping levels of estrogen are responsible for the changes in mood, right?
Well, maybe not. As of right now, there is actually not a lot of scientific evidence to support that assumption. It is more likely that other more indirect factors are responsible for depression during menopause.
I recommend checking out this fascinating article. In particular, I would like to highlight this passage:
“Crosscultural research provides examples of communities in which women have positive attitudes to the menopause and report few or no symptoms. These suggest that the psychological impact of the menopause is influenced by the social values ascribed to older women and the roles available to them, as well as cultural differences affecting lifestyle factors, such as diet and exercise.”
Here are some other interesting findings reported in the same article:
- Quite a few studies have actually found no increase in depression prevalence among menopausal women.
- Many studies have found that psychosocial factors are most predictive of whether women will experience depression during menopause.
- A longer menopause increases risk for depression (likely owing to the other symptoms).
- Menopausal women with other issues like arthritis or thyroid problems are more depression-prone.
- Here’s another direct quote from the article: “Overall, there is no conclusive evidence that hormone replacement therapy improves depression in women seeking help for menopausal problems over and above placebo effects.”
So actually, if you have been feeling depressed and people around you have shrugged and said, “Oh, that is just because you are going through menopause,” you actually have had your symptoms quite unfairly and ignorantly blown off.
Of course, that would be true even if hormonal changes were responsible for the changes in your mood.
But the fact that they probably play no direct role at all makes this kind of dismissive behaviour even more offensive.
Factors During Menopause Which Could Be Feeding Into Your Depression
So now you know that declining estrogen levels are likely not the cause of your depression during menopause. So let’s take a look at some of the factors which could actually be responsible. Then we can talk about what you can do about your depression.
1. The symptoms of menopause are (quite literally) a pain.
On the whole, pain is generally undesirable, particularly when it is something we cannot control. During menopause, you may be subjected to a significant amount of pain and discomfort. That by itself can be a depressing experience.
Women with more severe symptoms or symptoms which last longer (owing to a long perimenopause or menopausal transition) may be more susceptible to depression as a result.
2. You could be losing out on valuable sleep.
Sleep is important for proper physical and psychological function, and you need around 8 hours a night in order to feel your best.
Unfortunately, during menopause, you may have a hard time getting that type of sleep. You may be woken up frequently by hot flashes and night sweats, or you might simply have a hard time falling asleep because of your changing hormones. So this is yet another factor which may be linked to increased menopausal depression.
3. You may be struggling with low self-concept.
Self-concept is an important psychological construct. It refers to the mental image we hold about who we are. It is based on our beliefs about ourselves as well as how others respond to us.
This study found a link between low self-concept and depression during menopause. This makes a lot of intuitive sense, as there are many events during menopause which could pose a threat to self-concept.
For example, if your self-concept is connected strongly to your fertility, the loss of your ability to reproduce could damage your self-concept. Some people also have self-concepts which rely on a sense of youthfulness, which may be lost during this transition.
It does not help that other people may treat you differently during and after menopause. They may act as if you are made of glass, or simply behave as if you are “old.” These act as negative mirrors, reflecting back a self-concept which may not match who we truly feel we are. But even if we disagree, the opinions of others can erode at our sense of ourselves. This naturally can be a depressing experience.
4. You may be dealing with poor social support.
This goes back to what I was saying above. During menopause, you may find that social support is lacking. Others who have not had the experience may make ignorant assumptions about what you are going through, and may refuse to take you seriously.
Plus, many people live in cultures where youth and fertility are upheld as really important. As such, you might find yourself subjected to ageism. Indeed, professionally, this can be quite virulent. You might even be having a hard time holding down a job when you really need the money. Needless to say, being subjected to prejudice like this is really depressing.
5. It is possible you might have other health conditions.
If you do have arthritis, a thyroid condition, or some other health disorder, that alone might be responsible for your depression. Menopause is a natural transition, but disease by definition is something the body should be without. If you are worried about your health, depression is likely to result.
6. Aging or death may be worrying you.
For a lot of women, the prospect of getting older is by itself quite frightening and depressing. You may worry about the physiological and social consequences. Will people still find you attractive? Will they still take your ideas seriously in the workplace? Will they continue to treat you with respect and dignity?
These are all very reasonable concerns, because we do live in a world where ageism is a problem. And health issues are increasingly likely the older you get.
Mortality can be scary too. We all have different perceptions of death and attitudes toward its inevitability. But even if you do not have an overtly negative view of death, it is the ultimate unknown.
You could have many happy, healthy years ahead of you, but menopause is itself a kind of death. It is the permanent end of one phase of your biological existence. As such, it is a reminder of the ultimate end ahead.
7. You may be upset about losing your fertility.
If you were hoping to have more children or you strongly link your self-concept to your fertility, knowing that you can no longer bear children can be a devastating psychological blow. If you are still in perimenopause, there may be some options if you do want to have kids—but once you have arrived at menopause, that opportunity is gone.
8. You could be having issues with sexuality.
There are a lot of things that can go wrong sexually when you reach menopause. Vaginal dryness can lead to friction and pain. Changes in hormone levels can lead to reductions in sensation. If a fertile self-concept played a role in your sexuality, losing your fertility could also reduce your perception of yourself as a desirable person, and so on. Add your vasomotor symptoms to the mix, and you may have a hard time even taking an interest in sex.
If sex is something you usually enjoy, this can be a depressing experience. Thankfully there are solutions out there—something I will touch on shortly in the next section on solutions.
9. Other life changes could be going on concurrently with menopause.
Finally, there could be other things going on in your life which have you feeling depressed. Perhaps your adult children have recently moved out. Maybe you just retired from your career and do not know what to do with yourself. Perhaps you have had to downsize to a less expensive house because you cannot find a job. Maybe you still haven’t achieved what you hoped you would by this point in your life. Any of these could have you feeling depressed.
Practical Solutions for Dealing with Depression During Menopause
So now you know some of the factors which might contribute to menopausal depression. Different causes call for different solutions. Let’s take a problem-solution approach.
Problem: The symptoms of menopause are (quite literally) a pain.
Solution: There are a lot of individual ideas for treating the slew of physiological symptoms which can crop during menopause. The exact approach to take depends on the specific symptoms you are manifesting. Here are some articles where I’ve provided in-depth suggestions for different symptoms:
- Menopause Bloating: How to Stop Bloating from Menopause and Shed Excess Water Weight
- How to Address Post Menopausal Hair Loss
- 7 Methods for Immediate Relief of Severe Hot Flashes
If you are looking for a way to treat many symptoms of menopause simultaneously, a great approach is to take a supplement for menopause which contains vitamins, minerals and herbs that balance your hormones. This is a gentler approach than hormone replacement therapy (HRT), but it can be very effective.
Problem: You could be losing out on valuable sleep.
Solution: HRT has been found to be effective in improving sleep for postmenopausal women. This means that the herbal approach of balancing your hormones may help treat your sleep issues as well. You can also try an herbal supplement formulated to help restore sleep duration and quality.
Problem: You may be struggling with low self-concept.
Solution: This is a tough one, since you and you alone can hold together your own self-concept. One thing you can do is look for the things that haven’t changed, and make those more central to your identity than those which have changed.
It is also important to remember that menopause is not just an ending—it is also a beginning. Instead of focusing wholly on the past and what you have lost, look to the future and ask yourself if you can become something new. While it may sound trite, maybe it really is time for the caterpillar to become a butterfly.
Problem: You may be dealing with poor social support.
Solution: This is another tough issue, because there is only so much you can do about it. You cannot force society to recognize you as a valuable, contributing member, and that is a painful reality you will have to deal with.
As to the people close to you, those who say they care about you owe you their support. Do what you can to help them understand your difficulties. Hopefully they will come around. If you still are not finding the support you need, this may be a sign that you need to search for new connections.
Problem: It is possible you might have other health conditions.
Solution: The only way to deal with this is to confront the issue directly. If you haven’t yet, visit a doctor’s office and find out what your treatment options are. Hopefully you will be able to cure or manage your health condition. The sooner you take action, the more likely it is you will have a positive outcome.
Problem: Age or death may be worrying you.
Solution: Rather like the self-concept issue, there are no easy answers here. You can work on reframing your concepts of both and getting away from negative cultural perceptions, but that alone probably will not be enough.
Ultimately, you will need to learn to live with the fact that mortality is inevitable. The answer to how you can do that is going to be highly individual, because it is largely a question of how you are going to fill your life with meaning which is specific to you. If you do need help along the way, it may be useful to schedule an appointment with a therapist.
Problem: You may be upset about losing your fertility.
Solution: If you are still in perimenopause and would like to have children, you should consult with a fertility specialist. There are things you can do to increase your chances of getting pregnant. You also might think about freezing some of your eggs if you are not ready yet.
If that window has passed, this is another situation where speaking with a therapist would probably be very helpful. This is a matter which directly involves your self-concept, and there is of course no way to restore your fertility. So you will need to find a way to be at peace with that.
Problem: You could be having issues with sexuality.
Solution: This is a topic which I have actually gotten into in-depth in other articles. I recommend starting with Menopause & Sex: How Menopause Affects Sexuality. Here I take the same problem-solution format and provide tips for dealing with low libido, vaginal dryness, loss of interest in sex, and other issues which may arise. You can also read 4 Tips for Better Sex During Menopause.
Problem: Other life changes could be going on concurrently with menopause.
Solution: The solutions for dealing with other life changes are as diverse as the issues which you may be dealing with. So the approach you take here will depend on your individual situation.
Say for example you just retired, and you are depressed because you have lost your daily routine and you have no idea how to fill the hours. With this situation, you need to find something to be passionate about, and discover meaning outside of work.
If your children have just left home, you likewise are facing a big change in your daily routines. You may once again need to discover something else to provide you with meaning and satisfaction. Alternately, perhaps it is time to think about adoption.
Whatever problems or challenges are confronting you, you need to face them, or you will continue to feel depressed, even after menopause.
Conclusion: Depression During Menopause is Hard to Deal With, But There Is a Lot You Can Do About It Right Now
The good news is that unless you are clinically and chronically depressed, there is a good chance that your psychological symptoms will eventually abate and you will go back to life as usual.
According to this study, “Depressive symptoms as assessed herein increased during transition to menopause and decreased in postmenopausal women.”
So this too shall pass—so long as you take an active role in dealing with it. You now know that depression during menopause is likely not a result of hormonal changes. If they do play a role, it is probably a minor one.
That means that you need to look at other aspects of your health and life and try and figure out what is causing you to feel down. Once you identify the factors, you can take action to improve your circumstances and start feeling better.