Coping With Depression During Perimenopause
Afra Willmore and counselor Eric Patterson discuss the prevalence of depression in perimenopause and how to manage it.
Afra’s Advice for Depression During Perimenopause
Depression at any time of life can be difficult, but if it hits during the early stages of menopause (perimenopause) it can be devastating, especially to women who may already be anxious about what the future holds.
General advice for depression often focuses on getting out and about, eating healthily, increasing exercise levels and maintaining good relationships with friends and family who can support you. But the hormone fluctuations during perimenopause often cause a loss of confidence, physical changes and psychological symptoms which can affect your ability to manage these simple lifestyle changes.
Take exercise for instance. The onset of the menopause can cause sleep issues, feelings of exhaustion, mental and physical fatigue. Motivating yourself to go to an evening fitness class or an early morning gym session might be almost impossible.
It’s a good idea to firstly get checked out by a doctor to make absolutely sure that your extreme tiredness is not being caused by an undiagnosed health condition or vitamin or mineral deficiency.
Some clinics offer a “well woman" check, which is basically a check of your overall health and fitness. They usually focus on preventative measures to avoid future health issues, but the doctors and nurses carrying out the checks should be able to listen to concerns about any current issues and advise you how to proceed further.
Increase Energy to Prevent Depression
If you get the all clear health-wise, try some simple changes to increase energy. Make sure you eat healthily, cut down on caffeinated drinks and avoid altogether at least an hour before bed and aim to get between seven and nine hours sleep each night.
Getting a Better Sleep
Make sure your bedroom is not too hot or cold, wear nightclothes made from natural fabrics to cut down on night sweats if they are waking you up, and try to leave your stresses at the bedroom door — some people find writing them down before bedtime helps!
It might be tempting to have a glass or two of something alcoholic to help you relax, cheer up or get to sleep, but be wary of becoming reliant on this. If you have concerns that you cannot cope without drinking alcohol, speak to your doctor.
Talk It Out
Now you might have heard the saying “a problem shared is a problem halved."
Sharing feelings and worries is often extremely beneficial to people suffering from anxiety, stress and depression no matter what stage of life it strikes.
Although a professional counselor is your best recourse, it may be that talking over your problems and feelings with the people in your circle might also have a positive effect.
Think about who you trust — maybe your partner or a close relative. Maybe you have a religious or spiritual leader who you could chat with, a neighbor or a close friend.
Usually what helps is an empathetic ear from someone who won’t judge or even necessarily give advice.
Even just a coffee with a friend talking about anything but your stress can help — lifting your mood and distracting you from your depression. It might only work briefly, but at least it will demonstrate that you can feel happy.
Talking to friends is fine if you find it relieves some of the stress or lifts your mood. However, if you feel at any time that you want to harm yourself or that you don’t want to carry on living, seek emergency professional help immediately.
Mental Health and Exercise
What about exercising with menopause? It’s common knowledge that exercise produces “feel good" chemicals in the body. Once again, it might be worth calling on your friends and/or family to help motivate you when you just feel like hibernating at home.
Even planning and enjoying a brisk daily walk will help, and if you can combine that with a nice chat with a pal, you might soon feel brighter.
Challenge yourself to improve your time or distance walked or run. Many women find that, freed from many of the responsibilities of a very young family, they have more time for themselves and end up enjoying exercise instead of feeling it’s a chore to be squeezed in around grocery shopping and taxiing kids about.
Join a class and you might even make some new friends! You don’t have to go high-impact — activities like Tai Chi or yoga may help with your mental and physical wellbeing.
Delve Into a Hobby
If exercise really isn’t your thing, think about taking up a new hobby or rediscovering a past love. No, not the guy from high school — something like art, or music or crafts.
All of these things can prove stress busting, and the joy and satisfaction you gain from them might be enough to get you through perimenopausal depression.
What If All This Isn’t Enough?
The key to happiness is often as simple as making time for yourself and things you enjoy — whether that’s rock-climbing or eating rocky road ice cream occasionally with friends.
Sometimes, though, there isn’t enough yoga, chats or ice cream in the world to lift the darkness. Depression can be caused by a chemical or hormonal imbalance, and it’s absolutely not a sign of failure to accept chemical help to fix it.
Speak to your doctor about medication — they might be able to offer help with sleeping, mood or anxiety. Used alongside non-drug techniques and under close supervision you could soon be back to feeling like yourself.
You might even find your personal and professional relationships improve too, as the people around you realize the person they love and respect is still there for them.
Counselor Eric’s Advice for Menopause and Depression
Menopause is not usually a happy time in a woman’s life. Often, it is a time met with dread, caution, and pessimism.
Through perimenopause (the time with more variability in your hormones and less consistency in your menstruation) you will face new challenges. You will feel uncomfortable physically. Unfortunately, this unease will try to spread into your mental health as well.
People experiencing symptoms of perimenopause regularly report increased mental health signs and symptoms related to anxiety and depression. This does not mean you must succumb to these conditions, though.
This is your chance to learn about the connections between your physical health and your mental health. This is your chance to practice prevention to maintain your mood.
Physical Health Contributors
To win a battle, you must know your opponent. Perimenopause is sneaky because it does not directly cause depression; instead, it can trigger the onset of several symptoms that are linked to depression.
For example, perimenopause is associated with sleeping problems from hot flashes and overall discomfort at night, lower self-esteem from a changing body image and weight gain, and mood changes from surging hormones. Individually, these symptoms would not equate to depression, but together they push you towards depression.
Furthermore, the physiological changes of perimenopause often create higher levels of stress. When stress is higher, any task can be more time-consuming, more arduous, and more frustrating. Added distress can result in problems like:
- Changing appetite
- Low levels of energy and motivation
- Increased anxiety
- Reduced attention and concentration levels
- Higher irritability
Social Health and Situational Contributors
Beyond the physical changes directly caused by menopause, there are other life changes that occur during the time of perimenopause. These issues will add another layer of stress that nudge you closer to depression.
The social and situations contributors of depression include:
- Aging parents that may die or require special assistance.
- Children leaving home and empty-nest syndrome, meaning your responsibilities in within the home are changing.
- Changing relationship status and/or the lower sexual interest that usually accompanies perimenopause.
- Transitions with work if you choose to reinvest in your work or move in new direction due to changing needs at home.
- Changing social relationships.
All of these changes affect your identity. It can be easy to lose track of yourself, your needs, and your goals. With uncertain self-esteem, depression will move in with new intensity.
Mood Boosters
As depression continues to emerge, you will be well served to take active measures to prevent its progression. Since you will not be able to stop the course of menopause, you can take steps to preserve and improve your mood, energy, interests, motivations, and self-esteem.
Reinvest In Your Physical Health
The hormonal changes will be largely outside of your control. Your doctor may recommend some treatments, but the rest is up to you.
Maintain your physical health by improving your diet to feed your nutritional needs and increasing your exercise to flood your brain with helpful neurotransmitters. Since sleep is important and greatly affected, try to explore behavioral interventions like ice packs to achieve more comfortable, restful sleep.
Refine Your Relationships
As noted, your relationships are vulnerable during perimenopause. The relationships with your parents, children, spouse, and friendships may suffer from the added stresses of menopause.
You may gain new relationships from a return to work or lose relationships from your decision to change your career. At this point, it is valuable to take an inventory of your relationships to see which ones need extra care to flourish and which ones should no longer survive.
Focus your energy on relationships that are high quality rather than a higher quantity of relationships.
Reimagine Your Identity
Quite literally, menopause marks the end — the end of your menstruation and the end of your former self. This ending can strip away your identity as it strips away your self-esteem.
This can lead to isolation, and as you no longer know who you are and what you enjoy. There is another option, though. You can instead choose to rediscover, reinvent, and reimage your identity.
You can continue with characteristics that give you pride and satisfaction as you foster new interests and attributes.
Redefine Fun
Part of your new identity will involve deciding what you like and what you don’t like to do for fun. Do you like going to the movies after a quiet dinner at home, or do you like to skydive after launching yourself over a flaming school bus on a dirt bike?
Just because you spent so much time doing certain activities does not mean that you must continue unchanged. Since so many changes are coming with perimenopause, this is the perfect opportunity to redefine your ideas of fun.
Is It Depression?
It may be challenging to differentiate depression from sadness, but it will be an important distinction for you to make. There is danger in overestimating and underestimating your feelings that could lead to unwanted experiences and reactions.
Major depressive disorder is a clinically diagnosable condition that is marked by someone experiences at least five symptoms of depression more often than not for at least two weeks. Depression is a serious condition that can only be diagnosed by a mental health professional.
From there, your mental health expert can recommend treatment options that can improve your menopause-related depression through a series of therapeutic interventions and/or the use of medications. Either one or both combined can do much to aid your recovery.
The link between depression and menopause may not be apparent at first, but menopause’s effect on your physical health and the social health transitions contribute to mood disturbances that can build to depression. Understand what you are up against and decide to retaliate.
You cannot stop menopause, but you can limit the reach of its negative influence. You can be happy with menopause!