How to Tell If You Have Menopause Blues or Clinical Depression?

Author: Dr. Manisha Ranjan MBBS, MGO, FGO, DGO

Consultant – Obstetrician & Gynaecologist at Motherhood Hospital Noida Sector 48  

As we all know when a woman reaches her 50’s, the reproductive hormones naturally tend to decline. This not only terminates the period, but also brings about other physical and mental changes. Many people talk of mood changes being a normal part of the change of life or menopause. 

But not only are these hormones related to reproduction, but they also play a role in defining the person’s mood. For many women it may just be the menopause blues but for the rest, it may lead to depression. 

Here’s how to tell if you are experiencing menopause blues or if you have clinical depression. 

Perimenopause Phase

As you enter perimenopause, you may experience mood swings. It may be hard to tell if these are just temporary or symptoms of a more serious mental health problem. While many women go through menopause without experiencing depression, many women will experience depression either as a recurrence of previous depression or for the first time in their lives. Depression can make coping with menopause very difficult or impossible. It may impact relationships, professional, and personal life. 

Make a Menopause Journal

The best way to differentiate a normal menopause from depression is to analyse your mood. It will be ideal for you to start a journal that will help you track your mood, activity level, other menopause symptoms, and menstrual cycle for a period of three to four months. This will be convenient if you decide to talk about your symptoms over with a professional. 

What is Clinical Depression?

Clinical depression, also known as major depressive disorder or unipolar depression is a serious condition characterized by intense sadness or despair that lasts more than two weeks, and that interferes with your daily life. Major depression is typically characterized by symptoms such as sadness, feelings of emptiness, loss of enjoyment of hobbies, work, other activities, weight loss, insomnia, fatigue, loss of appetite  and constant thought of dying. 

Causes of Midlife Depression

There are ample reasons why women in their 40s may experience  depression; it may be biological, situational, or psychological. Factors such as hormonal changes, Response to loss Medical conditions and Drug and alcohol use may contribute to depression. 

Symptoms of depression while going menopause may be common, but they may vary depending on severity. Here’s how you can cope with menopause depression and the menopause blues.

Menopause and Age

Some studies suggest that the age of menopause and depression have found that women with longer reproductive period are likely to not get depressed, reason being longer exposure to estrogen produced by the body.

How to treat Menopausal Depression?

Symptoms of depression during menopause may be the same but they may vary in terms of severity. Try these methods of coping with menopause depression and the menopause blues. 

  •     It’s okay to feel sad or down for a day or two. Even grief following a major loss is normal for up to a year. But if these symptoms persist then it is mandatory to talk to a psychologist or a counselor about your condition.Or alternatively, you may seek  interpersonal or cognitive behavioral therapy as these two therapies have helped a lot of women dealing with depression.
  •     Natural remedies may be an effective way of managing depression for women who experience symptoms that are not so severe. You can try everything from special teas to herbal supplements to keep your symptoms in check.
  •     It is not common for women going through menopause to experience insomnia. Hot flashes and other physical changes can all affect your sleep cycle and eventually your mood. Focus on getting better sleep by meditating which may also improve your mood.
  •     There are several other women out there who are going through menopause and understand what it feels like firsthand. To understand your situation better, read a book on the subject, join a support group, or look up online. 

Menopause or depression symptoms are not uncommon in a woman’s life during this phase, but when these symptoms persist, it might be more than just menopause.

Perimenopause: Age, Stages, Symptoms & Treatment

Author: Dr. Suhasini Inamdar MBBS, MS (OBG)

Consultant – Obstetrician & Gynaecologist at Motherhood Hospital Indiranagar, Bangalore  

What is Perimenopause?

Perimenopause occurs among women during the natural transition period before menopause, when the reproductive functions begin to wane – this is the time when the ovaries reduce the amount of estrogen produced and it lasts till the point when the ovaries stop producing eggs. It normally lasts from around 40 years of age to 55, but in some women it can even start in their mid to late 30s. 

Perimenopause Symptoms

The level of estrogen is uneven during this time and the menstrual cycles become irregular. This means that bleeding could happen twice a month or happen once in two months, and there are cycles when the ovaries may not release an egg. The first sign for a woman who is approaching menopause is when the woman’s menstrual cycle is either infrequent or involves less bleeding. 

The common problems during this period are hot flashes, which is a feeling of intense heat and sweating with rapid heartbeat and usually occurs during the night. Other symptoms are sleep problems, vaginal dryness and mood swings due to the changes in hormone levels. Low estrogen could also lead to frequent vaginal and urinary infections. It is also possible that due to poor tissue tone, she could experience incontinence. This could also lead to psychiatric problems. The bone density also decreases, increasing the risk of osteoporosis – which causes fragile bones. Women could also develop male balding patterns due to the increase in ratio of testosterone as compared to estrogen and this may also lead to them developing extra facial hair. 

Lipid profiles also go haywire during this period and because of the reduced levels of estrogen, it could lead to an increase in LDL – bad cholesterol. Cardiac and cerebral strokes are also very common in perimenopause phase because of poor cholesterol levels. This period of perimenopause is expected to last around 5-10 years. 

Perimenopuse Diagnosis 

It is important for women to keep a track of their periods and the symptoms so that they can discuss it with their doctor. The doctor usually asks to do a test to make sure it is not a thyroid condition which also cases hormonal imbalance. The usual tests are Follicle Stimulating Hormone test. During menopause, the FSH levels increase and estrogen levels decrease. Prolactin levels are also tested to check if they are high, which signals approaching menopause. Anti Mullerian Hormone (AMH) is another test that shows the ovarian reserve and when that is low, it also means she is heading towards menopause.

 The doctor also asks for certain blood tests and scans, to check the thickness of the endometrium. If the woman is not getting periods during perimenopause, the inner lining should not be very thick. If it is thick, they conduct other tests like hysteroscopy and D&C, pap-smear tests to rule out abnormalities like cervical cancer. 

Perimenopuase Treatment and Management 

Once menopause has been confirmed, the doctor may recommend medication and hormone replacement therapies to deal with the symptoms of perimenopause. The person may not necessarily need any treatment if the symptoms are not severe. But, there is a possibility that it may affect the quality of life – it is even possible for daily life to be affected if the symptoms are severe. 

Doctors might recommend psychiatric help for women who are having a difficult time with mood swings and irritability. Women also need to follow some basic lifestyle changes in order to deal with symptoms. For hot flashes, it is recommended that they sleep in a cool and airy place. A change of place during the hot flash may help as will drinking cool water. 

It is important to follow a good and nutritious diet and avoid fried food and sweets. The doctor will also recommend taking vitamins and supplements for getting the required nutrition. It is recommended they avoid or reduce intake of caffeine, alcohol and smoking as these increase the symptoms. Women can use lubricants to manage the problems of vaginal dryness. 

Exercise is a very important part of managing symptoms. It keeps one healthy and delays the problems of aging. Maintaining a positive attitude also helps a lot towards addressing mood swings and mental issues. Perimenopause is a very natural part of life and much of the symptoms can be handled naturally by just following a good lifestyle rather than depending on medications.