Key takeaways:
Mood symptoms are common during menopause, but most people going through menopause don’t develop major depressive disorder.
Menopause is a risk factor for major depression, along with prior depression, a family history of depression, major life changes, and more.
Depression is treatable. And when it’s related to menopause, there may be additional treatment options.
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Menopause is the time in a woman’s life when periods slow down and stop. There are many physical and hormonal changes during this time that can affect mood. Some common symptoms of menopause, such as hot flashes and insomnia, can also affect mood.
Let’s take a closer look at the links between menopause and depression, along with tips for prevention and treatment.
Can menopause cause depression?
It can. But many women go through menopause with no problems at all. After all, menopause is a normal life transition — not a medical condition.
All the same, there’s evidence that some women may be at greater risk of clinical depression in the years before, during, and after menopause. Experts don’t know exactly why this is. Mood changes and depression during menopause may be connected to many different things.
Understanding the link between menopause and depression
Here are some of the ways menopause and depression risk may be connected.
Hormonal changes
During menopause, the body starts to make less progesterone and estrogen. These are hormones that the ovaries make. They control your menstrual cycle and have many different jobs in your body, too.
Anxiety, low mood, and irritability can occur as levels of these hormones start to go down during menopause. And some people may be especially sensitive to these hormone changes, putting them at higher risk for depression.
Disturbed sleep and sleep deprivation
Many people have problems sleeping during menopause. This may be because hormonal changes can cause night sweats and insomnia. And not sleeping well can cause or worsen mental health problems like anxiety or depression.
Major life changes
Stressful life events during menopause can put you at risk for major depression. Common problems include:
Job loss
Divorce
The death of a loved one
Caring for aging parents
Health conditions — like cancer, thyroid problems, and chronic pain — are also linked to depression.
Prior depression
A person’s risk of depression during menopause more than doubles if they’ve had depression before. But not everyone going through menopause experiences depression. In fact, most women don’t. However, mood changes like anxiety, irritability, and low mood during menopause are very common.
Signs and symptoms of depression in menopause
Major depressive disorder (MDD) symptoms during menopause are the same as any other time in your life. MDD can make you feel sad and depressed. It can also affect your thinking and behavior.
To be diagnosed with depression, you need to have at least one of these two symptoms:
Feeling depressed, sad, hopeless, or empty most of the time
Losing interest or enjoyment in almost all activities
Quiz: Am I depressed?
Can perimenopause cause depression?
Yes. For most people, menopause happens naturally in their 40s or 50s.
But hormonal changes can start much earlier — as much as a decade before menopause. This time period before menopause is called perimenopause.
During perimenopause, hormone levels begin to go down. You still get a period, but it might be lighter or more irregular. Many people also start to have menopause symptoms during this time, including mood swings.
And just like during menopause, your risk of depression goes up during perimenopause. In fact, there’s even some evidence that your risk for MDD is at its highest toward the end of perimenopause.
How to overcome depression in menopause
If you’re diagnosed with MDD during menopause, take heart: There are many good treatments that can help. These include:
Antidepressant medications
Lifestyle changes
What is the best antidepressant for menopause-related depression?
The best medication for menopause-related depression depends on many factors. It’s a good idea to talk with a healthcare professional about your medication options.
Medications that may be used to treat menopause-related depression include:
Selective serotonin reuptake inhibitors (SSRIs), such as escitalopram (Lexapro) or paroxetine (Paxil, Brisdelle)
Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor) or desvenlafaxine (Pristiq)
Menopausal hormone therapy, either alone or together with antidepressants
Some of these medications can also help with other menopause symptoms, like hot flashes, sleep problems, and anxiety.
How else can you deal with depression during menopause?
As menopause approaches, there may be lifestyle changes you can make to help your mental health and balance your mood. Here are some things that can potentially help with mood swings and depression:
Regular exercise
Mindfulness practice
Quality sleep
Avoiding tobacco and alcohol
But keep in mind: Though these strategies can be helpful, they aren’t always enough to overcome a diagnosis of MDD. For many people, lifestyle changes work especially well when combined with medication or therapy.
When to get help
It’s never too early to talk with a healthcare professional about your menopause symptoms or mood concerns. As you get closer to menopause, it’s a good idea to start reviewing symptoms to look out for and treatment options for the future. If mood symptoms become frequent and begin to affect your day-to-day life, make sure to discuss this with a healthcare professional.
Frequently asked questions
It’s hard to say. For most people, depression will get better over time. But how quickly it goes away will depend on your symptoms, the severity of your condition, and what type of treatment you receive.
If you’re concerned about depression, talk to a healthcare professional. They can evaluate you for depression, rule out other health conditions, and guide you toward the best treatment.
Yes, anxiety is common before, during, and after menopause. It may affect as many as half of all women.
It’s possible that vitamins or supplements could be helpful for mood during menopause. So far, there's limited research. But some studies suggest possible benefits from vitamin D, pollen extract, and St. John’s wort.
It’s hard to say. For most people, depression will get better over time. But how quickly it goes away will depend on your symptoms, the severity of your condition, and what type of treatment you receive.
If you’re concerned about depression, talk to a healthcare professional. They can evaluate you for depression, rule out other health conditions, and guide you toward the best treatment.
Yes, anxiety is common before, during, and after menopause. It may affect as many as half of all women.
It’s possible that vitamins or supplements could be helpful for mood during menopause. So far, there's limited research. But some studies suggest possible benefits from vitamin D, pollen extract, and St. John’s wort.
The bottom line
Mood changes during menopause are very common. This can be related to hormonal shifts as well as other life circumstances during this time. There are many treatment options for menopause-related depression, including lifestyle changes, therapy, and medication. It’s never too early or too late to have a conversation with a healthcare professional.
Why trust our experts?
References
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Chatterjee, R. (2020). As menopause nears, be aware it can trigger depression and anxiety, too. NPR.
Clayton, A. H., et al. (2010). Depression or menopause? Presentation and management of major depressive disorder in perimenopausal and postmenopausal women. The Primary Care Companion to the Journal of Clinical Psychiatry.
Groumellec, A. L., et al. (1975). [Study of P50 in patients under continuous O2 inhalation and during chronic respiratory acidosis]. Le Poumon et le Coeur.
Let’s Talk Menopause. (n.d.) Menopause & mental health.
MedlinePlus. (n.d.). Depression.
National Institute on Aging. (2021). What is menopause?
The Menopause Society. (n.d.). Mental health.
The Menopause Society. (2024). Feeling depressed as a result of menopause? Hormone therapy may help.
Tolentino, J. C., et al. (2019). DSM-5 criteria and depression severity: Implications for clinical practice. Frontiers in Psychiatry.
Willi, J., et al. (2019). Assessment of perimenopausal depression: A review. Journal of Affective Disorders.
World Health Organization. (2022). Menopause.
