Depression and Menopause — Do They Go Hand-in-Hand?

If you’ve been diagnosed with depression during menopause or perimenopause, you’re not alone – and it’s possible you may be at an elevated risk.

While additional studies need to be conducted, some research has demonstrated that women may be more susceptible to depression during the menopause transition, with between 20-40% of women experiencing depressive symptoms during this period of time.¹ Newer research also suggests that those in the perimenopause stage may be at the most elevated risk.²  But does this mean women approaching perimenopause or menopause are destined for a shift or decline in their mental health?

Not exactly.

Here we break down the potential connection, as well as the factors that may increase the risk for developing depression, or depressive symptoms during menopause or perimenopause.

Is There a Correlation Between Menopause and the Onset of Depression?

As women’s health research into this specific area evolves, experts are learning that both perimenopause and menopause are vulnerable times for women to develop depressive symptoms— especially for those who have experienced prior episodes of depression in the past.³

Because of this, it’s more than valid to wonder, “does menopause cause depression?” Fortunately, in this instance, correlation doesn’t equal causation. In other words, while the hormonal and social shifts experienced during menopause may increase the chances for the onset of depression, it’s far too simplified to say menopause or perimenopause is a direct cause.

Similar to most menopause symptoms women experience, the heightened risk for depression may have something to do with underlying and volatile hormonal fluctuations. The same hormones that control your menstrual cycle also influence your levels of serotonin—a well-known hormone that promotes feelings of happiness and well-being.⁴ As hormone levels drop as we enter perimenopause, so does serotonin, leaving many women feeling sad, anxious, and on-edge.⁵ The rollercoaster of ever-changing and then steeply declining estrogen and progesterone levels during menopause may contribute to an increase in overall moodiness and irritability⁶ and perhaps may be responsible for a decreased capacity to cope with daily challenges.

The good news is that although hormonal fluctuations may have an effect on a potential decline in mental health, it’s not a guarantee. In fact, it’s been found that the majority of women make it through menopause without developing a major mood disorder.⁷

In addition to the aforementioned hormonal fluctuations, below we’ll outline some of the potential risk factors that could increase a woman’s chance of developing or triggering underlying depression during menopause or perimenopause.

Risk Factors for Menopause Depression

Entering perimenopause or menopause may increase a woman’s chance of developing depression, but several other risk factors are also involved. Here are a few of the more common ones:

History of Depression

One study of more than 440 perimenopausal women found that those with a prior history of a major mood disorder had a 59% risk level of developing depression during midlife, while those with no history of a major mood disorder carried only a 28% risk.⁸ While some women may experience their first encounter with depression during menopause, most who have bouts of perimenopausal or menopausal depression have experienced it sometime earlier in their lives.^{9, 10}

Relationships and Social Support

Research shows that a lack of social support as well as being widowed, single, or divorced are potential risk factors for developing depression during menopause.¹¹ In one study, women who had experienced the death of a partner, were divorced, or had been separated were twice as likely as married women to have elevated depression scores.¹²

The findings underscore the importance for women to have access to a strong, community-based support network—regardless of marital status—through all ages and stages of life as a way to potentially prevent depression or feelings of excessive lonliness.¹³

Poor Sleep

A night of poor sleep can be a key contributor for moodiness and or mood swings. Consistently interrupted or a routine lack of sleep, however, could be considered a major risk factor in depression— specifically during menopause.¹⁴

In fact, poor sleep is thought to make a person 10 times more likely to become depressed.¹⁵ Considering insomnia and hot flashes are both not uncommon symptoms experienced during menopause, and are often key ingredients for a poor night’s rest, it’s no wonder there may be a correlation between menopause and an increases risk for developing depression.

Fortunately, women can learn how to get better sleep during menopause with simple sleep hygiene hacks, lifestyle tweaks, and relaxation techniques.

Life Challenges

Perimenopause typically begins in your 40s, and for some women in their 30s.¹⁶ This is also a common time for women to experience a myriad of common life stressors and changes such as:¹⁷

• Caring for aging parents
• Career challenges
• Health issues
• Kids leaving the home

These types of stressful life events, coupled with hormonal changes, could potentially and significantly increase a woman’s chance of developing a mood disorder during menopause.¹⁸  

Mental Health and Menopause— Know When to Seek Help

If you’ve been diagnosed with depression, know you don’t have to navigate it alone and many options exist to help you through. The good news is that rates of depression tend to decline during postmenopause, when reproductive hormones, such as estrogen and progesterone, begin to stabilize – however this can be unpredictable if depression has been something you’ve experienced prior to this hormonal transition.¹⁹

If you’re struggling with depression or suspect you may have symptoms of a mood disorder, it’s important to speak to your healthcare provider about what you’re experiencing. A specialist may be able to assess your needs and point you in the right direction for mental health therapy, medication, and other helpful resources.

When properly diagnosed, depression can be successfully managed. You don’t have to suffer through it – and you certainly don’t have to do so alone.

Find additional resources for depression at:

• 9-1-1 or your nearest emergency room if it’s a mental health emergency
• Substance Abuse and Mental Health Services (SAMHSA) National Helpline: Visit online or call 1-800-662-4357
• National Alliance on Mental Illness (NAMI): Visit online, call 1-800-950-6264, or text NAMI to 741741
• National Suicide Prevention Lifeline: Visit online or call 1-800-273-8255
• Psychologytoday.com is also a great resource for finding mental health care providers specific to your needs

Resources

1. https://womensmentalhealth.org/posts/essential-reads-who-is-at-risk-for-depression-during-the-perimenopause/
2. https://www.sciencedirect.com/science/article/pii/S0165032724006438
3. https://journals.lww.com/menopausejournal/Abstract/2018/10000/Guidelines_for_the_evaluation_and_treatment_of.5.aspx
4. https://www.hopkinsmedicine.org/health/wellness-and-prevention/can-menopause-cause-depression#:~:text=Reaching%20menopause%20can%20be%20a,worse%20out%20of%20the%20blue.
5. https://www.hopkinsmedicine.org/health/wellness-and-prevention/can-menopause-cause-depression
6. https://my.clevelandclinic.org/health/diseases/22354-low-estrogen
7. https://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/depression-mood-swings-anxiety
8. https://pubmed.ncbi.nlm.nih.gov/25417760/
9. https://womensmentalhealth.org/posts/essential-reads-who-is-at-risk-for-depression-during-the-perimenopause/
10. https://www.news.harvard.edu/gazette/story/2024/03/menopause-depression-risk-has-been-exaggerated/
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088347/
12. https://pubmed.ncbi.nlm.nih.gov/10232296/
13. https://mentalhealth.bmj.com/content/26/1/e300802
14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910023/#:~:text=These%20research%20findings%20support%20our,of%20developing%20depression%20(28).
15. https://www.hopkinsmedicine.org/health/wellness-and-prevention/can-menopause-cause-depression
16. https://www.mountsinai.org/health-library/report/menopause#:~:text=A%20period%20called%20perimenopause%20usually,women%20ages%2040%20to%2044.
17. https://www.hopkinsmedicine.org/health/wellness-and-prevention/can-menopause-cause-depression
18. https://www.news.harvard.edu/gazette/story/2024/03/menopause-depression-risk-has-been-exaggerated/
19. https://www.hopkinsmedicine.org/health/wellness-and-prevention/can-menopause-cause-depression#:~:text=Reaching%20menopause%20can%20be%20a,worse%20out%20of%20the%20blue.