How to Cope With Perimenopausal Depression

Twice as many women as men will experience some form of depression in their lifetime, the Centers for Disease Control and Prevention (CDC) reports. The transition to menopause—known as perimenopause and marked by one full year without menstruation—is a common time for depression to manifest.

Research shows that depression can occur during perimenopause, in part, due to fluctuating levels of ovarian hormones, with declining estrogen levels being the biggest culprit. Yet, perimenopausal depression is still an underrecognized issue in the medical field, making it all the more important to identify the signs. Typical signs of depression may include, but are not limited to, two or more weeks of feeling depressed or down, disruption in sleep patterns, lack of interest or pleasure in formerly enjoyed activities, and, in some cases, thoughts of suicide.

The North American Menopause Society reported that women who struggled with severe PMS in their adolescent years may experience stronger mood swings during perimenopause than those who didn’t.

While other big life changes—children leaving the home, career changes, personal struggles—can be factors in increased feelings of depression, it is important to talk to your doctor if you notice any symptoms. Your doctor may prescribe a low-dose oral contraceptive to adjust estrogen and progesterone levels, but you have control over a number of lifestyle changes and activities that can help alleviate feelings of depression.

Get back to nurture & nature

Prioritize social interactions, in a safe and healthy way given the COVID-19 pandemic. It may come as no surprise that socialization helps lift spirits. Limiting the number of in-person social interactions can nearly double the risk for depression in older adults.

Human beings are hardwired to crave social connection—and time in the outdoors. A relatively new field called ecotherapy, or nature therapy, claims that time spent in nature positively affects moods. The benefits of spending quality time surrounded by nature include a reduction in stress, anxiety and depression, according to Harvard Men’s Health Watch.

Of course, making time to enjoy nature, taking a long walk or even sitting quietly in a park can boost mood and overall mental health for people of all ages.

Limit screen time

Social media and breaking news are always at our fingertips. But be mindful of excessive time spent online; perhaps try to limit your news or social media intake to just 30 minutes per day.

Gazing at a screen prior to bed can alter sleep patterns, particularly if you’re immersed in something stressful. Many women already struggle with insomnia during perimenopause, so adding calming pre-bed routines such as meditation or reading a book—one with covers and paper pages—can help.

Other good sleep habits include going to bed and rising at consistent times, and avoiding meals, caffeine and alcohol just before bedtime.

Practice gratitude

Practice self-love and gratitude with a daily gratitude journal or a meditation challenge. While it might seem simple, make time to start your day with an act that gives you joy: a good cup of coffee or tea, perhaps a look through an old photo album, or time spent reading a favorite book. Simple, small acts and safe, regular routines have been shown to help fight mild depression and anxiety.

In the end, finding new and creative ways to regulate and soothe the body and mind during this natural transition into menopause might be your best medicine.

If you need help, call the National Suicide Prevention Lifeline (Lifeline) at 800-273-TALK (8255), or text the Crisis Text Line (text HOME to 741741). Both services are free and available 24 hours a day, seven days a week.