You’re not “going crazy”. You’re not weak. And you are definitely not alone.
If your mood has dropped around perimenopause or menopause, it can feel confusing and scary. One day you’re okay, the next you’re crying in the car for no clear reason or feeling completely flat and numb.
Based on our recent survey on Menopause Myths – What Women Really Think!, approximately 68% of women reported experiencing depression during this transitional phase. This significant finding highlights the prevalence of depression among women going through menopause.
Furthermore, the survey data indicates that women over the age of 50 are particularly susceptible to experiencing depressive symptoms. It also showed that menopause’s emotional challenges require more awareness and support for women.
Today, I’m going to share what I know about menopause and depression, including causes, symptoms, and treatment tips.
Important: This article is for education only. It can’t diagnose you or replace medical advice. Always talk to your doctor or mental health professional about any new, worrying, or worsening symptoms.
What is menopause, and why can it affect your mood?
Menopause is the point in time when you haven’t had a period for 12 months in a row. The years around that point are called perimenopause (the lead-up) and postmenopause (after). Your estrogen and progesterone levels start to change, often going up and down before they finally settle at a lower level.
Estrogen doesn’t just control your period. It also affects parts of your brain that handle mood, sleep, and stress. When estrogen levels rise and fall, some women notice mood swings, anxiety, or low mood that feels very different from how they felt before.
The important thing to remember is this: if your mood has changed during this time, you’re not imagining it. The changes in your body are real, and they can be strong. This can help you feel more in charge again by letting you know that.
Key Takeaways: What Should I Know About Menopause and Depression?
- Yes, menopause can raise your risk of depression. Studies show that the perimenopause and early postmenopause years come with a higher risk of depressive symptoms compared to premenopause.
- Hormones are a big part of the story, not the whole story. Falling and fluctuating estrogen levels can affect brain chemicals that control mood, but life stress, sleep problems, and past mental health also matter.
- It’s common, not a character flaw. Large studies show women in menopause can have several times higher odds of depression symptoms than before menopause.
- Help is available. Effective options include talking therapies (like CBT), antidepressant medications when needed, lifestyle changes, and sometimes hormone therapy for menopause-related mood symptoms.
- You should never “just put up with it.” If your mood is low most days, you’ve lost interest in things you used to enjoy, or you’re having dark thoughts, it’s time to talk to a doctor or mental health professional.
- Any thoughts of self-harm are an emergency. Get urgent help from local emergency services, a crisis line, or a trusted doctor straight away. You deserve support now, not “later.”
Is it normal to feel depressed during menopause?
Feeling a bit more emotional, teary, or irritable is very common in perimenopause and menopause. Studies have found that depressive symptoms and even clinical depression are more likely during this transition compared to premenopause.
More recent research also shows that women in menopause can have much higher odds of depression symptoms than before, especially if they already had mental health struggles earlier in life.
So yes, it is common, but that doesn’t mean you should suffer in silence. Common doesn’t mean “nothing can be done.” Common means, “Many women go through this, and there are known ways to help.”
What does “menopause depression” actually feel like?
Menopause-related depression can feel like regular depression, but it may also be mixed with other menopause symptoms like hot flashes, night sweats, brain fog, and tiredness. Common signs include:
- Feeling sad, empty, or hopeless most days
- Losing interest in things you used to enjoy
- Low energy and feeling “heavy” or “slowed down”
- Sleeping too much or not enough (often waking in the night)
- Feeling guilty, useless, or like a burden
- Struggling to focus or make decisions
- Changes in appetite (eating much more or much less)
- Thoughts that life is pointless or that your family would be better without you
You might notice that some days are worse than others, especially if your hot flashes were bad overnight or you didn’t sleep well. You might tell yourself, “I should be able to just push through,” and then feel guilty when you can’t.
Why do falling estrogen levels affect my brain and mood?
Estrogen talks to many chemicals in your brain, including serotonin and dopamine. These chemicals help control mood, motivation, and how you handle stress. When estrogen swings up and down, those brain chemicals can also shift, which may increase your risk of depression and anxiety.
Researchers have followed women over time and found that the menopause transition is a “window of vulnerability” for depression. In some large studies, women in perimenopause had a significantly higher risk of developing new depression than women who hadn’t started the transition yet.
This doesn’t mean every woman will develop depression. It means that if you already have stress, sleep problems, or a history of low mood, the hormone changes can make everything feel louder and harder to manage.
Who is more at risk of depression during menopause?
Any woman can experience depression during menopause, even if she has always felt mentally strong. But research shows some factors that raise the risk:
- A past history of depression, anxiety, postnatal depression, or strong PMS
- Early or premature menopause (before age 40) or sudden menopause, such as after surgery
- Difficult life events (loss, relationship stress, money worries, caring responsibilities)
- Poor sleep from hot flashes and night sweats
- Chronic health problems or long-term pain
- Lack of support or feeling misunderstood by loved ones or doctors.
If you see yourself in this list, it doesn’t mean depression is guaranteed. It simply means you might want to keep a closer eye on your mood and ask for help early, not as a “last resort”.
How do I know if it’s “just hormones” or real depression?
This is a very common question. Hormonal mood swings and clinical depression can look similar, and they can also overlap. Here are some simple ways to think about it:
- Timing: Hormonal mood swings can come and go more quickly. Depression tends to stay for at least two weeks or more.
- Depth: Feeling a bit snappy or teary can be part of a PMS-like mood. Feeling hopeless, empty, or like you can’t see a future is more worrying.
- Impact on your life: If your mood is making it difficult to work, care for yourself, or connect with people, it’s time to talk to a professional.
Doctors and mental health professionals use clear criteria to diagnose depression. They won’t judge you; their job is to help you figure out what’s going on and what might help.If you’re unsure, act as if it is important. You never lose anything by asking for help early. You might save yourself months or years of silent suffering.
READ ALSO: How to Lessen the Psychological Effects of Menopause for Over 50
What treatments can help with menopause-related depression?
There is no “one size fits all”, but there are several proven options. Your doctor will help you choose based on how severe your symptoms are, your medical history, and your personal preferences.
Common treatments include:
Talking therapies
Therapies like cognitive behavioural therapy (CBT) can help you understand your thoughts, manage worry, and build practical coping skills. NICE guidelines and other expert groups recommend CBT as an effective treatment for depression in adults, and menopause-specific CBT can also ease menopause symptoms like hot flashes and sleep issues.
Antidepressant medication
For moderate to severe depression, antidepressants are still considered a key treatment. They can help rebalance brain chemicals and lift mood over time.
NAMS and other expert bodies note that antidepressants remain first-line treatment for clinically significant depression in the menopause transition, even if hormone changes are part of the cause.
Hormone replacement therapy (HRT)
For some women, HRT can help with mood symptoms that are clearly linked to menopause, especially in the perimenopause years.
Recent position statements suggest that for many healthy women under 60 and within about 10 years of menopause, the benefits of HRT (for hot flashes, sleep, and sometimes mood) often outweigh the risks when prescribed correctly.
HRT is not a magic mood cure and is not usually used on its own for major depression, but it can be part of a wider plan that includes therapy, lifestyle changes, and sometimes antidepressants.
What can I do at home to support my mood during menopause?
You deserve proper medical care if you’re depressed. Alongside that, simple daily habits can gently support your brain and body. None of these are “quick fixes”, but they can make a real difference over time:
- Move your body most days. Even 10–20 minutes of walking, stretching, or gentle workouts can help your brain release mood-supporting chemicals and improve sleep.
- Protect your sleep. Keep a regular bedtime, keep devices out of bed, and talk to your doctor if hot flashes or night sweats are waking you often. Sleep and mood are tightly linked.
- Feed your brain. Aim for regular meals with protein, fibre, and healthy fats (like olive oil, nuts, seeds, and fish if you eat it). Avoid long stretches where you don’t eat at all and then grab only sugar.
- Calm your stress system. Simple breathing exercises, gentle yoga, meditation, or quiet time outdoors can help calm your nervous system and soften anxious thoughts.
- Stay connected. Talk to friends, family, or a support group. Sharing what you’re going through reduces shame and breaks the feeling that you are “the only one”.
These are things you can do to help your nervous system land more softly. Not only do they not replace medical care, but they also help your body respond better to all of it.
When should I see a doctor or mental health professional?
Please do not wait until things feel unbearable. It’s a good idea to see your doctor if:
- Your low mood has lasted most days for two weeks or more
- You’ve lost interest in things you normally enjoy
- You’re struggling to manage daily tasks or work
- You feel on edge, panicky, or tearful much of the time
- You’re worried about how you’re coping
Bring notes about your symptoms, how long they’ve lasted, and any other menopause symptoms (like hot flashes, night sweats, period changes, or sleep problems). This helps your doctor see the full picture.
If your doctor doesn’t take your concerns seriously, please try again with someone else if you can. Many women are still told “it’s just stress” when actually they are in perimenopause and need targeted care. You are allowed to ask questions and seek another opinion.
READ ALSO: How You Can Find Balance During Menopause Over 50
What if I’m having very dark thoughts?
Any thoughts like “My family would be better off without me”, “I don’t want to be here”, or ideas about harming yourself are urgent. These are not just “menopause mood swings”.
If you are having these thoughts:
- Please reach out to someone you trust at your earliest convenience.
- Please reach out to your doctor or mental health professional at your earliest convenience.
- If you feel you might act on these thoughts, seek emergency help or a crisis service in your country right now.
You’re not a bother because you need help. You deserve care and safety because you are a person going through a hard time with your health and emotions.
Is there hope that I’ll feel like myself again?
Yes. Many women find that with the right support, their mood improves and they build a new, steadier version of themselves in midlife and beyond.
Research shows that the higher risk of depression is strongest during the transition and early postmenopause years; it does not stay high forever. PMC+1
You are moving through a chapter, not staying stuck in it forever. With treatment, support, and kinder self-care, your brain and body can find a new balance. You are allowed to ask for help, you are allowed to rest, and you are allowed to protect your joy.
What are the treatment options for depression during Menopause
There are several ways to deal with depression during menopause, including:
Medication
Antidepressants like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can help regulate mood and relieve depression symptoms.
Hormone therapy
Hormone therapy, also known as hormone replacement therapy (HRT) or menopausal hormone therapy (MHT), is a medical treatment that uses hormones to supplement or replace the hormones naturally produced by the body.
In some cases, a doctor may suggest hormone therapy to help relieve depression caused by changes in hormones during menopause. Hormone therapy can use estrogen alone or estrogen and progesterone together. These hormones can be given in different ways, such as pills, patches, gels, creams, or vaginal preparations.
But hormone therapy has some risks, so it’s important to talk to your doctor about it to see if it’s right for you. Since it’s usually only given for a short time, it needs to be checked on and followed up on regularly. Before choosing hormone therapy, it’s important to get a thorough evaluation and think about other treatments or changes to your lifestyle.
Alternative therapies
Alternative treatments for depression, such as acupuncture, massage, or herbal supplements, may help some women feel better. But you need to talk to your doctor before trying any alternative treatments to make sure they are safe and effective.
Closing Thoughts
Menopause is a normal transition in a woman’s life, but it is not without its emotional toll. Understanding the signs and symptoms of menopause-related depression is crucial.
The best way to combat the negative effects of menopause on your mental health is to educate yourself on the many factors that contribute to it.
If you’re struggling with depression during menopause, reaching out for emotional support and considering your treatment options can make a world of difference.
Always keep in mind that I’m rooting for you, and there are several resources to help you get through this.
FAQs on Menopause and Depression
If your mood is low most days for two weeks or more, you’ve lost interest in things you used to enjoy, or it’s hard to manage daily life, please talk to a doctor. If you ever have thoughts of harming yourself or feel you can’t stay safe, seek emergency help immediately. You never need to “wait until it gets worse.”
Menopause doesn’t “cause” depression in every woman, but the hormone changes around this time do raise the risk, especially if you’ve had depression, anxiety, or strong PMS in the past. Life stress, sleep problems, and health issues can add to this load and trigger a depressive episode.
Antidepressants are not meant to change who you are. Their job is to help lift the heavy fog of depression so you can feel more like yourself and use your coping skills again. Some people use them short-term; others need them longer. Your doctor will explain benefits, side effects, and how to start or stop safely.
For some women, HRT helps mood symptoms that clearly link to menopause, especially if they also have hot flashes and sleep problems. It’s not usually used alone for major depression, but it can be part of a full plan. Whether it’s right for you depends on your age, health, and risk factors, so it needs a proper medical discussion.
Lifestyle changes like exercise, good sleep, and stress-reduction are powerful supports, but they’re not always enough on their own for clinical depression. Think of them as strong foundations. Many women need a mix of lifestyle steps plus therapy, medication, HRT, or all three. There is no shame in needing medical treatment.
For most women, no. The higher risk of depression is tied to the transition years and early postmenopause. With time and the right treatment, many women feel more stable, grounded, and confident than before. This chapter is challenging, but it is not your final story.
This article was first published in May 12, 2023 and last updated on December 11, 2025.
