We all know about post-partum depression. But women experience major psychological changes at menopause too. Dr Neelam Suri, senior consultant, obstetrics and gynecology, laproscopic and robotic surgery, Indraprastha Apollo Hospitals, says: “Menopausal depression is indeed a valid concern, although it may present differently than typical depression. The risk of depressive symptoms significantly increases during the perimenopausal phase-the years leading up to menopause-due to dramatic hormonal fluctuations, particularly decline in estrogen. Studies have shown that women transitioning through perimenopause are at elevated risk for the onset or worsening of depressive symptoms, even if they have no prior history of depression. This period is sometimes described as a “window of vulnerability,” as women may be more sensitive to mood changes and mental health issues. While not every woman will experience major depression, the psychological complaints that arise can meaningfully impact quality of life. It’s important to recognise menopausal depression as a unique phenomenon that requires attention and, when necessary, intervention.”
What are the psychological changes during menopause?
Menopause is associated with a spectrum of psychological changes stemming from hormonal shifts and life transitions. Common psychological symptoms include mood swings, irritability, anxiety, depressive feelings, loss of confidence, decreased self-esteem, forgetfulness, and trouble concentrating. Sleep disturbances and fatigue can further exacerbate these issues, creating a cycle that is challenging to break. Memory lapses and cognitive complaints, sometimes described as “brain fog”, are also reported frequently. These symptoms can be compounded by situational stressors, such as changes in family roles, work pressures, and evolving self-image. Many women experience a mix of these psychological symptoms, which may range from mild to severe depending on individual factors, including personal history and support systems. Recognising these changes as part of the menopausal transition is vital for appropriate self-care and seeking support if needed.
What are the key symptoms of menopausal depression?
Signs of menopausal depression can blend with both menopausal symptoms and classic depression. Key indicators include persistent sadness, feelings of hopelessness, loss of interest in usual activities, increased fatigue, changes in appetite or weight, sleep disturbances (including insomnia or oversleeping), impaired concentration, and low self-esteem. Some women report heightened irritability, anxiety, and mood instability. Physical symptoms, such as low energy and poor motivation, can also signal underlying depression. It is common for these symptoms to emerge or intensify during perimenopause, sometimes before other menopausal markers like menstrual changes appear. If these signs persist for more than two weeks, are severe, or interfere with daily functioning, it may suggest clinical depression rather than just a temporary mood dip.
When to see a doctor, and should medicines be taken for it?
You should see a doctor if feelings of sadness, irritability, anxiety, or low motivation persist for several weeks, disrupt daily life, or if you experience suicidal thoughts. Seeking professional help is also recommended when self-care and lifestyle changes don’t alleviate symptoms or if the distress feels overwhelming. A healthcare provider can assess whether the symptoms are primarily due to menopause or other causes and recommend appropriate treatment. Medicines such as antidepressants or hormone therapy may be considered when symptoms are moderate to severe or when quality of life is profoundly affected. Treatment is individualised, and medication isn’t always necessary-talking therapies, lifestyle interventions, and support groups can be effective in many cases. Prompt professional assessment ensures the safest and most effective approach for symptom relief.
Any lifestyle tips to combat menopausal psychological changes?
Lifestyle modifications can play a significant role in alleviating psychological symptoms during menopause. Regular physical activity-like brisk walks or yoga-releases mood-enhancing endorphins and helps manage stress. Maintaining a balanced diet supports overall well-being and stabilises mood. Prioritising restorative sleep, practicing mindfulness, and engaging in relaxation techniques such as meditation or deep breathing can help manage anxiety and irritability. Staying socially connected also combats isolation.
