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Menopause & Depression: Connections, Signs, & How to Cope

Published: April 21, 2022 Updated: November 25, 2022
Published: 04/21/2022 Updated: 11/25/2022
Headshot of Iris Waichler MSW, LCSW
Written by:

Iris Waichler

MSW, LCSW
Headshot of Naveed Saleh, MD, MS
Reviewed by:

Naveed Saleh

MD, MS
  • Is There a Link Between Menopause and Depression?Connection
  • Can Menopause Cause Depression?Cause
  • Signs of Depression During MenopauseSigns
  • If You’ve Been Diagnosed with Depression in the PastPrevious Depression
  • Menopause Depression TreatmentTreatment
  • When to Seek Help for Depression and MenopauseGet Help
  • Natural Remedies for Menopause DepressionNatural Remedies
  • Final Thoughts on Dealing With Menopause & DepressionConclusion
  • Additional ResourcesResources
Headshot of Iris Waichler MSW, LCSW
Written by:

Iris Waichler

MSW, LCSW
Headshot of Naveed Saleh, MD, MS
Reviewed by:

Naveed Saleh

MD, MS

Depression is one of the most frequent mood disorders that women can experience during menopause. This is especially true for women with a history of depression. Psychotherapy and medication management are common treatment options that offer successful outcomes for menopausal depression.

Is There a Link Between Menopause and Depression?

There is a direct relationship between menopause and depression. Falling estrogen and progesterone levels can trigger mood swings that make you less able to cope with stress.1 Hormonal dips can also set off a depressive episode. Interrupted sleep due to hot flashes also contributes to depression. Additionally, menopause occurs during midlife, a time when women experience loss and stress. The accumulation of life changes can fuel symptoms.

Find a supportive therapist that specializes in life transitions for women. BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

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Can Menopause Cause Depression?

The hormonal changes that happen during menopause, as well as shifts in life stages and potential difficulty sleeping, can lead to a higher risk for depression.

Hormonal Fluctuations

There is a long period of time leading up to menopause that involves substantial hormonal changes, which can impact mood and affect. Given that the menstrual cycle is changing, hormones are fluctuating frequently and rapidly, including brain chemicals such as serotonin. When hormone levels drop, so do brain chemicals, which can lead to feelings of depression and irritability. These hormone changes can also lead to mood swings and it can take time to adjust to this new normal.2

Sleep Problems

During the process of menopause, due to changes in the body and brain, having bouts of sleeplessness and insomnia is common. This is typically due to the temperature shifts women experience, often referred to as hot flashes. The lack of sleep also can lead to deeper feelings of depression.

Life Changes

Menopause typically falls during a particularly stressful point in someone’s life, when they may be balancing caregiving for both children and older parents. When someone is dealing with heavy issues related to parents’ health, children’s lives, career aspirations and their own personal health issues, it can lead to more feelings of depression.

Signs of Depression During Menopause

Experts on women’s health believe that estrogen interacts with chemicals in the brain, ultimately affecting mood. In some women, the decrease in estrogen during the time period surrounding menopause (i.e., perimenopause) may lead to depression.3 In addition to mood swings, signs of menopause depression include reduced energy and ability to concentrate. Researchers note that depressive symptoms may differ due to the woman’s age and specific stage of the menopausal transition.4

Signs and symptoms associated with depression during menopause include:

  • Interrupted sleep (often due to hot flashes)
  • Reduced ability to concentrate or focus
  • Reduced energy
  • Feelings of helplessness
  • Mood swings
  • Ongoing episodes of irritability and anger
  • Feelings of sadness/hopelessness
  • Restlessness
  • Decreased libido
  • Thoughts of self-harm
  • Social isolation

If You’ve Been Diagnosed with Depression in the Past

Those who have experienced depression, including postpartum depression, are at a higher risk of developing menopause depression.1 Another higher risk group is women who have had severe premenstrual syndrome (PMS) or PMDD. Those who had severe PMS when they were younger may have more serious mood swings during perimenopause.2

Does Depression Dissipate Post-Menopause?

When menopause is over, the resulting hormonal imbalance stabilizes. As such, depression and other mood fluctuations tend to stabilize, too. However, if there was a previous diagnosis of depression, there is a higher risk of continued depression. One report concluded that most women transition to menopause without mood disturbance, but perimenopause may represent a more vulnerable time with risk increasing from early to late perimenopause and decreasing postmenopause.4

Help For Depression

Talk Therapy – Get help from a licensed therapist. Betterhelp offers online therapy starting at $60 per week. Get matched With A Therapist


Virtual Psychiatry – Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with top-rated psychiatrists. Take the online assessment and have your first appointment within a week. Free Assessment

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Menopause Depression Treatment

If you experience four or five common symptoms of menopause depression daily for two weeks or more, consider seeing a healthcare professional. Mental health professionals can screen you using tools like the Patient Health Questionnaire-2 (PHQ), which confirms the presence of depressive symptoms, and the PHQ-9, which rules out physical or medical causes for those symptoms.

Here are four treatment options for depression with menopause:

1. Hormone Replacement Therapy (HRT)

This treatment helps stabilize mood swings due to hormonal imbalance. It centers on adjusting estrogen levels and can be done by endocrinologists, internists, family medicine physicians, and obstetrician-gynecologists. HRT has been successful at alleviating symptoms of depression; however, there are risks. Speak to your physician about the pros and cons of HRT to determine whether it’s the best treatment option for you.

2. Medication

If your depression is severe and impacting your ability to function, medication for depression may be used. The recommended medications for depression stemming from menopause are selective serotonin reuptake inhibitors (SSRIs).3 Examples of these include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa). Medications have risks of side effects. It is important to talk with your doctor about the pros and cons of medication to decide what is right for you.

3. Psychotherapy

There are two types of therapy effective for treating depression stemming from menopause. The first is interpersonal therapy, which focuses on strengthening relationships and enhancing communication. Second, cognitive behavioral therapy (CBT) is a short-term therapy that involves associating physical symptoms with thoughts, feelings, and behaviors. It teaches patients to alter negative thoughts and feelings to create positive outcomes.

4. Exercise

Exercise boosts endorphins that can reduce depression and increase your sense of well-being. In addition, it is a way for women with menopause to regain control of a seemingly out of control body.

When to Seek Help for Depression and Menopause

If you notice depressive symptoms emerging and lingering during menopause or perimenopause, discuss your concerns with your primary care physician (PCP) or obstetrician-gynecologist. Describe your symptoms and how they impact your daily life. From there, look for a therapist with experience in women’s health and depression. Consider starting your search with an online therapist directory, making sure the therapist is licensed and certified. Be sure to check the specifics of your insurance coverage for mental health services as well.

7 Natural Remedies for Menopause Depression

Lifestyle changes can improve your quality of life while coping with menopause depression. These techniques are designed to help you regain control over your body and mind during challenging times. Do some research to determine which options feel most comfortable for you.

Here are seven ways to cope with menopause depression:

  1. For mild to moderate depression, consider herbal remedies such as St. John’s Wort. Herbal remedies can interact with many medications, it is important to talk with your doctor or pharmacist before starting any herbal medication to ensure it is safe for you.
  2. Break large tasks into smaller ones, set some priorities, and d o what you can, as you can.
  3. Postpone important decisions until the depression has lifted.2
  4. Practice mindfulness techniques. Yoga, meditation, deep breathing, and guided imagery are excellent coping methods that help you relax and slow down.
  5. Get as much sleep as you can. Make an effort to grab a nap whenever you can.
  6. Be cognizant about connecting with others. Isolation can enhance and perpetuate depression. Try to maintain social interactions with family and friends as much as possible, and be with people who make you feel relaxed. If you have women in your network who are experiencing menopause, reach out for support.
  7. Engage in exercise at a comfortable level, but first, consult with your doctor. Physical activity is a proven stress reducer, which can alleviate depression.

What Can I Do About My Changing Body Image?

It can be difficult to deal with the changes that bodies go through during menopause, such as shifts in body shape and weight distribution. It can feel like you are not in control of your body as you can do everything right and still not have the shape you once had or the shape you want.

Learning to accept who you are the way you are and dig deep into yourself to remember who you are at your core beyond your body image will be important during this time. Finding other people in similar situations and spending time with people who love and support you can also help add more joy to your life. It’s important to try to continue to stay on your journey of self-love during this time and have grace for yourself.

Final Thoughts on Dealing With Menopause & Depression

If you find that menopause depression is altering your relationships, ability to work, or the quality of your life, take action and consult a healthcare professional as soon as possible. Learn as much as you can about depression linked to menopause so you have a better understanding of what is happening and why. Take charge in terms of your self-care, and remember, you’re not alone.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Talk Therapy 

Online-Therapy.com – Get support and guidance from a licensed therapist. Online-Therapy.com provides 45 minute weekly video sessions and unlimited text messaging with your therapist for only $64/week. Get Started

Online Psychiatry

Hims / Hers – If you’re living with anxiety or depression, finding the right medication match may make all the difference. Get FDA approved medication prescribed by your dedicated Hims / Hers Healthcare Provider and delivered right to your door. Plans start at $25 per month (first month). Get Started

Learn Anti-Stress & Relaxation Techniques

Mindfulness.com – Change your life by practicing mindfulness. In a few minutes a day, you can start developing mindfulness and meditation skills. Free Trial

Choosing Therapy Directory 

You can search for therapists by specialty,  experience, insurance, or price, and location. Find a therapist today.

Choosing Therapy partners with leading mental health companies and is compensated for marketing by Online-Therapy, Hims / Hers, and Mindfulness.com

For Further Reading

  • Best Books About Depression
  • Best Self-Help Books for Women
  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov
4 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Jennifer Payne, MD. Can Menopause Cause Depression? Johns Hopkins Medicine. Retrieved from https://www.hopkinsmedicine.org/health/wellness-and-prevention/can-menopause-cause-depression

  • Depression and Menopause. (2021) North American Menopause Society. Retrieved from https://www.menopause.org/for-women/menopauseflashes/mental-health-at-menopause/depression-menopause

  • David A. Khan, MD, Margaret L. Moline, PhD, Ruth W. Ross, MA, Lori. L. Altshuler, MD, Lee S. Cohen, MD. Depression During the Transition to Menopause: A Guide for Patients and Families. Retrieved from https://womensmentalhealth.org/wp-content/uploads/2008/04/menopause_guide.pdf

  • Anita H. Clayton, MD, Philip T. Ninan, MD. (2010) Depression or Menopause? Presentation and Management of Major Depressive Disorder in Perimenopausal and Postmenopausal Women. Primary Care Companion to the Journal of Clinical Psychiatry. 2010;12(1). Doi: 10.4088/PCC.08r00747blu. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882813/

update history

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

  • Originally Published: April 12, 2021
    Original Author: Iris Waichler, LCSW
    Original Reviewer: Naveed Saleh, MD, MS

  • Updated: April 21, 2022
    Author: No Change
    Reviewer: No Change
    Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Added “Can Menopause Cause Depression?” and “What Can I Do About My Changing Body Image?”. New material written by Silvi Saxena, MBA, MSW, LSW, CCTP, OSW-C and reviewed by Dena Westphalen, PharmD.

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Headshot of Iris Waichler MSW, LCSW
Written by:

Iris Waichler

MSW, LCSW
Headshot of Naveed Saleh, MD, MS
Reviewed by:

Naveed Saleh

MD, MS
  • Is There a Link Between Menopause and Depression?Connection
  • Can Menopause Cause Depression?Cause
  • Signs of Depression During MenopauseSigns
  • If You’ve Been Diagnosed with Depression in the PastPrevious Depression
  • Menopause Depression TreatmentTreatment
  • When to Seek Help for Depression and MenopauseGet Help
  • Natural Remedies for Menopause DepressionNatural Remedies
  • Final Thoughts on Dealing With Menopause & DepressionConclusion
  • Additional ResourcesResources
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