Two new studies, Risk for New Onset of Depression during the Menopausal Transition: the Harvard Study of Moods and Cycles ("General Psychiatry, April, 2006), and Associations of Hormones and Menopausal Status with Depressed Mood in Women with No History of Depression ("Archives of General Psychiatry, April, 2006), have found the transition to menopause to be linked to depression. Both studies implicate hormonal changes as at least partly responsible for the depression.
One study followed 231 Philadelphia women, ages 35-47, for eight years. All were pre-menopausal without history of clinical depression. Over the course of the study, 43 percent began the transition into menopause (perimenopause) which included skipped and irregular periods and changes in menstrual blood flow.
It was discovered that women during perimenopause are four times more likely to report a high number of depressive symptoms than women who are pre-menopausal, and twice as likely as premenopausal women to develop clinical depression. After controlling for the effects of smoking, body mass index (a measure of height-weight ratio), premenstrual syndrome, hot flashes, insomnia, general health, marital and employment status and age, researchers found that depressive symptoms and changes in hormone production were significantly correlated. This study found that the strongest risk factor for depression was a fluctuating level of the female hormone estradiol.
Another study conducted over 6 years was based on telephone interviews and questionnaires answered by 460 Boston women ages 36-45, none of whom had any previous history of clinical depression. Results showed that those who entered perimenopause (70 percent) were nearly twice as likely to develop serious depressive symptoms and clinical depression (regardless of age and stressful events such as divorce and death in the family). The study found that the greatest increased risk was for women who had hot flashes.
Researchers said that hot flashes may raise the risk of depression or that depression may result from the same hormonal changes that cause hot flashes. In this study, hormone replacement had no effect on depressive symptoms in general but did provide some relief for severe depression. The authors of the study hypothesize that by suppressing hot flashes, hormone replacement might at least temporarily improve depression in women undergoing menopause.
Whether hormonally driven or environmentally influenced, most depression is highly treatable. If you are suffering, stop letting depression push you around and spill out onto significant others, co-workers, even acquaintances or strangers. Ask your primary care or mental health professional for help. The first step may be the hardest, but help is readily available.
Peggy Nolen is a licensed professional counselor in Covington. She specializes in recovery from traumatic experience, depression, anxiety and problems with drugs and alcohol. She can be reached at (770) 314-5924.
