Perimenopause is the reproductive stage before menopause. During perimenopause, the body decreases the amount of estrogen it produces, leading up to a cessation of menstruation. As a result, perimenopausal women can develop depression, which the Cleveland Clinic notes can occur during menopause as well. Perimenopausal depression causes mood and behavioral changes that may require psychotherapy or medication.
Time Frame
The Cleveland Clinic explains that perimenopause occurs eight to 10 years before menopause. Barbara L. Parry, MD, author of "The American Journal of Psychiatry" article "Perimenopausal Depression," explains that women with perimenopausal depression start showing signs of depression between the ages of 45 and 49.
Prevalence
Parry notes that more than a third of women have their first depressive symptoms while perimenopausal. The author adds that 75 percent of perimenopausal women have mood changes and sleep problems.
Signs and Symptoms
Perimenopausal depression can affect women's moods and behavior. For example, perimenopausal depression can cause a low mood, feelings of hopelessness and problems with concentration. Depressed women can lose interest in activities they enjoy, which can result in social isolation. Sleep disturbances can occur. Helpguide.org notes that depression can cause women to sleep more or less than usual. The changes in sleep can result in a lack of energy. Perimenopausal depression can also cause changes in appetite and weight. For example, some depressed women may eat more than they regularly do, which can result in weight gain. Severe perimenopausal depression can cause suicidal thoughts in some women. Parry points out that the risk of suicide increases in women when they are between the ages of 45 and 64.
Diagnosis
When diagnosing perimenopausal depression, doctors may give women a questionnaire in which they rate their own moods and behaviors. For example, Misty Richards et al., authors of "The American Journal of Psychiatry" article "Premenstrual Symptoms and Perimenopausal Depression," explain that doctors may give patients a Daily Rating Form, which asks questions about their mood, anxiety, sleep, sexual interest, appetite, concentration and energy levels. This questionnaire provides doctors with insight on how patients view their symptoms. To test if a woman is perimenopausal, doctors will do a laboratory test, such as a measurement of follicle-stimulating hormone, which helps control the menstrual cycle. Doctors may also use other depression diagnostics, such as the Beck Depression Inventory.
Coping
The Cleveland Clinic points out that several techniques can help women cope with the signs and symptoms of perimenopausal depression. For example, women can use relaxation techniques, such as yoga and meditation. Having a strong support system and participating in hobbies can help with the social isolation. Other lifestyle coping methods include eating healthy foods and exercising regularly. Some women may need antidepressants, which are a type of medication that alters neurotransmitters and improves mood. Another option is psychotherapy in which patients talk to a therapist and work on ways to deal with the depression.
References
- Cleveland Clinic: Perimenopause, Menopause and Depression
- "The American Journal of Psychiatry"; Perimenopausal Depression; Barbara L. Parry, MD; January 2008
- "The American Journal of Psychiatry"; Premenstrual Symptoms and Perimenopausal Depression; Misty Richards, BSc, David R. Rubinow, MD, Robert C. Daly, MD, and Peter J. Schmidt, MD; January 2006
- Helpguide.org: Depression in Women -- Causes, Symptoms and Treatment
