The Estrogen Fix by Mache Seibel

Author:Mache Seibel
Language: eng
Format: epub
Publisher: Rodale
Published: 2017-03-16T04:00:00+00:00

Menopause and Mental Health

A little brain fog and moodiness is common for many menopausal women. For some, however, menopause puts them at an increased risk of more challenging mental health issues. In fact, some of my patients share with me that they feel like they are “losing their minds.” It’s important to recognize if you might be at increased risk of depression. Depression is sometimes described as feeling sad, blue, unhappy, miserable, or down in the dumps. But for some women with a history of severe clinical depression or postpartum depression, the transition into menopause can cause thoughts of harming themselves. If any of those feelings surface for you, tell your health-care provider; estrogen may be your answer, but if not, estrogen plus antidepressants or other treatments can prove lifesaving.

Women who are depressed before menopause, who have had premenstrual or postpartum depression or sexual dysfunction, who are physically inactive, or who have a lot of hot flashes are at more risk of depression as they enter menopause. But women who have not been dealing with any of these issues before they enter perimenopause will overwhelmingly transition into menopause without experiencing severe problems. Still, up to 23 percent of women do report some mood changes, primarily during perimenopause. In fact, in the Harvard Study of Moods and Cycles,52 premenopausal women with no lifetime history of major depression who entered perimenopause were twice as likely to develop significant depressive symptoms as women who remained premenopausal, and women with hot flashes were at even greater risk. That study also found that women who entered the menopausal transition and who were taking some type of hormonal therapy to reduce their menopausal symptoms or to regulate their cycles did have about the same percentage likelihood of feeling sad or experiencing other depressive symptoms, but they had a decreased risk of developing clinical depression compared with women who did not take any type of hormone therapy.

Part of this has to do with gender differences between men’s and women’s perception of emotions. Dr. Mark George, while working at the National Institute of Mental Health, performed PET scans53 on both male and female subjects while asking them to conjure up their saddest memory. PET scans map the flow of blood within the areas of the brain that are active during a given time. To his surprise, the total area of women’s brains that was active during memories of strong emotion was eight times larger than the area of men’s brains. This may be one of the reasons why women are twice as susceptible to depression as men. There are other differences too. According to scientists at McGill University, serotonin production is 53 percent higher in men’s brains than in women’s. Serotonin is a brain chemical that is believed to be lower in people who suffer from depression and is the hormone that drugs like Celexa, Paxil, Prozac, and Zoloft, categorized as selective serotonin reuptake inhibitors, known as SSRIs, increase in the brain. One in four women and one in ten men in America will require treatment for depression at some point.

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