Depression or the ‘menopause blues’ can be one of the more common symptoms of perimenopause and menopause. It may be that rather than just feeling sad all of the time your mood is up and down like a rollercoaster. You are not losing your marbles this really is because your hormones are also on a rollercoaster ride of their own,
On top of that feeling wobbly about sex, body image, getting older, being on your own can also cause us to spiral. We are 10 times more likely to suffer from depression if we sleep poorly, have a history of depression and smoke or drink alcohol.
Chronic stress (which of course is linked to poor sleep and alcohol reliance- a vicious cycle) and low levels of nutrients such as iron, B9 and B12 can also contribute. Therefore trying to get to the bottom of why you feel depressed can be really important in order to get control back and get well.
The symptoms of depression are varied and include:
- Persistent feelings of sadness, hopelessness or irritability
- Angry outbursts
- Low appetite or overeating
- Oversleeping, inability to get to sleep or stay asleep
- Overwhelming fatigue and lack of motivation
- Loss of interest in activities previously enjoyed
- Difficulty making decisions and absorbing information
- Thoughts of suicide
- unexplained physical pain
Types of depression
Many of us may have a ‘depressed mood’ whereby we experience a feeling of sadness that comes and goes. This is perfectly normal and rarely requires treatment as it will pass over us like a wave and we just need to ride it out. Depression can also be a ‘symptom’ because of a medical, nutritional or life situation such as a low functioning thyroid, medication side effects, low ostrogen, low B12, iron, vitamin D, divorce, loss of a job, COVID stress, bereavement etc. Again this is usually over a short period and can be managed with diet and lifestyle changes, herbs and supplements and counselling. Occasionally (without support) it can develop to what is known as ‘clinical depression’ which is when there is a known chemical imbalance or brain inflammation, that affects the ability to live and function normally and medical treatment is usually required.
The connection between depression and hormones
The connection between mood and hormones is clear – when oestrogen declines so does serotonin (our happy hormone). Because oestrogen doesn’t necessarily steadily decline but rather is up and down and up and down, it explains why one minute you are jolly and the next minute you are weeping, one minute you are laughing and the next minute you want to rip someone’s head off. Plus if you are having night sweats and not sleeping, if you are stressed because of work, family, Covid, money etc and cortisol is through the roof, and you are drinking red wine every night just to get through the day then you will undoubtedly be suffering even more.
However you experience the menopause blues – whether it is a fleeting moment or full blown depression. You do NOT have to suffer on your own and help is absolutely available to you. If you are really struggling to cope then first and foremost you MUST see your GP and get help.
One of my frustrations is that anti-depressants are routinely given to women experiencing the menopause when women are not depressed. Ironically, one of the side effects of anti-depressants can be depression and even suicidal thoughts. So please be aware of this if you are on anti-depressants and feel depressed. You need to discuss this with your GP. I am not an advocate of anti-depressants unless absolutely necessary, and if you are struggling to get through the day then this is where they may be vital for you to get your life back. Also, if you are suffering from depression then low dose oestrogen may also be necessary as a last resort. Whether you take medications is always a toss up between the benefits and the risks. Sometimes the risks are just worth it in order to feel normal again.
For more mild or moderate depression then there is so much that we can do:
- Get blood tests to rule out other reasons for the depression – check the function of your thyroid by getting a TSH test, check that you are not deficient in Iron, B9, B12 and Vitamin D. For some stupid reason some GP’s won’t test for vitamin D unless you live Invercargill – if this is the case then you can order a blood test yourself from https://mytests.labtests.co.nz/. There is some strong research showing the link between low amounts of vitamin D and depression (the research shows that low vitamin D levels may cause depression not that vitamin D supplements can treat depression).
- Exercise is absolutely crucial – exercise increases the release of endorphins which make us feel good and it also increases the production of new nerve cells improving brain function. Some studies have shown that sustained exercise was just as effective if not more effective than anti- depressants in mild to moderate depression.
- Get a good night’s sleep – turn off those devices a couple of hours before bed, have a warm shower or bath or foot bath, drink a relaxing herbal tea and create a bedtime routine.
- Reduce alcohol and smoking. There is nothing good about smoking! End of! Whilst I love a good tipple myself, drinking alcohol will stop you getting a deep sleep so it might be that you have to reduce or even abstain from drinking until your depression lifts. If you are using alcohol as a form of stress management then get support because there are other far more effective ways to do this.
- Relaxation and Stress Resilience is key here. Whatever works for you. Find the time to chill out and find your joy (easier said than done when you are depressed). Massage, yoga, reading, music, dancing, breathing techniques, gardening, painting…whatever floats your boat – do it. You have to put yourself first – it’s not selfish, it’s necessary! Mindfulness and meditative practices can be fantastic but you must be careful – don’t meditate using Dr Google. Instead get proper support from a qualified yoga or meditation teacher as some meditation techniques can make depression worse.
- Cognitive Behavioural Therapy has been shown time and time again to be fantastic for depression. It is a talking therapy whereby you become aware of your thoughts in order to change your emotions. Thoughts create emotions and emotions are energy. By changing your thoughts you change your emotions and thereby change your decisions, actions and outcomes.
- Journaling can be a useful tool for mild depression to catch those thoughts and then change them. For many people journaling can be a really insightful and helpful tool to dig a little deeper as to why you think and feel the way you do.
- Diet is massive – if you eat crap food, you are going to feel crap. If you are eating foods that are inflammatory (basically processed, high fat, high sugar foods – you know the ones I mean 🙂 and/or if you are eating foods that you may be intolerant to (dairy, gluten, eggs, anything with colours and numbers are the most common) then you can end up with a ‘leaky gut’ which means that some substances are absorbed (when normally they wouldn’t be) and end up in your bloodstream. These can cause an immune reaction, sometimes certain inflammatory substances can end up in the brain causing inflammation which may be another cause of depression. A recent study in 2019 showed a link between suicidal thoughts and inflammation (1)
- Herbs can help – St.John’s Wort and Saffron are 2 of the most commonly used herbs for depression. St John’s Wort is probably the most researched herb to date and the research on its effectiveness for depression is outstanding. The problem is that it interacts with so many other medications. Please do not take St John’s Wort if you are on ANY medications (including the contraceptive pill), get advice from a naturopath or herbalist (not a bloody pharmacist or doctor or Google). Saffron has also been shown to be as effective as the anti-depressants (imipramine and fluoxetine) (3, 4 )
Please get professional advice before you take herbs and don’t swap anti-depressants for herbs without speaking to your doctor first.
- Counselling or Coaching support – You are not on your own, please reach out and get support. Postpone any important decisions until the depression has gone or is at least well managed, Break down larger tasks into smaller tasks to try and prevent overwhelm. Try not to isolate yourself – try to participate in something that will get you out of your head and into your body, This is especially important if you are feeling lonely and/or your depression is exacerbated by divorce, separation or ‘empty nest syndrome.’ Give it time – be kind to yourself, it can be frustrating but just know it will pass like a wave. Some great organisations’ to contact include: https://depression.org.nz/ and https://loneliness.org.nz/
Shout out if you need support or help. We are here for you xxx
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