Does menopause or premenstrual syndrome (P.M.S.) cause depression?
Premenstrual Syndrome is a very common condition that occurs seven to fourteen days prior to the onset of a menstrual period due to the hormonal change that takes place during that interval. It has both physical and psychological symptoms that usually clear when the period starts. Up to to ten percent of women have P.M.S. mood changes severe enough to greatly interfere with their lives. Many women become profoundly depressed during the P.M.S. days. No one is certain why this is so, but some researchers have suspected that changing estrogen levels may affect the serotonin levels in the brain which control mood.
Menopause has always been blamed for causing depression and has been unkindly referred to as "mental pause." This is not so. It is not mandatory to become emotionally unstable at menopause.
There is no question that mood is affected by the hormonal fluctuations of menopause and of normal menstrual periods. These fluctuations won't however, actually cause a chemical depression. In my observation, menopause and P.M.S. tend to magnify the symptoms of a preexisting underlying depression. If for example, a woman has been suffering with a mild undiagnosed depression or dysthymia for many years, the hormonal change at menopause or during her P.M.S. days, may magnify her depressive symptoms to the point where she wants treatment. The menopause or menstrual cycle was not the actual cause of the depression but it aggravated the condition enough to expose it.
When women go to their doctors complaining of menopausal and depressive symptoms, they usually get treated for only the menopausal symptoms or cyclic bloating and the underlying depression is missed. It is important to treat both the menopausal and depression symptoms separately. They are both legitimate biochemical, treatable conditions. Both menopausal and P.M.S. depressions respond well to antidepressants.
There are other circumstances taking place in a menopausal woman's life that can aggravate her mood and which have nothing to do with her hormonal status. She likely has teenagers who may be already exhibiting symptoms of mild depression which they inherited from her. This will greatly increase her stress levels.
She may also be married to a man who is himself struggling with an undiagnosed depression and being a man, would never go for help. He would far rather blame his emotions on his wife's menopause. A woman in menopause is always a convenient target for a depressed man in denial who is going through is own "mid life crisis."
The text of this section contains excerpts from "Healthy Moods".
Illustrations by Rev. Jim Keddy
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