Mood disorders are diseases that affect mental health. They are characterised by the prolonged presence of uncomfortable emotions such as sadness, anxiety or even extreme happiness (1). These disorders can happen at any time in life, but during perimenopause and menopause, the risk increases. Significant mood changes may occur due to the decrease in the main female hormones, oestrogen and progesterone during menopause.  

The reduction of hormones is one of many factors that alter the production of serotonin, known as the hormone of happiness. These hormonal changes as well as other factors such as life stresses can predispose women to changes in mood (2). For this reason, women close to menopause may be interested to learn about the most common mood disorders in this stage of life and take care of their mental well-being. 

How Common are Mood Disorders in menopause?

A study has shown that up to 35% of perimenopausal and menopausal women might present with mood disorders (3) and another study has suggested depression is two to four times more likely in women during the menopause transition than in premenopausal women (4). 

There are many different types of mood disorders, but we list here the most common in menopause and perimenopause. In addition, we present their signs, symptoms, and other important characteristics (5). Nevertheless, if you think you are suffering from any of these disorders, we strongly advise you to consult a doctor. 

Depression

It is common for some symptoms of the depressive disorder to manifest when women are close to menopause. Specifically, some women may start suffering from clinical depression or seasonal affective disorder in this period of life. It is also more common for depressive symptoms to appear in women who have already experienced depressive symptoms before menopause (6). It is vital to consider the presence of the following symptoms to know if you should consult a psychiatrist (6): 

• Intense feelings of sadness and hopelessness 

• Changes in appetite with weight gain or weight loss 

• Sleep disturbances, including insomnia or excessive sleep 

• Constant fatigue 

• Trouble concentrating 

• Feelings of guilt or worthlessness 

• Slower movements and thinking 

• Agitation 

• Self-destructive thoughts 

If you are suffering with the symptoms about, please do seek professional support and advice. 

Anxiety or Angst

During the transition to menopause, it is common for symptoms of an anxiety disorder to appear, even in women who previously did not present with these symptoms previously (Hantsoo, 2017). Anxiety often occurs in menopause due to the changes in hormone levels. In addition, exposure to symptoms such as hot flushes or insomnia can lead to increased stress. For these reasons, it is normal for you to feel some of the following symptoms (Chad, 2021):

• Irritability
• Nervousness or a feeling of tension
• Fear for no reason, accompanied or not by a racing heart
• Panic attacks
• Social phobia (fear of interactions with people)
• General distress
• Constant worry

Like any other mood disorder, anxiety may appear alone or together with another type of disorder or symptom.

Other mood disorders

There is some evidence that other disorders, such as bipolar disorder and schizophrenia, are more common during the menopause transition. Bipolar disorder is characterised by outbreaks of emotional disturbances – sadness or exaltation (9). Women who have this disorder may see an increase in symptoms during this phase of life (10). 

Is it Possible to Prevent Mood Disorders?

Although mood disorders have their origin in multiple causes, you can reduce the risk of these diseases by taking care of your mental health. Here we include a series of day-to-day recommendations (11, 12): 

• Exercise regularly. Thirty minutes of physical activity a day is enough to improve your mood. 
• Talk to someone you trust. Remember that you will feel better expressing your concerns and motivations openly. 
• Don’t neglect your sleep. Sleeping well is very important for your mind. Take care of your mind with good sleep hygiene. 
• Avoid harmful substances, such as illicit substances or an excess of alcohol. 
• Eat healthy food and stay hydrated. A balanced diet helps your mind and gives your body energy. 
• Focus on the good. When faced with problems, try to see the positives. 
• Look around you, observe the world, listen to its sounds, enjoy its shapes and colours. 
• Create goals and priorities daily and try to reflect on what you have achieved every day before going to sleep. 
• Do the things you enjoy. Whether that is enjoying a film, taking a walk or spending time with friends. 
• Be grateful for things. Practice gratitude with yourself and with those around you. 
• In addition, there are nutrients such as magnesium, melatonin, or omega 3 that help sleep better and regulate brain functions (13). 

These mental health care tips may help improve symptoms of common menopausal mood disorders that you now know about. But if the symptoms persist, please visit a doctor. 

References

• 1. Mental Disorders [Internet]. World Health Organization; 2022 Jun 8 [cited 2024 Sep 16]. Available from:  https://www.who.int/news-room/fact-sheets/detail/mental-disorders 
  2. Menopause [Internet]. Endocrine Society; 2022 [cited 2024 Sep 16]. Available from: https://www.hormone.org/diseases-and-conditions/menopause/menopause-mood-swings 
  3. Hunter, M., & O’Dea, I. Cognitive Appraisal of the Menopause: The menopause representations questionnaire (MRQ). Psychology, Health, and Medicine; [Internet]. 2001 [cited 2024 Sep 16]. 6(1), 65–76. doi:10.1080/13548500020021937 
  4. Freeman, E.W., Sammel, M.D. Methods in a longitudinal cohort study of late reproductive age women: the Penn Ovarian Aging Study (POAS). Womens Midlife Health [Internet]. 2016 [cited 2024 Sep 16]. 2(1). Available from: https://doi.org/10.1186/s40695-016-0014-2 
  5. Bhatt, N. Menopause and Mood Disorders [Internet]. Medscape; 2021 [cited 2024 Sep 16]. Available from: https://emedicine.medscape.com/article/295382-overview#a1 
  6. Bromberger, J. T., & Epperson. Depression during and after the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease. Obstetrics and Gynecology Clinics of North America [Internet]. 2018 [citado 2024 Sep 16]. 45(4), 663–678. Available from: https://doi.org/10.1016/j.ogc.2018.07.007 
  7. Hantsoo L, Epperson CN. Anxiety Disorders Among Women: A Female Lifespan Approach. Focus [Internet]. American Psychiatric Publishing; 2017 Apr 1 [cited 2024 Sep 16];15(2):162–72. Available from: 10.1176/appi.focus.20160042  
  8. Chand SP, Marwaha R. Anxiety. [Updated 2023 Apr 24]. StatPearls [Internet]. [cited 2024 Sep 16]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470361/ 
  9. Jain A, Mitra P. Bipolar Disorder. [Updated 2023 Feb 20]. StatPearls [Internet]. [cited 2024 Sep 16]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558998/  
  10. Bhatt VN. Menopause and Mood Disorders. [Updated 2023 May 16]. Medscape. [cited 2024 Sep 16]. Available from: https://emedicine.medscape.com/article/295382-overview#a1  
  11. Caring for your Mental Health [Internet]. National Institute of Mental Health (NIMH). 2024 [cited 2024 Sep 16]. Available from: https://www.nimh.nih.gov/health/topics/caring-for-your-mental-health 
  12. 6 Ways to Take Care of Your Mental Health and Well-Being. [Internet]. World Health Organization. 2021 [cited 2024 Sep 16]. Available from: https://www.who.int/samoa/news/detail/07-10-2021-6-ways-to-take-care-of-your-mental-health-and-well-being-this-world-mental-health-day 
  13. St-Onge M-P, Mikic A, Pietrolungo CE. Effects of diet on sleep quality. Adv Nutr [Internet]. 2016;7(5):938–49. [cited 2024 Sep 16]. Available from: https://doi.org/10.3945/an.116.012336