Mood disorders and menopause

Mood disorders are diseases that affect mental health. They are characterised by the prolonged presence of uncomfortable emotions such as sadness, exaltation, or even both (WHO, 2019). These disorders can happen at any time in life, but during perimenopause and menopause, the risk increases. Significant mood changes occur due to the decrease in the main female hormones, estrogen, and progesterone during menopause. The reduction of hormones adds to other factors that alter the production of serotonin, known as the hormone of happiness. All this predisposes women to changes in mood (Solorzano, 2018). For this reason, every woman close to menopause must learn about the most common mood disorders in this stage of life and take care of their mental health.

How Common are Mood Disorders in menopause?

All affective disorders can be divided into two groups (Sekhon, 2021):

  • Bipolar disorders: characterised by extreme mood swings, ranging from sadness to excitement or moodiness.
  • Depressive disorders: moods accompanied by emotions such as anguish, sadness, or loss of interest.

Both types of disorders can happen during menopause due to hormonal changes. But how common are they? A study has shown that up to 35% of perimenopausal and menopausal women might present with mood disorders (Hunter, 2001).

What are the Most Common Mood Disorders in Menopause?

When referring to mood disorders, whether they are depressive or bipolar, we are not talking about a single type of disorder. These categories can be divided into a long list of conditions, and knowing them all is a complex task that requires expert knowledge. We list here the most common mood disorders in menopause and perimenopause. In addition, we present their signs, symptoms, and other important characteristics (Bhatt, 2021). 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 major 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 (Bromberger, 2018). It is vital to take into account the presence of the following symptoms to know if you should consult a psychiatrist (Bromberger, 2018):

  • 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

The more symptoms you have, the more likely you will suffer from a mood disorder. In this case, you should not self-diagnose but look for 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.

Bipolar Disorder

Bipolar disorder is a mental illness characterised by outbreaks of emotional disturbances, sadness or exaltation (Jain, 2021). It can start in menopause, but it is more common for women who are already experience this disorder to see their symptoms increase during this period of life (Bhatt, 2019). Bipolar disorder consists of two types of conditions: type 1 and type 2. A mental health expert will be able to diagnose and differentiate between the two through the observation of symptoms (Jain, 2021). We leave here a short list of symptoms of bipolar disorder that may occur in menopause (Marsh, 2015):

  • Spontaneous crying
  • Irritability and emotional lability
  • Lack of energy
  • Little motivation
  • Difficulty to focus
  • Sleep that is constantly interrupted

Keep in mind that bipolarity is a severe illness unrelated to having conflicting emotions or opinions. If you think you or a person close to you has bipolar disorder, you should consult a doctor. Mood Disorders and Menopause

Is it Possible to Prevent Mood Disorders?

Although mood disorders such as bipolar disorder have their origin in multiple causes that only a professional can identify and help with, you can prevent these diseases by taking care of your mental health. Here we include a series of day-to-day recommendations for taking care of your own mental health (NIH, 2021; WHO, 2021):

  • 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 (St-Onge, 2016).

By sticking to these mental health care tips, you’ll find that you will improve symptoms of common menopausal mood disorders that you now know about. But if the symptoms persist, please visit a doctor. References Bhatt, N. (2019). What Triggers Exacerbations of Mood Symptoms in Bipolar Disorder during Menopause? Latest Medical News, Clinical Trials, Guidelines - Today on Medscape. Retrieved from: https://www.medscape.com/answers/295382-172983/what-triggers-exacerbations-of-mood-symptoms-in-bipolar-disorder-during-menopause Bhatt, N. (2021). Menopause and Mood Disorders. Overview, Pathophysiology, Etiology. Obtenido de: https://emedicine.medscape.com/article/295382-overview#a1 Bromberger, J. T., & Epperson, C. N. (2018). Depression during and after the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease. Obstetrics and Gynecology Clinics of North America, 45(4), 663–678. Retrieved from: https://doi.org/10.1016/j.ogc.2018.07.007 Chand, S. P., & Marwaha, R. (2021). Anxiety. In StatPearls. StatPearls Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK470361/ Hantsoo, L., & Epperson, C. N. (2017). Anxiety Disorders among Women: A Female Lifespan Approach. Focus (American Psychiatric Publishing), 15(2), 162–172. Retrieved from: https://doi.org/10.1176/appi.focus.20160042 Hunter, M., & O’Dea, I. (2001). Cognitive Appraisal of the Menopause: the Menopause Representations Questionnaire (MRQ). Psychology, Health, and Medicine, 6(1), 65–76. doi:10.1080/13548500020021937 Jain, A., & Mitra, P. (2021). Bipolar Affective Disorder. En StatPearls. StatPearls Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK558998/ Kulkarni, J., Gavrilidis, E., Hudaib, A. R., Bleeker, C., Worsley, R., & Gurvich, C. (2018). Development and Validation of a New Rating Scale for Perimenopausal Depression-the Meno-D. Translational Psychiatry, 8(1), 123. Retrieved from: https://doi.org/10.1038/s41398-018-0172-0 Marsh, W. K., Gershenson, B., & Rothschild, A. J. (2015). Symptom Severity of Bipolar Disorder during the Menopausal Transition. International Journal of Bipolar Disorders, 3(1), 35. https://doi.org/10.1186/s40345-015-0035-z Mayo Clinic Staff. (2021). Mood Disorders. Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/mood-disorders/symptoms-causes/syc-20365057 NIH. (2021). Caring for your Mental Health. National Institute of Mental Health. Retrieved from: https://www.nimh.nih.gov/health/topics/caring-for-your-mental-health Sekhon, S., & Gupta, V. (2021). Mood Disorder. En StatPearls. StatPearls Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK558911/ Solorzano, C., & Minkin, M. (2018). Menopause Mood Swings. Hormone Health Network. Retrieved from: https://www.hormone.org/diseases-and-conditions/menopause/menopause-mood-swings Spijker, J., & Claes, S. (2014). Stemmingsstoornissen in de DSM-5 . Tijdschrift voor psychiatrie, 56(3), 173–176. Retrieved from: http://www.tijdschriftvoorpsychiatrie.nl/assets/articles/56-2014-3-artikel-spijker.pdf St-Onge, M. P., Mikic, A., & Pietrolungo, C. E. (2016). Effects of Diet on Sleep Quality. Advances in Nutrition (Bethesda, Md.), 7(5), 938–949. https://doi.org/10.3945/an.116.012336 WHO (2021). 6 Ways to Take Care of Your Mental Health and Well-Being. World Health Organization. Retrieved 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 WHO (2019). Mental Disorders. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/mental-disorders Last edited: 9th May 2022