September 2, 2014

Post Menopausal Depression

Women are at an increased risk for major depression during the transition from the menopausal period to the post-menopausal period. This form of depression is treated as most other forms of depression using antidepressants such as the SNRIs or SSRIs. I have seen and treated quite a bit of post menopausal depression in my private practice. This depression is caused by a physiological condition as with most other causes of mental illness; this depression is due to the change in hormones in a woman’s body. As a first line of evaluation; I often look for an underlying physical condition that might be the cause of the mental illness. These hormonal changes including some thyroid conditions, diabetes and other illnesses can cause depression. Menopause or the two year period after menopause is also a marker that I consider in an evaluation.

A recent study on the risk of post-menopausal depression didn’t conclude or determine what exactly was causing the depression in the study group. However, when the body goes through such radical changes as menopause; it wouldn’t be surprising to observe acute depression and even major depression due to the imbalance of hormones in the body. The body is experiencing great changes during and after menopause. We know that estrogen acts as a hormonal antidepressant and with menopause the estrogen levels in a woman’s body significantly decline. As a psychiatrist in Scottsdale I have noticed and increase in post-menopausal depression in my practice. Many women are not taking hormone replacements therapy which is also a factor in the increased incidences of post-menopausal depression.

Post Menopause – The Risk Factor

Menopause is known for causing mood swings; a 10 year study suggests that women are at risk for major depression both during and after menopause. The study included 221 women aged 42 to 52 who were pre-menopausal at the unset of the study. Extensive screening was conducted to rule out any pre-existing or current depressive conditions in the women so the study could be as unbiased as possible. It turned out that these women were at a significantly greater risk during menopause and also within two years after their last menstrual period. One surprise from the study was that the risk was much greater for the women during the post-menopausal periods instead of the pre-menopausal periods. Again the researchers were hesitant to attribute the depression to the change in the reproductive hormones but did indicate the possibility of a correlation. From a clinical point of view women entering this period of life can begin to take life-style changes to reduce the risk such as increasing their exercise program, cutting down on the trans-fats in their diets, avoiding stressful situations when possible, and alerting their practitioner to any signs of depression. This is especially important since we know that the earlier we intervene with antidepressant medications, the less debilitating the depression will be, and also offer a better prognosis. The newer antidepressants have a very high rate of effectiveness approaching 70% for the first medication tried. One antidepressant Effexor XR has been shown to be a very effective antidepressant medication for those suffering from depression and other related symptoms of menopause.

What Might Prevent Post Menopausal Depression?

Even though the estrogen levels are quite low in menopausal woman  many are reluctant to introduce synthetic or even more natural hormones into their bodies. This reluctance is due to recent information that has shown an increased risk of certain cancers in women that used these hormone treatments. With these risks associated with hormone replacement, more women are not taking replacement therapy and this may be one of the causes for the increase in depression among this group. Exercise and diet, and possible antidepressant therapy are more and more important. We are not sure if the depression associated with menopause is either temporary or a trigger for life long major depression.

This study on post-menopausal depression was in an article in the Psychiatric News May 20, 2011. The study was funded by the National Institutes of Health and the Department of Health and Human Services. Sometimes diet can help prevent post menopausal depression. None the less the subject of post-menopausal depression is of more interest as our population ages and we see the need to deal with this phenomena. I have seen an increase in post menopausal depression at my psychiatric practice in Scottsdale. If you are seeking a Phoenix psychiatrist or psychiatry practice in Scottsdale, please contact me to schedule an appointment.

this article on post menopausal depression is for informational purposes only and not for the diagnosing or treating of any mental illness
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