Women are often at increased risk for depression when they reach midlife. The reasons are unclear, but scientists think it may be related to a personal or family history of depression, and/or to the life stressors and role changes that come with middle age.
Although menopause is often believed to contribute to the onset of depression, research actually indicates that depression is more likely to occur in the period leading up to menopause, called the perimenopausal years. It is during perimenopause that estrogen levels gradually decline, which some studies suggest may bring on depression.
WHAT ARE THE SYMPTOMS OF MIDLIFE DEPRESSION?
The most common symptoms include:
Two or more weeks of depressed mood
Decreased interest or pleasure in activities
Change in appetite
Change in sleep patterns
Fatigue or loss of energy
Difficulty concentrating
Excessive feelings of guilt or worthlessness
Extreme restlessness and irritability
Thoughts of suicide
Depression and the onset of menopause share many of the same symptoms, including sleep problems, fatigue, irritability, anxiety and difficulty concentrating. Because of this, depression can go undiagnosed and untreated in women who may think these problems are a natural part of aging.
Untreated depression in older women can increase their risk of developing other serious medical conditions, including:
Heart attack
Loss of bone mineral density, increasing the risk of fractures
HOW IS DEPRESSION TREATED IN MIDLIFE?
Women should not have to suffer needlessly. Depression is treatable at any stage of life.
Medication
Antidepressant medications are an important treatment option for women who are moderately to severely depressed. Read more about antidepressants here, then talk with your healthcare provider about whether an antidepressant might be right for you.
Some clinical studies have shown that hormone replacement therapy, particularly taking estrogen, may help fight depression in the early stages of menopause. Although an exact connection has not yet been established, estrogen therapy may be useful in combination with other treatments for depression. Be sure to discuss both the risks and benefits of hormone replacement therapy with our healthcare provider.
Herbal remedies, dietary supplements and alternative medicine
Unfortunately, very little scientific evidence supports alternative treatments for depression, and because these remedies are not regulated, there is no standardized information about ingredients or dosing instructions. Some supplements or remedies may have a negative interaction with antidepressants or other medications you may be taking. Be sure to talk to your healthcare provider before taking any herbal or dietary supplements.
Psychotherapy
Either alone or in combination with medications, psychotherapy, sometimes called “talk therapy,” has been shown to be effective in helping patients manage the symptoms of depressive illnesses. Two approaches, Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) are particularly effective in the treatment of depression. If you’ve been diagnosed with depression, discuss these treatment options with your healthcare provider.
Self-Care
In addition to pursuing medication and psychotherapy as strategies to treat your depression, you can take a number of actions on your own to help manage your symptoms and feel better. The Take Care of Yourself section of this website contains useful information about incorporating the following self-care strategies into your treatment plan:
Support
Often the caretaking responsibilities of women in midlife are doubled – caring for their own children while also caring for elderly relatives. A good support system is important. Ask for help with housekeeping, meals and other daily tasks. Don’t feel you have to do it all yourself.
Exercise
For improving both physical health and mood, there’s no substitute for physical activity. Most experts suggest striving for 30 minutes of physical activity, three times a week, but as little as 10 minutes a day has been shown to be beneficial. Happily, the activity doesn’t have to be strenuous to make a difference. A brisk walk is all it takes.
Stress management
Stress can make depression’s symptoms worse. Some of the stressors of particular concern to women in midlife include children leaving home, caring for an elderly parent, occupational problems, marital changes and the death of a parent or loved one. These transitions have been linked to depression in women.
Another potential source of stress: the high expectations women place on themselves. It’s important to set realistic expectations about what you can accomplish, and let go of trying to do too much or be perfect. Allow yourself time to rest and relax, spend time with others, and make it a priority to participate in activities you enjoy. Read more about stress and stress-relievers here, and talk to your healthcare provider about establishing a plan to keep stress in check.
Sleep
Getting enough good quality sleep is important for promoting good physical health at all stages of life and is essential for managing the symptoms of depression. Take time to learn about establishing good sleep habits, and make sleep a priority.
Nutrition
Sound nutrition is also key to managing your depression. In addition to the nutrition advice available on this website, which is focused on controlling the symptoms of depression, your healthcare provider may make specific recommendations about foods to eat or avoid, as well as vitamin and mineral supplements to take.
More information about depression in women at different life stages:
Depression during pregnancy
Postpartum depression
Premenstrual Dysphoric Disorder (PMDD)