What Are the Origins of Depression in Perimenopausal Women?

Caroline Dott, PhD

Risk Factors for even Minor Depression include:

bullet

Being female (because of normal varying hormone levels)

bullet

Having a personal or family history of depression

bullet

Having marital problems

bullet

Lack of a satisfying support system

bullet

Substance and alcohol abuse

Psychosocial Vulnerability Model of Depression based on Stressful Life Events:

bullet

Loss of mother before age 15, physically or emotionally

bullet

Caring for 3+ children under age 14

bullet

Lack of marital intimacy

bullet

No employment outside of home

Female-Intensive Differences in Depression between Women and Men

bullet

Women: Higher lifetime risk for depression ESPECIALLY following reproductive events characterized by lowered circulating estrogen levels.

bullet

Studies consistently find 2:1 female to male ratio in incidence of depressive disorder.

bullet

Most of the psychiatric crises related to depression occur the day before and the first day of menstruation coinciding with lowered estrogen levels.

bullet

About 70% of women with seasonal affective disorder (SAD) have a history of mood changes in connection with their menstrual cycles.

bullet

Reproductive cycle events can stimulate emotional changes in women predisposed to affective behaviors:

bullet

Depression is associated with oral contraceptive use, & with late luteal phase of menstruation when estradiol & progesterone levels reach their lowest level (in an estimated 3% to 5% of women).

bullet

During the postpartum period, 10% to 20% of women develop a major depressive disorder following the significant decrease in estrogen & progesterone levels to 100 times less than prenatal levels.

bullet

At perimenopause, up to 80% of women develop mood changes.

TAKE HOME MESSAGE:

Hormonal fluctuations during certain phases of the reproductive cycle may indicate a woman=s susceptibility to affective changes. Be aware of and chart your own behavioral/emotional changes during your monthly cycles, and during pregnancy (teach this to your daughters), including:

bullet

Fatigue, Sleep Disturbance

bullet

Sadness, Depression

bullet

Anxiety

bullet

Irritability

bullet

Headaches

bullet

Confusion

bullet

Low Energy

bullet

Sexual Disinterest

bullet

Swelling