How to combatdepression and anxiety andwhen you’re menopausal

They’re two of the least visible symptoms as well as two of the least talked about, but almost a quarter of women will experience symptoms of anxiety or depression around the time of the menopause. So while you might feel like you’re alone, you’re definitely not.

And when you know what you’re up against, tackling it will start to feel a whole lot easier, we promise.

What is the difference between anxiety and depression?

Anxiety is characterised by feelings of tension and worry that are difficult to control. People with anxiety tend to be constantly irritable or ‘on edge’ and worry excessively about normal, everyday things.

Depression is characterised by low mood and losing interest in pleasurable activities.

Although depression and anxiety might seem to be at opposite ends of the mood spectrum, some of the symptoms overlap and it’s common to have symptoms of both at the same time. 85% of people with depression also experience anxiety.

Symptoms of depression and anxiety

The core symptoms of depression are low mood, sadness and a loss of enjoyment in most activities for at least two weeks.

Other symptoms of depression include:

• feelings of guilt
• feelings of helplessness
• feelings of worthlessness, low self-esteem or low confidence
• suicidal thoughts or thoughts about death
• loss of motivation
• lack of energy
• changes in appetite
• loss of sex drive
• sleep disturbances
• unexplained aches and pains

The core symptoms of anxiety are excessive anxiety and worry on most days for at least six months.

Other symptoms of anxiety include

• feeling restless or ‘on edge’
• irritability
• muscle tension or aches
• headaches
• sweating
• dizziness
• fast heartbeat and shortness of breath
• fatigue
• difficulty concentrating
• sleep disturbances

The menopause and anxiety

23% of women experience mood changes around the time of the menopause, and symptoms of anxiety like tension, worry, nervousness and panic become more common as the menopause approaches.

Can the menopause cause anxiety?

Women who have never had mental health issues before can experience symptoms of anxiety for the first time around the time of the menopause, while women with a history of anxiety may find that their symptoms get worse.

This is probably because oestrogen plays an important role in managing your brain’s activity. When your oestrogen levels drop, it can affect how your brain works and cause symptoms of anxiety like poor concentration, irritability, mood swings and panic attacks.

You might be more likely to get symptoms of anxiety during the menopause if you have a history of PMS, because your body may be more sensitive to hormonal fluctuations.

The menopause and depression

Research suggests that your risk of depression increases as you approach menopause. Feelings of low self-esteem, low energy and reduced motivation are common around the time of the menopause.

Can menopause cause depression?

Scientists think that oestrogen might have mood-enhancing effects, so decreasing levels of oestrogen could contribute to feelings of depression.

Menopause symptoms, like hot flushes and vaginal dryness, and life changes like children living home can also exacerbate feelings of sadness and low mood.

If you have a history of depression, menopause might make the symptoms worse. And if you have a history of post-natal depression, you might be more likely to experience symptoms of depression at menopause as you could be more sensitive to hormonal changes.

How to deal with anxiety and depression

The NHS recommends using self-help measures like getting plenty of rest, taking regular exercise and doing relaxing activities like yoga and tai chi to tackle mood swings, low mood and anxiety during menopause.

Meditation and breathing exercises can also help, as can eating a healthy, balanced diet and reducing your intake of caffeine and alcohol.

Treatment for anxiety and depression

If you think your symptoms of anxiety or depression are related to the menopause, HRT could help. HRT works by topping up low levels of oestrogen. This can help you to feel calmer, more motivated and energetic and generally happier.

If you have severe symptoms of anxiety or depression, and HRT and self-help measures don’t help, cognitive behavioural therapy (CBT) might be useful. In serious cases, your GP might also prescribe antidepressants or anti-anxiety medication.

Help for depression and anxiety

If symptoms of depression or anxiety are seriously affecting your daily life, health or wellbeing, or you are having suicidal thoughts, make an appointment with your GP.

You can also get advice and support from Anxiety UK on 03444 775 774 or the Samaritans on 116 123.