Women are almost twice as likely as men to experience depression. Of those women, one in four will experience clinical depression in her lifetime. These statistics are not surprising when we understand how the female hormones affect brain chemicals (neurotransmitters) that ultimately influence mood. The hormonal and life changes associated with menstruation, the postpartum period and menopause can contribute to or trigger depression, and anxiety.
Premenstrual syndrome (PMS) or the more severe condition Premenstrual Dysphoric Disorder (PMDD) can occur in approximately 75% of all menstruating women. These conditions are defined by severity of symptoms and the specific timing in the female cycle. Mood changes occur anywhere from a few days up to two weeks prior to menses beginning. Common emotional symptoms can be any or all of the following for some: extreme anxiety, mild irritability, anger, self-loathing and depression. To learn more about PMS specifically please click here. (PMS HYPERLINK)
Postpartum depression (PPD) occurs a few days or even months after childbirth. Roughly 10% of pregnancies result in postpartum depression. Often times it goes undiagnosed. The signs of postpartum depression include:
- Decreased energy
- Difficulty sleeping
- Poor appetite
- or Overeating
- Trouble focusing
- or Trouble remembering
- or Trouble making decisions
- Being overly worried about the baby
- or No interest in the baby
Baby Blues are less intense symptoms than PPD, such as sadness, despair, anxiety, and irritability. Up to 80% of new moms experience these transient symptoms.
Within 48 hours after childbirth, 90-95% of hormones (estrogen, progesterone and thyroid) will drop drastically causing an imbalance in normal hormonal production.
Menopausal associated depression/anxiety can be present for years until hormones balance out again. The menopausal years encompass perimenopause through postmenopause. During menopause, the menstrual cycles become irregular due to hormonal fluctuations and eventually cease due to an overall decrease in production of all female hormones from the ovaries. During this time the typical menopausal symptoms of hot flashes, night sweats, insomnia, depression and anxiety can occur. Those who had PMS symptoms of depression and anxiety are more likely to experience mood changes during the menopausal years if not treated previously.
This arises because the ovaries are waxing and waning in the production of hormones, meaning estrogen and progesterone levels are constantly fluctuating until the ovaries are no longer the primary site of hormone production. Levels will eventually level out postmenopausally but will be lower in comparison to the premenopausal years.
A number of therapies are available to improve mood changes due to hormonal imbalances. No matter where you are at in your cycle of life. PMS, postpartum depression and menopausal associated mood changes will improve once hormones begin to stabilize. There is an explanation as to why mood changes occur during different phases of a woman’s life. Spikes and dips of estrogen directly affect Serotonin levels. Serotonin is one of the main neurotransmitters that elevate mood. Dopamine, and Norepinephrine, other common neurotransmitters, are also influenced by estrogen levels and will contribute to a sense of well being when produced at normal amounts. A lack of progesterone is also a contributing factor both in individuals suffering from pre-menstrually or menopausally. Progesterone’s metabolite allopregnanolone binds to the GABA receptor which is known to be a calming neurotransmitter. The lack of progesterone so to speak can also be a reason why individuals suffer from insomnia and anxiety.
It is important to understand in addition to one’s hormone levels, mood may be influenced by genetic history and environment. There can be several factors that play a role in mood. All of these need to be taken into account to balance mood and hormones.
Treatment is two-fold. First, it is important to address the causes of the hormonal imbalance and secondly address the neurotransmitter imbalance. Herbal hormone balancing formulations and sometimes hormone therapy based on the individual is often recommended. Also, specific tests can be done to determine the levels of the neurotransmitters: serotonin, dopamine, norepinephrine and other brain chemicals that influence mood. Once the levels have been evaluated, appropriate recommendations using botanicals and other supplements can be used to bring the body into a better balance. When working with postpartum patients there are limitations on what we are able to recommend based on whether they are currently breastfeeding but this has never kept a patient from getting better. Acupuncture has been found to improve mood significantly for many patients.