Menopause is referred to as \u201cthe change\u201d for a reason. While we often associate menopause with the physical transformation that occurs after a woman\u2019s child-bearing years, the transition can also be a time of emotional turmoil.. Irritability, mood swings and other non-physical symptoms are not uncommon.\u00a0 In fact, menopause can raise the risk for clinical depression, a mental health disorder that robs you of joy and can make you feel so sad, helpless, or hopeless that it\u2019s impossible to live a normal life. Depression during menopause makes what is often a challenging transition even more difficult.\u00a0 Depression can make you feel emotionally unable to handle your regular responsibilities or cope with even the smallest setbacks.\u00a0 You may find that you\u2019ve lost interest in or obtain little to no please from the things you once enjoyed.\u00a0 Low energy, fatigue\u00a0 and poor concentration are frequent symptoms. Depression typically manifests in physical symptoms as well.\u00a0 For example, you may find yourself struggling with insomnia or waking up earlier than planned and unable to fall back asleep.\u00a0 You may also feel like sleeping all the time. Appetite changes are also common \u2013 some women with depression have to force themselves to eat due to a low appetite, while others find themselves eating more than usual \u2013 and struggling with subsequent unwanted weight gain.\u00a0 Headaches, muscle or joint pain, and digestive upset may also accompany depression. Fluctuating Hormones The transition the body goes through to reach menopause is called perimenopause. During this time, your body experiences hormonal fluctuations. Estrogen levels decline while levels of other hormones, such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH), rise. This hormonal flux triggers the physical symptoms with which you may already be familiar.\u00a0 These include\u00a0 menstrual irregularities, insomnia and hot flashes, as well as the decreasing ability to get pregnant. These shifting hormones may also be responsible for depression symptoms in some women. While researchers aren\u2019t exactly sure how the process works, some believe the fluctuations disturb the equilibrium in the chemical balance of the brain, leading to depression. The physical discomfort of perimenopause may play a role in depression symptoms as well. Insomnia is common, making it very difficult to get through busy days. Hot flashes are uncomfortable and, when they happen in public places, can make you feel embarrassed or conspicuous. Other Factors Hormonal imbalances are rarely the only culprit to blame when depression develops during menopause. Researchers have found that other factors also increase the risk of depression during this transitional phase of life. For instance, one study found that women who reported negative stressful events were more likely to have depression during perimenopause, especially during its later stages . Studies also show that women are more likely to have depression in perimenopause if they had previous bouts of depression or postpartum depression. Genetics can also play a role.\u00a0 Women with a family history of depression may also be more prone to developing it during menopause. Depression during menopause may also have its roots in the life changes that often occur around the same time. For example, you may feel sad that you\u2019re no longer able to bear children. Perhaps you\u2019re experiencing feelings of hopelessness due to the realization that you are aging \u2013 that your youthfulness is slowly becoming a thing of the past.\u00a0 Not only do you see signs of aging every time you look in the mirror, you also have to cope with the media\u2019s constant emphasis on maintaining a youthful appearance.\u00a0 Like many women your age, you may have taken on a stressful new role, such as caring for a sick, elderly parent. These are significant factors that can impact any woman\u2019s emotional health. Treating Depression If symptoms of depression are interfering with your life or causing significant distress, it\u2019s important to consider treatment. Depression is not a sign of weakness.\u00a0 And even if you don\u2019t have a prior history, don\u2019t assume you have to \u201cpower through\u201d it all alone. \u00a0Following are several options to consider that can help alleviate symptoms: Psychotherapy.\u00a0 Talk therapy is a critical part of treating depression at any stage of life. Working with a psychologist, clinical social worker, or other qualified mental health professional can be very beneficial.\u00a0 While there are many different types of therapy, cognitive behavioral therapy (CBT) has consistently been shown to be one of the most effective types for treating depression.\u00a0 A cognitive behavioral therapist can help\u00a0 identify negative and irrational beliefs and thought patterns that play a significant role in depression.\u00a0 For example, a negative belief for some menopausal women is \u201cI\u2019m old and undesirable now \u2013 my good years are over.\u201d\u00a0 Once identified, you can begin to replace these thoughts with ones that are more rational and empowering. Antidepressant medication.\u00a0 For some women, psychotherapy isn\u2019t enough, especially if symptoms are severe.\u00a0 While medication is not recommended as the sole treatment for depression, it can be a helpful adjunct to therapy.\u00a0 Antidepressants like Zoloft, Paxil and others work by restoring the balance of certain brain chemicals (neurotransmitters) that are believed to be depleted in people with depression. The key to successful antidepressant treatment is to take them exactly as prescribed, which allows your brain to gradually achieve and maintain a consistent balance that helps improve your mood. If a specific medication doesn\u2019t work for you, don\u2019t give up. You may need to try several before discovering the one that\u2019s right for you. Remember that antidepressants are intended to work in conjunction with therapy, not in place of it. Hormone replacement therapy. Also called HRT, this treatment is used to relieve the physical symptoms of perimenopause. These drugs raise estrogen levels to treat hot flashes, night sweats, and other symptoms that can make menopause especially challenging for some women. Research suggests that low-dose oral or patch HRT improves depression symptoms as well . HRT is considered a short-term therapy and is often only prescribed for 2-5 years. There are side effects, so this treatment is not right for every woman. Speak with your gynecologist and a mental health professional to learn if HRT is something you should consider. Treat physical symptoms. Treating physical symptoms will help you feel more comfortable, and in turn boost your emotional well-being. To battle hot flashes, keep a fan at your desk or workstation, wear layers you can remove during the day, sleep in little or no clothing, and \/ or lower the room temperature. If you\u2019re struggling with insomnia, talk with your physician about options for relief. Prescription sleep aids may help in the short-term, but they should always be used with caution.\u00a0 Changing your sleep habits will provide longer-term relief, and without unwanted side effects. Exercise regularly. Research has shown that regular exercise \u2013 particularly aerobic exercise like brisk walking, jogging, or swimming laps, is just as effective for alleviating symptoms of depression as taking antidepressants.\u00a0 Regular exercise can significantly improve mood during the transition into menopause. In one study, women who exercised had more positive moods and fewer cognitive difficulties than those who did not work out . Expand your world. The life changes that sometimes coincide with menopause can create feelings of emptiness. For example, if you\u2019re feeling overwhelmingly sad about your children \u201cleaving the nest,\u201d seek out activities that add positive \u201cbusy-ness\u201d to your life. Consider boosting on-the-job skills by taking a relevant class, or take up a hobby you\u2019ve always wanted to try. Consider couples or family therapy. Menopause often coincides with changes in significant relationships. For instance, you may suddenly find the house empty of the children you had raised or charged with full-time care of an elderly parent. Couples who stayed together for their children or who\u2019ve grown apart over the years may choose to separate or divorce at this stage of life.\u00a0 These kinds of situations can strain your connection with a partner or other family members. Therapy can help you pinpoint the underlying issues and help you deal with them in a healthy manner.\u00a0 As a result, you\u2019ll feel more positive about life. Menopause doesn\u2019t have to be a dreaded transition.\u00a0 Rather, it can be the beginning of a wonderful and exciting new chapter in your life.\u00a0 If you\u2019re struggling with symptoms of depression, don\u2019t hesitate to get help.\u00a0 You deserve to be physically comfortable and emotionally healthy. Consult your gynecologist and a mental health professional to discuss\u00a0 the best options for getting your life back on track.