Experts Release New Guidelines For Treating Women With Depression

By Kelly Burch 09/13/18

A panel of mental health professionals created new guidelines to get more women help with their mood disorders during middle age. 

woman holding her head in pain.

A team of medical professionals has released new guidelines for evaluating and treating depression in perimenopausal women, after finding that the condition is common in the years leading up to menopause. 

“Perimenopause is a window of vulnerability for the development of both depressive symptoms and major depressive episodes,” Pauline Maki, lead study author and professor of psychology and psychiatry in the University of Illinois at Chicago College of Medicine, told Chicago Tonight. “The recent suicide of Kate Spade at 55 years of age shows the seriousness of mental health issues in midlife women, a group that has shown a 45% increase in suicide rates over the past 15 years.”

Researchers found that in the three to four years before menopause, the time when periods become irregular and women experience symptoms including hot flashes, women are at an increased risk for depression. The risk is greatest for women with a history of depression, but it is also increased for those with no depressive background. 

“If there is underlying low-level depression to begin with, perimenopause can increase the intensity of depressive symptoms,” Maki said.

Despite the prevalence, Maki said that depression during middle age has been largely ignored by the medical community. That’s why a panel from the North American Menopause Society and the National Network of Depression Centers Women and Mood Disorders Task Group came together to form the guidelines in hopes of getting more women help with their mood disorders during middle age. 

Maki says the message from the research and recommendations is two-fold. 

“If your mood is low, if you’re feeling irritable, I want (women) to understand there is a consensus that this is normal during menopause,” she said. However, “this is something women don’t have to live with,” she added. 

Maki speculates that hormonal changes in the brain, combined with life stressors including caring for adult children and aging parents, increase the risk for depression in the years before menopause. 

“When you add in hormonal changes that can affect the brain’s ability to cope with these stressors, it’s no surprise that depression is a common occurrence in midlife women,” she said.

Even low-level depression can have an impact on a person’s quality of life, so doctors and patients should be open to treating depression with antidepressants and therapy, Maki said. Hormone therapy to treat the physical symptoms of menopause—particularly hot flashes that interrupt sleep—can also improve depressive symptoms. 

“It is important for women and their health care providers to recognize that these symptoms are common during perimenopause and can be treated,” she said. “By treating some menopausal symptoms, we can help overcome some of the depression symptoms.”

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.