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The perimenopause can be an emotional roller coaster rivaled only by puberty. What can you do to find relief from mood swings and even clinical depression?

The perimenopause — the run-up to the grand finale of menopause itself — can be a turbulent time in life. All sorts of things are going on in your body. The gradual decline in estrogen levels is also believed to impact serotonin and norepinephrine, neurotransmitters that have a lot to do with mood, and besides that, you may also be feeling a bit weird about this long chapter of periods and reproductive potential coming to an end. 

The physical symptoms that often strike during this time — fatigue, sleep disturbances, hot flashes, forgetfulness, and trouble concentrating — are quite enough to induce anxiety, mood swings, and irritability all in themselves, just as hormonal fluctuations produce physical side effects, they're contributing to all that emotional stuff as well. 

Clinical depression is shockingly common anyway, affecting about 10 percent of the population, but while you're premenopausal, you may have double the risk of becoming depressed. As common as this is, it also robs you of the quality of life that you deserve and could have with treatment.

Ways in which the perimenopause can affect your mood

Whatever you're currently dealing with, one thing is certain — you're far from alone. 

A whopping seven in 10 women suffer from irritablility as they enter perimenopausal territory, which of course means you have a short fuse, are easy to anger, and get irritated by things that didn't bother you so much before. Yup, emotionally, it's basically like a second puberty. 

You may also find yourself feeling more anxious — worried, fearful, rumimanting — than before. Some women will develop an anxiety disorder for the first time of their lives during the perimenopausal period, while others who've struggled with anxiety before will find that it comes back with a vengeance during this time. Panic attacks may or may not be part of the package. 

Some perimenopausal women find themselves dealing with unexpected crying spells, which may be familiar to you if you've ever been pregnant before. A combination of hormonal upheaval and life changes will be the culprit, and rather than feeling extra annoyed for having them, this may be a time during which you re-examine the way in which you deal with your emotions. 

Did you know that up to half of all premenopausal women suffer from insomnia — which can mean you can't fall asleep, but also that you keep waking up during the night or consistently wake up much earlier than you planned to? This is no surprise when you consider the fact that many women suffer from night sweats at this time. Sleep deprivation is well-known to really mess with your mood. 

At the more severe end of the spectrum of mood changes, you have clinical depression — and up to one in five perimenopausal women may struggle with it. 

The perimenopause brings new challenges: What can you do to alleviate mood swings and mood swings?

Deciding how to handle the trouble you're facing begins with evaluating how serious it is. Women who recognize themselves in the symptoms of clinical depression — which also means they have them most days and most of the day for at least two weeks — should seek medical attention:

  • Feeling sad (including lots of crying in some cases), down, irritable, empty, hopeless, guilty, or worthless 
  • A loss of interest in activities you used to find enjoyable or meaningful
  • Low energy
  • Trouble concentrating and feeling indecisive
  • Changes in your sleep patterns — you can't sleep well, or find yourself oversleeping
  • IChanges in appetite, resulting in either weight loss or weight gain
  • A change in appetite causing weight loss or gain
  • Thoughts about death or suicide, plans to commit suicide, or having attempted suicide
Though hormonal factors may play a role in triggering depression during the perimenopause and beyond, the same steps that would help anyone else will help you during this time too. We'll add that you don't need to be clinically depressed to benefit from lifestyle changes or therapy. 

Consider therapy

Whether you're clinically depressed or not, therapy is a good way to deal with any issues that you're dealing with right now that would benefit from, well, therapy. If the therapist's personality and way of working meshes well with your expectations, that is. The menopause can be an emotional roller coaster, and not just because of hormones, but because it's a time during which many women reconsider what they want to do with their lives. A few sessions (eight or so) of cognitive behavioral therapy can shed a new light on everything. 

Antidepressants: Not just for depression

Low-dose antidepressants are sometimes prescribed to menopausal women dealing with hot flashes, so these medications aren't just for those going through a depressive episode. If you do happen to be depressed, SSRI antidepressants are likely to be the first point of call, but some women find that they interfere with libido and sexual function. Other antidepressants, like duloxetine (Cymbalta) or bupropion (Wellbutrin), are a better option in this case. 

St John’s Wort: A herbal remedy for depression

St John’s Wort is one of those herbal remedies that has actually been proven to work — as well, research shows, as tricyclic antidepressants for mild to moderate depression. Menopausal women who are depressed may prefer this to pharmacological antidepressants, which may induce a wider spectrum of side effects. St John's Wort can, however, interact with other medications you may be taking, so ask your doctor before trying it.

Hormone replacement therapy

Hormone replacement therapy, including bioidentical hormones, alleviate all sorts of menopause symptoms, including mood swings. Because research has found that hormone replacement therapy has some health risks, increasing your risk of cancer and stroke among other things, it is important to use hormone replacement therapy for the shortest possible time and to discuss the risks vs benefits with your doctor in detail;

Exercise: A natural feel-good 'treatment'

Working out regularly is a great way to fight stress and boost your mood — as well as helping you find relief from other nasty menopause symptoms, such as weight gain. Consider exercising at least two and a half hours a week, but choose both cardio and strength training. You are, of course, more likely to stick with exercises you actually enjoy, so choose something that appeals to you — walking, swimming, yoga, Tai Chi, or dancing, for instance. 

Are you getting a healthy and balanced diet?

A healthy and balanced diet will nourish your body, and help you feel better. That means eating a good three meals a day and some snacks — meals made from scratch are, of course, a better chocie than processed foods that contain lots of sugar, fat, and carbs, as you want to avoid blood sugar fluctuations that can make you moody. Omega-3 fatty acids, which you can find it salmon, sardines, soy, walnuts, and flax, among other things, are partocularly good at taming those mood swings.

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