Not Feeling Like Yourself During Menopause? When to Ask for Help
Why can anxiety or depression emerge during perimenopause—even for women who have never experienced them before? Reproductive psychiatrist Dr. Karen Horst explains how hormonal changes and brain chemistry can affect mood, stress regulation, and emotional well-being. Dr. Horst explains how to recognize when symptoms are more severe, interfere with daily life, or may require treatment.
Transcript:
Jamie Forward: So, why might someone who has never really experienced anxiety or depression begin having symptoms during perimenopause? And I guess really the follow-up to that question is, how can you tell the difference between what’s sort of menopause related mood changes and something that’s more extreme that needs treatment?
Dr. Karen Horst: I would say to answer your last point, if the symptoms are very, very bothersome and impacting a woman’s ability to function in her life, and we’re talking just other health-related practices like exercise, if her function is impaired by her symptoms, treatment is indicated. How we distinguish severity has to do with intensity, number of symptoms, intensity of them, and length of time that they’ve experienced those symptoms.
For example, a major depressive episode has to last two weeks and involve either loss of interest – anhedonia – or sadness plus four or five other specific symptoms like interruption of sleep, tearfulness, low motivation, suicidal thinking, all that sort of thing.
The research has shown that women have an increase in both depressive symptoms not meeting criteria for major depressive episodes and also an increase in incidents of major depressive episodes, but they’re both clinically significant.
