Perimenopause and menopause

Risk of depression may increase during the transition to menopause, a stage called perimenopause, when hormone levels may fluctuate erratically. Depression risk also may rise during early menopause or after menopause — both times when estrogen levels are significantly reduced.

Most women who experience bothersome menopausal symptoms don't develop depression. But these factors may increase the risk:

  • Interrupted or poor sleep
  • Anxiety or a history of depression
  • Stressful life events
  • Weight gain or a higher body mass index (BMI)
  • Menopause at a younger age
  • Menopause caused by surgical removal of the ovaries

Life circumstances and culture

The higher rate of depression in women isn't due to biology alone. Life circumstances and cultural stressors can play a role, too. Although these stressors also occur in men, it's usually at a lower rate. Factors that may increase the risk of depression in women include:

  • Unequal power and status. Women are much more likely to live in poverty than men, causing concerns such as uncertainty about the future and less access to community and health care resources. Some women face added stress from racial discrimination. These issues can cause feelings of negativity, low self-esteem and lack of control over life.
  • Work overload. Often women work outside the home and still handle home responsibilities. Many women deal with the challenges of single parenthood, such as working multiple jobs to make ends meet. Also, women may be caring for their children while also caring for sick or older family members.
  • Sexual or physical abuse. Women who were emotionally, physically or sexually abused as children or adults are more likely to experience depression at some point in their lives than those who weren't abused. Women are more likely than men to experience sexual abuse.

Other conditions that occur with depression

Women with depression often have other mental health conditions that need treatment as well, such as:

  • Anxiety. Anxiety commonly occurs along with depression in women.
  • Eating disorders. There's a strong link between depression in women and eating disorders such as anorexia and bulimia.
  • Drug or alcohol abuse. Some women with depression also have some form of substance abuse or dependence. Substance abuse can worsen depression and make it harder to treat.

Recognizing depression and seeking treatment

Although depression might seem overwhelming, there's effective treatment. Even severe depression often can be successfully treated. Seek help if you have any signs and symptoms of depression, such as:

  • Ongoing feelings of sadness, guilt or hopelessness
  • Loss of interest in things you once enjoyed
  • Significant changes in your sleep pattern, such as trouble falling or staying asleep or sleeping too much
  • Fatigue, or unexplained pain or other physical symptoms without an apparent cause
  • Problems concentrating or remembering things
  • Changes in appetite leading to significant weight loss or weight gain
  • Physical aches and pains
  • Feeling as though life isn't worth living, or having thoughts of suicide

Not sure how to get treatment? Consider turning to your primary care provider first — for example, your family doctor, internist, nurse practitioner, obstetrician or gynecologist. If needed, your primary care provider can refer you to a mental health professional who specializes in diagnosing and treating depression.

Remember, depression is both common and treatable. If you think you're depressed, don't hesitate to seek help.

Jan. 16, 2016 See more In-depth