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Menopause treatment: Antidepressants aren’t your only option

Catherine Jeans
Article written by Catherine Jeans

Date published 14 August 2019

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Feelings of depression are very common for menopausal women, who, in fact, are three times more likely to suffer with depression than those who have not yet reached menopause.

GPs often prescribe antidepressants to help with these symptoms, and in research conducted by Healthspan, we found that of women who visited their GP for menopausal symptoms, almost 40% were prescribed antidepressants. However, we also found that only 15.9% of these women described depression as a symptom they were experiencing, and up to 87% would rather treat their symptoms naturally.

Here, we'll focus on natural alternatives to antidepressants, with a wide variety of nutritional and self-care strategies which may help to support your mental and emotional wellbeing throughout menopause.

Why do women experience depression during menopause?

Depression is generally diagnosed when a person experiences extreme sadness that lasts for more than two weeks, often with no specific cause. Feelings of depression may interfere with your daily life: you may have very low self-esteem, and your sleeping and eating patterns may be affected. Whilst the risk of being diagnosed with depression increases three-fold during menopause, not every woman experiences depression the same way, and your symptoms may actually not warrant a full diagnosis of depression. However, our research indicates that 64% of women felt their mental state was being affected by menopausal symptoms, which correlates with other research that has shown that up to 80% of perimenopausal women experience depressive-type symptoms.

However you experience depressive symptoms going through menopause, there can be a number of different causes behind them. Firstly, many women feel more vulnerable at this time due to the physical changes that are happening to them. They may feel a sense of loss as their menstrual cycle ends, and often body shape can change, too, which may affect your self-esteem. For many women approaching menopause, they are also experiencing a key period of change in their lives, as children may leave home, and elderly relatives may require more support.

Studies have shown that the hormonal changes experienced as part of the menopause can also directly affect your mental health. There are thousands of oestrogen receptors in your brain, and they are particularly concentrated around the area of the brain that is involved with emotion. As oestrogen levels decline during menopause, this can also affect your serotonin levels, the 'feel-good' and mood regulating neurostransmitter, due to the fact that oestrogen blocks the breakdown of this important brain messenger. Oestrogen also has an effect on endorphin release, which are the brain chemicals associated with pain relief, stress management, and emotions. So it's easy to see why changing sex hormone levels can have an effect on your mental health and sense of emotional wellbeing.

Natural alternatives to antidepressants during menopause

There are many natural alternatives to antidepressants, however it's important to discuss any depressive-type symptoms with your GP, especially if you are feeling very low, or even suicidal.

Emotional support

Doing whatever you can to support your emotional health is really key: it may be that you need to be referred for a course of counselling or other talking therapy, to discuss strategies to help you cope with your changing symptoms and feelings. Many women find CBT (cognitive behavioural therapy) useful at this time, because it may help you to recognise patterns in your thinking, and help you to reframe things into a more positive light.

Also, be sure to look to your network of friends and family around you, and take time to discuss your feelings with someone you trust. You may find that many women you know have been through, or are going through exactly the same thing as you are. Get outside as much as you can for gentle exercise, as light may help to stimulate oestrogen production. Sensible sun exposure may also help to support your mood, as vitamin D deficiency is associated with an increased risk of symptoms associated with depression, such as anxiety and fatigue. As little as 10 minutes per day of physical activity such as brisk walking, Pilates or yoga can also help to stimulate endorphin flow, which are your 'feel good' brain chemicals.

Stress management for positive mental health

Strategies to manage your stress levels are also an important part of supporting your mental health. Stress can not only exacerbate hormonal issues, it can also affect your sleep, and contribute to feelings of being overwhelmed and anxious. In terms of how you eat, avoid meal skipping, and using caffeine and other stimulants to give you energy. Instead, include plenty of protein-rich foods in your diet such as lean meat, fish, eggs, cottage cheese, nuts, seeds, beans and pulses: these help to prevent low blood sugar, which further stresses the body. Switch to herbal teas, redbush tea, or decaffeinated drinks.

Get a good night's sleep to support your serotonin levels

Good quality sleep is vital for your mental health, and supporting your serotonin levels before bedtime may help to manage depressive symptoms. Tryptophan is an amino acid found in chicken, turkey, cottage cheese, yoghurt, almonds, and chickpeas (e.g. in hummus). It is one of the key building blocks of serotonin, so try and combine these foods with a small amount of carbohydrate such as an oatcake, porridge, or piece of wholemeal toast about 30 minutes to an hour before bedtime. The carbohydrate is important to help deliver the tryptophan to your brain. You could also try the supplement 5HTP (5-hydroxytryptophan), which is a derivative of tryptophan that is important for serotonin production.

B vitamins are also important to help support the production of neurotransmitters such as serotonin, especially B6, B12 and folic acid. Make sure your diet is rich in these nutrients (wholegrains, bananas, eggs, dairy, meat, fish and green leafy vegetables), and consider taking a B complex that contains around 400mcg of folic acid, 10mcg of B12, and 20mg of B6. Another important nutrient for supporting good sleep is magnesium, which is the second most commonly deficient nutrient in adults. This mineral helps to support muscle relaxation, which is why it may help to support your sleep patterns and anxiety relief. Good food sources are nuts, seeds, green leafy vegetables and fish; you could also consider supplementing around 200mg of magnesium citrate or glycinate before you go to bed.

Herbal extracts to support your mood

St John's Wort (hypericum perforatum) is one of the most commonly known herbs to support mental health. Research suggests that it works in a similar way to antidepressants, however with less side effects, and is most effective in mild to moderate depression.1 It may be taken as capsules, tablets, tinctures or tea: just check the dose required on the packet you buy, as preparation strength varies. As with any herbal preparation, do discuss this option with your GP before taking this herb, especially if you are taking any other medication.

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Catherine Jeans

About Catherine Jeans

Catherine Jeans DipION mBANT CNHC is a nutritional therapist and founder of The Family Nutrition Expert. She has a special interest in women’s health, supporting hormonal balance and optimal wellbeing in women of all ages, through the use of food, nutrition and functional health.