Menopause & Depression

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  • If you had this problem and recognize yourself in my description please comment from your own experience. 

    I am so tired, do not know what to do. I had always been very sensitive, reacting to everything but over the last few years when I approached mid40s and all hormonal premenopausal changes after a very stressful life it became very bad. It is like constant PMS. Every tiny little negative thing hurts me a lot, way out of proportion to a stressor. It is like if I had no skin emotionally. Every rude word, every even little stress, every sad news I heard on TV, even listening to a sad song can make me cry. 

    My ability to handle stress has disappeared now. It is one of symptoms of adrenal fatigue syndrome-have all the other symptoms too and cortisol test confirmed. I am exhausted, anxious and depressed all the time. 

    It is so hard to function like that. I am overreacting all the time. Little things which most people would easily ignore, make me sad for days or weeks. I do my best to avoid negative people and do not listen to sad news on TV if I can. 

    I work in medical field so it is very stressful and patients LOVE me because of that extra compassion and empathy that I feel their pain and do my best to relieve it. But downside is that I suffer from this, getting sad all the time and those overwhelming emotions interfere with my ability to function. 

    I am a single mom of a teenager. Have a dog. Tried so far without success: therapy for 6 months each with 2 therapists (CBT and EMDR), meditation, light exercise, healthy food, vitamins, limiting negativity (from TV, newspapers and staying away from negative angry people), herbal calming teas. Helped a little only increasing sleep time and doing less work/going on vacation but finances do not allow to decrease work anymore. 

    Please how to get this "thick skin"? How to became calm and happy and a little numb to pain? How to care less? Was anyone able to achieve it? I do not want to become heartless or indifferent but I want to stop suffering from every little thing. Were you able to overcome it and to become calm? 

    Please do not suggest meds, or going to the doctor or taking hormones. Would like to find natural, not chemical solution. 

    I used to feel the same. In my case it was depression manifesting itself as overly sensitive. Once I started taking steps to compat depression such as creating a social network, making exercise a priority, I am starting to feel better. I also found I need to eat low to no carbs in the morning (makes me more energetic during the day) and have carbs only for dinner to help the adrenal fatigue.

    You mention light exercise but I would try heavy exercise - HIIT, spinning anything that keeps your working really hard, ramp up slowly.

    I know you didn't want meds, but FWIW a low 30mg dose of cymbalta really works me,

    I hear you. I'm there too, about to turn 45 and feeling sad, and pissed off, all the time.  Thinking about when I feel good: when I'm hiking, and when I'm with my women friends.  My advice (to you and myself) is consciously schedule and protect time with other women.  Schedule dates together, hikes, dinners, breakfast, whatever you can get on the calendar. Get it on there and don't make it the first that gets dropped when something "more urgent" comes up. good luck and hugs to you. we can get through this!  

    Dear Friend; here is my experience: After going into peri-menopause, I found myself having anxiety attacks, and way over-reacting to even the slightest thing. I immediately started looking at my emotional life and wondering why I was feeling the way I did. Meanwhile, my blood pressure was going way up, and I was also diagnosed as pre-diabetic. Argh! Thank heavens, I chanced into a solution, and the understanding which came with it; here's how: Looking at my blood pressure and blood sugar, my doctor suggested I go on a diet, assuming that the root cause was weight gain. It turned out she was wrong, but I decided to go on yet another diet. I can't really tell you why I chose the Atkins diet, but I did, and as soon as I started to read about the effect of carbohydrates on blood pressure, I knew I had hit pay dirt. Although I am unable to find any research on it, it is clear to me that estrogen helps us metabolize carbohydrates, and the dropping estrogen levels of menopause leave us suddenly unable to handle what had been normal loads. Too much blood sugar yields too much cortisol, excess weight, stress on the system, and the rest. After radically decreasing carbohydrates in my diet, and increasing exercise to at least 1/2 hour per day x6 days per week, my anxiety attacks went away, and my blood pressure and blood sugar stabilized. (I also take lots of supplements: co-enzyme Q-10, taurine, arginine and magnesium.) Best to you!

    Sounds like your level of empathy is quite high, which can be great for others but really hard on you. I feel burdened to take on the emotions of others as well and found a lot of practical and spiritual advice from a book called Boundaries by Cloud and Townsend- I think that's how you spell their names. It teaches about placing proper Boundaries of responsibility around your life which is especially important for empaths. I'm sorry you re feeling so much weight on your shoulders.

    Hi There. I can totally relate. I'm 45 and the last 5 years have been brutal. Here are a few things that have helped me. 

    * Cut back on caffeine, white carbs, dairy and refined sugar. Mostly I eat paleo, though do have some carbs after a hard workout.

    * Hard workouts with weight training. I like circuit style HIIT classes, but there are tons of great boot camps, cross fit gyms etc. The heavy weight lifting and intense cardio is key... though I'm not sure why.

    * Allow myself to not be so nice and maybe even embrace it a bit. (Why do I have to be so damn nice all the time?)  Maybe even saying to people "I'm kind of cranky right now so bear with me." or "Crap, I'm stressed out. I know this shouldn't be freaking me out, but yeah.. it is. Can you help?"

    * Opting out of any social situations that drain me. This was a hard one for me to figure out because by my nature I'm social, but realized that many friendships and social groups were exhausting me.

    * Figuring out something I love to do right now for fun and making time each week to do it. (I'm taking an improv class.) Ideally something that is a bit out of your normal exhausting routine. One friend is taking a dance class, another making sure she paints each week. Another friend goes on a hike 2x week... etc.

    * For me, having lunch one on one with a different friend 1 or 2 times a week has been really helpful. I like the one on one connection... and it seems a lot of women in their 40's are struggling. It's nice to have a partner in misery. :)

    * If I can fit it in, a 1-2 hour nap in the middle of the day is useful. 

    Hope that helps!

    Your experience sounds very similar to my own. I often find that when all else fails, it's that I'm lacking community and a sense of support from those around me. It takes a ton of effort these days, but I suggest very actively seeking out friends, meetup groups, classes, and close connections. Nothing reduces stress for me like doing something fun or relaxing with a friend and authentically connecting. Talking about problems doesn't seem to help nearly as much as doing something fun and nourishing together, like cooking, crafting, going on a little adventure outdoors, or something of that nature. We really have to try to stay connected to our communities in the modern world, if we are even lucky enough to have them!

    I hope that is helpful, and if you are in need of a friend I would be happy to meet!

    First off, I really appreciate your writing and sharing this.  It's inspirational to see this level of self-awareness in the middle of what sounds frankly like hell.  

    I haven't experienced the degree of what you describe, but I feel that I've experienced a lighter/lesser form -- maybe early stages of what you describe?  If I'm right, then I hope this helps.  If not then please know I only mean to help:

    When I feel closest to what you describe, the first thing I do is catch up on sleep.  I normally don't feel that I need it that badly, but it always turn out that given the opportunity I will sleep for 10-11 hours straight.  Sometimes it takes a week or more to be able to get the time, and sometimes I find myself lying awake for an hour or more before I can sleep, but given a solid night's sleep, I always feel different the next day.  (A couple extra nights make a difference too, even though that's not normally possible.)

    That usually gives me the ability the next day to do some other self-care: hydrate, get a bit of exercise, even take half a day off work.  It all compounds, and soon I feel able to start thinking bigger about solutions.

    Now, you've tried most of this, it sounds like, without (enough) success, so I guess I would just ask: have you tried getting as much sleep in a night as your body will allow you to get?  When things get bad for me, "a little more" sleep doesn't do it.  It's got to be like a fourteen-hour stretch of winding down, falling asleep, and knowing that I don't have to wake up until I'm done sleeping.

    Then I experience not that I'm a little more numb, but rather that the "gain" on my inputs is no longer pegged at 11. I mean: after a ton of sleep, everything feels normal instead of so unnaturally intense.

    If it's adrenal fatigue:

    • You've gone through a lot of the options, but please note you will have to keep at them for a  long time to see results. Sometimes there's a gradual change and sometimes you need more to get relief.
    • I do recommend you continue with exercise--30 minutes walking your dog each day, especially in daylight, during which time you focus on being in the moment and turn thoughts away from other issues. 
    • You could consult a naturopath or acupuncturist to get  supplements to address adrenal fatigue. 
      This does pose some risks: supplements are not well regulated, are of variable potency, and may be contaminated.  Please use only supplements from a reliable company that has its products tested by a 3rd party, and use no supplements sourced from China or Hong Kong--far too risky.

    Adrenal fatigue may not be the only issue:

    • Sounds like me about 20 years ago, even before menopause: as if I had no skin or emotional resilience, despite 20 (expensive!) years of therapy.

      Here's what I've learned: To stay in balance, our bodies constantly adjust a complex brew of chemicals and hormones.  You are already living with a bad chemical mix that is "unnatural."  Instead of "nature=good, chemical=bad," think in terms of "healthy & effective" versus "unhealthy or ineffective." 

      Respectfully, if "natural" remedies aren't working, re-think your assumptions and expand your options. I was very much opposed to using antidepressants, afraid they would make me someone else.  Instead, they've reduced my hypersensitivity and given me more resilience; they help me function and I've had no side effects.  Also, I needed no hormones, herbs, or medication to endure menopause.  I don't know if they'd work for you.  But just remember, whether it's herb teas, supplements, therapy, or prescriptions, it's all an attempt to rewire your body and alter your chemical mix in one form or another.

    Good luck!

    Sweetie - since you have just started down the long road to menopause, you really need to make sure you have a good support system around you.  6 months of therapy is not really long enough to see results, try it for a longer period of time.  If you are not finding yourself connecting to the therapist, interview a few to find the one that will work for you.  It can take a bit of time to get that connection.  Have you tried Yoga?  When did you have a recent physical?  While I get you really do not want to go on meds,  or go to the doctor, you really need to ask your physician for a more natural way to approach this change in life.  There are several over the counter items out there that could help.   Remember to breathe, especially in those moments when you recognize you are having stress and overreacting.  You say you have a teen at home but do not mention how that relationship is going for you.    As for the thick skin, that comes with time and practice but put yourself first.  Nothing is an overnight success and being kind to yourself is important.  Sometimes you have to walk away from a situation so you do not get overly involved.  Accept the fact that you cry more easily.  Going through the change of life is not easy but you can work through it.  While I don't know you, I venture to bet you are basically a very nice, kind, lovely person.    Find joy and peace in little things to start.  Best to you and good luck.  

    I am an older mom that has worked in the medical field since 1990. I too suffer from exhaustion and being overly sensitive. I’ve done a couple of things that have helped me grow emotionally so I don’t go down that road. Exercise and good food with plenty of protein and veggies helps. The biggest change is using dialectical behavior therapy techniques. I didn’t use a therapist because they are pricey, I just use a work book. It’s possible to stop the negative thoughts and make a happier life. I so wished I had these tools when I was younger. You are welcome to contact directly for more details. 

    Being in the medical firld I am sure you have some exposure to the concept of mind-body connection. Therapy will not fix your issues. Developing coping skills will only take you so far. As a mom of three kids under 10 and being in the premenopausal ( and  older than you) stage, I urge you to reconsider the option of  getting a GOOD holistic or functional medicine doctor to work out a plan of balanicing your hormones through a combination of nutrition, supplements, the right type of exercise and if needed, bioidentical hormones. To deprive yourself of all healthy options available to you is like telling you to do a marathon with one leg. Sure, theoretically, you could hop 26.2 miles, but why would you choose to do that to yourself?  A functional medicine, holistic or osteopathic doctor will not push Big Pharma solutions, but will get to root causes and fix those over a reasonable period of time. You will return to a more balanced,  grounded place within yourself and how you are in the world by nurturing all aspects of your life and taking stock of the comprehensive changes that need to be made. Embrace all healthy options available to you and be kind to yourself. Your spirit resides in your body, and if your hormones are all out of whack, no psychological or cogntive intervention will give you the inner peace, resilience and stability you seek. I’ve been there and continue to work on it. Take care of yourself, but it will have to be on a body, mind and soul level. Best of luck to you!

    I'm also very sensitive to other people's emotional states -- I think it's true of all highly empathetic people -- so I can understand both why your patients adore you and why you find it so exhausting!

    I know you've already tried two therapists, but I do know and have worked with a truly extraordinary therapist in East Bay, Jurgen Braungardt (braungardt [at]  

    The other form of therapy I've always thought might be effective for highly sensitive people (but haven't tried) is solution-focused therapy, which asks patients when they've felt relief even for a brief time (eg, for an alcoholic, when was the last time he or she stayed sober for even a few hours?) and then builds off that positive experience.  Here's a description from Wikipedia:

    I hope one or both of these is helpful!  I really would recommend reaching out to Jurgen -- he's incredibly compassionate and effective.

Archived Q&A and Reviews

Questions Related Pages

Experiencing mood changes with menopause

June 2009

I've been experiencing some unpleasant mood changes now that my periods have stopped. I am consumed by anger and sadness with very little respite. There is lots of stress in my life. I have a history of depression - most recently am trying out an Emsam patch. Any positive results with HRT for depression? Other tips to share? Thanks anon

Hi, Need to make this quick, but wanted to empathize and offer you Sara Gottfried 's info. She is at the Center For Integrative Medicine on Lake Merritt in Oakland, and she is wonderful. She is a Harvard-trained MD but is very into natural and alternative means of treating hormonal imbalance, primarily perimenopause/menopause. When I first saw her a couple of years ago I was CONSTANTLY exhausted, pissed off, hagard, had low-grade depression and did I say pissed off? PLUS chronic insomnia. It felt like bad PMS that was becoming more and more my natural state.

She put me on bioidentical hormones and supplements, and I now sleep through the night MOST nights, am not depressed, have very good energy, and **LOVE** my life again.

It may take awhile to get an appt., and after that it may take a few months to get yourself ''balanced'' (she does blood/saliva testing and bases treatment on that) but it is SO WORTH IT!

Her website is Phone is 510.893.3907 Best of luck to you! Anonymous

My gynecologist says she is finding that a low dose of antidepressant helps women making the transition. I am trying Wellbutrin, and it does seem to be smoothing out the edges on my mood and making me feel generally less tired and ponderous. Hope this helps you. --Also there

Psychiatrist for pre-menopausal depression?

March 2008

My partner, already treating for long-term depression, is having a really hard time with a new job and now is pre-menopausal as well. It's become pretty bad, and we're thinking she might get a fresh look at an old problem with a different psychiatrist. She'd like to try a female doc this time - maybe one who deals a lot with these issues, so she'd have a more invested grasp of current meds or ideas that might help get us through this. Any suggestions? -anon

I usually prefer female practitioners myself, but I have to recommend Randy Bloch in Walnut Creek. He's worth the drive. Google him & check out his website & credentials. Suzanne

Hi, I do realize that your question specifically asked about a psychiatrist for your partner, and I'm afraid I can't help there, but since you also mentioned medical issues and depression associated with pre-menopause, I wanted to wholeheartedly recommend Dr. Sara Gottfried . Her Oakland practice is called Integrative Medicine for Women. She is a Harvard-trained, board certified Gyn who specializes in bioidentical hormone balancing in perimenopausal and menopausal women. She provides a great balance between western/allopathic and alternative/holistic medicine, and REALLY knows her stuff. At 46 with a 3-year-old (yikes), I was having a horrendous time with insomnia, exhaustion, depression, terrible mood swings, heart palpitations, zero libido, ETC. when I found Dr. Gottfried, and she has truly been a Godsend for me (and my family!). All of my symptoms are now at least 90% better, and I love my life again! I am a Kaiser fan, but their solution for me was to offer me the Pill, which makes me nuts and severely depressed. Dr. Gottfried's website is Best wishes to you and your partner. Feeling SO much better!