Can Menopause Cause Anxiety, Depression or Panic Attacks?

Transitioning into menopause can be a turbulent time for some women. Your hormone levels drop quickly, which causes your period to slow to a stop, and some other not-so-fun symptoms (hello, hot flashes) to set in.

But those changes may also affect the chemicals in your brain, and in turn, your mood.

The changes in hormone levels that happen in your body during perimenopause and menopause may cause you to sometimes feel anxious or depressed, says psychiatrist Lilian Gonsalves, MD. But severe and ongoing panic, anxiety and depression are not the norm.

Here, Dr. Gonsalves answers some questions about the mental and emotional aspects of menopause and how you can overcome these challenges.

Q: Is it normal to feel anxious as menopause sets in?

A: The fluctuation of estrogen and another key hormone, progesterone, in your body can cause feelings of anxiety or depression. But frequent, troubling high anxiety or panic attacks are not a normal part of menopause. Some women develop a panic disorder during menopause.

Q: Does having panic attacks mean you have panic disorder?

A: Not necessarily. Those with panic disorder have frequent panic attacks. And, in between, they worry about when the next one will strike and try to adjust their behavior to head it off. But a single or a few isolated panic attacks don’t mean you have a panic disorder.

Women who were prone to anxiety in the past or who had postpartum depression are sometimes more likely to have a panic disorder during menopause. But any woman can develop one.

Panic disorders can be hard to identify because some symptoms, such as sweating and palpitations, mirror those that many women experience anyway during perimenopause and menopause. But, just because a panic disorder is not easily diagnosed, that doesn’t mean that it doesn’t exist or that you can’t treat it.

Q: Is there a link between menopause and depression?

A: Changes in hormone levels may influence neurotransmitters in the brain. The drop in estrogen levels can also lead to hot flashes that disturb sleep, which can then lead to anxiety and mood swings.

If you experience symptoms of depression nearly every day for two or more weeks, you might be depressed. Talk with your doctor about finding a treatment that will work for you. Your doctor will also want to rule out any medical causes for your depression, such as thyroid problems.

Q: How do I know when to seek help for emotional problems during menopause?

A: When depression or anxiety causes difficulties in your relationships or at work, and there isn’t a clear solution to these problems, it’s probably time to see your doctor. More specific reasons to seek help include:

• You have suicidal thoughts or feelings.
• Your negative feelings last more than two weeks.
• You don’t have anyone in whom you can confide. If you don’t have anyone to share your thoughts with, it’s hard to know if what you’re thinking makes sense. A good therapist will offer invaluable perspective on the issues most important to you.

Q: Can hormone therapy ease my emotional problems during menopause?

A: While there’s growing evidence that hormone therapy can help with emotional symptoms, it alone is not effective in treating more severe mental health conditions. Your doctor my prescribe medication for anxiety or depression. Counseling also helps treat the psychological symptoms.

You may feel better after menopause ends and your hormones level out. But talk to your doctor as soon as possible to start the right treatments.

Q: Is there anything else I can do to cope with emotional concerns during this phase of my life?

A: A healthy lifestyle can help ease the menopause transition, including the following steps:

• Exercise and eat healthy.
• Engage in a creative outlet or hobby that gives you a sense of achievement.
• Turn to friends, family members or a professional counselor for support. Stay connected with your family and community. Nurture your friendships.
• Take medicines, vitamins and minerals as prescribed by your doctor.

Q: Are problems with memory and concentration a normal part of menopause?

A: Unfortunately, trouble concentrating and minor memory problems can be a normal part of menopause. Experts don’t understand exactly why this happens, but if you are having them, talk to your doctor. They can at least provide some reassurance.

Activities that stimulate your brain can also help rejuvenate your memory, so spend some time with crossword puzzles or cozy up with a book. Keep in mind that depression and anxiety may make memory concerns more noticeable.