Many women experience depressive symptoms during the menopausal transition. The psychiatric community has criteria that define a major depressive disorder. These criteria include depressed mood or lack of interest in daily activities for more than two weeks.
The mood disorder should be a change from the person’s typical baseline. During a period of depression, a person will demonstrate impaired function with social, occupational, or educational activities. Additional symptoms include at least 5 of the following, present nearly every day:
Anxiety symptoms that are severe including irrational worrying, feeling tense or fearful, and trouble with relaxation may be a part of a depressive disorder.
An evaluation of a patient with these symptoms should include looking for causes that may contribute such as substance abuse, medical illnesses, bereavement that includes marked functional impairment, and other psychiatric disorders.
A previous history of a major depressive episode is an important factor since those with depression will often have recurrences. A physician must also consider the degree of functional impairment that the person is experiencing. Functional impairment involving personal relationships, school or work, relationships with peers, the degree of stress or anxiety, and concerns regarding suicidal ideation or self-harm are important factors to assess.
Many women going through menopause will experience mood changes. Depressive symptoms of menopause vs. a clinical depression are important to differentiate, because the treatments may be very different. Hormone therapy may be helpful for depressive symptoms, but clinical depressions should be treated with anti-depressants, therapy, and other modalities.