From PMS to pregnancy and on through menopause, hormonal fluctuations can wreak emotional havoc for women. Fluctuating levels of estrogen and progesterone alter brain chemistry, especially the mood-altering neurotransmitters serotonin, dopamine and norepinephrine. Levels of cortisol (the stress hormone), are also affected. These hormone fluctuations are most dramatic during peri-menopause (the years leading up to menopause).
Why do some women escape the emotional effects of hormone fluctuations, while others suffer terrible symptoms? Some women's brain cells are more genetically sensitive to hormone levels.
That being said, lifestyle habits also play a key role. If you have genetic sensitivities, healthy lifestyle habits will not eliminate your symptoms but they will lessen the severity. On the other hand, even if you have no genetic sensitivities, poor lifestyle habits alone can cause debilitating symptoms when your hormone levels change.
Erratic estrogen levels trigger correspondingly erratic levels of mood-altering neurotransmitters in the brain. Estrogen has the most powerful effect on a woman’s brain and nervous system. Erratic levels of estrogen and neurotransmitters also affect cognition -- mental functions such as reasoning, memory, language, alertness, concentration, reading and writing. Nervous system changes also affect energy levels and the ability to handle stress.
During peri-menopause, biochemical imbalance between estrogen and progesterone is exacerbated.
Why is hormone-related depression more prevalent today?
Medical researchers blame a higher stress lifestyle and greater exposure to toxins in food and the environment. Stress affects both brain chemicals and hormone balance – creating a double-whammy effect on mood. Also, meat and poultry today are injected with hormones (except those identified as hormone-free). Many doctors blame this for earlier puberty in girls, as well as greater hormone imbalance throughout life.
All this is exacerbated by poor eating habits, lack of consistent exercise and insufficient sufficient rest. A diet high in simple carbohydrates, for example, disrupts blood sugar levels which in turn worsens imbalances in hormones and brain chemicals.
Premenstrual depressed mood
About 80% of women have minor mood fluctuations during the 10 days prior to menstruation, including depression, anxiety and irritability. Other symptoms may include tension, insomnia, bloating, headaches, breast tenderness and cravings for carbohydrates.
Another 15 to 20% of women experience moderate to severe depressed mood, anxiety and irritability.
And about 2-5% suffer from a more serious condition, called pre-menstrual dysphoric disorder (PMDD). Many of the symptoms of PMDD are similar to those of clinical depression.
Up to 50% of women experience what is commonly referred to as the post-partum blues within the first few weeks of giving birth. These mood swings usually improve in a few weeks and require no intervention.
Post-partum depression is much more severe than the normal blues, affecting about 10% of women. In a small number of cases (less than 1% of new mothers), post partum depression can lead to psychosis, including hallucinations and delusional thinking. This is a serious condition that can lead to the death of both mother and baby. Doctors warn that post-partum psychosis should be considered a psychiatric emergency.
Read about post-partum depression symptoms and healing strategies
Peri-menopausal and post-menopausal depression
Women ages 45 to 55 are 4 times more likely to suffer depression than younger women, mainly the result of erratic estrogen levels and imbalances between estrogen and progesterone.
In perimenopause, wildly erratic estrogen levels disrupt neurotransmitters affecting mood, energy, sleep, cognition, memory and concentration. Physical symptoms include insomnia, hot flashes, fatigue and muscle pain. Fluctuating stress hormone levels (cortisol) exacerbate irritability and depressed mood, as well as cause oversensitivity to stress.
By the time a woman reaches menopause, hormone levels have usually stabilized. After menopause, however, low estrogen levels can continue to disrupt mood.
Read about menopausal depression symptoms and healing strategies
How do I know if I have a clinical depression?
If you have the symptoms of depression that impair your ability to function at work, home or in relationships, see your doctor for a complete medical exam. At the same time, read Hormonal Healing Strategies and implement suggestions that apply to you (unless your doctor advises against these).
Hormonal fluctuations can trigger rapid progression of an already existing mental illness such as major depressive disorder or bi-polar disorder. Prior to the "hormone trigger", the symptoms may be mild and undiagnosed.
That being said, be sure to also read the Hormonal Healing Strategies section. A combination of excessive stress, lack of rest and exercise and nutritional deficiencies can mimic symptoms of mild to moderate clinical depression. In my opinion (this is not a medical opinion, but one based on my research) many instances of non-clinical mid-life depression are caused primarily by adrenal exhaustion and exacerbated by hormonal fluctations or a serious illness.
Be proactive about your health if you want to build long-term physical, mental and spiritual health.