Am I depressed or is this just me now?
If you've been asking yourself this question, you're not alone. Many women in perimenopause or menopause experience unexpected changes in mood, low motivation, or a sense of emotional flatness that can feel unfamiliar and unsettling. These shifts can resemble depression, but they may also be linked to hormonal changes that occur during this stage of life.
Fluctuations in oestrogen and progesterone affect neurotransmitters like serotonin and dopamine, which influence mood, energy, and emotional resilience [1, 2]. What feels like depression may, in some cases, be a hormonal imbalance and recognising the difference can be the first step toward getting the right support.
What Does Menopausal Low Mood Feel Like?
It might begin subtly. Tearfulness over things that never used to affect you. A creeping irritability or a lack of motivation. You may feel flat, disconnected, or emotionally fragile. For some women, mood changes are clear and recognisable, with sudden swings or feeling intensely emotional for no obvious reason. For others, the shifts come in waves, building gradually over time.
Many describe mood swings that seem to come out of nowhere. One moment you feel fine, the next you are snapping or crying. Some experience what is often called menopause rage — sudden, intense outbursts of frustration or anger that feel unfamiliar or out of character. These are not character flaws. They are symptoms.
Women commonly report:
- Mood swings that feel unpredictable, with sudden shifts in emotion
- Heightened emotional sensitivity, where everyday stresses feel harder to manage
- Anxiety or a persistent sense of unease, even without a clear trigger
- Emotional numbness or a loss of interest in things that used to bring joy
- Irritability and low tolerance for stress
- Reduced resilience and a feeling of being easily overwhelmed
These symptoms may come and go or last for days or weeks. They can be worsened by poor sleep, chronic stress, or hormonal fluctuations, but sometimes there is no clear cause. Regardless, the effects can be significant, impacting your relationships, work, self-esteem, and overall quality of life.
Crucially, this is not about personal weakness. These changes are driven by biological and hormonal shifts that affect brain chemistry. You do not have to wait it out or suffer in silence. Support is available, and the right treatment can make a meaningful difference.
Why It Happens: The Hormone and Brain Connection
During perimenopause and menopause, oestrogen levels don’t just drop, they fluctuate dramatically. These hormonal swings affect the brain directly, especially regions responsible for mood regulation, like the prefrontal cortex and limbic system [5, 6].
Oestrogen plays a key role in modulating serotonin, dopamine, and cortisol, the chemicals that help us feel calm, connected, and resilient. When oestrogen declines, these systems become more vulnerable, especially under stress [7, 8].
There’s also growing evidence that women with a history of premenstrual mood issues, postnatal depression, or significant life stressors are more likely to experience mood symptoms during menopause [9, 10, 11].
What’s the Difference Between Depression and Menopausal Low Mood?
The symptoms can overlap: low energy, loss of interest, poor sleep, tearfulness, and lack of motivation. But menopausal low mood often comes alongside other hormone-driven symptoms like:
- Hot flushes or night sweats
- Brain fog
- Mood swings or sudden anger
- Irregular periods
- Joint aches or fatigue
It may also feel more cyclical or changeable than typical depression [12]. Still, the line can be blurry and many women benefit from support regardless of the root cause.
How to Feel Better: What Helps?
The good news? There are options. Effective ones.
- HRT: Replacing oestrogen (and sometimes progesterone or testosterone) can significantly improve mood symptoms in menopausal women [13, 14, 15]. Some studies suggest that HRT may be more effective than antidepressants when mood issues are hormone-driven [16].
- Sleep and Stress: Poor sleep and chronic stress amplify mood changes. Addressing night sweats, cortisol surges, and daily overload can ease emotional strain [17].
- Talk Therapies: CBT (cognitive behavioural therapy) and other forms of counselling can support resilience, especially in combination with hormonal treatment [18].
- Nutrition and Supplements: Emerging research links low omega-3, magnesium, and B vitamins to low mood during menopause. A balanced diet and targeted supplements may help [19, 20].
- Movement and Connection: Gentle exercise, time outdoors, and staying socially connected are small but powerful tools. You're not meant to do this alone.
When to speak to someone
If your mood is affecting your daily life, your relationships, or your sense of self. It’s time to talk to someone. Menopausal low mood is common, but that doesn’t mean it should be ignored.
Speak to a menopause clinician who understands the hormonal landscape. They can help you explore whether HRT, therapy, or a combination of approaches is right for you.
You’re not broken. You’re not imagining it. And you’re not alone. With the right care, it does get better.
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