Many women experience bouts of depression as they approach menopause. As a matter of fact, midlife can be considered a period of increased risk for depression in women, the majority taking place in the years during the transition through the menopausal years. This period of time is associated with gradual declines in estrogen levels, which may be linked with the onset of depression.

It can be confusing when trying to determine if you’re suffering from depression, simply going through menopause or experiencing both. This is because many symptoms of menopause and depression are very similar, such as interrupted sleep patterns, fatigue, hot flashes, mood swings, anxiety and difficulty concentrating. It’s important, however, to talk with your doctor if you think you may be suffering from depression; don’t play guessing games with your health because if left untreated, depression can lead to additional episodes, which have the potential to be more severe. Untreated depression can also result in physical complications, such as heart attack and the loss of bone density.

If your doctor thinks that your depression is as a result of declining hormone levels as you’re approaching or experiencing menopause, there’s a possibility he will suggest hormone replacement therapy, which includes estrogen. It’s important to discuss both the benefits and risks of hormone replacement therapy, including potential benefits to your overall mood. Recent studies have shown that the risks of hormone therapy include heart attack, stroke and breast cancer, and some professionals believe that these risks may outweigh the benefits women can receive from this course of treatment. That being said, estrogen therapy remains the most effective treatment for many menopausal symptoms.

Short term therapy (12-20 weeks) has also proven to combat depression in women experiencing menopause. Especially effective are Cognitive Behavioral Therapy, which focuses on negative thoughts and behaviors that tend to worsen depressed mood and teaches better ways of thinking and behaving, and Interpersonal Therapy, which helps individuals to communicate more effectively with others to help eliminate stressors.

Fortunately, the benefits of exercise in depression are well documented. Exercise helps with the treatment of depression by releasing the body’s mood-elevating compounds, reducing the depression hormone cortisol, providing a feeling of accomplishment and enhancing self esteem. I personally exercise approximately an hour most days of the week, but even exercising as little as ten minutes per day has been found to have beneficial effects for many women experiencing menopausal depression.

You may also want to consider a prescription medication to help you cope with the symptoms you’re experiencing. Discuss this possibility with your doctor because there are several effective and well-tolerated antidepressant medications now available. These medications have been proven to be an essential part of treatment for women who are moderately to severely depressed.

It’s also important to simply take care of yourself by eating a well balanced diet, decreasing your intake of refined sugar, caffeine, alcohol and chocolate. Are you getting enough sleep? Sleep deficiencies can make depression worse, so if you must, develop relaxing bedtime rituals, such as taking a hot bath or reading a good book.

Finally, just give yourself a break. Not only are you experiencing symptoms of menopause, but midlife also brings about life events that can be stressful, adding to the risk of depression, irritability and moodiness. Perhaps your children are leaving home, you’re caring for an elderly parent or have recently experienced the loss of a loved one. All of these events will undoubtedly add stress to an already busy life. Take time for yourself, eat a healthy diet, exercise and know that you’re a strong and capable woman and you will get through this.