Depression

We’re all about equipping you with the know-how to understand your symptoms, and we especially emphasize the specific, tangible ways to manage them. Our goal is to empower YOU to take charge of your menopause journey, starting today.

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Many lifestyle interventions have been studied to assess their effect on mood disorders such as depression. Some — such as meditation, exercise, and improved sleep — present conclusive, positive results while others — such as diet — are more difficult to discern. Elektra’s founding physician, Dr. Anna Barbieri, MD recommends the following lifestyle interventions for mood improvement regardless of whether you’re also pursuing pharmacologic therapy.

Lifestyle

Nutrition & Diet

There is a strong positive correlation between a plant-based Mediterranean diet and a lower risk of anxiety and depression. The diet is low in saturated fats and animal proteins, rich in antioxidants and fiber, and loaded with B vitamins (which have been clinically proven to impact depressive symptoms, anxiety, and stress). It’s anti-inflammatory, veg-heavy, low-carb, low-sugar, and high in brain-healthy fats. And because it kicks most refined and concentrated sugars to the curb and focuses instead on non-starchy veggies, beans, fruits, and whole grains, it’s considered a “low-glycemic index” diet — meaning it won’t dramatically spike our blood sugar. This is what we want to see (and eat)!

The Mediterranean diet is often grouped together with the traditional Japanese diet, which has the added bonus of fermented foods that act as natural probiotics. Both are excellent alternatives to a typical “Western” diet. In fact, studies have found that the risk of depression is 25-35% lower among those who follow Mediterranean and Japanese-style diets.

For more information, refer to our full guide to nutrition during menopause.

Holistic Practices

Get out in nature

Routine, frequent exposure to the great outdoors has been shown to reduce anxiety and depression while improving an overall sense of well-being. Don’t underestimate Mother Nature!

Reduce stress

This is so, SO important — although easier said than done when everything and everyone seems to be competing for our attention. Here are a couple of our top techniques:

Cultivate a meditation practice

Over time, you’ll condition yourself to be more present while letting thoughts come and go. We recommend guided meditations on apps such as Headspace, Insight Timer, and Calm. Meditation not your thing? Try Heathmath, a form of biofeedback that focuses on breathing and heart rate, two powerful physiologic functions that you can activate to manage anxious feelings in real time.

Cultivate a gratitude and/or journaling practice

Studies have linked both practices to improved mood, and they can also help improve general feelings of well-being and facilitate mindfulness. Here are some great tips on how to start a gratitude practice.

Optimize high-quality sleep

Sleep disruptions affect neurotransmitter and stress hormone levels which, in turn, impair thinking and emotional regulation. That’s why it’s so important to prioritize those Zzzzsss. Here’s a handy guide with behavioral, nutritional, and supplemental solutions.

Psychotherapy

There are two types of psychotherapy recommended for menopause-related depression: interpersonal therapy and cognitive behavioral therapy (CBT) — both of which are often used in conjunction with medication. If you are interested in seeing a therapist, be sure to ask about their particular approach and practice.

Cognitive Behavioral Therapy (CBT)

CBT involves working with a coach or therapist to recognize and change beliefs — including negative thoughts and worries. That’s the “cognitive” part. And then there’s the “behavioral” part, which helps you develop better habits and mindset.

Interpersonal therapy

Interpersonal therapy focuses on understanding how human relationships may contribute to or relieve symptoms of depression.

A note about therapy: Societal stigma around mental health issues is strong, and many people are ashamed to see a therapist for help with depression (or anything). Elektra Health believes in smashing *all* the taboos around our health — emotional and mental health included — and we wholeheartedly embrace the evidence-based science behind therapy and counseling.

If you’re experiencing depression, anxiety, or other mood changes that interfere with your life, we encourage you to talk to a mental health professional.

Exercise

Scientists have found that regular movement decreases overall levels of tension, elevates and stabilizes your mood, improves sleep, and boosts self-esteem. The effect of exercise specifically on depression has also been studied, with results proving that it can be used as a form of protection from the development of depression in adults, as well as a tool to acutely manage and treat symptoms.

Exercise can play an important role in physical AND mental health.

According to the World Health Organization, 150 minutes per week of moderate-intensity movement (a brisk walk counts!) is enough to do the trick and reduce the risk of developing symptoms of anxiety and depression. 150 minutes = about 22 minutes per day — for most of us, that’s very doable!

Keep things interesting with a mix of different workouts, including strength training, cardio, and yoga. And if possible, bring it outdoors since research indicates that there may be added benefits when physical activity is done in nature.

Supplements & Over-the-Counter Solutions

Supplements and over-the-counter solutions may be effective in addressing some emotional symptoms associated with menopause, including anxiety and other mood changes, but if you are experiencing feelings of depression, it’s important that you see a provider for an evaluation.

We frequently get asked about St. John’s Wort, a supplement commonly used for depression. If you are considering this, Elektra strongly recommends that you discuss it with your provider to ensure you’re not risking negative interactions with other supplements or medications.

Prescription

Hormonal

Hormone therapy is a viable treatment option for women with elevated depressive symptoms who have been screened for common risk factors. Oral contraceptive pills are typically prescribed for early-late perimenopause, while hormone replacement therapy (HRT) is prescribed for late perimenopause-menopause.

Estrogen therapy alone is not approved to treat perimenopausal depression; however, there is evidence that it has antidepressant effects, particularly for those suffering from vasomotor symptoms (e.g., hot flashes & night sweats).

To learn more, refer to our full guide to HRT.

Non-Hormonal

SSRIs and SNRIs remain the first line of pharmacologic defense for anxiety and depression in peri- and menopausal women. SSRIs are selective serotonin reuptake inhibitors and SNRIs are serotonin and norepinephrine reuptake inhibitors — total tongue-twisters! These neurotransmitters are antidepressants that work by regulating serotonin (the “happy hormone” that controls mood) and norepinephrine (plays a key role in the body’s “fight-or-flight” response to stress). It should be noted that common side effects include weight gain and low libido.

Like therapy, there is still a stigma around taking these medications but for many of us who experience symptoms, they can be incredibly effective and helpful, and we have decades of research to back this up.

There are many SSRIs on the market, like sertraline/Zoloft and fluoxetine/Prozac. Other examples of SSRIs include:

• Escitalopram/Lexapro: associated with less weight gain and sexual side effects (i.e. low libido) than others
• Venlafaxine/Effexor: associated with higher risk of withdrawal symptoms, like agitation, headache, and flu-like symptoms, so proper weaning is important and should be done under the guidance of your provider

Future Treatments for Depression

Over the past several years, there has been more and more research looking at the use of psychedelics, like psilocybin (“magic mushrooms”) and MDMA (better known as molly, or ecstasy), for the treatment of depression. Several clinical trials are ongoing, including this one, and results are starting to suggest some positive benefits. This is an exciting area of research that Elektra will be keeping an eye on!

If you’re experiencing an emergency and need immediate help, call 911 or go to the nearest emergency room.

Phone
Suicide Prevention Lifeline
+ 1-800-273-8255

Crisis Text Line
Text HOME to 741741

We’re always keeping an eye out on emerging research and the latest clinical studies. Subscribe to our weekly Elektra Digest for the latest, science-based info direct to your inbox. Something work well for you that’s not listed here? We want to hear it! Shoot us a note at [email protected]. (We’re human, promise.)