Forging A New Path: Exploring Treatment For Menopause-Related Depression Posted January 12, 2016 in Depression Menopause can be a time of profound physical and emotional change as your body adapts to its new hormonal environment. While for some these changes are relatively benign, for 10-20% of menopausal women, the psychological upheaval combined with potentially uncomfortable somatic symptoms result in the emergence of major depression, severely damaging your ability to function emotionally and behaviorally in everyday life.[1. http://www.womenshealthmatters.ca/feature-articles/feature-articles/managing-menopause-related-mood-symptoms] Now, new research suggests that the age at which menopause starts is closely linked to your likelihood of experiencing depressive symptoms, and the measures typically used to stave off psychological distress may not offer the depression treatment benefits we previously believed.Age of Menopause Onset Linked to DepressionA meta analysis published in JAMA Psychiatry examined 14 studies with 67,714 research subjects and found that women who experience early menopause are more likely to experience depression later in life. The data revealed that “there was a 5% decrease in the risk for severe depression with each 2-year increase in age at menopause” and that women who entered menopause before 40 were 50% more likely to experience depression.[2. http://www.medscape.com/viewarticle/856813] Additionally, women with past histories of depression were less likely to experience future depression if they began menopause at a later age. Perhaps most significantly, the researchers found that whether or not a woman was using hormone replacement therapy (HRT) did not affect the likelihood of developing depression. As lead author Dr. Eleni Th Petridou says, “It seems that HRT use does not offset the odds of depression.” The study highlights the importance of depression screening for menopausal women, particularly those who are at higher risk due to earlier menopause onset, as well as the need for depression treatment that goes beyond HRT.Menopause-Related Depression TreatmentIf hormone replacement therapy doesn’t appear to effectively protect against depression, what can you do to address symptoms of menopause-related depression? While the initial trigger for this form of depression may be hormonal, the development and effects of major depression as the result of menopause are complex. For many women, menopause brings with it a host of psychological, physical, social, and behavioral changes that can contribute to your experience of depression and treatment must be designed to address your specific symptoms and underlying causes. As Patricia Nicholson of Women’s College Hospital writes:There is a multitude of factors that can affect mood during menopause, and a vast range of symptoms different women will experience in different ways with differing severity. But in many cases, the tools for coping with mood problems will follow similar themes: managing symptoms, managing life stressors, and managing transitional issues.[3. http://www.womenshealthmatters.ca/feature-articles/feature-articles/managing-menopause-related-mood-symptoms]By drawing on a range of evidence-based modalities and holistic therapies, you can begin to heal from both emotional and physical distress to recapture your quality of life and rejuvenate your sense of wellness.AntidepressantsAntidepressants, including SSRIs, SNRIs, and bupropion, can be used to alleviate depressive symptoms by triggering neurotransmitter activity that elevates mood. Some antidepressants, such as Effexor, can also reduce the “number and severity of hot flashes for most women,” minimizing physical discomfort that can contribute to psychological distress and sleep disruption.[3. http://www.webmd.com/menopause/antidepressants-for-hot-flashes] A skilled psychiatrist can create a tailored medication plan that will provide you with the greatest benefit with minimal side effects.Cognitive Behavioral TherapyCognitive Behavioral Therapy (CBT) is a goal-focused therapy that gives you emotional and practical tools for addressing sources of distress by establishing positive patterns of thought and behavior. While CBT has been found to be a remarkably effective form of depression treatment in general, until recently little research had been done specifically on the efficacy of CBT on menopause-related depression. Last year, however, a team of Canadian researchers found that half of menopausal women were significantly less depressed following 16 sessions of CBT and 25% no longer exhibited any depressive symptoms.[4. http://www.reuters.com/article/us-menopause-depression-cognitive-mindfu-idUSKBN0IR22Y20141107] CBT that combined psychoeducation, coping skills, and physical relaxation techniques was particularly effective. CBT has also been found to alleviate physical symptoms of menopause. A number of studies have also found that CBT significantly reduces hot flashes and night sweats, resulting in improved mood, sleeping patterns, and overall quality of life. [5. http://www.theguardian.com/society/2012/feb/15/cognitive-behaviour-therapy-menopause-symptoms]Holistic TherapiesMenopause can often disrupt your relationship with your body as you struggle against physical discomfort and seek to adapt to your new physical reality. Holistic therapies such as acupuncture, massage, and meditation can allow you to re-connect with your body in a positive and productive way while also enhancing your mood and ability to cope with distress. As Trisha Gura writes, yoga may be especially useful in regaining mind-body harmony and offer meaningful benefits for combatting depression:Yoga practices may provide a source of distraction from daily life and enhancement of self-esteem, helping women to focus on the simplicity of movement and forget about work responsibility and demands, and thus reduce anxiety as well as depression.[6. http://www.yogajournal.com/article/health/the-graceful-change/]The skills you develop through holistic approaches can be integrated in your everyday life, giving you the ability to engage in continuous self-healing and ongoing personal growth.Therapy GroupsConnecting with others who understand your distress can be deeply nourishing and allow you to break through the isolating effects of major depression. For women in menopause, therapy groups may be a particularly comforting space to explore phase of life issues that impact your psychological state, and work through your emotions, experiences, and coping skills within a supportive, non-judgemental environment. Expressing yourself and learning alongside peers who share your struggle with depression is often a vital part of depression treatment, regardless of the initial trigger of the depression.Depression Treatment at BridgesAt Bridges to Recovery, our innovative program combines the best therapeutic modalities with compassionate care that honors your unique experiences and needs. We understand that menopause-related major depression requires thoughtful, personalized treatment designed to address multiple layers of psychological and physical distress and give you the ability to successfully manage emotions and cope with important life transitions. As such, we provide an immersive, multidimensional therapeutic experience that seeks to address the full scope of your emotional and somatic experiences, empowering you to create positive change and restore your sense of well-being. The intensive nature of our residential program allows you to receive more treatment in 6 weeks than would be possible in a year of outpatient treatment, resulting in more rapid relief of symptoms and improved quality of life. Together, we can build a foundation of psychological tranquility and help you realize your potential as you move forward into this new stage of life.Bridges to Recovery offers comprehensive treatment for people struggling with major depression in a serene residential setting. Contact us to learn more about our renowned clinical curriculum and how we can help you or your loved one on the path to healing.