Dr. Dresner explains how fluctuating hormones affect mood swings.
Hormones and mood is a hot topic. There is lot of information out there, but there really isn’t enough information out there. So, just as sort of a background piece of demographic information, before puberty, boys and girls have an equally likely risk of becoming depressed. After puberty, women are twice as likely to become depressed over the course of their lifetime until menopause, and at menopause, the risk for depression in men and women again is about the same.
So during the years of reproductive hormonal cycling, women are twice as likely to experience depression as men. Up to one in four women experience an episode of depression in their lifetime. It’s extremely common and it occurs during childbearing years, between the ages of 18 and 45. So, hormones clearly play some kind of a role in making women more vulnerable to mood symptoms.
Look at premenstrual symptoms, PMS or premenstrual dysphoric disorder, mood disorder, depressive disorder associated with premenstrual hormonal change. Any menstruating woman has the same cycle of hormonal change; not all menstruating women have depression or even agitation premenstrually. So it’s a vulnerable group of individuals who develop more severe depressive symptoms during periods of hormonal change. That’s the same with postpartum adjustment, and that’s the same with perimenopause.
In the seven years really leading up to menopause, which in most women occurs around the age of 51, women experience what we call perimenopause which is a period of hormonal disregulation, temperature disregulation, things like night sweats and hot flashes and irregular menses, irregular periods, either lighter bleeding or periods that are 6, 7 or 8 weeks apart or just kind of unpredictable. During that period of time, the ovaries are sort of misfiring and we’re looking at lower levels and irregular levels of hormonal discharge so that you’re not looking at a neat cycle. You can’t predict when those symptoms are going to occur, but there’s a greater degree of emotional liability, of emotional reactivity, of depressive and anxiety symptoms in individuals in the perimenopause and it’s extremely important to recognize that.
It’s for some women, yeah, that’s what perimenopause is. For women who are vulnerable to depression or to mood disorders, that is the time when they may become depressed, even depressed for the first time. So, understanding the role of hormonal influence is important; intervening is even more important. Writing it off to, you’re just, and a lot of women even say, "I'm PMSing," you know, as if that’s an explanation. Well yeah, but if you’re having significant depressive symptoms during those periods of time, treatment is extremely effective, safe and effective, and these women should be evaluated by a mental health professional for intervention.
About Dr. Nehama Dresner, M.D.:
Dr. Nehama Dresner, M.D., is a licensed, Board-certified psychiatrist (in general psychiatry and psychosomatic medicine) with specialized training and nearly 20 years experience in Women's Mental Health and Medical Psychiatry. She is Associate Professor of Clinical Psychiatry and Obstetrics/Gynecology at Northwestern University Feinberg School of Medicine and is actively involved in medical education. A fellow in the Academy of Psychosomatic Medicine and the America Psychiatric Association, she speaks locally and nationally on issues related to psychological aspects of women's health and medical psychiatry. Dr. Dresner's clinical specialty is psychosomatic obstetrics, and gynecology, women's emotional development, and psychiatric treatment of the medically ill.