Depression and Perimenopause

by Christiane Northrup, M.D.

Mood Issues & Stress

Dear Dr. Northrup,

I am a 50-year-old smack in the middle of perimenopause. I am trying to get through this as naturally and positively as I can, but it is difficult. During the last six months I have suffered from terrible anxiety and panic attacks, while obsessing over my high blood pressure. I am seeing a therapist, acupuncturist, and holistic nutritionist. Your book has helped, but I feel alone and I feel like this won’t ever end. Every woman I know is taking HRT and antidepressants. I do not want to go that route. I want to heal myself, but it is a painful and difficult journey. Is there some type of support group? Do you have any pearls of wisdom for someone who feels this way? Does the grief and sadness ever go away? I appreciate any help you can give me. – E.K.

Dear E.K.,

First thing you simply must know is that the perimenopause is designed by nature to bring up the unfinished business of the first half of your life so you can heal it and move on. Seriously. Many women sail through this phase, particularly those who have faced difficulties earlier in life and have tapped into their spirituality and Source energy.

Depression is usually anger turned inward. And it’s well-nigh impossible to reach midlife without some old resentments, grief, anger, and disappointments having built up. You’ll know you’re doing better when you feel like yelling or throwing things. It’ll mean you are mobilizing energy.

One way to get this energy going is to set up two chairs facing each other. Imagine that someone you are having trouble with is sitting in the chair opposite you. Now go ahead and tell them everything you’ve always wanted to say. Let ‘er rip. Don’t hold back. (The person doesn’t even have to be living, by the way.) You may need to do this several times in order to really let go of the “charge.” But when you do, your vigor will start to return.

Another way to really get clear on exactly what’s coming up for you is to talk with a professional. I recommend a reading with psychologist Doris Cohen, Ph.D., author of Repetition: Past Lives, Life, and Rebirth (Hay House 2008). Doris, a highly skilled intuitive who works with angels and spirit guides, is the best I’ve ever worked with. Also read her book, which is very illuminating. To contact her, visit her Web site.

Here are some other, specific tips to ease what you’re going through:

  • Nutritionally, depression is often associated with low levels of vitamin D. So get your level checked. It should be between 50–80 ng/ml. Then get out in the sunlight or start taking high dose vitamin D if it’s low. (You may need a prescription for the higher levels of Vitamin D in order to get your levels up quickly.) You also need enough omega-3 fats (1000–4000 IU per day), because cell membranes are made up of omega-3 fats. These healthy fats are found in fish oil, salmon, and ground flax seeds. Magnesium (400–800 mg day) is also very soothing for nerves.
  • Natural full spectrum light also elevates mood. At the very least, get some full spectrum light bulbs. A light box is ideal, but pricey.
  • Depression is also associated with low levels of neurotransmitters such as serotonin and dopamine. The quickest way to get those levels higher is to do things that are pleasurable. When you have fun, it raises nitric oxide levels in your blood, instantly boosting feel good hormones. If you can possibly mobilize yourself to see some uplifting movies, do so. Read The Secret Pleasures of Menopause too! It’s full of ways to enhance pleasure and fun in your life, especially at midlife.
  • Exercise also lifts mild to moderate depression over 50 percent of the time. Join a walking group and get out in natural light regularly.
  • Keep a journal. (I recommend my Wisdom of Menopause Journal by Hay House, which is designed specifically for this life stage.) Pay attention to your dreams, and record them along with your thoughts. I also recommend working with affirmations—saying them and journaling—them like the ones in my Wisdom of Menopause Journal.
  • Hang around positive people, not negative Nancies.

If all else fails, it’s fine to try some bioidentical estrogen and progesterone. Both hormones can have positive effects on mood. And trust me, this will end. You are at a crossroads. Take heart! – C.N.

Learn More — Additional Resources

Last Updated: February 16, 2009

Christiane Northrup, M.D.

Christiane Northrup, M.D., is a visionary pioneer and a leading authority in the field of women’s health and wellness. Recognizing the unity of body, mind, and spirit, she empowers women to trust their inner wisdom, their connection with Source, and their ability to truly flourish.


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  1. Robin
    14 years ago

    At the same zoo was a walrus “playing with himself”. The crowd noticed and was tittering. A young boy who had been taught correct body parts hollered ‘MOMMY LOOK his penis’ at which point the woman talking to the crowd had to address the situation, explaining it was a “teenager” going into maturity!

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