Ever found yourself wondering, “What’s going on with me?”, or feeling uneasy in social settings? Maybe you’ve also had days when you cried for no reason — or just needed some alone time. That’s exactly how I felt when I hit perimenopause! Anxiety and depression can sneak in during these years, often without anyone telling you why.
If you’ve been there too, then welcome to the midlife club. (Not the nicest welcome party, I know!)
Back then, when I went to my doctor, he didn’t mention or relate any of my emotional lows to menopause. I left with a prescription for antidepressants, but it didn’t feel right for me — even if I was unaware at the time that I was in perimenopause.
It took me years to understand that everything in our body works as one; that our brain is not isolated! And blaming ourselves for feeling blue only makes everything so much harder. For me, labeling myself as an unstable woman just added extra weight on my shoulders!
I’m not saying pills are bad, though. They can be useful. But we should not see menopause as a disease that needs to be treated. It makes a big difference to know where the symptoms are coming from!
And so, I want all women to know that as we transition into menopause, our body tells us that it needs extra care and attention. We have to listen and work with it!
You can feel more balanced and enhance overall well-being in menopause by:
- Eating hormone-balancing, nutrient-dense foods
- Keeping your gut healthy
- Doing more relaxing and less intense exercises
- Practicing self-care
- Considering supplements and herbs for added support
- Trying natural progesterone cream
Can we achieve emotional balance and mental clarity overnight?
No, but the steps are necessary for you to thrive in midlife and beyond!
So, before we dive into the solutions, stay with me as we tackle many important aspects of our emotional well-being.
Trust me, it is very much possible to turn your midlife blues into brighter days!
Table of Contents
What Hormones and Brain Chemicals Influence our Mood in Midlife?
Progesterone, estrogen, serotonin and cortisol are the primary hormones and brain chemicals that affect our emotional well-being. They influence how we feel and think — which explains why having fluctuations in their levels make us emotionally unstable in menopause!
Let’s start with progesterone as it is the first key hormone that declines during our midlife years. Besides its benefits in reproductive function, did you know that it also takes the spotlight in keeping us emotionally balanced?
That’s right! Progesterone is known for its soothing and calming properties. That’s why when progesterone levels start to decline in perimenopause, it creates a flow-on effect on how you feel!
→ Low progesterone levels can reduce GABA activity — a brain chemical that promotes relaxation! In turn, low GABA (gamma-aminobutyric acid) levels in the brain make you feel more anxious, stressed and restless!
→ Progesterone counterbalances the stimulating effects of estrogen. So, as progesterone levels drop, there may be a relative increase in your estrogen levels — leading to estrogen dominance. This imbalance in progesterone-estrogen ratio can result in mood swings, irritability and depressive symptoms!
Just like progesterone, estrogen also starts fluctuating and eventually declines in menopause. As an effect, your serotonin (your feel-good brain chemical) goes down, while cortisol (stress hormone) goes up.
Did you spot all that domino effect? That’s how hormonal fluctuations and chemical imbalances make us feel highly emotional in midlife! They are also the reasons behind other common symptoms in menopause — such as insomnia, racing thoughts, headaches, gut issues and joint pain!
And hormones are only part of the picture. Your mood is also shaped by your thyroid, your blood sugar, your gut and the nutrients your brain runs on. A sluggish thyroid or low vitamin D, B12 or iron can all look like anxiety or depression. That’s why I always say: look at the whole body, not just the brain!
Is anxiety any different from just worrying?
You would know it’s anxiety when your thoughts are more persistent, overwhelming and uncontrollable. Other symptoms that usually go with anxiety are brain fog, agitation, dizziness, excessive sweating and heart palpitations.
Most of the time, you would not instantly know your triggers — making it feel like a random wave of emotions take over your mind! There can be times that you have specific triggers, but often, it really is our hormones that make us feel like riding this wild rollercoaster.
Sometimes anxiety comes as a sudden, full-body wave: a pounding heart, tight chest and pure dread. That may be a panic attack in menopause. It peaks within about ten minutes and usually passes in 5 to 20. But if you have chest pain, can’t catch your breath or feel like you might faint, call 911 right away.
Depression, on the other hand, feels more like a sense of discouragement, gloom and demotivation. Besides the emotional symptoms, it’s also common to have changes in appetite, lower energy levels and a lacking interest in socializing.
And if the darkness ever feels too heavy to carry, please reach out today — to someone you trust, your doctor or a support line. Asking for help is a strong thing to do.
Yes, there are diet changes and lifestyle tweaks we can do to find balance from within. But in some cases, taking supplements and hormone replacement therapy might be the extra support our body needs at this phase of life!
The Popular Question: Does Menopause Cause Anxiety and Depression?
No, menopause does not automatically mean you will get anxiety and depression. But perimenopause is a more fragile time for your mood. The swinging hormones make you more sensitive to stress — and how you eat, move, sleep and rest can make a real difference.
A big 2024 review found that women in perimenopause were about 40% more likely to have depression symptoms than before it started. The risk is higher if you’ve had depression before, strong PMS or low mood after having a baby. Knowing that isn’t scary — it just means you can plan ahead and be extra kind to yourself.
Anxiety and depression typically start in perimenopause as the soothing hormone progesterone declines. Some women say the symptoms can go as far as postmenopause, but that depends on many factors, including:
- Your diet and eating habits
- Your physical activity and daily movement
- Your stress levels and how you cope
- Your environment and exposure to toxins
- Your social circles that affect your emotional well-being
- Your overall health status (and any possibility of underlying medical issues)
Besides hormonal imbalances, dealing with other symptoms in midlife, such as sleep disturbances, night sweats, low libido and more, can also be “secondary sources” of anxiety and mood problems. (I’ve rounded up the whole list in my guide to the emotional symptoms of menopause.) Because who’s ready to get out of bed and conquer the world when we didn’t have that sweet, restful night? Tell me!
The Adrenals: Your Allies in Managing Anxiety and Stress
“Adrenal fatigue” deserves a little preaching here. Conventional medicine doesn’t use it as a diagnosis, and your adrenals don’t really run out. But the feeling behind the name is very real! In functional medicine we look at the whole stress system instead: the constant chat between your brain and your adrenals, plus your blood sugar, sleep and gut. When that system gets out of rhythm, you feel it everywhere.
The adrenals are like your little factories that produce cortisol and other hormones that help you cope with stressors. So, when you’re constantly stressed, your adrenals also work overtime to send you more stress-busting helpers! After months of nonstop stress, your whole stress system can get stuck on high alert — or swing the other way and leave you flat and drained.
What happens then? You may feel tired but wired, anxious and irritable. Little things you used to shrug off suddenly feel like too much. That’s your stress system asking for a break — not a sign that you’re weak!
💡 FACT: Women are about twice as likely as men to have an anxiety disorder. We also tend to turn stress inward and carry it quietly — which is one more reason midlife lows can build up without anyone noticing.
“Any anxiety or mood disorder experienced in menopause, is brought on by hormonal imbalance. Equating hormone imbalance to mental disorders, triggers shame and guilt among women. This leads to huge hesitations towards addressing these symptoms. With regards to brain chemistry, hormonal imbalance can and should be treated with food, supplements and hormones.”
― Mia Lundin, Expert on Women’s Hormonal and Emotional Well-Being
6 Natural Remedies for Anxiety and Depression in Menopause
Eating a hormone-balancing and nutrient-dense diet, keeping your gut healthy, doing some relaxing exercises, pampering yourself, taking supplements and trying progesterone creams are some of the natural ways to relieve anxiety and mood problems in midlife!
1. Have a Hormone-Balancing, Nutrient-Dense Plate!
As we age, we need good nutrients more than ever. Again, it’s time to see that everything in our body works as one! What you fuel your body with makes a huge impact on how you feel.
Protein is one of those nutrients that we need for several reasons. It is rich in tryptophan — which is then absorbed by the body and transported to the brain. There, it’s converted into 5-HTP and then into serotonin, which helps regulate your mood and sleep!
I say, protein is your midlife bestie for a lot of other reasons, too:
- Feeling full for longer and having better hunger signals
- Enhancing cellular function
- Building those amino acids
- Having more muscle mass
- Repairing and building tissues
- Maintaining the health of your bones, teeth, hair and nails
- Transporting oxygen throughout your body
- Metabolizing other essential nutrients
- Reducing the risk of heart-related problems
Convinced enough? Protein power indeed! You can go for grass-fed meat, organic chicken breast, liver, fish, eggs, vegetables, fermented food, beans, lentils, nuts and seeds. Not sure how much you need? My Midlife Protein Calculator works it out for you in a minute!
How about carbs? Well, we have to be more careful of them as we age — especially refined carbs (white rice, pasta, bread, refined flour, pastries, cereals, sweet treats, sugary drinks). They tend to end up in the belly very quickly, plus they lead to glucose spikes! Some good carbs you can go for instead are sweet potatoes, quinoa, buckwheat, barley and oats.
Also, include some brain-boosting omega-3 fatty acids in your diet — think salmon, mackerel, sardines, walnuts, chia and flax! Other healthy fats that can upgrade your nourishing game in midlife are avocados, olives, olive oil and ghee.
Loading up on cruciferous veggies and leafy greens will provide you with all those essential vitamins and minerals, too! Many veggies are packed with phytoestrogens and adaptogens that are fantastic for hormonal balance.
Lastly, go organic when you can, and skip foods with long lists of additives and ingredients you can barely pronounce. Big studies link eating lots of ultra-processed food with a higher risk of depression — so real food really does matter for your mood!
“Nutrition is the most under-utilized medication, yet it is the most effective.”
― Dr. Mary Claire Haver
2. Keep Your Gut Healthy!
Eating nutritious foods is, of course, a top priority. Next to that is to ensure your gut is doing its job well! If it isn’t digesting and absorbing those nutrients properly, your body won’t get what it really needs.
Also, when we talk about gut health, many of us only think of its role in digestion. But there’s actually so much more to it! In fact, about 90% of your body’s serotonin is made in the gut. It doesn’t travel straight up to your brain, but your gut and brain are in constant conversation — so a happy gut really does help a happy mood!
And did you know about the “gut-brain” axis? It serves like a communication superhighway between your gut and your brain. When everything is in harmony down in your gut, it sends positive signals up to your brain. Conversely, if there are imbalances, they can lead to mood swings, anxiety, brain fog and stress. Yup, keeping your gut healthy is vital for both your physical and mental health!
What can we do to maintain gut balance?
Besides the healthy food sources we’ve mentioned in the previous sections, it’s also important to include gut-friendly foods in your diet. Think about adding probiotics and prebiotics!
Probiotics are the good bacteria found in foods like yogurt, kefir, sauerkraut and kombucha — which help boost your gut flora. Prebiotics, on the other hand, are the fibers found in foods like garlic, onions and asparagus that feed those good bacteria — helping them thrive!
3. Exercise: Less Intense, More Relaxing!
Remember our talk earlier about the stress system? One of the things you can do to give it a break is to lessen any intense workouts and do more relaxing routines! And please don’t skip moving altogether. A big 2024 review in the BMJ found that walking, yoga and strength training all eased depression — some about as well as talk therapy.
Taking a stroll in nature would be my top recommendation here. Just think about it: Breathing in the fresh air, feeling the sunshine on your face and soaking up all that natural beauty. Oh, your mind and body (and adrenals) will thank you!
You can also do exercises that focus more on movement and breathing. Give yoga, meditation, Qigong or Tai Chi a try!
Speaking of… why not try breathing exercises? I know it sounds simple, but guess what? Most of us don’t actually breathe mindfully! When we take those deep breaths, sending the air all the way down to our bellies, it’s like hitting the reset button. It keeps us calm, helps our lymphatic system do its thing and even flushes out toxins! Keep it slow, with a longer out-breath. Fast, shallow over-breathing can cause palpitations and dizziness all by itself.
Really, just do anything you can do out there that will make you feel more refreshed and aligned — not wiped out. If you’re the hustler type with your workouts, it might be time to take that grind down a notch!
4. Self-Care is Never Selfish: Pamper Yourself!
Many of us love to be “good girls” with high expectations of ourselves. I think it’s time for us to work on that!
Work smart, not hard. I understand the constant need to be productive — whether it’s at home or at work. But that doesn’t mean we should do it all!
Say no to things that don’t lift your spirits. Loosen up on perfectionism! Let the day unfold and try to find beauty even in the not-so-perfect moments! Let “peace of mind” be your new “productive”.
After all, midlife is your time to change “being there for everyone” to “being there for YOU”!
How about a warm bath? I mean, who doesn’t love the idea of soaking in some bubbly goodness after a long day? It’s such a great way to recharge! Add some Epsom salt or essential oils — lavender is especially calming. You can also light a few candles and put on your favorite playlist! As you do this, imagine the tension melting away, your worries drifting like bubbles in the air. This is your time to recharge, nourish your spirit and remind yourself that you deserve this moment of peace!
It’s about finding little pockets of joy in your day. Whether it’s enjoying a quiet cup of tea, diving into a good book, getting a massage or even indulging in a face mask, every bit of self-care counts. You define your “self-care” and do just that, girl!
In midlife, treating yourself isn’t even a luxury — it’s a necessity.
5. Consider Supplements and Herbs for Added Support!
You may also want to consider using supplements that support your hormones! There are plenty in the market made of herbs, natural ingredients and organic sources. Here are some of them:
- 5-hydroxytryptophan (5-HTP) – synthesized from tryptophan, which increases serotonin levels! Don’t take it with an antidepressant — together they can push serotonin too high.
- Gamma-aminobutyric acid (GABA) – your brain’s own calm-down messenger. Some women find a supplement relaxing, though the research is still thin.
- Magnesium – calms the nervous system, promotes better sleep and relaxes your muscles!
- Zinc – improves your brain and body’s ability to cope with stress!
- B-vitamins – especially helpful in preventing fatigue and promoting a more stable mood!
- Amino acids – the building blocks of your hormones! Lysine and arginine are two vital amino acids during menopause that improve your stress response!
Aside from helping you ease anxiety and emotional dips, these supplements may also help relieve other menopause symptoms — like crashing fatigue, hot flashes, vaginal dryness and low libido.
For herbal remedies, one of the most well-known mood enhancers is St. John’s Wort. It’s the best-studied herb for mild to moderate low mood. But it clashes with many medicines, including antidepressants, birth control and blood thinners. So check with your doctor or pharmacist first. NCCIH has a clear page on St. John’s Wort if you want to read more.
Ashwagandha, chasteberry, rhodiola, maca root, licorice, ginseng and ginkgo biloba are also popular helpers for stress. Many women find they take the edge off and give them a little lift! (Skip licorice if you have high blood pressure.) I’ve rounded up my favorites in my guide to herbs for menopause.
My go-to is KSM-66. It is a high-quality extract of ashwagandha — a well-known adaptogenic herb used in Ayurvedic medicine for centuries. I find this supplement helpful in managing stress, reducing anxiety, improving my energy levels and enhancing my overall well-being! If you take thyroid medicine or have liver issues, check with your doctor first.
6. Try Natural Progesterone Cream!
Natural progesterone creams offer a non-invasive way to manage hormonal mood dips. Many functional practitioners use them in perimenopause, because progesterone is usually the first hormone to drop — and lots of women say they feel calmer day-to-day. How much the skin absorbs varies from woman to woman, so it’s smart to work with someone who tests your levels.
Some women even report feeling more in control and less overwhelmed after having these creams. Plus, because natural progesterone is bioidentical (the same shape as the progesterone your body makes), it’s more likely to work harmoniously with your body! Synthetic options can sometimes have side effects. Body-identical progesterone also comes as a capsule, as part of HRT — and many women find it helps them sleep, too. One important thing: if you use estrogen and still have your womb, a cream is not enough to protect it.
Like supplements, Menopausal Hormone Replacement Therapy (MHRT) should always be discussed with your healthcare provider. They can help you figure out what suits you best!
The Importance of Working with the Right Healthcare Professional
If you find that the simple dietary and lifestyle tweaks just aren’t cutting it, don’t hesitate to seek professional help. Sometimes, we all need a little extra guidance tailored specifically to our needs — especially during the transformative years of our lives!
Just as our body changes and evolves, so too can our understanding of our health.
Consulting a professional, whether it’s a dietitian, a health coach or even your family doctor, can provide you with fresh insights and actionable steps! They can help identify any underlying issues — whether it’s hormonal changes, nutritional deficiencies or lifestyle habits.
Finding someone with expertise in hormones would be ideal. This way, you can discuss if hormone replacement therapy is suitable for your current health needs! They also know which form and dosage are appropriate — for maximum perks and minimal risks.
This is where functional medicine shines. Instead of only asking “how do we treat the mood?”, it asks “why is the mood off?” A good practitioner looks at your whole body as one system. Think hormones, thyroid, blood sugar, gut, sleep, and nutrients like vitamin D, B12, iron and magnesium. Low levels of any of these can feel a lot like anxiety or depression!
Talk therapy can help too. The UK’s NICE menopause guidelines recommend CBT (a practical kind of talk therapy) for low mood and anxiety, and say HRT can help low mood that starts with menopause. And if it’s true depression, medication can be a lifeline while you work on the roots — there’s no shame in that.
Together, with the right guidance and your newfound knowledge in this article, I’m positive you can create a more vibrant and balanced life!
Afterthoughts…
So many people today (including children) are given all sorts of diagnoses — from ADHD to mood disorders and personality disorders.
In my family, there are younger members who are diagnosed with mental health problems and are put on antidepressants. No one ever asked them about their diet, how much sleep they got or their toxin exposure. They were not given any tests to see if they lacked any nutrients to fuel their brain. Their hormone levels were not assessed thoroughly.
As a believer of functional medicine and holistic wellness, I’m all about building a solid foundation. And I mean, giving the roots what they need so everything can grow strong and healthy! Medicine has its place — but the roots deserve attention first. And if you’re already on an antidepressant, never stop it on your own. Your doctor can help you taper safely.
From one woman to another, I encourage you to take time for yourself during this period. Prioritize your peace, ensure you have plenty of recovery time, eat well, stay active and surround yourself with supportive people who make you feel good!
Avoid making any big decisions, as we may not be our “true selves” right now. Trust the process. Be patient and gentle with yourself, too!
Whether it’s through any of the tips and hacks we’ve covered, or some professional help, there is always a way out. You deserve to have a breakthrough at your own pace. You’ve got this!
Anxiety and Depression in Menopause: FAQs
Can perimenopause cause anxiety even if I’ve never had it before?
Yes. Swinging estrogen and progesterone affect your brain’s calming chemicals, so anxiety can show up for the first time in your 40s.
How do I know if it’s hormones or depression?
Often it’s both, and you don’t have to sort it out alone. Mood that goes up and down with your cycle points to hormones. Feeling low most days for more than two weeks needs a chat with your doctor.
Can HRT help with anxiety and depression?
It can help low mood that started with perimenopause, especially if you also have hot flashes or poor sleep. It isn’t a treatment for clinical depression on its own.
What’s the quickest natural thing I can do today?
Go for a walk outside, eat a proper protein-rich meal and do five minutes of slow breathing. Small, but they add up fast!
References:
How to increase serotonin in the human brain without drugs – PMC (pmc.ncbi.nlm.nih.gov)
The risk of depression in the menopausal stages: a systematic review and meta-analysis – PubMed (pubmed.ncbi.nlm.nih.gov)
Depression in the menopause transition: risks in the changing hormone milieu – PMC (pmc.ncbi.nlm.nih.gov)
Menopause: identification and management (NG23) – NICE (www.nice.org.uk)
Exercise for depression: systematic review and network meta-analysis – BMJ (www.bmj.com)
Anxiety disorders – Cleveland Clinic (my.clevelandclinic.org)
Is adrenal fatigue “real”? – Harvard Health (www.health.harvard.edu)
Transdermal progesterone creams for postmenopausal women: more hype than hope? – PubMed (pubmed.ncbi.nlm.nih.gov)
St. John’s Wort – NCCIH (www.nccih.nih.gov)
Protein and heart health – Heart Foundation (www.heartfoundation.org.au)
Written by Gita — Certified Fasting Therapist, Nutrition Coach and Keto Coach, and founder of My Menopause Journey since 2014. Every article is built on published research and trusted health sources, updated regularly, and shaped by her own journey through menopause. Read more about Gita and her credentials.
Nice :/
It really good posts n useful tips n advices thnk u sooooo much
Nice
Really so good to no more n more coz ladies go through ol dis so much in late ages in there life’s
Plz tel wat vitamins we shuld take in this time of menopouse as we start to miss our monthly n ol of a sudden it stops wat vitamans n probiotics r good for it
Hello Yashmin,
We can’t give advice on what options to take or not. Always consult a physician or a qualified professional when it comes to health matters.
Our articles describe different herbs, vitamins and supplements, how they can affect you and where you can find them. All these and more details are provided for informative purposes.
Later this week, we will publish a new article about different Menopause Supplements. If you decide to test supplements by yourself, always try one product at a time and find out how you feel or respond to it.
What we could advise you for now is to do some simple tests, which we have also written about. https://mymenopausejourney.com/test-to-take/.
Enjoy Menopause 🙂
Gita