Menopause and depression can share many overlapping symptoms, making it hard to tell them apart.
As a result, women in perimenopause and menopause are commonly misdiagnosed with depression instead of what’s actually going on: the change of life. Understanding the differences between this natural shift in hormones and the clinical mental health issue that is depression is important if you want any hope of getting the right support and treatment. The tricky part is that these conditions aren’t mutually exclusive; you can indeed be going through menopause and struggling with depression. However, more often than not, there are some differences that are easy to spot if you know what you’re looking for.
1. Understand the hormonal shifts in menopause.
Menopause is marked by major hormonal changes, particularly a drop in oestrogen and progesterone. These changes can affect mood, sleep, and energy levels, which are also common symptoms of depression. Hormonal changes can make emotions feel more intense and unpredictable, leading many to wonder if they’re experiencing more than just menopause. Tracking your symptoms can help clarify the situation. If mood swings seem tied to physical changes like hot flushes, night sweats, or irregular periods, it’s more likely hormonal. However, if sadness or hopelessness persists and feels overwhelming, depression could be at play.
2. Recognise how depression presents itself.
Depression isn’t just about feeling sad—it often comes with a sense of hopelessness, low energy, and difficulty enjoying things you once loved. You might notice changes in appetite, sleep patterns, or a lack of motivation. Unlike the temporary mood swings of menopause, depression symptoms tend to linger and interfere with daily life. If you’re experiencing persistent feelings of worthlessness or thoughts of self-harm, it’s important to get professional help. Depression can overlap with menopause, but these deeper emotional signs usually indicate something beyond hormonal fluctuations.
3. Pay attention to how long your symptoms last.
Menopause symptoms like irritability or mood swings tend to come and go, often triggered by hormonal changes. Depression, on the other hand, persists for weeks or months without relief. If low mood is constant and unshakable, it may point to depression rather than menopause. Journaling your symptoms over time can help you notice patterns. For example, if mood changes coincide with hot flushes or poor sleep, menopause might be the culprit. If feelings of sadness are more consistent and unrelated to physical symptoms, consider exploring depression as a possibility.
4. Evaluate your energy levels.
Fatigue is common in both menopause and depression, but the causes differ. Menopause-related fatigue is often tied to poor sleep caused by night sweats or insomnia. In contrast, depression-related fatigue can feel like a heavy, unrelenting exhaustion that affects your motivation and ability to function. If better sleep routines improve your energy levels, menopause might be the cause. However, if you still feel drained despite getting adequate rest, it could signal depression. Discussing this with a healthcare provider can help clarify what’s going on.
5. Notice changes in your self-perception.
During menopause, hormonal shifts can lead to frustration or a sense of losing control over your body, which may temporarily impact self-esteem. Depression, however, often brings deeper feelings of worthlessness or guilt that go beyond physical changes. If you’re experiencing persistent negative thoughts about yourself or your abilities, this might point to depression. Menopause-related mood swings are typically situational and tied to specific moments, whereas depression casts a longer emotional shadow.
6. Look at your appetite and weight changes.
Both menopause and depression can cause changes in appetite and weight, but the patterns may differ. Menopause might bring cravings or shifts in metabolism, leading to weight gain. Depression often causes loss of appetite or overeating as a way of coping with emotional distress. Pay attention to how you feel about food and whether changes are tied to your emotional state. If eating habits are driven by sadness or stress rather than hormonal shifts, it could indicate depression. Tracking these patterns can help your doctor determine the cause.
7. Consider your focus and memory.
Many women experience “brain fog” during menopause, which can make it harder to concentrate or remember things. That cognitive sluggishness is typically tied to hormonal fluctuations. Depression, however, often brings a more pervasive sense of difficulty concentrating, which might feel like a mental block or detachment from your surroundings. If your focus improves after addressing physical symptoms like sleep or hot flushes, menopause may be the cause. If not, and you find yourself struggling to engage mentally in tasks or conversations, depression could be a factor.
8. Assess your sleep quality.
Sleep disturbances are a hallmark of menopause, often caused by night sweats or insomnia. Depression can also disrupt sleep, but it tends to involve early waking, trouble falling asleep due to racing thoughts, or excessive sleeping during the day. If you’re waking up drenched in sweat or tossing and turning due to temperature fluctuations, menopause is likely the root cause. However, if your sleep issues stem from persistent feelings of worry or sadness, depression might be worth exploring.
9. Notice how you handle stress.
Both menopause and depression can heighten sensitivity to stress, but the underlying causes differ. Hormonal changes in menopause might make you more reactive or irritable in specific situations, whereas depression often creates a constant sense of being overwhelmed or unable to cope with daily life. If you find that stress feels unmanageable even in routine situations, it might signal depression. Menopause-related stress often improves as you learn to manage symptoms, while depression requires a deeper focus on emotional health.
10. Understand the emotional rollercoaster of menopause.
Menopause often brings mood swings that can feel like an emotional rollercoaster. One moment you’re fine, and the next, you’re tearful or irritable. These fluctuations are usually tied to hormonal changes and tend to pass relatively quickly. If your emotional ups and downs feel connected to physical symptoms like hot flushes or changes in sleep, menopause might be the explanation. Depression, however, is more likely to create a lingering low mood that doesn’t fluctuate as much.
11. Consider your social interactions.
Menopause might cause temporary mood changes that make you feel less social, but depression often makes you pull away from the people you care about more dramatically. If you’re consistently avoiding social situations or feeling disconnected from loved ones, it could indicate depression. Notice whether your mood improves when you’re with people you care about. If social interaction feels like a chore rather than a comfort, depression might be a factor worth exploring further with a professional.
12. Think about your outlook on life.
Menopause might create moments of frustration or sadness, but these feelings are usually situational and tied to specific challenges. Depression, on the other hand, often comes with a pervasive sense of hopelessness or apathy that affects your overall outlook on life. Ask yourself if your low mood feels temporary or more entrenched. If it’s hard to imagine things getting better, depression could be the underlying issue. Talking to a doctor or therapist can help you get the clarity and support you need.
13. Don’t ignore physical symptoms.
Physical symptoms like joint pain, headaches, or digestive issues can accompany both menopause and depression. While menopause-related discomfort often stems from hormonal changes, depression can cause or exacerbate these physical issues due to its impact on overall well-being. Speak with your healthcare provider if these symptoms persist, as addressing the root cause, whether hormonal or emotional, can help improve your quality of life. A full picture of your physical and mental health will guide the best treatment plan.
14. Talk to your GP to help you get some more clarity.
If you’re unsure whether you’re experiencing menopause, depression, or both, consulting a healthcare professional is essential. They can help identify the root cause of your symptoms and recommend appropriate treatments, whether that’s hormone replacement therapy, lifestyle changes, or mental health support. Don’t feel like you have to figure it out alone. Professionals can provide a personalised approach that addresses both the physical and emotional aspects of what you’re going through, helping you feel better faster.
