11 ways to combat depression in menopause and mood swings

Our 40s and 50s mark many life transitions and events, such as achieving financial success, owning a home, and having a stable career. 

Along with these milestones also come challenges, like hormonal changes, ageing and menopause.

Menopause is a complex transition for many of us because it's associated with psychological symptoms, like an increased risk of depression and mood swings. 

If you’ve been experiencing any of these, here are 11 ways to help overcome depressive periods during menopause.

1. Get moving

There's a reason why doctors perpetually recommend exercise as part of the daily routine. Moving gives you a burst of energy and boosts your mood. 

When you do it outdoors, you also connect with nature, making you feel more calm and centred. 

Experts recommend 150 minutes of moderate-intensity activity weekly to help with depression and gain other benefits (1).

The most important thing about exercise is choosing an activity you can do regularly. If you find group activities more enjoyable, sign up for a yoga, pilates or Zumba class, or join a team sport. 

Otherwise, you can turn on YouTube and follow online exercise routines. Any movement can help you get through depressive states later in life.

RELATED: Different ways to get fit in midlife 

2.   Eat foods with unsaturated fats

Have you experienced eating something unhealthy and feeling bad afterwards? Food affects your body in several ways — including your mood.

In a study about the peri-menopausal state, women who consumed a blend of raw, unroasted peanut and sesame had lower Beck anxiety and depression scores than those who ate cookies made of soya flour and flaxseed (2).

The blend women consumed had a high amount of unsaturated fats, while the soya cookies were rich in protein and total phenols. 

The study concluded eating foods rich in unsaturated fats — like peanuts and sesame — can alleviate depressive symptoms and mood swings. Unless you have dietary restrictions, you can add avocados, nuts, pumpkin seeds and fish to your meal plan.

RELATED: Top nutrients to help ease brain fog, anxiety and low mood

3.   Get enough sleep

Forty per cent of women in their late 40s to early 50s experience sleep troubles like insomnia (3), hot flushes, sleep apnea and other sleep disorders. It can lead to a poor quality of life if not treated.

Getting quality sleep is essential to everyone, but even more so as we get older. Waking up in the middle of the night and not getting your sleep back can make you feel moody and irritable.

A conducive environment is key to achieving sufficient and uninterrupted sleep. 

Establish good sleep hygiene every night: 

  • Make sure the room has a comfortable, cool temperature and block all the lights out with thick curtains. 
  • Stop using electronic devices before hitting the bed. 
  • Regulate your circadian rhythm by sleeping and waking up at the same time every day.

RELATED: Improving sleep and overcoming insomnia during perimenopause, menopause and midlife

4.   Consider therapy

Therapy is the first-line approach for treating depression. Currently, 3.8% of people worldwide experience depression and need therapy interventions (4).

Cognitive behaviour therapy (CBT) is a form of psychotherapy ideal for managing moods, easing anxiety and depression in menopause, and fixing sleep troubles.

CBT looks at the connection between the symptoms you're experiencing, how you think and feel about them, and how you respond. If your responses trigger higher stress levels (5), your therapist will work with you to fix this. 

They can also teach you valuable coping skills and strategies for menopausal symptoms, including hot flushes and night sweats.

Besides CBT, other therapeutic approaches to help with menopausal depression are interpersonal therapy and supportive therapy. 

Menopausal depression can affect your relationships, but interpersonal therapy will teach you how to navigate the life transition while protecting your relationships. 

With supportive therapy, your therapist will provide emotional support and guide you in addressing particular life issues.

RELATED: Hypnotherapy for menopause: Can it help symptoms?

5.   Explore HRT (Hormone Replacement Therapy)

If your mood swings are severe and adversely affect your relationships and other aspects of life, contact your doctor about taking HRT. 

Ovaries produce high levels of two hormones — estrogen and progesterone. Both promote healthy body functions. 

As you enter the menopausal stage, the ovaries produce fewer hormones, which results in internal imbalances and menopause symptoms like hot flushes, depression and insomnia (6).

Experts discovered estrogen might help treat menopause-related depression and other symptoms. HRT can restore normal high estrogen levels, so ask your doctor if it’s an option for you.

HRT can be given via estrogen tablets, a patch, gel, or spray that you stick or apply to your skin. Estrogen implants are also available.

RELATED: Accessing affordable HRT: All you need to know about the new HRT prescription pre-payment certificate

6.   Ask about antidepressants

The National Institute for Health and Care Excellence considers HRT the first option for treating menopausal symptoms. 

However, if it's not the right option for you, antidepressants are an alternative. 

Ten milligrammes of selective serotonin reuptake inhibitors (SSRI) can increase serotonin activity and ease symptoms of flushes, sweats, and mood swings (7).

Antidepressants can have side effects, including headaches, nausea and suicidal feelings.

Always stay on the safe side by discussing how to manage these side effects with your doctor. Never adjust your dosage without your doctor's advice.

RELATED: What to expect from an online menopause clinic

7.   Use a diary

Writing is an effective tool therapists use to heal patients with depression in menopause and other psychological issues (8). 

Since 1986, more than 200 research studies have been conducted to establish the connection between healing and writing. These reports show expressive writing can enhance a person's physical and emotional state.

People who wrote about their negative feelings for 15 minutes daily visited their doctor less. They also have better mental well-being. 

Another study found a six-week writing intervention increased people's resilience and decreased their depressive symptoms, stress and trauma. 

At times when you don't want to talk about your feelings to anyone, writing them down can help release your emotional burdens.

RELATED: How to reduce anxiety during perimenopause, menopause and midlife

8.   Avoid smoking and alcohol

Smoke and alcohol are the worst things you can ingest when you’re in your 40s. 

A data review among premenopausal and postmenopausal women found ex-smokers and current smokers showing an elevated risk of depression compared to never-smokers (9). Heavy alcohol drinkers experienced the same outcome for both groups of women.

Surprisingly, a little bit of alcohol can be beneficial for both premenopausal and postmenopausal women. 

Based on the review, mild drinkers had a decreased risk of depression. But remember to seek medical advice if you plan to drink, especially if you are on any medication.

RELATED: How does menopause affect the brain?

depression in menopause

9.   Find time for hobbies

The menopausal stage can be a stressful time for most of us, but built-up stress can harm physical and mental health. 

One of the strategies to regulate pressure is to find a safe outlet or do something for fun. You can try gardening, cooking or a hobby you enjoyed when you were younger.

In a global poll, 22% out of almost 19,000 respondents confirmed hobbies and recreational activities gave meaning to their lives and kept them going during difficult times (10). 

If you consistently feel low, do something engaging with yourself or with friends to take your mind off depressive thoughts.

RELATED: Ways to boost your mental health during menopause

10.   Try art and creative therapies

Several literature pieces prove art therapy can help people cope with depression.

Getting involved in any form of arts — like music, dance groups and theatre — are healthy, safe diversions that improve your well-being (11). It gives you an avenue to express your negative feelings during a depressive state.

The best thing about art therapy is you can let go and not worry about taking out your emotions in the wrong place or on people. 

You can explore art therapy in a number of ways, such as dance, drama, music and visual art. Work with an art therapist to determine which method best suits your situation.

RELATED: 4 things to know about mindfulness for menopause

menopause yoga, depression in menopause

11.   Join a Mind-Body programme

As people become more aware of the importance of taking care of mental health, hundreds of mind-body programmes have materialised to support the cause. Mind-body practices include mindfulness meditations, tai chi, yoga, relaxation techniques and massage therapy.

These approaches are generally safe. Unless you have an existing health condition, you can try yoga or breathing techniques without a doctor’s recommendation and see if it helps you.

One study revealed mindfulness meditation reduced the severity, frequency and inconveniences of hot flushes for menopausal women (12). It has also lessened anxiety and depressive symptoms and improved women's self-esteem.

RELATED: Can yoga really help menopause symptoms?

Overcome depression in menopause and mood swings

As we reach the menopause, we become more vulnerable to depression and mood swings. 

Your 40s is a transitional phase, and for most of us, it's often accompanied by added responsibilities, like becoming a caregiver to a senior parent. 

These biological changes can easily lead you to experience depression during menopause, fluctuating moods and other mental health concerns.

Self-care is critical to increase your resilience, self-esteem and maintain a better head space. 

Consider HRT to improve severe mood swings, try things you enjoy, get some exercise and get enough sleep to take care of your overall health.

RELATED: We can't change the wind, we can adjust the sails

Mia Barnes is a freelance writer and researcher who specializes in women’s health and wellness. Mia is also the Editor-in-Chief of 
Body+Mind magazine and a staff writer for sites like the SMSNA and the MedShadow Foundation.


(1) NHS (2021). Exercise for depression. https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/exercise-for-depression/

(2) Menopause Anxiety and Depression; How Food Can Help? | Open Access Macedonian Journal of Medical Sciences. (2021). https://oamjms.eu/index.php/mjms/article/view/5555

(3) Pacheco, D. (2021). How Can Menopause Affect Sleep? Sleep Foundation. https://www.sleepfoundation.org/women-sleep/menopause-and-sleep

(4) Stella Center, Depression Signs and Symptoms. ‌https://stellacenter.com/resources/9548/depression-signs-and-symptoms

(5) Cognitive Behaviour Therapy (CBT) for Menopausal Symptoms, Women’s Health Concern Fact Sheet, Information for women

(6) NHS Choices (2019). Overview - Hormone replacement therapy (HRT). https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/

(7) Options when avoiding Hormone Replacement Therapy (HRT) Information Leaflet. https://www.liverpoolwomens.nhs.uk/media/3545/options-when-avoiding-hormone-replacement-therapy-patient-information-leaflet.pdf

(8) Siegel-Acevedo, D. (2021). Writing Can Help Us Heal from Trauma. Harvard Business Review. https://hbr.org/2021/07/writing-can-help-us-heal-from-trauma

(9) Kim, H., Yoo, J., Han, K., Fava, M., Mischoulon, D., Park, M.J. and Jeon, H.J. (2021). Associations Between Smoking, Alcohol Consumption, Physical Activity and Depression in Middle-Aged Premenopausal and Postmenopausal Women. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.761761

‌(10) NW, 1615 L.S., Suite 800Washington and Inquiries, D. 20036USA202-419-4300 | M.-8.-8. | F.-4.-4. | M. (n.d.). Where people around the world find meaning in life. Pew Research Center’s Global Attitudes Project. https://www.pewresearch.org/global/interactives/meaning-in-life/data/hobbies_recreation/

‌(11) Mental Health Foundation (2019). How arts can help improve your mental health. https://www.mentalhealth.org.uk/explore-mental-health/blogs/how-arts-can-help-improve-your-mental-health

‌(12) Effect of Mind-Body Approaches on Menopausal Symptoms among Women: A Community-Based Pilot Study

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