When to see your doctor about depression
Depression is a serious mental health condition. It’s essential that you consult your doctor to help you deal with it, whatever the cause. However, it can sometimes be hard to articulate how you’re feeling when sitting in front of a doctor. Before an appointment think about your own history including your periods, any post-natal issues or any depressive episodes. Keeping a diary of moods and periods before an appointment may help. A period tracker will help you monitor your moods.
Severe cases of hormonal depression may be premenstrual dysphoric disorder (PMDD) this is a very severe form of premenstrual syndrome (PMS), which can cause many emotional and physical symptoms every month during the week or two before you start your period. It is sometimes referred to as 'severe PMS'. PMDD symptoms are much worse than PMS and could have a serious impact on your life. Experiencing PMDD can make it difficult to work, socialise and have healthy relationships. In some cases, it may also lead to suicidal thoughts. If you are suffering severe symptoms you should seeks help and support. There are PMDD Facebook pages you can join to find additional help. In an emergency call the Samaritans for free on 116 123, or go to A&E.
Hormonal depression can go unrecognised. Many women don’t realise they are perimenopausal, so don’t make the hormone connection. Women struggling with low moods, tiredness and focus, may therefore be prescribed anti-depressants by their doctor when the possibility of perimenopause is not discussed. However, guidelines on menopause from The National Institute for Health and Care Excellence (NICE) say, ‘It has not been shown that antidepressant drugs called SSRIs and SNRIs can help with low mood during menopause if you haven't been diagnosed with depression.’
And then there’s always HRT….
Where depression is caused by hormone fluctuation and you are able to take HRT, transdermal oestrogen, is an option. Results of a research published in January 2018, in the American JAMA Psychiatry journal, found fewer women given HRT went on to develop symptoms of depression than those who were given a placebo. NICE guidelines recommend the use of HRT for symptoms of low mood. GPs will look at your unique risk factors to see whether or not HRT is appropriate for you.
The usual caveat here, that there are pros and cons to taking HRT. See our vlog, What is HRT? and our conversation with our gynaecologist, Dr Karen Morton Talking Menopause Depression & Anxiety. We don’t take a view. It’s for you to decide whether it’s for you or not.