By Staff of Leigh Ann Scott, MD, A Forum Health Provider
Depression Can Be A Symptom of Hormone Imbalances
Imbalances in your hormones and depression are interrelated. Conventional medical providers are quick to prescribe antidepressants when their patients present with symptoms of depression, however hormones could actually be the cause. Depression is a disease in and of itself, but it can also be a symptom of another underlying disorder. If the underlying disorder isn’t addressed, then antidepressants will only put a band-aid on the symptom and not treat the cause.
Antidepressants are the most commonly prescribed drug in the United States. Chances are that if you walk into your primary care doctor’s office complaining of feeling depressed, most are going to write you a prescription for an antidepressant medication without ever considering that there may be something else going on.
Interestingly, the largest demographic taking antidepressants are women in their forties and fifties. One out of every three women in this age group present with symptoms of depression. This is quite telling because this is also the time that women go through the phases of their lives called perimenopause and menopause. Hormones undergo drastic changes and can produce many symptoms including depression – another tell tale sign of the hormones and depression link.
Depressive symptoms associated with hormonal imbalances can have other signs too, including:
- Feeling overwhelmed
- Weight gain or changes in appetite
- Decreased pleasure in life
- Decreased libido
- Feelings of worthlessness or hopelessness
These are just a handful of things that may occur with hormonal imbalances, but these can also be symptoms of depression so it’s important to explore causation.
It’s also important to note that imbalances in one hormone often occur alongside imbalances in others. The endocrine system is the whole, and the glands/hormones are the parts and they all need to be in balance to work in harmony together.
Types of Hormonal Imbalances Associated with Depression
Both progesterone and estrogen hormones and depression can be linked. Progesterone, one of the female sex hormones, is what helps prepare the uterus to be an ideal place for a fertilized egg to grow. Estrogen is the hormone that prepares the uterus by building up the lining. At around day 14 of a woman’s cycle, progesterone levels rise which stops the uterine lining from building up. If there’s no egg, then progesterone levels drop and the lining of the uterus is shed.
When a woman enters the perimenopause stage her life, the first hormone to wane is progesterone. Reproductive years are starting to come to an end, so therefore, there’s no reason for progesterone to keep preparing the uterus for pregnancy. During these years, periods can become wildly erratic.
Fluctuations with progesterone levels can do the same thing to emotions by changing the brain chemistry which can lead to depression. Estrogen becomes the dominant hormone which can cause cortisol levels to rise and increase feelings of anxiety.
Progesterone also stimulates GABA, the feel-good/stay-relaxed neurotransmitter that’s also affected by the thyroid. When progesterone levels drop, GABA levels can drop too leading to feelings of both anxiety and depression.
Progesterone is the hormone that regulates sleep cycles so it’s not uncommon for women to begin to experience insomnia.
As progesterone levels decline in perimenopause, the delicate balance between estrogen and progesterone is thrown off, which creates a condition called Estrogen Dominance. This can occur at any age throughout a woman’s life, however it is especially prominent in the perimenopause years.
It’s important to note that it’s entirely possible for estrogen levels to be low, but to still have Estrogen Dominance because it’s all about the ratio between the two hormones. Estrogen Dominance can affect how the body assimilates thyroid hormones, which can cause hypothyroidism, also causing depressive symptoms.
As a woman gets closer to menopause, estrogen levels begin to decline. This can actually occur at any time during this phase as all hormones begin to fluctuate and ebb.
Estrogen also helps to boost serotonin levels. Serotonin is a neurotransmitter, or chemical compound, that helps to regulate mood. When serotonin levels decline, it leads to feelings of depression and anxiety, thus if estrogen levels are low, serotonin can also be low. Here you can easily see how changes in these hormones and depression are easily related. In fact, many antidepressants belong to a group of drugs called SSRIs, or Selective Serotonin Reuptake Inhibitors. These drugs aid in increasing serotonin levels.
If deficient estrogen levels are the cause of depressed symptoms, treating the deficiency will eliminate the symptom instead of masking it.
Women who have experienced depressive episodes during the reproductive years are much more likely to experience depression around the menopausal years. Also, women who have gone through surgical menopause (hysterectomy with removal of the ovaries) are also more likely to experience depression than women who go through natural menopause.
Testosterone has significant impact on mood and overall well-being. Decreased testosterone has been linked to both depression and anxiety. Many women find that once they get their testosterone deficiency addressed, that they feel like their old selves again and have pep back in their step. Low T in women can also cause loss of libido, fatigue, loss of muscle tone, and hair loss. Skin changes may also occur.
Hypothyroidism, or low functioning thyroid, can cause depressive symptoms. An under-active thyroid causes a slow-down in the entire metabolism so it’s not surprising that mood is low as well. The thyroid hormone, T3, is responsible for creating energy in the mitochondria of the cells. Without enough T3, overall energy levels fall. Besides depression, other common symptoms of hypothyroidism include fatigue, weight gain or difficulty losing weight, joint pain, and hair loss.
Hypothyroidism can also cause a drop in the neurotransmitter GABA. A neurotransmitter is a chemical that is produced by nerve cells and acts as a messenger to transmit signals between neurons, etc. GABA is a chemical found throughout the nervous system and in the cortex portion of the brain. It aids in regulating mood, anxiety levels, emotional stability, pain response, reactions to stress, and sleep, among other things. It’s thought of as the calming neurotransmitter.
While hypothyroidism and depression are two separate diseases, they include some of the same symptoms. If an underactive thyroid is the culprit, medication for the thyroid can eliminate or lessen the depression symptoms.
Additionally, thyroid issues often crop up during times of hormonal flux such as menopause in women or andropause in men.
Adrenal Hormones and Depression
The adrenal glands produce the “stress hormones” such as adrenaline, cortisol, and DHEA. It’s natural for adrenaline and cortisol to increase as a reaction to stress; they are the “fight/flight” hormones. However, when they become over-activated by chronic stress, the adrenal glands can become fatigued. Adrenal fatigue manifests in different ways which include depression, anxiety, and difficulty dealing with stress.
During menopause women are more likely to experience fluctuations with cortisol. When cortisol rises, it can contribute to weight gain and sleeplessness. However, when levels decrease, it can create mood swings to include depression.
Studies on how Hormones and Depression are linked
There have been numerous studies completed which show that your hormones and depression are connected, particularly with women going through the menopausal years being at much higher risk for developing depressive symptoms, even if they have no prior history of depression.
Some studies have shown that the significant hormonal changes that occur can also make a woman more vulnerable to physical and emotional challenges which can significantly affect function and quality of life.
Interestingly, one of the studies of 476 women, aged 40 to 60, noted that perimenopausal women experiencing depression were significantly more likely to have vasomotor symptoms (hot flashes) than the women who were not suffering from depressed symptoms.
For more detailed information regarding studies concerning hormones and depression, click here.