Anxiety & depression: should you use SSRIs? Hormones? Both? š
Letās talk about depression, anxiety and SSRIs.
Research shows that nearly 60% of women report anxiety & 44% experience depression in perimenopause.
Why?
Declining estrogen and progesterone mess with serotonin (your happy molecule ), dopamine (your motivation spark āØ), and oxytocin (your love / connection hormone ).
Meanwhile, progesteroneās GABA-boosting power ā your brainās ācalmā button ā also falls, leaving you feeling frazzled and often making sleep tough.
Unfortunately, medical providers arenāt generally aware that these are contributing factors and will suggest SSRIās before exploring other, more natural interventions that support healthy hormone levels.
Can SSRIās help?
Absolutely, they can be lifesavers, but they donāt address root hormonal issues.
If youāre wondering whether bioidentical hormone replacement therapy (BHRT) might help, this is a great place to start - see below.
And itās not an either/or situation ā you can combine SSRIs + BHRT for a comprehensive approach, if thatās what you truly need.
Can hormones help?
Yes!
Early in the perimenopause journey, many women find relief by supporting their falling progesterone levels (which often produces anxiety/depression). This can be done naturally, through supplemental progesterone* or a combo of the two.
I can be right cranky at the end of my cycle without my sweet friend progesterone aboard.
*Important notes:
Bioidentical progesterone can help, but contraceptive progestin drugs are BAD for mood (ie. levonorgestrel, drospirenone, norethisterone, etc). Theyāve all been linked with anxiety and depression.
Oral progesterone appears to be better for mood and cognitive effects than the topical cream (since some of the metabolites that come from liver processing reach the brain).
For most women, progesterone is good for mood because it converts to a neurosteroid called allopregnanolone, which sensitizes GABA receptors, increasing calm. YAY!
Testosterone can help as well - it starts to fall in our late 20s(!) and most women I see in their 40s and beyond are low T. Adequate levels of testosterone are associated with positive mood, increased energy, and overall feelings of well-being, while low levels can lead to mood swings, irritability, and a higher risk of depression.
Later in perimenopause, as estrogen falls, adding estrogen to the mix can help too.
The bottom line: If youāre over 40 and feeling off, donāt settle. Advocate for yourself and talk to your doctor about whether hormones could help. They may be the key to thriving, not just surviving.
My favorite herbs for easing anxiety
If youāre feeling more anxious in your 40s (and beyond), youāre not alone ā anxiety is a super common symptom while your hormones do a big dance-a-thonā¦
The good news:
Certain herbs can help support your mood and ease that anxious edge.
šæ Ashwagandha: A powerhouse for stress and anxiety relief, research shows it reduces cortisol levels. Like a hug for your nervous system.
šæ Magnolia Officinalis: Known for its calming effects, itās great for reducing stress.
šæ Rhodiola Rosea: Another fantastic herb for stress reduction and mental clarity. It can also be energizing so just donāt take it late in the day!
Supporting your body with these adaptogens can make a world of differenceā¦AND, everyone responds differently to these things, for reasons we often canāt predict (genetics, gut health, etc).
On janky days, I sometimes take all 3 of these together in a supplement called Cortisol Calm (which you can get here). It was designed to help reduce cortisol levels and support overall mental and physical well-being. I find it helps me remain calm and centered all day.
(Standard disclaimer: Please check with your medical provider before starting any new supplement.)
May the calm be with you.
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If youāre a midlife woman who wants my personal help to transform your health, balance your hormones, ignite your metabolism and lose weight the healthy, sustainable way, check out my Better Beyond 40 Formula program: please watch this video and book a free Discovery Call.
