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October 9, 2007 > Are You Facing Menopause and Feeling Sad?

Are You Facing Menopause and Feeling Sad?

Washington Hospital Discussion Group Focuses on Midlife Depression

Mood swings or even mild depression can be a normal part of menopause. But major depression is a serious condition that shouldn't be ignored.
"Sometimes it's difficult to know what you are experiencing," said Dr. Dikla Shidlov-Cohen, a psychologist at the Community Counseling and Education Center in Fremont. "Menopause causes hormonal changes that can affect our moods. It's important for women to educate themselves as much as possible so they can recognize the symptoms and understand what is happening both physically and emotionally."
Dr. Shidlov-Cohen will be facilitating an upcoming discussion group at Washington Hospital titled, "Midlife Mood Swings or Depression," along with her colleague Dr. Marcia Vasconcellos. Part of the monthly Midlife Transitions Discussion Group for women, the session is scheduled for Tuesday, October 16, from 6:30 to 8 p.m., at the Washington Women's Center, 2500 Mowry Avenue, in Fremont. For more information or to reserve a space, call (510) 608-1356.
While there are common symptoms related to menopause, the experience and timing is different for every woman. Most women transition into menopause in their 40s. This transition is called perimenopause and generally lasts from two to eight years.
Perimenopause signals the ending of your reproductive years. Reproductive hormone levels - estrogen and progesterone - rise and fall unevenly during perimenopause. Menstrual cycles become irregular and eventually stop altogether.
Hormonal fluctuations contribute to the common symptoms of perimenopause, which can include minor mood problems as well as insomnia and hot flashes. Add normal life stresses, and feelings of depression and unhappiness can be intensified.
The psychologists will help the group understand what happens during the transition to menopause and ways to minimize the impact. They will also help women identify when it might be time to seek professional help for depression.
"A trained psychotherapist can help you determine the cause of your depression and the appropriate treatment," Shidlov-Cohen said.

Mood Swing or Major Depression?
Life is full of ups and downs, which can be intensified during the transition to menopause. But when the down times last for weeks or keep you from living your "normal" life, you may be suffering from major depression.
"We're not talking about feeling a little blue from time to time," Shidlov-Cohen said. "We can all experience mood fluctuations. We are talking about something that begins to disrupt normal functioning."
She will explain both the emotional and physical symptoms of depression, including:
* Depressed mood most of the day for more than two weeks
* Loss of interest in activities once found pleasurable
* Fatigue or lack of energy
* Restlessness
* Feelings of guilt or worthlessness
* Difficulty concentrating
* Trouble sleeping or sleeping too much
Women at greatest risk for major depression during menopause are those with a history of depression or who suffered from depression after childbirth, called postpartum depression. Women who feel depressed around the time of their menstrual cycle may also be at greater risk.
The psychologists will provide information about treatment options that are available, including psychotherapy, antidepressant medication and hormone replacement therapy. While antidepressants and therapy are the most appropriate treatments for severe major depression in perimenopausal women, hormone replacement therapy may be effective for mild to moderate symptoms, particularly if the woman has never been depressed before.
"There are a lot of options depending on the woman and the severity of the depression," Shidlov-Cohen said. "Depression is very complex and individual."
To learn more and talk with other women who are facing similar challenges, attend the next Midlife Transitions Discussion Group on October 16. To reserve a space, call (510) 608-1356.
For more information about other Washington Hospital programs and services, visit

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