It's well recognized that perimenopause is a time of increased risk for depression. So far, researchers have shown that the perimenopausal women at highest risk are those with the most severe hormone fluctuations. There is a lot we still don't understand about how the hormonal state influences mood disorders, but a reasonable theory is that our hormonal state somehow affects our neurotransmitters (some well known neurotransmitters include dopamine and serotonin).
Now we have further information about what's happening to brain chemistry for perimenopausal women. A team at the University of Alberta in Canada recently released the results of a study they did comparing the brains of perimenopausal women to women with regular menstrual cycles. Using an MRI, the researchers measured the amount of glutamate (a neurotransmitter) in a specific area of the brain called the medial prefrontal cortex. Decreased glutamate in this area is associated with depression.
The important thing to note here was that the researchers excluded women who already had depression, anxiety, or other mental health diagnosis. Women were scanned at the same time in their menstrual cycles to minimize variability related to the ovulation cycle. So other than age and regularity of menstrual cycles, the two groups they compared were similar. And what did they find? That perimenopausal women, as a group, had lower glutamate in the medial prefrontal cortex than women with regular cycles.
The takeaway from this study for me, right now, is that for those folks in perimenopause who are noticing symptoms of depression - you're not doing it wrong. If the things that have kept you in good mental health your whole life aren't working as well now, there's biology behind that change. It's not fair, and it's not easy but it's also not your fault, There are these measurable changes happening inside the brains of perimenopausal women that put them at risk for depression. So set down any self blame you've been doing, so you can decide what might help you feel better.
Depression can be handled in many different ways and a caring provider will take time to make a plan with you that feels safe and achievable. If your mood is making things difficult right now, you deserve good care.