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Managing anxiety, depression, and mood swings during perimenopause

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Perimenopause
4
 minutes
February 28, 2025
Medically reviewed by: 

Perimenopause is a time of significant physical and emotional change. As hormone levels fluctuate, many women experience perimenopause mood swings, perimenopausal anxiety worse before period, perimenopause and depression, and heightened perimenopause and irritability. Understanding these emotional shifts and learning how to manage them can make this transition smoother and more manageable.

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Perimenopausal anxiety is worse before period

Many women report that perimenopausal anxiety is worse before their period. This heightened anxiety is often a result of premenstrual syndrome (PMS) symptoms overlapping with perimenopausal hormonal changes.

What to do:

  • Track your symptoms alongside your cycle to identify patterns and prepare for high-anxiety days.
  • Incorporate stress-reducing activities like yoga or deep-breathing exercises into your routine.
  • Consider talking to your doctor about hormonal therapy in the form of a contraceptive or other medications to manage anxiety.

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Understanding perimenopause mood swings

Perimenopause mood swings are one of the most common emotional symptoms women face during this stage. These sudden changes in mood are often linked to hormonal fluctuations, particularly the decline in estrogen, which impacts serotonin levels in the brain. As a result, women may feel irritable, tearful, or overwhelmed without any clear trigger.

What to do:

  • Practice mindfulness or meditation to help regulate emotions.
  • Establish a consistent sleep schedule, as poor sleep can exacerbate mood swings.
  • Engage in regular physical activity to boost endorphins and improve your overall mood.

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Perimenopause and depression

The connection between perimenopause and depression is complex, as hormonal changes (like the drop in estrogen levels) may amplify feelings of sadness, hopelessness, or loss of motivation. These emotions can be temporary, but if they persist, they may signal clinical depression.

What to do:

  • Seek support from a therapist or counselor who specializes in women’s health.
  • Focus on building a support network of friends, family, or support groups.
  • Evaluate whether hormone therapy or antidepressants could help manage symptoms.

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Menopause mood swings & perimenopause mood swings

While both menopause mood swings and perimenopause mood swings stem from hormonal changes, perimenopause often brings more unpredictable shifts due to fluctuating estrogen and progesterone levels. In contrast, menopause mood swings may stabilize as hormone levels plateau.

What to do:

  • Educate yourself on the differences to better understand what to expect.
  • Keep a journal to record your emotional patterns and triggers.
  • Stay proactive about managing stress through self-care practices.
  • Talk to your provider if HRT could be right for you and your health history to support your mental health journey in midlife. 

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Perimenopause and irritability

Perimenopause and irritability often go hand in hand. Small inconveniences might feel magnified, and frustration can arise easily. This symptom is another result of fluctuating estrogen levels and their impact on serotonin.

What to do:

  • Communicate openly with loved ones about how you’re feeling.
  • Take regular breaks during the day to recharge and reduce irritability.
  • Explore therapies like HRT that can help balance hormones and support mental health changes during perimenopause and menopause. 

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Expert-recommended strategies for managing emotional symptoms

Managing emotional symptoms during perimenopause requires a holistic approach that addresses both physical and mental health. Here are some expert tips:

  • Nutrition matters: Eat a diet rich in omega-3 fatty acids, whole grains, and leafy greens to support brain health.
  • Stay active: Regular exercise can reduce anxiety and depression while improving sleep and energy levels.
  • Seek professional help: Don’t hesitate to consult your doctor for tailored treatment options, including therapy, hormone therapy, or medication.
  • Prioritize self-care: Make time for activities you enjoy, whether it’s reading, gardening, or taking a long bath.

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When to seek help

If symptoms of perimenopause and depression, perimenopause mood swings, or perimenopausal anxiety begins to interfere with your daily life, it’s time to seek professional help.  This is especially true if these symptoms are new or worsening. A healthcare provider can help you explore treatment options and offer the support you need.

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Conclusion

The emotional toll of perimenopause is real, but it’s manageable with the right strategies and support. From addressing perimenopause and irritability to coping with menopause mood swings, taking proactive steps can help you navigate this transition with greater ease and confidence. Remember, you’re not alone, we are here to help you feel your best throughout midlife and beyond.

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