When mood follows the hormones

For many who menstruate this is no news: mood follows not only life but also a biological rhythm. The days before a period can lower spirits, shorten the fuse and weigh down the body — and for some, something deeper changes around menopause. This is not imagined or a weakness, and it deserves to be taken as seriously, and with the same sobriety, as anything else that affects how we feel.

The best-established pattern is the link between hormonal phases and mood. Premenstrual complaints are common, and a smaller group has PMDS (premenstrual dysphoric disorder) — a condition where low mood, irritability and anxiety in the last days before a period become so strong that they disrupt life. It is not "a bit of PMS", but a recognized condition for which help is available. And the transition toward menopause, perimenopause, is associated with a clearly raised risk of depression. In the large SWAN study the risk was roughly one and a half to two times higher during this period than before it. Hormonal fluctuations appear to make the brain more vulnerable to low mood, especially in someone who has been depressed before.