Journal / Mood, Anxiety, Depression

Hormonal Imbalances And Depression – Things You Should Know

Nancy L. Belcher

Medically reviewed by Nancy L. Belcher Ph.D, MPA

Written by Winona Editorial Team

Last updated November 25, 2021

Hormonal Imbalances And Depression – Things You Should Know

Hormones and Depression

Depression is something that we are hearing a lot about lately. While there are lots of reasons you may feel depressed, if you are in your late 30’s, 40’s, and 50’s, your naturally-occurring hormonal imbalances and depression are likely related and will continue to affect your mood and general outlook if not treated. 

Hormonal depression can lead to a loss of interest in activities that used to make you happy and leave you feeling irritable or sad. Even though most people feel sad or down for brief periods, depression is much more serious. Hormonal depression is often overlooked when thinking about clinical depression. 

You may have noticed some seriously frustrating side effects from peri- and menopause, like hot flashes, sleep disorders, and a depressed mood. Or, maybe you are easily triggered with high levels of anxiety, agitation, or an inability to focus. All of these symptoms are common with menopause, so being aware of how it all fits together will help you get back on track.

When women aren’t able to get past a depressive state, and it goes untreated, serious medical conditions can follow. Even if not extreme, untreateddepressioncan cause lasting issues that include.1,2

  • employment problems

  • the strain on relationships

  • drug and alcohol abuse

  • suicidal thoughts or attempts

Women who receive effective treatment for depression, like hormone replacement therapy and/or antidepressants, can go on to live healthy and happy lives. For some, depression may be a lifelong challenge that requires treatment on a long-term basis. For others, it’s about correcting hormones that have been thrown off. If you are feeling sad or depressed, please talk to your doctor.  Women of any age and life situation can have depression.

An Overview of Depression

Depression isn’t a simple condition with one known cause, but we do know that women are two times more susceptible to depression than men, and the risk of depression increases as we age. We must appreciate that the mind and body are interconnected. Rather than thinking of them as separate, let’s think of our mind and body as one balanced machine with many moving parts. 

For this reason, we have to look at the many factors that can increase your risk of developing depression. It is possible to develop depression with or without the risk factors listed below, but the more risk factors you have, the greater the likelihood of developing depression. 

The Risk Factors and Possible Causes of Depression 1-3

  • Being a Woman: Women experience depression about twice as often as men. Rates of depression have been found to be higher in women who are at home with children, and those who describe themselves as isolated, compared to women who are working or have a supportive social network. Restricted social networks lead to depression. Many women face additional stresses, such as responsibilities at work and home, single parenthood, and caring for children and aging parents.

  • Hormones: Hormonal factors may contribute to the increased rate of depression in women, particularly such factors as puberty, premenstrual changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause can cause depression and should be taken seriously.3  Hormonesare chemical messengers that can have a powerful influence on your brain and your mental well-being. When hormone levels are balanced, you can have stable moods and feel energetic, motivated, and mentally sharp. When hormone levels are out of whack,  you may experience symptoms that are associated with depression. 

  • Genetics: Depression may also be an inherited condition. You may have a higher likelihood of experiencing a depressive disorder if you have a family member with depression. It’s not as simple as finding one gene related to depression, it is believed that many genes may play a factor in causing depression.1 A history of one or more previous episodes of depression significantly increases the risk of a subsequent episode.

  • Situational: Sudden changes in your life, a trauma, or a feeling of loss of control can trigger depression. Children moving away from home, ailing parents, getting fired, more responsibilities at work layered on top of hormonal changes can definitely cause depression. 

  • Biochemical: When looking at brain scans some people have noticeable changes in their brains when suffering from depression. Neurotransmitters in the brain (serotonin, dopamine, or norepinephrine) will affect feelings of happiness and pleasure and can be out of balance in people with depression. Antidepressants work to balance these neurotransmitters, particularly serotonin. How and why these neurotransmitters get out of balance isn’t fully understood.

  • Seasonal: With fewer daylight hours in the winter, many women develop feelings of tiredness and a loss of interest in everyday activities. This condition was called seasonal affective disorder (SAD). SAD is recognized as a major depressive disorder with seasonal patterns. Your doctor may prescribe medication to help treat this condition. Where you live can be important. In regions with long nights and limited sunlight, depression is higher.

  • Major Life Changes and Stress: A stressful change in life patterns can trigger a depressive episode. Events may include a serious loss, a difficult relationship, trauma, or financial problems. When suffering from chronic stress, the constant flood of the stress hormones disrupts the production of the body’s other important hormones, leading to extreme hormonal dysfunction and hormonal depression.

  • Low self-esteem: People with low self-esteem, view themselves and the world with pessimism, or who are readily overwhelmed by stress, may be prone to depression. Other forms of low self-esteem look like perfectionism and sensitivity to loss and rejection, which may increase a person’s risk for depression. Depression is also more common in people with chronic anxiety disorders and borderline personality disorders.

  • Abusing drugs or alcohol and/or taking certain medications, like sleeping pills.

  • Having a serious or chronic illness: Physical changes can be accompanied by mental changes. Things like a stroke, heart attack, cancer, Parkinson’s disease, and hormonal disorders can increase the risk of depression. Chronic pain is also known to be associated with depression.

An Overview of Hormone Imbalance and Depression

As women age, they can start to have hot flashes, develop insomnia, experience unexplained weight gain, have brain fog and memory problems, lose libido, and experience mood swings. These symptoms occur mostly due to decreased estrogen, progesterone, and testosterone.

Going through peri- and menopause is like living with an endocrine disorder, and just like with other endocrine disorders, you are dealing with physical issues as well as possible cognitive and mental health issues.2,3

Using bioidentical hormones to restore your body to its natural balance is vital to treating hormonal depression. Bioidentical hormones, such as estrogen, progesterone, and testosterone, are made to be exactly like what is produced in our bodies, and supplements what we already have been making most of our lives.

Experts say that there is definitely a relationship between hormones and your sense of well-being. Your hormones work together with your nervous system to maintain your sense of balance or equilibrium both physically and mentally. Equilibrium is what your body wants, but if it’s off, like when going through peri- and menopause, a lot can go wrong. When hormones are out of balance it affects both your body and your mind.

If your mood has changed, it may help to look at the underlying hormonal factors that may be impacting your feelings of sadness and depression. Hormonal imbalances can lead to many symptoms of depression.

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Common Hormonal Imbalances that Can Cause Depressive Symptoms

Of all of the hormones our bodies produce, there are four that above all others are known to lead to symptoms of depressive disorders when they are out of balance.

  • Estrogen: Estrogen plays a role in the production of neurotransmitters in your brain (serotonin, dopamine, and GABA). Too much or too little estrogen can change the neurotransmitter levels and lead to feelings of depression.6

  • Progesterone: Often called the “relaxation hormone,” progesterone has a calming effect when it is produced at the right levels. When hormones are off-kilter or when progesterone hormone is low, it can lead to depression, as well as irritability, anxiety,  Sleepless nights, and brain fog.5

  • Testosterone: In both men and women, testosterone helps prevent depression, and decreases cognitive impairment and Alzheimer’s disease. Low testosterone levels have been shown to increase symptoms of depression and anxiety, such as trouble concentrating, lack of motivation, and fatigue.4,5

  • Thyroid: Thethyroid plays a powerful role in keeping your brain and body healthy and involved in mood regulation. Too little or too much hormone is linked to ⅓ of all depressions.5

Overcoming Depressive Symptoms Related to Reduced Hormone Levels

When hormonal imbalances are leading to depression and are behind your feelings of sadness and loss of energy, antidepressants may be part of the solution, but maybe are not the full answer. If your depression is due to hormones, antidepressants won’t get your mind right. 

If you are in peri- or menopause, it is your hormonal dysfunction that could be contributing to your depressive symptoms. This can leave you going from one antidepressant medication to another in search of relief without success. When you get your hormones right, it may improve symptoms of depression by stabilizing your moods, boosting your energy, and clearing away the brain fog.

Treatment and Ways to Deal with Depression

  • Hormone replacement therapy

  • Mental Health therapy

  • Adopt healthy lifestyle habits that can help support mental health

  • Understand the cycle of depression. If you’re tired and can’t engage in the activities you love, your mood will take a hit, leading to depression, which leads to more fatigue.

  • Follow good sleeping habits 

  • Use smart lifestyle choices (e.g. avoid alcohol for stress-relief)

  • Exercise can help correct depression, anxiety, and other mental health issues

  • Antidepressant medications 

  • Decrease Stress: Some ideas for stress-relief include

  • Daily deep-breathing exercises and focusing on your breath 

  • Creating a pre-bedtime self-care ritual

  • Spending time in nature simply walking or meditating

  • Journaling (or listing) your worries and anxieties

  • Meditation & yoga 

Symptoms of Depression and Menopause

While thesymptoms of depression can vary depending on the severity, there are some standard symptoms to watch for. The problem is that symptoms of depression are also similar to the symptoms of menopause. We know that menopause is not caused by depression, but maybe depression has a lot to do with menopause.  

Common symptoms include

  • sadness/unhappiness

  • tiredness/fatigue/no energy

  • trouble focusing or concentrating

  • anger/irritability/frustration

  • mood swings

  • lost interest in pleasurable activities

  • sleep issues (too much or too little)

  • craving unhealthy foods

  • anxiety/worrying/panic attacks

  • restlessness

  • brain fog/trouble concentrating, thinking clearly, or making decisions

  • poor performance 

  • suicidal thoughts or tendencies

  • pain, headaches, or muscle aches

  • lack of motivation 

  • low libido

How is depression diagnosed?

Since depression can’t be tested for using blood tests, your doctor will ask you questions about your thoughts and feelings. Your doctor will be able to diagnose you based on your symptoms and answers.


Hormonal imbalances and depression are something we must take seriously. While there are lots of reasons you may feel depressed, if you are a woman in your late 30’s, 40’s and 50’s, your hormonal imbalances are likely related to your mood and general outlook. 

With peri- and menopause you may be easily triggered with high levels of anxiety, hormonal depression, agitation, or an inability to focus. It’s unfortunately not uncommon, but being aware of how it all fits together and what you can do to manage it is key.

Hormonal depression can lead to a loss of interest in activities or feeling sad. Even though most people feel sad or down for brief periods, hormones and depression are often overlooked when thinking about clinical depression that is more than just feeling sad. Hormonal imbalance depression can lead to a serious medical condition when women usually aren’t able to get past a depressive state and it goes untreated. 

You don’t have to keep feeling this way. Take the first step today and start your first month of treatment with Winona. Get ongoing, personalized treatment for depression with medication delivered monthly.  Improve your quality of life with the support of Winona’s licensed physicians. In order to treat your depression, your Winona doctor may prescribe hormone treatments. Treatment solutions will be tailored to your specific case since causes and symptoms of depression can vary.

If you think someone is at immediate risk of self-harm or hurting another person, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

  • Call 911 or your local emergency number.

  • Stay with the person until help arrives.

  • Remove any guns, knives, medications, or other things that may cause harm.

  • Listen, but don’t judge, argue, threaten, or yell.

“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”