Two recent studies show a woman is most at risk for a first bout of depression the closer the gets to menopause.

One of these studies measured 231 women in the Philadelphia area, over eight years, observing hormone levels. The researchers found that a woman’s chances of slipping into depression grew as her hormones changed.

According to Ellen Freeman, co-author of the study and researcher at the University of Pennsylvania School of Medicine, “It’s not all in your head.”

Most women who reach menopause will not suffer from depression, but these two new studies suggest that some women could be more sensitive to this life-transition.

“There is a subgroup of women who, for multiple reasons, may be more vulnerable,” explains Dr. Lee Cohen of Harvard Medical School, and co-author of the second study. This second study followed 460 Boston-area women over a course of six years.

The Philadelphia study found that women with a history of PMS were more likely to experience depression the closer they got to entering menopause.

Cohen said women and their doctors shouldn’t discount a disabling depression during the transitional phase around entering menopause.

“Those who develop depression really need to be treated,” with talk therapy, antidepressants, or a combination, he said. Hormone therapy may be helpful to some women, he added.

The federally-funded studies, published in the April issues of Archives of General Psychiatry, observed only women with no prior depressive history. The women were in their 30s and 40s when the studies first began.

Cohen and a co-author disclosed in the paper that they have financial ties to several manufacturers of antidepressants.

According to the Boston study, women nearing menopause were almost twice as likely to develop depressive symptoms as women not yet undergoing menopause. In the Philadelphia, outcomes showed women who reported symptoms of depression were five times more likely to be nearing menopause.

Some medical experts theorize such depression could stem from disruption of sleep due to hot flashes. However, both new studies found depression to be independent.

In the Harvard study, the women most likely to get depressed were those having both hot flashes and other more stressful events in their lives, such as losing a family member or getting a divorce, noted Nancy Fugate Woods, dean of nursing at the University of Washington.

Woods says, “It isn’t possible, in the reality of women’s lives, to tease those things apart completely.” Woods has undertaken similar research; however, she was not involved in the new studies. “No matter how clever the research design is, you’re still stuck with human beings.”

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