How do you know if it’s perimenopause or good old fashioned depression?

[Hightideattheseaside]

Felt very low the last few months. I have two ND children that melt down daily and my DH and I both work full time so life can be difficult. The last few months I have felt less able to cope, have increasing anxiety, feel so, so low some days - to the point of imagining not being around anymore. What makes me think it’s peri is that some days I feel ok! I feel quite up beat and optimistic. So maybe the dark times are hormone induced?

But I’m only 42 and I had a blood test and all good, period very regular, sleep still mostly ok, not many other symptoms so maybe I’m just depressed? I’m not enjoying my job and the weather is just bleak, which again makes me think maybe just depressed and ground down by life.

I want to go to the GP for help but I don’t whether to ask for HRT or antidepressants. Don’t really want antidepressants due to side effects but feel I’m approaching the point I need something.

A blood test can’t diagnose peri.
You could try the HRT and see if you start to feel brighter. One of my main symptoms was a feeling of flatness. The HRT sorted that out.
You could also keep a very simple diary - tick box or scale of 1-10
My symptoms were the flatness, difficult periods, occasional hot flush, brain fog.
What helps? Going for a walk every day- not easy in this weather so maybe a walking pad. Increasing my protein.
If you monitor your mood for at least 2 months then you can see if your mood is linked to your cycle - but only if you are not on hormonal contraptions.
However if you try the HrT and you feel better then maybe you will have your answer.

Thanks for the reply. I’m not on hormonal contraception. I’ve been trying to track my symptoms and things are definitely worse the week before my period. A couple of months ago things got very dark leading up to my period I was ready to walk in the sea. I felt such relief when I started bleeding it was almost instant. There was a pattern that I’d feel happy for the first couple of weeks of my cycle.

However I’m finding myself increasingly sad/ flat all the time. I guess I should try HRT first to see if I feel brighter. Im a bit nervous to go to the GP though as when I mentioned it before she sent me for a blood test but basically said I was too young. So I’m not sure how receptive she’ll be and I don’t have much energy/ confidence to advocate for myself at the moment.

I think that it would be a good idea to speak to your GP re the possibility of depression. Depression does fluctuate but is triggered by hormone dips. For me the perimenopause made me angry and frustrated but never suicidal. However, at 40, when I was diagnosed with post natal/grief related depression, I often thought about running away or driving into the river. The crunch came after a day out when I got out of the car and ran into the field next to our house and just screamed.

Our hormones fluctuate sufficiently through our cycle to aggravate depression before peri is a problem.

I had 18mnths of antidepressants and didn’t look back until I hit fifty and started to act like a fire breathing dragon. HRT made an instant difference but then I stopped taking it due to breast cancer diagnosis. I was post meno by this time and I’m now hormone free and coping really well despite a series of major life catastrophes. I was worried that my mood would plummet but was pleasantly surprised how level my moods are now.

I’m sorry to hear your GP isn’t helpful OP…. I’ve been seeing my GP since I was 42 and she immediately ordered me a lot of blood tests etc. I’d been silently suffering for at least three years. She has been amazing and that’s been super helpful. I had the coil fitted September 2025 and went on HRT patches November ish (when I was just 43!) and we reviewed it after three months and I’ve just increased to the 75 patches as I still feel anxious/low. I have 5 and 10 year old and asked her what was normal mum shit and what is peri symptoms!

I still feel anxious - especially driving. I hate that. But the wanting to die has massively reduced. I’m still waiting to feel…frequent moments of real happiness? But it has occurred … and before HRT it was never.