Am I peri-menopausal or depressed? Don't know how to tell the difference.

[Athyrium]

I'm nearly 50, and have a history of depression - I am currently on 100mg of sertraline for that, having realised 6 months ago that citalopram wasn't working any more. However, the last couple of years, taking ADs hasn't in itself been enough to stop mood swings, irritability and general low mood. I have absolutely no motivation any more. I am almost on a path of self destruct - drinking way too much, eating badly. These behaviours are not entirely new, but they have become constant. I seem to spend my life fretting that I am mad/ill/lazy/stupid...you name it. In the past, the low mood/lethargy would be temporary. Now it seems almost constant. Thing is, I don't have a whole lot of other peri-menopause symptoms. Ok, my periods are a bit different, I have put on weight, I can be a too warm mornings....but mostly I just seem to be irritable, miserable and unmotivated. Im starting to worry that maybe this is just me Any advice would be really appreciated.

I think it's really hard to know. But it could be both. If you have a history of depression then lack of oestrogen may just make it worse even though you are taking ADs.

There is quite a lot of recent research which has shown that most ADs are ineffective for mild depression. [http://www2.hull.ac.uk/news-and-events/news-archive/2008-news-archive/february/antidepressants.aspx THis] and similar research has been in the press lately.

Have you thought about finding someone to help you with lifestyle changes- such as a good life coach, a wellness coach or one who works with women over 50 perhaps? They'd help you structure exercise and changes to your eating / drinking habits.

There is a lot of research by the charity MIND which shows that exercise outside ( walking) in green spaces works as well for some people as ADs.

Maybe the answer is a combination of lifestyle changes and HRT to see if that helps?

link to research on ADs

Thanks pink. I am seeing a therapist at the mo (through an alcohol dependence counselling charity) but finding that hard going. Dragging up my dark and distant past is painful. Makes me want to drink more quite frankly!!

I have been keeping an eye on my mood calendar-wise lately. I reckon I currently only get about 10 days a month relief from PMT type symptoms (such as sore boobs, irritabilty, low mood) and the rest of the time I feel hormonal. So my period starts and I feel tired but ok for a week and a half or so. Then back to doom and gloom. Does that sound peri-menopausal?

Think I will crawl off to my GP, shes quite sympathetic on the whole.

If your symptoms are cyclical or exacerbated by your cycle then they are (at least partly) hormonal, even though you have a history of depression, and only hormone replacement will help - but without irregular periods it might be difficult to get a prescription.

Because you are on sertraline this will be reducing symptoms such as hot flushes and sweats that you might be feeling if you weren't on sertraline - even if your periods were still fairly regular. Some women are very sensitive to changes in oestrogen and experience early symptoms of menopause due to the hormonal changes at this time.

I agree with pinkfrocks' advice - that lifestyle changes and HRT may well be of benefit and defo to see your doc. Glad you are getting help re the alcohol as limiting this is the best thing you could do for your future health and would definitely limit the impact of menopausal symptoms!