BLOG

The Hormone - Depression Link

There’s some controversy around what really causes depression.

Some say it’s all genetic, others say it’s your environment, or maybe it’s how you think and react to events in your life.

There’s support for most theories. We know some people are more susceptible to depression, so genes must play a role.

Being in an abusive relationship or negative work environment can cause depression too.

Most people will also agree that if we dwell on negative thoughts, we can become depressed.

So there are a mix of causes that work together, and we’re starting to understand that it’s complex. Science is also starting to find that hormones play a role too.

Depression is surprisingly (and sadly) common in our society, and it’s on the rise. More and more research is going into how to help people avoid depression, manage it, and get better.

Medication is one treatment that works for some.

However, many people on antidepressants or anti-anxiety medications just aren’t seeing results or benefits from their medication, and that can indicate that something else—like a hormonal imbalance—is causing the symptoms.

When considering hormones as a cause of depression, consider this: A woman’s hormone’s are always changing.

Both sexes go through puberty, but women go through all kinds of hormonal changes at that time, and then monthly for three or four decades before another huge hormonal shift.

Rita Nonacs, M.D., Ph.D., Associate Director of the Center for Women’s Health at Massachusetts General Hospital looked at how this affect’s depression in women in her book A Deeper Shade of Blue.

“Throughout her reproductive years, not only is a woman exposed to different types of hormones and different levels of these hormones than a man,  she experiences constant hormonal fluctuation,” writes Dr. Nonacs.

This hormone yo-yo effect wreaks havoc on many women, especially those vulnerable to depression and anxiety.

The hormone-depression link is well researched and documented.

Claudio Soares and Brook Zitek authored a paper titled, “Reproductive hormone sensitivity and risk for depression across the female life cycle: A continuum of vulnerability?”

The paper’s abstract begins with, “Throughout most of their lives, women are at greater risk for depression than men. Hormones and neurotransmitters share common pathways and receptor sites in areas of the brain linked to mood, particularly through the hypothalamic-pituitary-gonadal axis.”

They theorized, and then proved with research, that women “presenting with episodes of depression associated with reproductive events (i.e., premenstrual, postpartum, menopausal transition) may be particularly prone to experiencing depression, in part because of a heightened sensitivity to intense hormonal fluctuations.”

It seems at any point of their life, women are experiencing hormone fluctuations that affect their mood.

The two authors noted, “The gonadal steroids estrogen and progesterone have been shown to affect brain regions known to be involved in the modulation of mood and behavior.”

This isn’t the only hormone interaction at play in depression. We’ll discuss this one first and then thyroid and cortisol issues related to depression.

 

Female Hormonal Changes and Depression

It’s interesting to note that males and females suffer about the same rate of mood and anxiety disorder...before puberty.

After puberty, however, that rates rise in women, who are 1.5 to 3 times more likely to suffer from major depressive disorders than are men.

Puberty brings all kinds of hormonal changes, and women’s hormones fluctuate throughout their cycle. Many people are aware of premenstrual syndrome, or PMS.

It’s a worrying statistic that at just 15 years old, girls are twice as likely to suffer from depression as boys, and their risk of suffering from depression going forward remains consistently higher.

Dr. Nonacs states however that “at no other point are women more vulnerable to depression than during their childbearing years”.

During puberty, girls experience massive rises in the hormones estrogen and progesterone. These are responsible for physical changes such as the development of breasts. However, they also impact the brain.

Estrogen, for example, is known to diminish the production and effects of cortisol, known as the “stress hormone”, something deployed by the body to counteract the effects of stress and anxiety.

Progesterone, on the other hand, has been shown to have a calming effect and the ability to mitigate panic symptoms.

The process of menstruation involves fluctuations in the levels of estrogen and other hormones. Some women experience depression-related symptoms such as sadness, irritability, and fatigue prior to menstruation.

More severe case of emotional problems related to menstruation is known as premenstrual dysphoric disorder (PMDD).

PMDD has recently been inducted into the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and so is officially recognized as a mood disorder.

Most women experience at least one or two unpleasant symptoms associated with PMS, but you will only receive a diagnosis of PMDD if you are suffering from at least five symptoms. These may include:

  • Mood swings and emotional episodes
  • Acne
  • Headaches
  • Increased appetite
  • Panic attacks
  • Dizziness
  • Tiredness
  • Insomnia
  • Tender breasts
  • Irritability

Between 3 and 8 percent of women will experience these more severe symptoms. Talk to a patient with PMDD and they’re likely to complain of cramps, back aches, night sweats, and other problems.

Strangely, the cause of PMS and PMDD is a mystery. The closest we have to an answer is imbalanced hormones, mostly those associated with the menstrual cycle like the previously mentioned estrogen and progesterone.

Postpartum depression is a more widely documented manifestation of the effects of these hormone imbalances, and menopause is also counted among this family of hormonal conditions.

As such, the case for a direct link between hormones and depression is compelling. Women are vulnerable to depressive episodes at many times in their life, due to a variety of factors, but one of the most pressing has to be fluctuating hormones.

All the changes experienced during adolescence, pregnancy, as well as later cycles and menopause, are taxing processes on the body and mind.

It becomes painfully obvious that women need physical care to deal with the normal symptoms of menstruation and hormonal shifts through pregnancy and menopause. Care shouldn’t stop there.

Women need support for emotional health as well. Managing hormones becomes very important for overall health.

Women may also experience thyroid and cortisol hormone issues on top of these.

 

Thyroid Hormones and Depression

Despite not being immediately related, depression is a major symptom of hypothyroidism. This is a condition that means your thyroid gland can’t produce enough hormones to function properly.

There are medications available to treat this condition, and unlike adrenal fatigue, is a medically recognized condition.

Hypothyroidism and PMDD share many of the same symptoms. If you found that PMDD fit some but not all of your boxes, check the symptoms below to see if more apply.

  • Slowed heart rate
  • Aches and pains
  • Losing your voice
  • Thinning hair
  • Disrupted menstrual cycle
  • Neck swelling
  • Joint or muscle pain
  • Weight gain
  • Constipation
  • Sensitivity to cold
  • Tingling hands or fingers
  • Dry, flaky or yellowing skin
  • Brittle or thick nails

 

If you’re suffering from any or most of these symptoms, consult your doctor. They can provide blood tests that can detect abnormalities in thyroid hormones and confirm a diagnosis of hyper or hypothyroidism.

It’s also worth noting that any condition that affects your health can affect your mood and cause depression.

Thyroid conditions lead to people feeling “off” and unhealthy, and combined with fatigue, aches and pains, thinning hair.. Well, you can see how it could lead to depression.

 

Cortisol and Depression

Cortisol is an immensely important hormone for a number of reasons. One of these is that it helps regulate blood pressure and blood sugar, two things that contribute towards our experience of stress and depression.

Chronic stress can result in prolonged elevated levels of cortisol, which can in turn lead to higher blood pressure and blood sugar, as well as a diminished ability to stave off infections, and to keep weight off.

People suffering from depression also tend to lack the proper levels of something called serotonin, as well as exhibiting higher levels of cortisol.

Taking steps to reduce the stress in your life is a great way to start the road to recovery from depression.

It may also be worth reading up on something called adrenal fatigue, which is a related condition that is caused by high levels of cortisol, ergo chronic stress.

Basically your adrenal glands become fatigued because your body becomes resistant to the effects of cortisol while demanding the adrenal glands constantly produce high levels of the hormone.

During this process, you may experience similar symptoms to those discussed here like mood swings, depression, anxiety and insomnia.

 

Adrenal Issues and Depression

Imbalances in the stress hormones adrenaline, cortisol, and the precursor hormone DHEA can cause depression, anxiety, and insomnia. These may not be related to mental health.

Chronic stress hormones make you feel anxious, unable to sleep, and irritable.

A chronic deficiency of stress hormones can make you feel sluggish, tired even when you sleep, moody, and depressed.

When you have daily fluctuations and imbalances, it can cause a mix of both sets of symptoms.

It’s easy for a doctor to miss this and prescribe antidepressants when it’s a hormone issue.

For example, a symptom of undiagnosed hypothyroidism is depression that doesn’t  respond to antidepressant therapy.

Dealing with Hormonal Depression

A first step is running blood work and checking hormone levels. Some doctors do this before moving forward with antidepressants. If your doctor doesn’t, consider requesting it.

Your doctor should consider your complete medical history, assess your symptoms, do a thorough clinical exam, and run comprehensive blood testing to evaluate and diagnose any hormone balances.

Antidepressants and anti-anxiety medications often have side effects, and no one wants to deal with that over a medication that won’t treat the problem is the underlying cause is actually a hormonal issue.

Hormones interact and affect our health in many ways. Learn more at www.powerofhormones.com.

 

 

References:

https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression

 

https://www.holtorfmed.com/the-link-between-hormones-and-depression/

 

https://www.medicinenet.com/premenstrual_dysphoric_disorder_pmdd/article.htm

 

Women, Hormones, and Depression. Therese Borchard. https://www.everydayhealth.com/columns/therese-borchard-sanity-break/women-hormones-and-depression/

 

“Reproductive hormone sensitivity and risk for depression across the female life cycle: A continuum of vulnerability?” Soares, Claudio. Zitek, Brook.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440795/