Women suffer from major depression about twice as often as men and this tends to be the case during times when their hormones are in flux, such as around the time of their menstrual period, childbirth and perimenopause.

Aside from the physical sensations of hot flushes and sweats many women also experience sadness or even depression as they move into perimenopause and then menopause itself. In a way this is a very natural reaction as one phase of life is ending, the opportunity to have children may have already passed or life ambitions you sought have not happened.

I hear often from women who have been switched from HRT to antidepressants as a way of handling their symptoms, whether physical or mental, but such drugs do have a wide range of potential side effects including nausea, dizziness, dry mouth, anxiety and sleeping problems. Many women look for alternatives and happily there are helpful supplements and lifestyle tips that can help.

Natural ways to deal with depression

If hormonal imbalance is behind depression then it makes sense to make sure your hormones are balanced. This means dealing with low progesterone levels and avoiding oestrogen dominance. Progesterone is known to enhance mood and has none of the side effects or withdrawal symptoms associated with HRT or antidepressants so simply supplementing at perimenopause can keep emotions in balance. For some women with more severe depression, and no signs of oestrogen dominance, Dr Jeffrey Dach in the USA has found success supplementing with a combination of both progesterone and oestrogen, depending on the patient’s needs.

Other factors can also be poor nutrition as a variety of vitamin and mineral deficiencies are linked to symptoms of depression. A diet high in sugar, processed foods, additives and with few fresh fruits and vegetables will supply few of the body’s essential needs. If also either low in omega-3 fatty acids or with an imbalanced ratio of omega-6 to omega-3 then that too is associated with increased rates of depression. Improving your diet can really make a substantial difference.

If you have a chronic illness then that is related to depression in two ways. The stress of this may trigger an episode of major depression. In addition, certain illnesses — for example, thyroid disorders, Addison’s disease and liver disease

Lastly, the impact of stress cannot be overestimated as it plays havoc with our hormones and can overwhelm our ability to cope with even low levels of anxiety or depression. This is due to the high levels of the hormone cortisol, which are secreted during periods of stress, as they affect the neurotransmitter serotonin – our ‘feel good’ factor.

Although you may not feel like it, the evidence that regular exercise can help relieve depression is now firmly established. Even if that is a five minute walk in the garden, round the block, or starting a class such as yoga and tai chi. The latter will also help relieve stress and anxiety as focusing on getting the movement right gives your brain little time to let in the negative thoughts or feelings you may be experiencing. It’s not about getting it right, but about giving yourself the chance to think of something else that is so helpful.