Why Do I Feel Crazy? Menopause Depression and Anxiety

3 minute read

By: Alloy Staff|Last updated: May 10, 2022
Medically reviewed by: Sharon D. Malone

It's normal to feel emotional during perimenopause and menopause. While you experience this new phase of life, you experience many changes resulting from fluctuating levels of estrogen and progesterone. For example, you may experience hot flashes, mood swings, and insomnia.

Your body also undergoes many changes. Women may gain weight. Sleep can become hard to come by, libido issues can affect your sex life, and vaginal dryness can make everything feel downright uncomfortable. These changes can all add up to make you feel crazy, but we’re here to assure you that you’re not.

Can Menopause Make You Mentally Unstable?

As perimenopause causes your hormones to fluctuate, and menopause causes your hormones to decrease, you may experience rapid, unexplainable mood changes. Increased feelings of irritability, nervousness, and sadness may make you feel like you’re losing your mind, but there’s no need to panic. 

Every woman undergoes menopause as a normal part of aging, and with it comes many mental and emotional changes that can throw a wrench into daily life. About 75% of women experience emotional symptoms as a part of menopause, so just know that you’re never going through menopause’s symptoms alone.

How Hormones Affect Your Moods

When you reach perimenopause and transition into menopause, your body's levels of estrogen and progesterone first start to fluctuate and then start to dramatically decrease. It’s normal to feel unstable during this period, as the neurotransmitters in the brain responsible for mood regulation can be affected by decreased levels of hormones.

A decrease in estrogen also causes hot flashes which make it difficult to sleep and further contribute to feelings of fatigue and irritability. We all know that without adequate rest, everything feels worse, and our emotional reserve is at its lowest.

Menopause Mood Swings

Even though most women don't become severely depressed or anxious during menopause, lack of energy, mild mood swings, and irritability are common. Women with a history of anxiety or depression are also at greater risk of developing worsening symptoms as they experience menopause.             


Menopause comes at a particularly difficult time in most women’s lives.  Many of us are dealing with teenagers, negotiating work, marital and relationship stress, and taking care of aging parents. Suppose you're battling bothersome night sweats and fatigue on top of all the little surprises that life has in store for you. it's no wonder that we are not feeling our best.  

Sometimes life comes at you hard, and we cannot let additional stressors such as hot flashes and sleeplessness get in the way of our coping strategies. Feeling overwhelmed or anxious is not uncommon during the menopausal transition. We can’t promise to fix your life, but we can help you by eliminating the factors that may be making it hard for you to get a handle on your emotions. 

Remember clinical depression includes feelings of pervasive sadness for more than two weeks. It also has other symptoms such as difficulty sleeping, irritability, guilt, decreased energy, decreased appetite, or difficulty concentrating. Talk to your doctor right away if depression symptoms become a persistent part of your daily life.


Do you experience an intense, instant sense of heat that starts around your face and neck and causes you to sweat? These are hot flashes, common in menopause, and can cause symptoms like feelings of anxiety.

It's sometimes difficult to tell hot flashes and anxiety apart. Generally, anxiety symptoms accompany sudden fear and other symptoms such as dizziness, numbness, and feelings of losing control.


Irritability, defined as a low threshold for experiencing frustration, is common during menopause. Most women report experiencing irritability at least once a week. Like most of menopause’s other symptoms, fluctuating levels of estrogen are associated with these feelings. Imagine having PMS every day. That’s what some women’s perimenopause and menopause feels like.  

Treatment for Menopause

Menopause is treated by supplementing hormones that your ovaries have stopped producing.  The good news is that the amount of hormones needed to control symptoms is far less than your body would normally produce before menopause. The most common form of menopause hormone therapy is systemic estrogen replacement, with or without progesterone depending on whether or not you’ve had a hysterectomy.

For women who are not able to take hormones, an SSRI such as paroxetine can also help reduce hot flashes. To find out which type of menopause hormone therapy is right for you, speak to a doctor about your symptoms and your medical history. And assessing both the potential benefits and risks together with a menopause-trained doctor will be the best strategy for getting you on the road to feeling better.

If you’re looking for a holistic approach to battling your menopause symptoms, regular exercise, meditation, and yoga can be effective when used alongside certain medications. It also helps to improve your diet as much as possible by avoiding excessive alcohol, sugar, and caffeine. Not only will it benefit your overall health, but it can decrease the severity of some menopause symptoms.

When Anxiety and Depression are Serious

Do you have severe symptoms of anxiety or depression? Menopause may worsen pre-existing anxiety and depression, and it can also predispose a person to develop serious symptoms. Severe anxiety, panic attacks, and depression are not typical in menopause. 

If you experience severe symptoms like those described above, talk to a doctor immediately. If you have thoughts of hurting yourself, seek professional help immediately. You can call the suicide hotline (1-800-273-8255), available 24 hours a day. Or call 911 to go to the emergency department, where a doctor can see you right away.

Treatment for Anxiety and Depression

If you have moderate to severe symptoms of anxiety or depression, medication may be an effective treatment option. There are many types of antidepressants, and your doctor can help you pick the right one. Selective serotonin reuptake inhibitors are the most common but have some side effects. Other antidepressants include serotonin-norepinephrine reuptake inhibitors and tricyclic antidepressants.

Generalized anxiety disorder and panic disorder can also be treated with SSRIs. Another class of medications, called benzodiazepines, are also used to treat anxiety. However, these medications can be addictive and should be used with caution.

Psychotherapy and relaxation therapies have also been shown to reduce anxiety and depression symptoms. It’s important to speak with your doctor to decide which treatment is best for you.

Alloy Can Help with Menopause Symptoms

Despite all of the available options for menopause treatment, you may need to get to the root cause of your discomfort. And if your symptoms are due mainly to the menopausal transition and the upheaval of hormones in its wake, then menopause hormone therapy may be for you.

Alloy provides menopause hormone therapy to alleviate some of menopause’s most difficult symptoms, including mood swings. If you’re experiencing menopausal depression or anxiety, and you need a hand to get through this new stage of life, trust Alloy’s menopause-trained doctors to create a treatment plan that will help provide the relief you deserve. 

Getting help is easy–all you have to do is take our quiz or choose a menopause treatment solution, complete our medical intake form, and start talking to one of our dedicated doctors.


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Written by:

Alloy Staff

Who is Alloy? Alloy exists to help women age healthfully and feel like their best selves. We approach women’s health with radical honesty. We fuse together powerful medical expertise, science backed treatments, and the support of a community that knows how you feel. We don’t just get you - we are you.

Medically reviewed by:

Sharon D. Malone

Dr. Sharon Malone is among the nation’s leading obstetrician / gynecologists with a focus on the specific health challenges associated with menopause.