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The Misdiagnosis of Mood Changes:Understanding Mood Disorders in Perimenopause

Discover why understanding the subtle changes in your mood could be the key to preventing the misdiagnosis of serious health conditions as you navigate the complexities of perimenopause.

If you’ve been following Revivele for a while, you know that mood and hormones are intricately linked, and our cycles can influence our levels of anxiety and exacerbate mood disorders on a monthly basis

When we enter perimenopause—a time of intense hormone fluctuation as our bodies’ reproductive capabilities wind down toward menopause—symptoms of anxiety and mood disorders can become more pronounced.

Being aware of the changes your body will undergo, and how these can impact your memory, mood, sleep patterns, and stress or anxiety levels can help you face these difficult symptoms with empowerment.

However, it’s crucial to pay close attention to these changes, as fluctuations in mood can sometimes be misleading. Symptoms that may appear to be anxiety or depression could, in fact, be early indicators of other significant health issues, such as Alzheimer’s. Misdiagnosis can lead to delays in the appropriate management and support, emphasizing the importance of comprehensive health evaluations during this time.

Unfortunately, many women are not aware of these common symptoms, and as they experience intense levels of hormone-related anxiety and stress, these symptoms can cause panic, or heightened feelings of confusion and distress. Perimenopausal anxiety and mood disorders are symptoms—they do not define who you are.

In this blog, we want to reassure you that you’re not alone, and there are ways to manage symptoms of anxiety and mood disorders as you transition into menopause. By fostering a deeper understanding of these processes, we aim to empower you with the knowledge and resources needed to address not only the common symptoms but also to advocate for comprehensive care should more complex health issues arise.

Keep reading to learn about:

a. How do hormones influence mood?
b. Hormones and depression
c. Hormones and anxiety
d. Hormones, mood disorders, and Alzheimer’s disease
e. Supplements to help manage anxiety and mood disorders

Let’s get started.

How do hormones influence mood?

Estrogen and progesterone are hormones that ebb and flow throughout each month. These
control our reproductive cycles: ovulation and menstruation.

However, estrogen and progesterone are not the only hormones that influence a woman’s reproductive cycle. To learn more about the function of female hormones, and how and why these fluctuate throughout the month, take a look at our other blog: female hormones 101.

When hormone levels are too high or low, they can cause imbalances that result in physical symptoms (hot flashes, insomnia, irregular periods, vaginal dryness), as well as mental and emotional symptoms (brain fog, moodiness, irritability).

A hormonal imbalance can impact your body’s natural function, your overall health, and cause serious emotional side-effects such as depression and anxiety.

Also Read: Which perimenopausal symptoms should you be concerned about? Take a look at the symptoms that may signal future risk.

Hormones and depression

Depression, or depressive disorder, is a depressed mood or loss of pleasure and/or interest in the activities you usually love, for long periods of time. Clinical depression is different from situational or occasional depression, which might occur due to a particular occurrence in life (such as a break up, difficult week at work, or loss of a loved one).

Depression is unrelated to regular mood changes or feelings about difficult things that happen in everyday life. Depression is a pervasive feeling of despair, low or no motivation, and a lack of joy during both the downs and the ups of normal life for an extended amount of time.

Depression is a difficult experience for anyone to bear for any length of time – and it’s extremely difficult for women who experience episodes of depression on a monthly basis throughout their lifetime

Depression and your period

Many women experience forms of depression or depressive symptoms during their period, from as early as the start of their period to menopause.

KidsHealth has information for young girls experiencing their first periods who report that they feel depressed during certain phases of their cycles each month, and many women experience symptoms of depression during their cycles throughout adulthood.

Premenstrual dysphoric disorder (PMDD) causes severe anxiety, depression and mood changes during a woman’s cycle, especially leading up to the first day of her period.

PMDD is different from premenstrual syndrome (PMS), which is the experience of bloating, fatigue, and cramps, as well as symptoms of irritability or sadness.

PMDD is a severe form of PMS – meaning that all symptoms are experienced more severely, from the cramps to the sorrow, resulting in feelings of deep depression or anxiety each month during a woman’s period

Depression and perimenopause

As a woman ages, experiences of depression may actually increase – especially if you have a history of depression – though there are women who experience depression for the first time during perimenopause.
Some studies have shown that the risk of serious depression is significantly increased in perimenopausal women.

The greater risk of developing depression during perimenopause may take place for a few reasons:

  • Psychological shifts: As a woman exits her childbearing years, her sense of self – carefully cultivated by society throughout her life – may be significantly altered, which can be extremely difficult for many women.
  • Hormonal imbalances: Estrogen and progesterone levels naturally decrease as we age, sending our bodies, and our moods, into a state of flux. This can be both distressing and frustrating for many women, who may otherwise have felt relatively balanced in their moods throughout their lives prior to perimenopause.
  • Symptom sabotage: The symptoms of perimenopause include hot flashes (which can feel embarrassing and distressing, as some women think they’re panic attacks or heart attacks), brain fog (which includes difficulty concentrating and poor memory, which can be frustrating and concerning), and insomnia (chronic sleep deprivation is a known contributor to feelings of heightened anxiety and depression).

Perimenopause can be a very challenging time in any woman’s life, as it feels as if your body and your mind are turning against you.

You are certainly not alone if you have ever felt this way – however, we want to reassure you that there are ways you can mitigate your risk of developing depression as you age. This blog is meant to inspire hope in women as they age, and we promise we’re going to talk about some of the ways to reduce these symptoms.

Before we talk about the steps to take to address symptoms, we want to talk about the other commonly experienced mood disorders that women may experience during perimenopause.


Hormones and anxiety

Anxiety is a defense mechanism in our brains that we all have. Sometimes, anxiety is a good
thing. Anxiety is the alarm bell that tells us to look for an escape route when we smell
smoke.

But sometimes, due to past traumas, periods of intense stress, or hormonal fluctuations, our
anxiety system can go into hyperdrive and convince us there are dangers when there are
none.

Anxiety may affect each person in a slightly different way. Anxiety might look or feel like:

  • Constant nervousness, even when going about your usual daily routine
  • Feelings of panic, even when there is no danger
  • Sweating
  • A sense of dread that something bad is going to happen
  • Shakiness or dizziness
  • Shortness of breath
  • Panic attacks, including a racing heart or searching for an escape to non-dangerous situations (like social settings or calm, crowded spaces)
  • Fearfulness, which can be mild or severe and very confusing

Some people experience intense anxiety when they experience physical or mental symptoms that are unusual to them.

For example, a woman who has her first hot flash might have a panic attack during the hot flash (exacerbating the symptoms), because she is confused about what’s happening and believes she’s having a heart attack, or that the hot flash is a symptom of her body in distress.

Anxiety and your period

Anxiety disorders occur more often in women than in men, and although there aren’t definitive results that point to hormones as the cause, female hormones are constantly in flux in a way that male hormones simply are not – which means we can safely assume that our hormones have the power to cause or exacerbate anxiety.

Anxiety comes in many forms known as anxiety disorders, such as:

We can also add PMDD to this list, as we know from above that PMDD can cause both depression and severe anxiety during a woman’s cycle, usually in the one or two weeks leading up to a woman’s period.

Symptoms of PMDD usually go away two or three days after a woman’s period starts, but this cycle can still be distressing for many women.

Anxiety and perimenopause

Perimenopause can be a period of heightened anxiety for many women, for all the reasons listed above (and other, physical reasons).

However, there is a silver lining: after menopause, PMDD may resolve itself.

Perimenopause is a marathon and may last for years, however there is an end in sight. Menopause (the 12 month anniversary of the first day of your last period) usually comes with a settling down of hormones.

Related: Find out here – what are the signs perimenopause is coming to an end?

Hormones, mood disorders, and Alzheimer’s disease

Depression and anxiety are not the only mood disorders caused or exacerbated by hormone fluctuations. As hormones change in our bodies, women are also at risk of developing other mood disorders.

While sometimes the onset of mood disorders comes with an end date – like menopause – sometimes, mood disorders go overlooked as early warning signs of something more severe going on: like Alzheimers.

Perimenopause usually begins between the ages of 30 and 50, most likely in a woman’s 40s, and many symptoms – though common – should be monitored closely to ensure they’re not signals for the onset of future diseases.

Women are more at risk of developing Alzheimer’s disease than men, and the risk increases with age. For example, insomnia is a symptom of perimenopause and hormone fluctuation, and is also linked to an increased risk of developing dementia.

Mood disorders may present in various ways, such as:

  • Changes to one’s personality
  • Erratic behavior or extreme irritability
  • Argumentative or extremely defensive behavior
  • Steady decrease in interest in things you used to enjoy

Sometimes, increased irritability or a decrease in motivation are temporary. But women and their loved ones should be aware of – should, in fact, closely monitor and document – any changes to personality or behavior throughout the aging process.

It can be hard to know when to take certain symptoms seriously if “all that’s changing” is someone’s mood. However, changes in mood that are sudden, severe, or long-lasting, should be addressed as soon as possible.

From Heart to Heartache: Dr. Kavita Desai’s Personal Story of her Mom’s Early Onset Alzhiemers

In Dr. Kavita Desai’s personal experience with her mom, personality and mood changes were the early warning signs that went missed, the harbingers of something far more serious than anyone expected: early onset Alzheimer’s disease.

Over a decade, Kavita watched as the woman who had once been her best friend and cornerstone transformed before her eyes.

Initially marked by subtle shifts in mood and increased argumentativeness, her mother’s condition progressed into a deepening struggle with anxiety and eventually communication.

The journey was long and painful; the daily phone calls that used to be filled with love and laughter slowly turned into a minefield of hurt feelings and misunderstandings. Prior to becoming ill, Kavita’s mom was a kind, sweet, loving and patient woman. And initially, as her mother’s mood shifted, Kavita didn’t think too much of it.

But by the time a medical diagnosis confirmed the fearsome reality, her mother had become a mere shadow of her former self. It took about a decade to have her diagnosed, and by that time, when her mom was 65 years old, her brain had atrophied (shrunk) by 50%.

Over time, the changes Dr. Desai had seen in her mom’s mood and personality became changes in her physical and cognitive ability:

  • Steady decline of mobility (walking, speaking)
  • Inability to recognize well-known faces
  • Inability to recognize the purpose of frequently-used items
  • Inability to hold conversations that last more than a few minutes
  • Inability to hold more complex conversations due to difficulty recalling past facts
  • Increased challenges communicating effectively in group settings, finding it easier to focus and participate in one-on-one conversations

Dr. Desai often reflects on her own personal journey with her mother’s health, believing that early warning signs of Alzheimer’s were overlooked. She emphasizes that if these signs had been recognized sooner, early intervention might have been possible, potentially altering the course of her mother’s experience.

This personal experience fuels her dedication to educating women about the importance of understanding and properly addressing mood changes during perimenopause, as these can sometimes be the first clues to more serious underlying conditions.

Embrace hope instead of despair

If you take anything away from this blog, let it be these three things:

  • Our hormones have a direct impact on our mood and emotional health
  • Our mood and emotional health will change as we age
  • As we age, we should monitor changes to our mood and emotional health

As mentioned above, this blog is not meant to frighten or upset you – it’s only meant to educate, so that you can know all the things that generations of women before us did not know.Now, let’s talk about some of the ways you can offset symptoms of anxiety and mood disorders during your period and beyond.

Now, let’s talk about some of the ways you can offset symptoms of anxiety and mood disorders during your period and beyond.

Tips to help manage anxiety and mood disorders during perimenopause

Here are some effective strategies to help manage symptoms of anxiety and depression during perimenopause:

  • Prioritize Sleep: Aim for 7-9 hours of quality sleep each night. Establish a calming bedtime routine and create a sleep-friendly environment by reducing noise and light.
  • Nutritious Diet: Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Foods high in omega-3 fatty acids, like fish, can be particularly beneficial for mood regulation. Significantly reduce or eliminate alcohol – known to perpetuate feelings of depression or anxiety.
  • Regular Exercise: Engage in regular physical activity such as walking, yoga, weight lifting or swimming. Exercise helps release endorphins, which naturally improve your mood and reduce feelings of stress.
  • Seek Therapy: Consider talking therapies such as cognitive behavioral therapy (CBT), which has been shown to be effective in managing symptoms of anxiety and depression. A therapist can provide support and strategies tailored to your personal experiences.
  • Mindfulness and Relaxation Techniques: Practices like meditation, deep-breathing exercises, journaling, or progressive muscle relaxation can help calm your mind and reduce symptoms of anxiety.
  • Incorporate a Daily Supplement: Alongside these lifestyle changes, consider adding a daily supplement designed specifically for perimenopausal women. Supplements that include adaptogens (such as ashwagandha), vitamins D and B, magnesium, and omega-3 fatty acids can support overall health and help mitigate mood swings and other symptoms associated with hormone fluctuations during perimenopause.

Revivele is a company created by a woman for women, with women’s health in mind. Our Essentials supplements were created to benefit women’s brain health and perimenopausal symptoms as we age to increase women’s comfort, and decrease the risk of developing serious diseases, exacerbated by the symptoms of perimenopause.

To reduce inflammation, improve brain function, reduce sleep disturbance, and repopulate the gut microbiome, we created the Essentials line of women’s supplements.

Join the Health Hub, made for you

Sign up for our upcoming and exclusive Health Hub: an interactive online platform designed to educate and support women regarding women’s health.

Our Health Hub will feature future-forward services such as lab testing, HRT, telehealth consultations, at-home sleep assessments, and therapeutic tools.

Don’t miss out. Sign up now and be one of the first to be notified when our Health Hub goes live!

Take your health into your own hands

Many women who experience the sudden onset of anxiety and mood disorders may feel like they’re losing their minds. You’re not losing your mind – Dr. Desai addresses this very phenomena in her book Lady Parts: Putting Women’s Health Back Into Women’s Hands.

Being armed with information means you can face each unsettling hiccup in your perimenopause journey with calm attentiveness.
Don’t ignore new symptoms as they arise – but don’t let them panic you, either. Falling into a panic cycle will only make each new symptom more difficult to bear.

Let’s work together to educate one another on what it means to be an aging woman.

At Revivele, women’s health is our mission. That’s why we’ve developed supplements made for women to address certain deficiencies common in women’s bodies as they age, and to help mitigate the difficulty of various symptoms as they arise.


If you’re interested in learning more about how to maintain your health as you age, read our other blogs, which are full of helpful details, research, and woman-to-woman understanding.
We’re all in this together!

To learn more about women’s health and wellness, and to understand the beneficial effects supplements can have on women’s bodies as we age, follow Dr. Kavita Desai’s women’s health & wellness company, Revivele, on Instagram, Facebook, and LinkedIn!

Don’t forget to order Dr. Kavita Desai’s book Lady Parts: Putting Women’s Health Back Into Women’s Hands to get more information, statistics, and research regarding women’s health!

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