The hidden side of menopause: Atypical depression

Menopause is a significant transition in a woman’s life, marked by fluctuating hormones and a range of physical and emotional changes. While many are aware of hot flashes, night sweats, and sleep disturbances, the emotional toll often gets less attention, especially when it presents in forms that don’t fit the “classic” image of depression. One such form is atypical depression, a subtype that may fly under the radar but can deeply affect quality of life during menopause.

Research from University College London suggests that perimenopausal women are around 40% more likely to suffer depressive symptoms than pre-menopausal women.

What is atypical depression?

Atypical depression is often overlooked as it's a specific subtype of depression. It's called 'atypical' because the symptoms are different from what we think of as typical depression, typically characterised by consistent low mood.

With atypical depression, you may be experiencing a temporary or fluctuating low mood which improves in response to positive events, but not for long. 

What to look out for:

• Regular feelings of low mood, occasionally interjected with brief moments of positivity.
• Increased appetite or weight gain.
• Excessive tiredness and daytime drowsiness.
• A heavy feeling in the body.
• Extreme sensitivity to rejection or criticism – small comments from loved ones feel overwhelmingly hurtful.
• Low energy and motivation.

The unpredictability of mood coupled with brief moments of positivity can make women question if what they're feeling really is depression, but these mood shifts are valid and deserve attention.

5 tips for self-managing atypical depression

Here are some evidence-based strategies that can help manage atypical depression during midlife:

1. Prioritise sleep

Poor sleep fuels depressive symptoms, so making sure you prioritise a great sleep routine is the first step towards managing atypical depression. Aim for a consistent bedtime every day, eliminate screen time before bed and replace it with mindful breathing or reading, and create a cool, quiet sleep environment. 

2. Stay active

Staying active, even when you don't feel like it, is essential because the quickest way to change your mood is to move. Regular physical activity is a proven antidepressant – even gentle walking or stretching will help regulate mood and fight fatigue.

3. Mindful nutrition

Manage increased cravings associated with atypical depression by making sure you swap carb-cravings for balanced meals rich in fibre, protein and healthy fats. This will help stabilise blood sugar and mood.

4. Practice mindfulness

Meditation and mindful breathing will quickly calm and rest your nervous system, reduce anxiety and increase emotional resilience.

5. Track your cycle and symptoms

Your menstrual cycle massively influences your mood. Tracking your symptoms and journaling about what you're experiencing will help you identify patterns so you can better prepare for more vulnerable times during each month.

When to seek help

If you're doing all the right things to manage your mood but symptoms are persisting, or you're finding your symptoms are affecting your relationships, work or ability to enjoy life, professional support from a women's mental health and well-being specialist is essential. In some cases, antidepressants or HRT may also be helpful.

Working with a coach who specialises in supporting midlife women can help support you through the emotional, mental and physical shifts that often arise during this powerful life stage.

It's important to remember that you are not alone in your experience, and there is nothing wrong with you. What you are experiencing is not a weakness, or a flaw, or something to 'push through'. It's an important opportunity to pay attention to your body, your emotions, and your deeper needs.