Emotional lability, anxiety, crying jags. Welcome to perimenopause. 70% of women experience depressive symptoms and alterations in mood when estrogen levels plunge or start to fluctuate. While many factors increase the risk, there is no denying that changes in hormone levels have something to do with anxiety, mood, and depression, even in people who never had issues before perimenopause. Dr. Pauline Maki is a world-renowned expert in menopause, mood, cognition, and the impact of menopause on the brain. She has authored hundreds of scientific articles and leads a National Institutes of Health (NIH) funded research program on women, cognition, mood, and dementia. In this episode, we take a deep dive into the science of why women have mood alterations and depression when estrogen levels start to fluctuate. In this episode: · What it was like to participate in Dr. Jill Biden’s White House Initiative on Women's Health Research · The difference between depressive symptoms, mood alteration and depression · The risk of recurrence if there is a history of depression during perimenopause · The risk of developing depression if there is no history of depression · The risk of developing mood alterations if there is no history of depression · Windows of vulnerability (pregnancy, post-partum, perimenopause) · What is occurring hormonally in the brain at the level of progesterone and estrogen receptors · The Science Behind Risk Factors for developing depressive symptoms or depression during perimenopause o Early menopause o BRCA mutations o History of major depressive disorder o Hormone sensitivity in the brain o Severe menopause symptoms o Childhood experiences o Current life stressors · Treatment Options for Perimenopausal Depressive Symptoms o No treatment- when will it go away? o Cognitive Behavioral Therapy o SSRIs o Hormone Therapy o NK3 Agonists o Progesterone?