QUESTION

I’ve just started perimenopause, and my mood swings are driving me crazy! I’m happy as a lark one minute…mad at the world the next…and then so sad that I’m weeping over cat-food commercials. How can I stay on a more even keel?

ANSWER

Mood swings are one of the top complaints from women who are entering into the menopausal transition. In perimenopause, the years leading up to menopause, your hormones—which play a big role in your emotional state—are particularly likely to fluctuate, sometimes wildly. This is especially true for women who already are prone to fluctuating hormonal mood changes—women who tend to have PMS symptoms, for example. So if you are now feeling that you can’t get a handle on your emotional ups and downs, be assured that it’s not a sign that you’ve become mean or weak or lack self-control. It’s because hormones that used to be in sync for you are now becoming unsynchronized. But you don’t have to keep riding an emotional roller coaster! There are a number of things you can do that will be immediately helpful. To start with, exercise is very effective at helping to stabilize mood. You don’t have go nuts with Olympic-worthy workouts—daily walks, especially outdoors when the weather is nice, go a long way toward restoring emotional balance. Eating a healthy diet will help, too. Sugar affects mood, so cut back. Also find ways to keep stress, a significant factor in moodiness, in check. Activities such as meditation, yoga and tai chi are especially effective ways to chill out. Finally, get enough sleep. Chronic exhaustion is a well-known amplifier of mood swings. These lifestyle habits help to smooth the hormonal ups and downs that affect moods. They also help to increase endorphin levels in the brain, control blood sugar, reduce stress and improve sleep—all of which independently help improve mood. If doing these things doesn’t seem to help—or doesn’t help enough—check with your doctor. Balancing the symptoms of menopause can be very helpful in keeping mood challenges in check. For example, if hot flashes have you worn and weary, cooling those hot flames will lighten your mood. For some women, going on an oral contraceptive can help stabilize hormonal fluctuations—and thus, mood. But you’ll want to weigh the pros and cons with your doctor. You’ll want to be particularly vigilant about your moods if you have a mood disorder or have had one in the past. Certain mood disorders, including depression or a tendency toward depression, anxiety or panic attacks, obsessive-compulsive disorder, bipolar disorder and others may be more challenging during perimenopause and menopause. Even a history of postpartum depression is something to bring up with your doctor. Be sure to see your doctor if you’ve been feeling particularly sad or anxious or in a very low mood for two or three weeks in a row. It could be a sign of clinical depression or anxiety, which needs to be taken seriously and may require treatment. To learn more about nondrug ways to improve mood, read these Bottom Line articles on how behavioral activation therapy and exercise can help with depression…and a supplement that alleviates anxiety and helps with sleep.