Perimenopause
Mood changes — perimenopause
Perimenopausal depression and anxiety have a real hormonal basis. Women with past postpartum depression or severe PMS are especially susceptible. This is not "just in your head" — it is neurochemistry shifting.
Key points
- ✓Ashwagandha + holy basil address the stress-axis underpinning
- ✓St John's Wort has good evidence but many drug interactions — review all meds
- ✓SSRIs and hormone therapy are both legitimate medical options; not failure to ask for them
- ✓Severe perimenopausal depression warrants medical-level care, not just herbs
- ✓Strength training + strength-social connection are both researched anti-depressants
Supportive herbs
Lifestyle & diet
Weight training 2-3× weekly, omega-3s (EPA-predominant 1-2 g/day), morning bright light, therapy or coaching tailored to this transition, protein at breakfast.
When to see a clinician
Suicidal ideation, inability to function, severe persistent depression — seek immediate care. This is a medical condition, not a character flaw.