Have you felt more anxious,tearful or low than usual, without really knowing why? Menopause and mental health are closely linked, and the changes can catch you off guard.
Hormonal shifts during perimenopause and menopause affect your mood as much as your body. For some women, this is the first time they've ever experienced anxiety or depression.
This article is written for women and individuals assigned female at birth (AFAB) who are noticing changes in their mood, motivation or emotional wellbeing during perimenopause or menopause. Not every woman's experience is the same.
Understanding why this happens makes it easier to know what to do next.
Why Menopause Affects Your Mental Health
Oestrogen regulates more thanyour cycle. It also has a direct effect on the brain chemicals that influencemood, including serotonin.
As oestrogen rises and fall unpredictably during perimenopause, mood can shift in ways that feel out of proportion to what's happening in your life. According to Beyond Blue, roughly 1 in 3 Australian women report bothersome menopausal symptoms, and over half of those say their emotional health has been affected.
What the Research Shows
A large meta-analysis published in the Journalof Affective Disorders, pooling data from over 9,000 women acrossAustralia, the US, China, the Netherlands and Switzerland, found that women arearound 40% more likely to experience depression during perimenopause than womenwho aren't experiencing menopausal symptoms.
Australian data points the same way. Women's Mental Health Australia surveyed 9,000 women in 2026 and found perimenopausal anxiety and depression affects nearly 1 in 2 women currently going through perimenopause(49%). Among all women in the study, the figure was 9%.
The same meta-analysis found nosignificant increase in depression risk after menopause, compared with before.The period of highest risk is the transition itself, while hormones are stillfluctuating.
Who Is Most at Risk
Some women are more vulnerable than others. According to BeyondBlue, risk is higher for women with a previous history of depression or premenstrual syndrome, those experiencing premature or early menopause, and women managing significant life stressors at the same time, such as parenting, caregiving, work pressure or health issues.
A previous experience of PMDD or postnatal depression can also signal greater sensitivity to hormonal change. Mention it to your GP or psychologist if it applies to you.
Recognising the Signs
Menopause-related mental health symptoms are as common as physical ones. They include irritability, sadness, difficulty concentrating, low motivation, constant worry, panic attacks and a reduced sense of self-worth.
These symptoms build gradually,which makes them easy to explain away as being busy or tired. Many women only recogniss the pattern in hindsight.
A note from our clinicians
In therapy, we often meet women experiencing anxiety or low mood for the first time in their lives during perimenopause. It can be disorienting, especially without a clear trigger. Understanding the hormonal piece doesn't remove the difficulty, though it does take away some of the self-blame, and that's usually where things start to shift.
A Story Many Women Recognise
Priya is a fictional example, based on experiences many women share.
Priya is 49. She's never struggled with her mental health before. Over the past year she's noticed worry that won't switch off, even when nothing is obviously wrong.
She snaps at her kids more than she'd like. She cries at things that wouldn't normally affect her. She assumes she's under pressure at work, so she pushes through.
When Priya finally speaks to her GP, she's surprised to learn her periods have already started changing, something she hadn't connected to how she's been feeling. Her GP explains that perimenopause can affect mood well before periods become obviously irregular.
With a clearer picture, Priya starts working with a psychologist alongside her GP. The anxiety doesn't disappear overnight, though it stops feeling like a mystery, and that makes it easier to manage.
Signs menopause may be affecting your mental health
• Feeling anxious, tearful or low without an obvious cause
• Irritability that feels out of character
• Difficulty concentrating or a drop in motivation
• A persistent sense of worry or dread
• Panic attacks, including ones that feel new for you
• A reduced sense of self-worth or confidence
What Can Help
Speak with your GP about what you're experiencing, particularly if symptoms are affecting daily life. Menopause hormone therapy eases mood symptoms for some women, and your GP can talk you through whether it's a suitable option.
Lifestyle factors help too. Regular movement, consistent sleep, reducing alcohol and stress management all support your mental health during this time, though they won't address the hormonal changes directly.
Speaking with a psychologist is worth considering, particularly if low mood, anxiety or panic are new for you. Therapy helps you understand what's happening, develop strategies for managing symptoms, and work through any self-blame that's built up along the way.
How Pivotal Women's Psychology Can Help
At Pivotal Women's Psychology, we support women and AFAB individuals experiencing anxiety, low mood and other mental health changes during perimenopause and menopause. We offer telehealth appointments across Australia, and for Australian and English-speaking women living overseas, so support is accessible wherever you live.
Our approach draws on evidence-based therapies including Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Compassion-Focused Therapy, tailored to what you're experiencing.
You don't have to workout what's happening on your own. We're here when you're ready.
About the author
Catherine Stovold is a Registered Psychologist (AHPRA PSY0002085487) with 10+ years of experience working with women through perimenopause and the mood, sleep and identity changes it can bring. Read more about Catherine here
Common Questions
Is it normal to feel depressed during menopause?
Low mood and depressive symptoms are common during perimenopause, and research shows the risk of depression is notably higher during this transition. That doesn't make it something to push through. If it's affecting your daily life, speak to your GP or a psychologist.
Can menopause cause anxiety even if I've never had it before?
Yes. Many women experience anxiety for the first time during perimenopause, driven by fluctuating hormone levels. It feels confusing when there's no obvious trigger, though it's a recognised and common experience.
How do I know if what I'm feeling is menopause or something else?
It isn't always easy to tell, and the two can occur together. A GP can help assess your hormonal picture and your mental health side by side, since menopause symptoms and other causes of low mood or anxiety often need to be considered together.
Should I consider hormone therapy for my mood?
Menopause hormone therapy helps mood symptoms for some women. Whether it suits you depends on your individual health history, so discuss it directly with your GP.
Can therapy help with menopause-related depression or anxiety?
Therapy can't change your hormones. It can help you understand what's happening, develop practical strategies for managing symptoms, and work through the self-blame that often builds up when mood changes aren't understood.
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