Every six months, I go to the psychiatrist. I was diagnosed with clinical depression and generalized anxiety in my late 20s, and since then, I’ve taken a handful of medicines to cope with both. I’ve changed prescriptions over time because eventually drugs stop working, but this time, when we needed to alter my current one (I had not been feeling awesome), I started wondering if this is what I had to look forward to from here on out. Would changing medicines on a regular basis as I get older (I’m in my late 30s now) because my anxiety and depression would get more complicated to treat become my new normal? Would I always be experimenting with combinations and new drugs to figure out how to feel better?
It turns out that this is only kind of true. According to Dr. Elizabeth Trattner, anxiety and depression do rise in women as they age, particularly between the ages of 35 and 50 (when it peaks). There’s depression related to menstruation, such as premenstrual dysphoric disorder, prenatal and postpartum depression and anxiety and transitional depression, occurring when women move into perimenopause and then into menopause, ending sometime in one’s 50s. What these three depressions have in common is the increasing and decreasing of hormones, specifically estrogen, which plays a significant role in regulating brain function.
Talia San Roman, a board-certified psychiatric mental health nurse practitioner in Arizona, says that a low-functioning/underactive thyroid can produce symptoms of anxiety and depression, which is why your doctor may test your thyroid first before prescribing psychiatric medication.
There’s also the fact that as changes in our bodies take hold, our physical appearances change, as do levels of energy. It’s vital that health care practitioners take this into account, says San Roman.
“We have to do our best to choose medications that will not cause drowsiness or weight gain,” explains San Roman. “Otherwise, the patient will not be compliant and you will not see the patient outcome you hoped for.”
Treating anxiety and depression can also be made complicated as we age because of chronic illnesses like cancer and heart disease, which are more common among women. According to the National Institute of Health, 1 in 4 women will die of heart disease. Doctors run into the wall of having to make sure that any antianxiety medication an individual is prescribed does not have an adverse drug interaction with any other medication they may be taking — in some cases, limiting medication options.
While anxiety and depression tend to exist in tandem and exacerbate one another, both are unique and vary according to who is living with them.
“I tend to describe anxieties like snowflakes — no two are alike,” says life coach Trish Barillas. “I feel the difference from your 20s to your late 30s would be the knowledge. When we are in our 20s, we are still trying to discover ourselves and our bodies. There is the unknown happening when you leave high school, friends and your home and it comes all at once. I’ve seen anxiety spike amongst women around transitional times.”
Barillas suggests that anxiety in many women is triggered by digestive system issues and that herbal supplements may help alleviate anxiety during the menstrual cycles by balancing out hormones.
People age, but standards of beauty remain the same.
Pregnancy, menstruation and menopause alter both how we look on the outside and how we see ourselves, which can contribute to depression and anxiety. In addition, there are the lifestyle changes that might arise as we age, such as the task of caring for an older parent, a responsibility that is assumed to be the domain of women.
There’s also the reality check, says Nicole Casanova a personal-development expert who has treated folks with anxiety and depression for more than 15 years.
“Anxiety and depression are the body’s wise signals, ushering us to make changes,” explains Casanova. “As we age, the severity of this reality check can become more and more harsh, making it more difficult to get a handle on. For example, not having reached your goals at 50 can initiate a more intense depression than for a 30-year-old woman.”
While there are challenges to treating anxiety and depression as we age, not everyone is impacted by them, and for the most part, they do abate with time, especially when they’re caused by hormonal changes like those in menopause.
When seeking treatment, be specific — ask your potential therapist and/or psychiatrist if they have experience working with people who live with depression and anxiety related to aging, trauma, etc. And definitely surround yourself with other people who are good listeners.
“Social support is connected to physiological changes,” says Dr. Roselyn Smith, a psychologist in Miami, Florida. “Getting physical affection from loved ones increases oxytocin, a hormone that can create feelings of well being.”