The time leading up to menopause (called perimenopause) is a physical and emotional roller coaster for some women. The so-called “change of life” comes with a host of symptoms triggered by hormonal shifts — hot flashes, insomnia, mood fluctuations and even depression.

When women go through sudden hormonal changes like those that come with perimenopause, puberty, postpartum and even their monthly cycle, they’re at a higher risk for depression say mental health experts. In general, women are twice as likely as men to develop the condition.

Hormonal Fluctuations

Most of the time, when people are talking about menopause or going through “the change,” they’re actually referring to perimenopause. During this phase, the menstrual cycle becomes irregular — longer, shorter, heavier, lighter, infrequent or closer together.

Sleep Problems

It’s common to experience bouts of insomnia during perimenopause, partly because of nighttime hot flashes. Poor sleep can make you up to 10 times more likely to become depressed.

Life Changes

Perimenopause typically occurs in your 40s. Turbulent hormones aside, this can also be a stress-filled stage of life with events that impact emotional health, such as:

  • Aging parents
  • Career pressure
  • Health problems
  • Kids leaving home