Depression is a serious and debilitating disorder, and suffers should seek medical attention if they are experiencing symptoms such as prolonged sadness, loss of interest or pleasure, changes in sleep or appetite, lowered self-esteem or fatigue. Although many circumstances can cause a person to experience depression, hormonal imbalances can cause a person to have difficulty in managing stress, feeling happy or hopeful, and maintaining normal sleeping and eating patterns. Women experience depression up to twice as often as men, and hormonal factors such as menstrual cycle changes, pregnancy, miscarriage, childbirth, pre-menopause, and menopause may contribute to this increased rate of depression in women.

Thyroid: Hypothyroidism (diminished level of thyroid hormones)is probably the most readily known hormonal cause of depression in men and women. Low levels of thyroid hormones cause a reduction in serotonin, which is an essential neurotransmitter influencing mood and behavior

Estrogen: Estrogen or progesterone deficiency in women during perimenopause or menopause is often associated with depression. A common sign of diminishing estrogen production is feeling overly sensitive to remarks by others or becoming tearful/crying for no apparent reason. Lowered levels of estrogen may cause feelings of sadness and hopelessness.

Estrogen improves mood, increases sense of well-beingandpromotes sleep by enhancing serotonin levels. Estrogen also promotes increased amounts of the calming neurotransmittergamma-aminobutyric acid (GABA). GABA is an anti-anxiety, anti-pain hormone that raises endorphins, therefore producing pleasurable feelings.Estrogen also increases norepinephrine activity in the brain, which is responsible for improving mood, cognition, alertness and energy.However, in some people elevated levels of norepinephrine cause anxiety, panic attacks and an agitated depression.

Progesterone: Progesterone is thought to promote good mood by boosting serotonin and GABA, which both calm anxiety and panic. Progesterone facilitates restful, refreshing REM sleep and less waking from deep sleep. Low levels of progesterone decrease serotonin, which can cause poor sleep and depression. Also, diminished amounts of progesterone prevent the balancing of the stimulating effects of estrogen and can lead to anxiety.

Cortisol: Depression has been associated with both elevated and low levels of cortisol. Depression, which is often characterized by symptoms such as low mood, inability to experience pleasure, and low energy, is a somewhat common response to stressful events, particularly when the stress is chronic or uncontrollable. Stress causes the release of increased levels of cortisol into the bloodstream, while resolution of the stress typically causes cortisol levels to return to normal.

When stress is severe or chronic, cortisol levels can remain excessively elevated. High levels of cortisol can create agitation and elevated blood sugar. Chronically elevated cortisol may induce depression by decreasing serotonin in the brain. When serotonin is low anxiety, insomnia, poor mood and depression can occur. Sometimes, after excessive or prolonged stress cortisol can “burn out” and levels can fall dramatically. Low cortisol levels cause anxiety, irritability, an inability to handle stress, fatigue and feeling overwhelmed.

DHEA and Growth Hormone: Decreased levels of these hormones have been associated with depression in men and women.

Testosterone: Depression in men is commonly a result of the declining levels of testosterone that occur with aging. Low levels of testosterone lead to irritability, grumpiness, anxiety, mood swings, and loss of enthusiasm. Testosterone elevates mood and in some cases relieves depression in men. Testosterone may improve mood by elevating levels of dopamine, (a “reward” neurotransmitter), serotonin, and noradrenaline in the brain. Testosterone enhances aerobic metabolism which increases overall energy, leads to increased vigor and enthusiasm.

Irritability and Hormones

Irritability is an inappropriate or exaggerated amount of anger or impatience exhibited in response to a situation. This is a common complaint and may be due to multiple factors including: stress, poor diet, drugs, alcohol, excess caffeine, headache, infection, anxiety, depression, and drug interactions, withdrawal from alcohol or drugs, or hormonal imbalance.

An imbalance in hormone levels, particularly of thyroid, cortisol, estrogen, progesterone and testosterone can result in reduced patience, anger, frustration, and over-reaction.

Hormone changes during perimenopause, menopause,and andropause can also have an indirect influence on irritability. Symptoms such as lack of sleep, hot flashes, night sweats, fatigue, and loss of libido can definitely contribute to irritability. Bioidentical Hormone Replacement Therapy (BHRT) can be an effective treatment for irritability.