Perimenopause and Depression: When Hormones Hijack Your Mental Health

What if the sudden mood changes, crushing fatigue, or unexpected anxiety you’re experiencing aren’t just stress or part of getting older, but signs of depression linked to perimenopause? In this episode, ADAA member expert and psychiatrist Dr. Crystal Clark joins host Gabe Howard to shine a light on one of the most overlooked mental health issues affecting women: the biological storm of perimenopause and its deep connection to depression and anxiety. They break down why up to 40% of women experience depression during this hormonal transition — and why so many are told to just “tough it out.”You’ll learn the early warning signs to watch for, the science behind hormonal shifts and mental health, and why dismissing symptoms as “normal aging” could be harmful. Plus, they explore how therapy, medication, lifestyle shifts, and even hormone therapy can play a role in recovery. Whether you’re in perimenopause, supporting someone who is, or just want to understand this life stage, this episode delivers clarity, compassion, and concrete takeaways. This episode has been sponsored by the Anxiety and Depression Association of America (ADAA). Our guest, Dr. Crystal Clark, is an internationally recognized psychiatrist in women’s mental health. She holds a Canada Research Chair in Reproductive Mental Health. She is an Associate Professor in the Department of Psychiatry at the University of Toronto, and the Associate Head of Research at Women’s College Hospital. Dr. Clark specializes in mood and anxiety disorders specifically across the reproductive life span (from menstruation to peri and post menopause). Dr. Clark’s research has focused on psychopharmacology for the treatment of perinatal mood disorders. Her research aims to prevent the recurrence of illness during pregnancy and postpartum through safe dose optimization and personalized dosing strategies. Her research also aims to develop identification and prevention strategies for all persons with perinatal mood and anxiety disorders including those who are disproportionately impacted by these disorders. Dr. Clark’s research has been funded by the Canadian Institute of Health Research and the National Institutes of Health. Among Dr. Clark’s many leadership roles, she is a past president of the Marcé of North America, an organization dedicated to advancing perinatal mental health care, and she serves on the board of directors of Marcé International. She has been a contributor to large initiatives in Canada and the US to improve perinatal mental health in North America. As a thought leader, Dr. Clark is a thought leader and has been a contributor by several media outlets including CBS, NPR, NY Times, and Chicago Tonight regarding issues related to perinatal mental health. Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington. Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.