The Impact of Hormones on Mental Health

The Impact of Hormones on Mental Health

Let’s talk about something that’s working behind the scenes 24/7 to shape how we feel: hormones. These little chemical messengers do so much more than we give them credit for, especially when it comes to our mental health. But here’s the thing - their impact often flies under the radar until things feel out of balance. So, let’s dive in and explore how hormones influence our emotional well-being and what we can do to feel more in control. 

Estrogen and Mental Health 

Estrogen, a primary sex hormone, is more than just a period hormone. It plays a major role in mental health. Think of estrogen as your brain's multitasking maestro - it conducts a complex symphony of neurotransmitters, keeping your mood, memory, and cognitive functions in harmony. But what happens when this hormonal harmony gets out of tune?

When estrogen levels fluctuate wildly or drop significantly, it can feel like your emotional world is on a roller coaster. Mood swings, anxiety, and even depression can creep in, making you wonder, "What's going on with me?" These hormonal shifts can also fog up your mental clarity and disrupt your sleep, leaving you feeling like you're wading through molasses. It’s not just you, there are specific physiological mechanisms at play. 

Serotonin

Estrogen boosts serotonin production and enhances the sensitivity of serotonin receptors in the brain through upregulating and inhibiting enzymes and receptors, increasing the brain’s sensitivity to serotonin. These effects collectively lead to increased serotonergic neurotransmission, which is associated with improved mood, reduced anxiety, and better stress coping mechanisms.

Glutamate

Estrogen affects the brain's hypothalamus and amygdala, crucial regions for managing emotions, stress responses, and sleep regulation. Specifically, estrogen increases the release of glutamate, the main excitatory neurotransmitter in the brain. This leads to improved neuronal excitability, which has been shown to enhance learning, memory, and other cognitive functions. Additionally, estrogen decreases the release of GABA, the main inhibitory neurotransmitter in the brain, further promoting increased glutamate transmission.

Dopamine

Estrogen influences dopamine, a neurotransmitter that regulates attention, motivation, and reward, through multiple mechanisms. Estrogen increases dopamine release in certain brain regions to improve sensorimotor function, and decreases in other areas that control executive function. The proper response of dopamine depends on the coordination of estrogen and progesterone balance.  

Mood Disorders

Fluctuations in estrogen levels, such as during peri/menopause or after childbirth, can lead to increased risks of major depressive disorder (MDD) and generalized anxiety disorder (GAD)

Perimenopause and Menopause

The decline in estrogen during these periods can lead to a 2-4 times increased risk of depression. This is partly due to the reduced neuroprotective effects of estrogen and its impact on serotonin and other neurotransmitters.

Postpartum Period: The dramatic drop in estrogen levels after childbirth is associated with an increased risk of postpartum depression, affecting up to 15% of mothers.

Premenstrual Dysphoric Disorder (PMDD)

Some women experience severe mood symptoms before menstruation, which is linked to sensitivity to normal hormonal fluctuations, particularly the drop in estrogen levels.

Puberty

The onset of estrogen production during puberty is associated with an increased prevalence of anxiety and depression in adolescent females compared to males.

Cortisol and Mental Health 

Cortisol, a steroid hormone produced by the adrenal glands, plays a crucial role in the body's stress response and significantly impacts mental health. Cortisol is your body’s natural alarm system - it helps you deal with challenges by kicking your fight-or-flight response into gear. But what happens when cortisol is on overdrive? When stress sticks around too long, cortisol levels can stay high, leading to anxiety, depression, and even burnout. Chronic stress can also disturb your sleep and focus, making everything feel harder. 

Stress Regulation

Cortisol is a key component of the body's stress response system. When faced with a stressor, the hypothalamic-pituitary-adrenal (HPA) axis is activated, leading to the release of cortisol from the adrenal glands. This increase in cortisol levels prepares the body to respond to perceived threats or stressful situations. However, chronic activation of this system can lead to persistently elevated or depressed cortisol levels, which may contribute to various mental health issues.

Neurotransmitter Interference

Serotonin

Chronic excess of cortisol in the brain may lead to serotonin deficiency due to decreased availability of tryptophan, the precursor to serotonin. This can affect mood regulation, sleep patterns, and digestive function.

Dopamine

Elevated cortisol levels can alter dopamine signaling, potentially affecting motivation, reward processing, and mood.

These neurotransmitter imbalances can contribute to the development of various mental health disorders, including depression and anxiety.

Anxiety Disorders and Other Mental Health Complications

Anxiety Disorders

Chronic stress and consistently high cortisol levels are linked to an increased risk of developing anxiety disorders. The persistent activation of the stress response system can lead to a state of hypervigilance and excessive worry.

Depression

Studies have shown that individuals with depression often exhibit elevated cortisol levels, particularly in the evening. This dysregulation of the HPA axis may contribute to the onset and maintenance of depressive symptoms.

Cognitive Impairment

High cortisol levels over time can affect brain functioning, especially in areas involved in memory. This may contribute to cognitive decline and potentially increase the risk of neurodegenerative disorders like Alzheimer's disease.

Post-Traumatic Stress Disorder (PTSD)

While the relationship between cortisol and PTSD is complex, research has shown that individuals with PTSD may have varying cortisol levels depending on the context. During periods of calm, their cortisol levels may be normal or lower than average, but they can spike significantly when exposed to stressors or trauma reminders.

Bipolar Disorder

Studies have found elevated cortisol levels in patients with bipolar disorder, particularly those with a history of suicidal behavior.

The Thyroid Connection

Thyroid hormones are often left out of the hormone balance conversation. When your thyroid is under or overfunctioning, it can affect your mental health in surprising ways.

Hypothyroidism: The Slow-Down Effect

If your thyroid is underactive, producing too little of the thyroid hormones T4 and T3, you may mistake these symptoms for depression or peri/menopause:

  • Depression: This is the most common mental health symptom in hypothyroidism, as the thyroid hormones modulate serotonin. You might feel persistently sad or lose interest in activities you once enjoyed. 
  • Cognitive fog: Memory lapses and difficulty concentrating can surface as thyroid hormones regulate brain glucose metabolism.
  • Fatigue and apathy: Thyroid hormones regulate mitochondrial energy production, muscle turnover, and base energy use. Low functioning thyroid can result in extreme tiredness leading to a lack of motivation and a general sense of disinterest in life.

Hyperthyroidism: The Speed-Up Syndrome

In the opposite direction, an overactive thyroid, pumping out excess hormones, can lead to:

  • Anxiety and nervousness: You might feel constantly on edge, with your heart racing and your mind unable to slow down.
  • Mood swings: Rapid and intense changes in mood can leave you feeling emotionally unstable].
  • Insomnia: Racing thoughts and physical restlessness can make it hard to get quality sleep, further impacting your mental state

How to Keep These Mental Health Hormones Happy

So, how do you keep these hormone powerhouses working for you instead of against you? Here are some of my evidence-based tips for estrogen, thyroid and cortisol health.

Practice stress-reduction techniques

While this may seem the most cliche of all, the evidence points to activating the parasympathetic nervous system as the best way to manage cortisol levels. Aim for guided meditation, deep breathing exercises, or yoga for 15-20 minutes daily. 

Incorporate adaptogenic herbs

Use herbs like Ashwagandha, Rhodiola, or Holy Basil to help normalize endocrine function and modulate stress response. For instance, taking Ashwagandha extract daily has been shown to enhance energy production, improve sleep quality, and support immune function.

Optimize nutrition for thyroid health

Many minerals required for thyroid function are not found in commonly eaten foods. Ensure adequate intake of iodine, selenium, and zinc. Include foods like seaweed, Brazil nuts, and oysters in your diet. Additionally, if you already have known thyroid issues consider reducing excess intake of thyroid inhibiting foods like raw cruciferous vegetables.

Support estrogen balance with diet

Consume foods rich in phytoestrogens, such as flaxseeds or soybeans and legumes, to help modulate estrogen levels. Adding 2 tablespoons of ground flaxseeds provides lignans to help reduce the effects of excess estrogen. One cup of soybeans provides isoflavones to manage declining estrogen levels. Adding these as daily dietary habits based on one’s situation, balances hormones.

Prioritize quality sleep

Aim for 7-9 hours of uninterrupted sleep nightly to support overall hormone balance. Establish a consistent sleep schedule and create a relaxing bedtime routine. Consider using blackout curtains or a sleep mask to minimize light exposure, which can disrupt cortisol and melatonin production.

Let’s Break the Silence

Hormones aren’t the bad guys—they’re just doing their job, sending messages to keep your body running smoothly. Often these hormones are not landing in levels that spark diagnostic or clinical concern. But sometimes, they need a little extra support. We’re here to open up the conversation and create a space where talking about hormones and mental health is not just normal but empowering. Because when we share what we know and lift each other up, we all thrive.

Remember, you’re not in this alone. We’re here to listen, support, and cheer you on every step of the way. Let’s navigate this journey together—because you deserve to feel your best, inside and out.


References:

Stress and Brain Adaptation

Role of serotonin in depression  

Brain circuits in addiction and obesity 

Thyroid and mood disorders. Journal of Neuroendocrinology 

 Omega-3 fatty acids and brain health. Frontiers in Aging Neuroscience

Benefits of exercise for depression 

Mindfulness for stress management

Obstet Gynecol Clin North Am

Management of Major Depressive Disorder in Perimenopausal and Postmenopausal Women 

Nature Mental Health volume 2

New Study IDs Moms at Highest Risk for Postpartum Depression 

PREDICTING FEMALE DEPRESSION ACROSS PUBERTY

Cortisol level dysregulation and its prevalence

Cortisol as a Biomarker of Mental Disorder Severity

High Cortisol and the Risk of Dementia and Alzheimer’s Disease 

Higher cortisol levels may proceed a manic episode 

The association between depression and thyroid function

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