For decades, women going through menopause were warned of the risk of developing mental health issues. But a new report that reviewed dozens of past studies of menopausal women who said they developed depressive symptoms found no evidence of a universal risk for worsening mental health in menopausal women.

Even the report's researchers were surprised. “ I assumed that menopause really does lead to quite a substantial increased risk of depression,” the co-author of the study, Lydia Brown, a psychologist, researcher and lecturer at Australia's University of Melbourne's School of Psychological Sciences, said in a press release. “You have all these factors — social, psychological, and hormonal — that are all at play at the one time, and together that could increase depression.”

There was no evidence of a universal risk for worsening mental health in menopausal women. The connection turned out to be much more nuanced.

The connection between mental health and menopause turned out to be much more nuanced. Only certain groups of menopausal women are more likely to have mental health problems, Brown and her team found.

The women who are most at risk for mental health issues with menopause tend to have had a stressful life event, such as an illness in the family or a divorce, around the time of menopause, or previous depression or depressive symptoms. They are also more likely to experience disturbed sleep as a result of night time hot flashes.

For example, one study found that women, who suffered frequent hot flashes and had recent stressful life events, had an increased risk of depression. But if they hadn't experienced a stressful event, their chances of depression weren't elevated.

The message the researchers want to get out to the public is that menopausal women aren't doomed to be depressed or to have to deal with other mental health issues such as anxiety, bipolar disorder or psychosis.

“It's a subgroup problem,” Hadine Joffe, also a co-author of the report and the executive director of the Connors Center for Women's Health and Gender Biology at Brigham and Women's Hospital, explained.

“It's hard to message these things to the public, because we don't want to underestimate. We also don't want to overestimate,” Joffe said. “We want to make sure that the menopause itself, isn't associated in a universal way with this adverse problem, because it isn't.”

Whether you're going through menopause or not, everyone experiences sadness at times, but depression is something more.

Depression affects people in different ways, but according to the American Psychological Association, most experience some combination of the following symptoms. For a diagnosis of depression to be made, the symptoms must last at least two weeks. If you are experiencing any of these symptoms for a prolonged period of time and feel they are interfering with your life, ask your healthcare provider for help:

  • Anger and irritability
  • Restlessness
  • Difficulty concentrating
  • Fatigue
  • Changes in sleep patterns — sleeping more or less than usual
  • Appetite changes — eating more or less than usual
  • Feelings of helplessness or hopelessness
  • Feelings of guilt or worthlessness
  • Chronic pain, headaches or stomachaches
  • Loss of interest in activities
  • Withdrawal from friends and family
  • Prolonged sadness or feelings of emptiness
  • Thoughts of death or suicide

The report is published in The Lancet.