I'm a 51-year-old woman in the midst of menopause and I feel incredible sadness. Do menopausal women generally suffer depression? When do these feelings go away?

--MJ

Some women experience mood swings, crying spells, and irritability during the menopausal years, which may be related to the drop in estrogen levels that occur naturally in midlife women. The sadness you report could also be related to changing hormone levels. Your health care provider, or one of several books now available on this subject, may give you more insight into the physiological processes and effects of menopause.

But there are psychological reasons, as well, why you may be experiencing sadness or depression. Women your age have sometimes been called "the sandwich generation," caught between the demands of raising your own children and the responsibility of caring for aging or ill parents. Being tugged in so many directions -- children, husband, parents, housework, job -- often leaves little or no time for the self. Self-care replenishes us, restores us. Without that refueling, we can become depleted physically and emotionally.

But there are psychological reasons, as well, why you may be experiencing sadness or depression. Women your age have sometimes been called "the sandwich generation," caught between the demands of raising your own children and the responsibility of caring for aging or ill parents. Being tugged in so many directions -- children, husband, parents, housework, job -- often leaves little or no time for the self. Self-care replenishes us, restores us. Without that refueling, we can become depleted physically and emotionally. A woman's perspective on the aging process itself may also contribute to feelings of sadness or depression. She may grieve the perceived loss of youth and fertility. A woman who has never had children, or may have wanted more children, may feel sorrow at the declining possibility of childbearing.

Midlife is also a time of reflection for many people, male and female. In looking back over one's life, one may feel regret at opportunities missed, roads not taken. The journey ahead may seem frightening and unfamiliar, particularly for those who have clung tightly to our culture's preoccupation with youth and beauty, or whose primary role models for aging have been parents or relatives who were frail and sickly. In addition, American culture tends not to value the older woman as much as other cultures in which post-menopausal women are the wise women whose counsel and skills are much sought after.

How long will your feelings of sadness last? It's hard to say. Again, your physician may be able to provide information and guidance regarding the hormonal changes and their effects. But it may also help to explore any possible psychological factors further, either on your own -- through reading or keeping a journal -- or by joining or forming a support group for women in mid-life. You may also find individual counseling helpful.

Whatever route you choose, I encourage you to pay attention to your sadness and what it may be telling you. Make time for yourself. Surround yourself with the images and counsel of menopausal and postmenopausal women who are vibrant and engaged in life, and whose strength and wisdom you admire.

The Change of Life can be a celebration, a passage, to a richer way of living. I wish you well on your journey. It's one that connects us all as women.