Increased melatonin secretion that is phase delayed into the morning characterized menopausal DP vs. NC. Years past menopause, FSH, sleep end time, and body mass index may modulate effects of altered melatonin secretion in menopausal depression.

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Previous work shows a relationship between measures of morning or evening preference (e.g., Morningness-Eveningness Questionnaire (MEQ) scores) and melatonin and sleep timing, body mass index (BMI) and mood. This study explores the relationship of these factors to atypical depression (ATD) symptoms, particularly increased appetite and hypersomnia, in depressed and non-depressed peri- and post-menopausal women. Participants were 19 normal control subjects and 10 depressed patients, 46 – 72 years of age. In a university hospital setting, we administered the MEQ and Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders (SIGH-SAD version), which includes a measure of ATD, 3–5 weeks before obtaining nighttime polysomnography and overnight plasma melatonin in dim light (< 30 lux). Scores on SIGH-SAD appetite-related items were significantly correlated with MEQ, dim light melatonin onset (DLMO) time and midsleep time (MST); BMI was related to MST, sleep end time, phase-angle differences between sleep and melatonin timing, and appetite measures. Results suggest that relative to women with earlier DLMOs and MSTs, depressed peri- and post-menopausal women whose DLMOs and MSTs are phase-delayed may experience increases in appetite, hypersomnia, and BMI. These symptoms might be relieved by sleep or light manipulations that advance melatonin and sleep timing parameters.

Current research suggests that mood varies from season to season in some individuals, in conjunction with light-modulated alterations in chronobiologic indices like melatonin and cortisol. The primary aim of this study was to evaluate the effects of seasonal variations in darkness on mood in depressed antepartum women, and to determine the relationship of seasonal mood variations to contemporaneous blood melatonin and cortisol measures; a secondary aim was to evaluate the influence of seasonal factors on measures of melancholic versus atypical depressive symptoms. We obtained measures of mood and overnight concentrations of plasma melatonin and serum cortisol in 19 depressed patients (DP) and 12 healthy control (HC) antepartum women, during on-going seasonal variations in daylight/darkness, in a cross-sectional design. Analyses of variance showed that in DP, but not HC, Hamilton Depression Rating Scale (HRSD) scores were significantly higher in women tested during seasonally longer vs. shorter nights. This exacerbation of depressive symptoms occurred when the dim light melatonin onset, the melatonin synthesis offset and the time of maximum cortisol secretion (acrophase) were phase-advanced (temporally shifted earlier), and melatonin quantity was reduced, in DP but not HC. Serum cortisol increased across gestational weeks in both the HC and DP groups, which did not differ significantly in cortisol concentration. Nevertheless, serum cortisol concentration correlated positively with HRSD score in DP but not HC; notably, HC showed neither significant mood changes nor altered melatonin and cortisol timing or quantity in association with seasonal variations. These findings suggest that depression severity during pregnancy may become elevated in association with seasonally-related phase-advances in melatonin and cortisol timing and reduced melatonin quantity that occur in DP, but not HC. Thus, women who experience antepartum depression may be more susceptible than their non-depressed counterparts to phase alterations in melatonin and cortisol timing during seasonally longer nights. Interventions that phase delay melatonin and/or cortisol timing -- for example, increased exposure to bright evening light -- might serve as an effective intervention for antepartum depressions whose severity is increased during seasonally longer nights.