Swimming for Depression During Perimenopause: More Than Just Exercise

Depression in Perimenopause: What Is Actually Happening

Depression during perimenopause is not simply feeling sad or going through a difficult time. For many women, it represents a genuine shift in how the brain regulates mood, driven by the hormonal changes of this transition.

Estrogen and progesterone both influence the systems involved in depression. Estrogen promotes serotonin production and receptor sensitivity, while progesterone has GABA-like calming effects on the brain. When both hormones become unstable, the neurological infrastructure that supports mood stability starts to wobble.

Research has found that women are significantly more likely to experience their first episode of major depression during perimenopause than during the stable reproductive years before it. This is not about psychological weakness. It is a biological vulnerability created by rapid hormonal change.

Depression in perimenopause often co-occurs with other symptoms like insomnia, anxiety, fatigue, and brain fog. These symptoms reinforce each other in cycles that can feel very hard to break. Poor sleep worsens mood, low mood reduces motivation to exercise, and less exercise leads to worse sleep. Understanding this cycle is the first step to interrupting it.

Why Swimming Has Unique Antidepressant Properties

All aerobic exercise has antidepressant effects, but swimming offers a set of advantages that make it especially well-suited for depression during perimenopause.

The act of being immersed in water has direct effects on the nervous system. Water stimulates the skin's pressure receptors in a continuous, gentle way that activates the parasympathetic nervous system. This is part of why a bath or shower often produces a noticeable improvement in mood. Swimming amplifies this effect through movement, which adds the benefits of aerobic exercise on top of the calming sensory experience of immersion.

Swimming reduces cortisol more effectively than many land-based exercises. A 2021 study in women under chronic stress found that aquatic exercise produced greater cortisol reductions than walking or cycling at comparable intensities. Since cortisol is closely linked to depression and anxiety, this difference matters.

The breathing pattern required for swimming is inherently slow and rhythmic. Freestyle swimmers typically exhale underwater and inhale during the stroke cycle. This slow, controlled breathing activates the vagus nerve and shifts the nervous system toward parasympathetic dominance, similar to the effect of meditation or slow breath work.

Swimming also generates endorphins, serotonin, and brain-derived neurotrophic factor (BDNF). BDNF is a protein that promotes the growth and survival of neurons in the hippocampus, a brain region consistently found to be reduced in volume in people with depression. Exercise-induced BDNF is one of the primary reasons aerobic exercise has antidepressant effects comparable to medication in mild to moderate depression.

Cold Water Swimming and Mood

Cold water swimming has attracted significant attention in recent years as a potential treatment for depression, and while it is not appropriate for everyone, the science behind it is worth understanding.

Cold water immersion activates the sympathetic nervous system initially, producing a stress response. With repeated exposure, the body adapts and becomes better at regulating that response. This adaptation appears to translate to better regulation of the stress response in other contexts, including emotional ones. Women who practice cold water swimming regularly often report a significant improvement in their ability to manage difficult emotions.

A 2023 case series and survey study found that cold water swimming significantly reduced symptoms of depression and anxiety in participants, with many reporting effects they described as comparable to medication. The effect was strongest in those who swam regularly over several months.

The neurochemical mechanism appears to involve the significant release of norepinephrine triggered by cold exposure. Norepinephrine is a neurotransmitter targeted by many antidepressant medications. Cold water may produce a natural norepinephrine surge with each swim.

You do not need to swim in icy open water to access some of these benefits. Finishing a regular pool swim with a cool shower, or choosing a slightly cooler lane, may produce partial effects. Anyone with cardiovascular concerns should talk with their doctor before attempting cold water immersion.

What the Research Shows

The evidence for exercise as an antidepressant is robust and includes numerous high-quality trials. Swimming specifically has been less studied than running or cycling, but the data that exists is encouraging.

A 2019 Cochrane review of exercise for depression found that aerobic exercise was significantly more effective than placebo or no treatment, and comparable to antidepressants in people with mild to moderate depression. The effects were maintained at follow-up when people continued exercising.

Studies on perimenopausal women specifically have found that regular aerobic exercise reduces depressive symptoms and improves quality of life. A 2020 trial published in Menopause found that 12 weeks of moderate aerobic exercise significantly reduced both depression and anxiety scores in perimenopausal women who had not responded to lifestyle interventions alone.

Research on aquatic exercise in populations with depression has shown promising results, with several studies finding equivalent or superior outcomes compared to land exercise, possibly because the barrier to participation is lower for people dealing with fatigue and low motivation. Water supports the body and reduces the perceived effort of movement.

Getting Started When Motivation Is Low

Starting any exercise habit when you are depressed is difficult. Depression reduces motivation, energy, and the capacity to initiate action. It is important to acknowledge this rather than treating swimming as something you simply need to decide to do.

Start with the smallest possible commitment. Tell yourself you only need to get in the pool. Once you are in the water, it is usually much easier to keep moving. Many people dealing with depression find that the anticipatory inertia is the hardest part, not the swim itself.

Schedule swims at a specific time and treat them like appointments. Morning swims are particularly effective because they front-load the mood benefit into the early part of the day and reduce the chance that energy runs out before you get to the pool. However, the best time is the time you will actually show up for.

Consider swimming with a friend, partner, or casual acquaintance from a water aerobics class. Social connection is independently protective against depression, and combining it with exercise creates a double benefit. It also creates gentle accountability without pressure.

Start with 20 minutes. You do not need a long swim to get the mood benefits. Research shows that even brief bouts of moderate aerobic exercise produce measurable improvements in mood. A 20-minute easy swim three times a week is a realistic starting point that can be built on over time.

Be kind about the early weeks. Depression makes everything harder. Missing a session does not mean you failed. It means you are dealing with a real condition. The goal is to show up more often than not.

Tracking Mood and Progress Over Time

When you are depressed, progress is hard to see. Days blend together and improvement feels invisible because it tends to happen gradually and unevenly. Having a record of your mood and your workouts is one of the most useful tools you can use.

Rating your mood each day on a simple scale, alongside noting whether you swam, gives you data about a relationship that would otherwise be invisible. Over four to six weeks, patterns typically emerge. Days after swimming often show slightly higher mood ratings. Weeks with three or more swims often look different from weeks with none.

This data is valuable not only for your own insight but for conversations with a doctor or therapist. Showing a professional a concrete record of symptom severity, activity, and sleep patterns gives them far more to work with than a general description of feeling low.

Depression in perimenopause often improves significantly as hormonal transitions stabilize, but that can take time. In the meantime, tracking progress, however incremental, helps reinforce that things are changing and that what you are doing is having an effect.

PeriPlan makes it straightforward to log both mood symptoms and workouts. Recording these together builds a picture of how your lifestyle choices and your emotional experience relate to each other over time.