August & Wellness: Hormones, Mental Health, and Weight Loss. By Matthew Clemons, PMHNP-BC.
August is a checkpoint month for mental health. Cumulative heat, months of broken sleep, loose routines, alcohol at social events, shrinking daylight, and back-to-school anticipatory stress stack up into a late-summer slump. In central North Carolina we lose more than an hour of evening light between the solstice and the end of August, and hot bedrooms keep nighttime temperatures above the 65 to 68 degrees needed for deep sleep.
Hormones and mental health: Cortisol elevation disrupts sleep, raises abdominal fat storage and blood sugar, and amplifies anxiety. Delayed melatonin pushes bedtimes later. Hypothyroidism mimics depression; hyperthyroidism mimics anxiety. Insulin resistance is linked to depression. Estrogen and progesterone fluctuations in perimenopause drive new anxiety, irritability, and depressive episodes. Low testosterone in men causes low mood, energy, and concentration.
Weight loss and mood: The relationship runs both directions. Depression lowers activity and disrupts appetite; weight change affects self-image, inflammation, and hormones. Some psychiatric medications cause weight gain, and alternatives exist — never stop a working medication abruptly. GLP-1 medications such as semaglutide and tirzepatide interact with psychiatric care through rapid weight loss, reduced intake, and altered alcohol tolerance. Principles: protein and fiber first, do not skip meals, limit alcohol, hydrate, move for mood, set process goals.
Sleep is the foundation: poor sleep raises cortisol, increases ghrelin, reduces leptin, impairs emotional regulation, and reduces medication effectiveness. Cool the bedroom, blackout windows, morning sunlight, consistent wake time, caffeine cutoff, no alcohol near bedtime.
Use August as a reset, not a reckoning. Sequence one small anchor habit at a time. Behavioral activation shows action precedes motivation.
Seek help if low mood or anxiety lasts more than two weeks, sleep has been poor a month, weight or appetite changed unintentionally, concentration is impaired, or medications feel less effective. For thoughts of self-harm, call or text 988.
Q: Why do I feel worse in August even though it is still summer? A: Accumulated heat, disrupted sleep, lost routine, shrinking daylight, and back-to-school anticipatory stress drive a common late-summer slump.
Q: How do hormones affect mental health? A: Cortisol, thyroid, insulin, melatonin, estrogen, progesterone, and testosterone all influence mood, energy, sleep, and concentration, and can mimic psychiatric conditions.
Q: Can weight loss improve depression and anxiety? A: Better metabolic health, sleep, and movement improve mood, but weight loss alone does not treat clinical depression or anxiety.
Q: Do psychiatric medications cause weight gain? A: Some do and some are weight-neutral. Discuss alternatives with your prescriber rather than stopping a medication that is working.
Q: Can I take GLP-1 weight loss medication with psychiatric medication? A: Often yes, with coordination between your prescribers and monitoring for interactions.
Q: How much does sleep affect mood and weight? A: Significantly. Poor sleep raises cortisol and hunger hormones, impairs emotional regulation, and reduces medication effectiveness.
Q: When should I see a psychiatric provider? A: If symptoms last more than two weeks or impair work, school, or relationships. For self-harm thoughts, call or text 988.
Q: Does Clemons Resiliency & Wellness offer telehealth in North Carolina? A: Yes, in-person in Wake Forest and telepsychiatry across North Carolina.
Call 919-578-5924 to schedule.