Managing PMS Depression

November 11, 2020

The majority of women experience some degree of discomfort around their menstrual period each month. 

Typically, symptoms occur a few days before, as well as a few days just after the menstrual period. Some women experience much worse symptoms, that can affect them both physically and emotionally, around their menstrual period. 

Let’s talk about these symptoms, and get a better understanding of what they may mean and how they can be treated. 

Understanding PMDD 

When PMS symptoms are more severe, they meet the criteria for premenstrual dysphoric disorder, or PMDD. As many as 18% to 35% of women suffer from premenstrual symptoms that are strong enough to be problematic in their daily life, but not intense enough to qualify for PMDD. As many as 5% of women have much more severe pre- and post-menstrual symptoms known as PMS depression, or PMDD.

PMDD Should Be Taken Seriously 

Too often, emotional and physical symptoms around a woman’s menstrual cycle are treated as trivial. However, these symptoms can actually be quite severe, resulting in significant life changes for women who are affected.

If you or someone you love experiences severe symptoms each month, seeking out treatment is very important. While it can be tempting to think that finding treatment isn’t important since you will overcome the symptoms every month after your period is done, symptoms can be very destructive to your life. 

The sense of anxiety caused when you anticipate the distress that you will experience around your menstrual cycle can affect your life even when you are not experiencing symptoms. Therefore, if you are experiencing more severe menstrual symptoms than are tolerable, you should consider seeking treatment.

PMDD can be destructive to your life and relationships, and it has serious consequences for your mental and emotional health. For many women, the failure to take PMDD symptoms seriously may contribute even more to feelings of being alone and feeling uncomfortable.

About 15% of women who experience PMDD will attempt suicide. This is a condition that needs to be taken extremely seriously by both the person experiencing it and others around her. 

Risk Factors for PMDD

It isn’t entirely known why some women experience much more severe symptoms around their menstrual cycle than others. However, it is believed that hormones play a role. 

Hormones help to regulate behavior and emotion centers in your brain. Hormones like progesterone, estrogen, and other sex hormones can affect the way your neurotransmission systems handle your thinking and your mood.

It seems that it is an imbalance in these hormones that is responsible for PMDD, although it isn’t known why some women experience it and others don’t. 

However, these are a few of the risk factors that appear to influence PMDD:

  • Stress, especially ongoing stress
  • Being overweight or obese
  • Cigarette smoking
  • A history of sexual abuse or trauma
  • Women who have a family history of PMS or PMDD
  • Women with a history of depression, mood disorders, or postpartum depression

Symptoms of PMDD

One of the most challenging aspects of PMS-related depression is separating it from mild premenstrual symptoms and other conditions. Depression, chronic depression, hypothyroidism, and chronic anxiety may all mimic PMDD. 

Sometimes symptoms are increased during the menstrual period but aren’t necessarily PMDD. These symptoms may also occur at other times, especially when life stressors occur. 

Here are the symptoms of PMDD:

  • Depression, anxiety, or tension
  • Irritability and abrupt mood changes
  • Inability to take interest in daily activities or things that you once enjoyed
  • Lack of concentration and a feeling of listlessness or decreased energy
  • Cravings for food or lack of interest in food
  • Inability to sleep and insomnia
  • Physical symptoms like bloating, breast tenderness, and painful cramping

Women with five or more of these symptoms with at least one related to their mood for most of their menstrual cycles in the last year may be diagnosed with PMDD. 

Additionally, these symptoms must be severe enough to interfere with daily life like school, work, hobbies, and relationships; they shouldn’t be due to another disorder or exacerbating another disorder; and symptom ratings should be documented for at least two menstrual cycles.

Some more symptoms that women experience in association with PMDD include panic attacks and a feeling of being overwhelmed and out of control. Joint and muscle cramps along with strong headaches are common as well.

Treatment for PMDD 

Too many women assume that they will have to live with their painful menstrual cycles for the rest of their life. This is especially common when women have experienced menstrual cycles with severe symptoms throughout their adult life since the beginning of menstruation. 

However, there are some excellent treatments for PMDD to help you get your life on track. 

Remember, this is a very serious disorder that should not be written off or treated indifferently. Seek out a treatment that works for you from a licensed health professional. 

Here are a few of the treatments they may recommend.

Serotonin Reuptake Inhibitors 

This is a very common and standard treatment for all forms of depression, including PMDD . 

This class of antidepressant works by slowing the reabsorption of serotonin in your brain. Since serotonin is responsible for mood elevation and equalization, increasing levels of serotonin in your brain is an effective way to improve your depression symptoms caused by hormone imbalances in the brain. 

As many as 60 to 90% of women with PMDD respond well to a drug that blocks serotonin reuptake, which makes this a highly effective treatment for PMDD even compared to other types of depression. Serotonin reuptake inhibitors seem to be much more effective than some other treatments commonly used for PMS and PMDD, such as progesterone.

It is essential that you work closely with your mental health provider to monitor your serotonin reuptake inhibitor medication schedule. These medications cannot be started and stopped suddenly and may take up to a month to be effective.

Because women with depression related to menstrual cycles do not experience symptoms throughout the rest of the month, they may not want to take medication for the entire month. However, altering medications yourself without the guidance of a healthcare provider can be very dangerous. 

Therefore, it is extremely important that you only adjust medications with the careful guidance of your mental health doctor.

 For this reason, it is advisable to choose a mental health professional whom you can maintain good communication with. They can easily adjust dosages as needed to control your symptoms appropriately without taking more medication than necessary or having adverse effects on your life. 

Lifestyle Changes 

Lifestyle changes are a good idea whether you choose to take medication or not. Different medications may cause different side effects, so it is especially important that you don’t have any aspects of your lifestyle that will add confusion to medication decisions. 

Here are a few of the lifestyle changes that are advisable if you experience severe PMS symptoms of any kind:

  • Diet. Caffeine, alcohol, and sugar can all make the symptoms of PMDD much worse. Eating smaller meals seems to ease symptoms as well. There is some evidence that consuming higher protein foods or complex carbohydrates may be helpful.
  • Exercise. Evidence supports aerobic physical exercise as being a general mood and energy booster for people suffering from depression and other mood disorders.
  • Supplements. A number of supplements may be helpful for the symptoms of PMDD, although they have not been well-studied or supported for the most part. Vitamin B6, magnesium, calcium, and some herbal remedies may all be helpful. 

Therapy or Active Relaxation

Women who experience severe PMS symptoms, especially associated with pain symptoms as well, can often experience severe stress and tension which can intensify the negative effects of the disorder. Therefore, many women find that active relaxation techniques and therapy can make a huge difference in their lives.

You might try a relaxation therapy or a meditation therapy such as yoga. Breathing exercises can also be very helpful. Some women find that massage therapy brings a lot of relief for both mental and physical symptoms. 

Talk therapy that involves plenty of feedback and affirmation can be very useful, especially for women who may feel relatively unsupported in regards to their PMDD symptoms.

It is important to maintain relaxation throughout other areas of your life as well. Make sure you get enough sleep, try to take off work when you are experiencing severe symptoms, and generally do all that you can to take good care of yourself so that you will be better able to overcome your symptoms. 

Seek Help for Your PMS Depression

If you are experiencing PMS depression or suspect that your PMS symptoms are more severe then they should be, seeking out treatment is your first step to recovery, and you can take that step with YANA. 

YANA is an online mental health clinic that makes it fast, easy, and affordable to get matched with a mental healthcare provider who can work with you to create a treatment plan that is tailored to your needs. You can even get prescription medication delivered discreetly to your door. 

Don’t feel like you need to live with these sorts of disabling symptoms forever. There are very effective treatments for PMS and PMDD, which can make a huge difference in your life and in the lives of your loved ones. 

Sources:

https://www.health.harvard.edu/womens-health/treating-premenstrual-dysphoric-disorder

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181677/

https://www.hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-dysphoric-disorder-pmdd

https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome/premenstrual-dysphoric-disorder-pmdd