PMS, also called premenstrual syndrome, is a group of symptoms that occurs one to two weeks before a woman gets her period. Almost 90% of women experience some form of PMS, but the kind and severity of the symptoms can vary widely from person to person. PMS can have both physical and emotional components and is thought to be a result of the natural fluctuations in hormone levels that occur between ovulation and menstruation.
Perhaps you have wondered for some time if you or someone you know is experiencing depression that may be connected to PMS. After all, fluctuations in hormone levels can be connected to changes in mood. Ahead, we’ll discuss the symptoms of PMS in addition to treatment methods that can potentially alleviate depressive symptoms connected to it.
What Are The Symptoms Of PMS?
While symptoms of PMS can vary widely between individuals, there are a few common symptoms. Some people may experience most of these symptoms, while some might experience only a few. The severity of the symptoms can also vary. Symptoms of PMS may change throughout a person's lifetime, especially after adolescence, after childbirth, and when approaching menopause.
Physical symptoms may include swollen, tender breasts, cramps, bloating, appetite changes, headache, backache, fatigue, and lowered libido. These symptoms can range from mild to debilitating, depending on the individual. Emotional symptoms may include irritability, mood swings, and feelings of sadness or depression. While PMS is often stereotypically associated with irrational emotional outbursts, it can manifest in a variety of different ways.
What Is Premenstrual Depression?
Premenstrual depression, also called premenstrual dysphoric disorder (PMDD), is similar to PMS but much more severe.
PMDD includes many of the symptoms associated with PMS, as well as symptoms of depression, including irritability, mood swings, feelings of sadness, withdrawal from friends and family, fatigue, and anxiety. The emotional symptoms associated with PMDD are generally much more severe and can significantly negatively affect a person's life during the two-week span in which they occur. In especially severe cases, people can even experience suicidal ideation* and other serious mental health issues.
*If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available 24/7.
While PMDD differs from PMS mostly in the intensity of the symptoms, PMDD differs from depression in that it only occurs at a particular time in a woman's monthly reproductive cycle. Symptoms of PMDD usually go away during or after menstruation and do not return for several weeks. For those who already have depression and other mental health issues, PMDD can exacerbate and intensify existing mental illness.
How To Treat PMS
Anyone who's ever had a period may be familiar with strategies for treating PMS, from herbal medicine to medications prescribed by a doctor. PMS treatment can include a variety of methods, depending on the severity of the symptoms.
While exercise might be the last thing on your mind when you're feeling under the weather, it can do a great job of fighting many of the typical symptoms of PMS. Exercise can help soothe physical symptoms like cramps and muscle aches. Physical activity can also have a positive impact on mental health and can even help stave off feelings of anxiety and depression. Exercise is a good idea at any time of the month, but it may be an especially good idea when you start to feel symptoms of PMS.
When you're about to get your period, it can be tempting to satisfy your cravings for junk and comfort food. But while it's okay to indulge a little, foods high in fat and sugar can make your PMS symptoms worse. Eating healthy, whole foods can help to combat PMS, especially just before your symptoms start to kick in. Foods high in calcium, magnesium, vitamin B6, and polyunsaturated fatty acids like omega-3 and omega-6 have also been shown to help reduce PMS symptoms. Try incorporating foods like dairy, fruit, nuts, fish, and leafy greens into your diet to reap these positive benefits.
Apply Heat To Sore Areas
For relief from physical symptoms, try applying heat and pressure to places where you're experiencing cramps or aches and pains. A hot water bottle is an easy, affordable option that does a great job of soothing PMS symptoms. You can also use a microwaveable hot pad or heated blanket. As an added measure, a hot cup of tea can warm you from the inside out and help promote calm and relaxation.
Get Enough Rest
Rest is important at any time of the month but is especially so when you're about to get your period. Lack of sleep can exacerbate any mental and emotional symptoms of PMS you might be experiencing, so it's a good idea to get a full night's sleep. If you're feeling especially under the weather, an afternoon nap can also help you rest and recuperate.
Use Over-The-Counter Pain Relief
Over-the-counter pain relief can help ease physical symptoms like headache, backache, and cramps. If your physical symptoms are severe, prescription pain medications are also available to help mitigate the effects of PMS.
Take Birth Control Pills
Some hormonal birth control methods can help prevent or lessen both physical and emotional PMS symptoms. The symptoms of PMS and the effects of various methods of birth control can vary widely from person to person, and some birth control methods can even intensify symptoms, so it's best to consult with a doctor and find the method that works best for you.
Ask A Psychiatrist About Antidepressants
For emotional symptoms of PMS, doctors can prescribe antidepressants to be used while symptoms persist. SSRIs, or selective serotonin reuptake inhibitors, are one of the more common antidepressants used to treat PMS. As with birth control, different people respond differently to different medications, so some trial and error may be necessary to find a strategy that works best for you.
The good news about PMS symptoms is that they usually go away on their own within a few days after the start of menstruation. While treatment strategies are often unique to each, there are many ways to manage the emotional and physical symptoms of PMS.
How To Treat PMDD
While most people who get periods experience some form of PMS, far fewer experience the intense emotional symptoms that constitute PMDD. While it's unclear why only certain people experience PMDD, it may be linked to different levels of hormones and neurotransmitters in the brain. PMDD symptoms are usually debilitating enough to cause significant impairment to daily functioning during the period in which they occur. Treatment options for PMDD include those for PMS but may also feature additional measures.
If you think you might be experiencing PMDD, it's important to get a medical diagnosis to gain the widest possible range of treatment options. Doctors can evaluate whether you might have PMDD based on the number, severity, and duration of your symptoms. If you're not sure whether you have PMDD or depression, a doctor can also help determine whether your menstrual cycle is exacerbating underlying mental health issues.
Just like for PMS, hormonal birth control can be an effective way of managing the symptoms of PMDD. Research is still ongoing concerning the effects of various hormones on PMDD, and it's still not clear the extent to which different methods of birth control might be effective in treating symptoms. Depending on the individual, hormonal birth control methods that feature progesterone, estrogen, and GnRH agonists can all affect hormone levels in ways that might mitigate the symptoms of PMDD. Hormonal birth control methods often include various combinations of these hormones, with different brands having varying amounts.
Antidepressants called SSRIs have been shown to have a positive effect on symptoms of PMDD. While the causes of PMDD are still unclear, researchers theorize that it may be connected to serotonin levels in the brain, making SSRIs uniquely effective at combatting the emotional symptoms of PMDD. People can often take antidepressants intermittently depending on the severity of their symptoms and the length of their cycle.
Just as with PMS, PMDD is usually only temporary, lasting one to two weeks at the end of the menstrual cycle. PMDD symptoms can be more severe and even life-threatening in some cases, so they should be taken seriously and treated medically when necessary.
The Benefits Of Online Therapy
If you are experiencing concerning symptoms related to PMS, PMDD, or depression, then therapy may be a helpful place to explore solutions. Online therapy is a particularly appealing option for many people who have busy schedules and may benefit from the flexibility in appointment scheduling that platforms like BetterHelp afford. Additionally, users can schedule appointments from a preferred location, if there is a strong internet connection. Whether you’re experiencing cramps, mood swings, or other symptoms, there’s no need to leave the comfort of your own bed, should that be the ideal place to attend a therapeutic session.
It's true that studies have affirmed online therapy’s effectiveness in treating people who experience symptoms of PMDD. In one 2019 study, 174 women with PMDD were randomized to a treatment group or waitlist control group. Those in the treatment group participated in an eight-week therapist-guided treatment course if internet-based cognitive behavioral therapy (iCBT). Evidence was taken before and after treatment, and at six months post-intervention. Researchers concluded that iCBT was highly effective in reducing the burden of PMDD and useful in adding coping styles and stress management.
While PMS and PMDD has many similarities and have an overlapping array of symptoms, there are important differences between the two. PMS is relatively common and can include both physical and mental symptoms. PMDD is much rarer and includes physical symptoms but has particularly severe mental and emotional effects. If you find that your life is significantly impacted by mental and emotional changes surrounding your menstrual cycle, you might be experiencing PMDD.
If you're experiencing symptoms of PMS, PMDD, or depression, there are a variety of resources available to you to help mitigate your symptoms and improve the way you feel on both a physical and mental level. BetterHelp offers a diverse selection of online therapy services that can provide you with the help you need to manage your mental health. Get in touch whenever you’re ready to learn more.
What are the 11 symptoms of PMDD?
Premenstrual dysphoric disorder (PMDD) can include both physical and emotional symptoms. As discussed in the above article, physical symptoms can include swollen, tender breasts, cramps, bloating, appetite changes such as food cravings or loss of appetite, headache, backache, fatigue, and lowered libido. Other physical symptoms may include joint or muscle pain. Mental symptoms may include irritability, mood swings, and feelings of sadness or depression. Sometimes, moderate to severe anxiety may be experienced.
Can PMS make you very depressed?
Premenstrual syndrome (PMS) can contribute to depression. However, if you are experiencing acute depression, you may be experiencing something else such as PMDD and should seek out the help of a mental health professional, as PMDD can involve severe symptoms.
How do you get rid of premenstrual depression?
PMS and PMDD can be managed with a variety of approaches. Managing on your own can involve eating a healthy and balanced diet, getting daily exercise, ensuring adequate rest, using ice packs or heating pads for pain management, and over the counter pain medications. More persistent and severe cases may require a doctor to diagnose PMDD or PMS so that prescription medications such as birth control and anti-depressants can be utilized if needed to help balance brain chemicals.
What does a PMDD episode look like?
PMDD looks and feels differently for everyone and can differ day to day. For one person, PMDD may involve fatigue, joint pain, and withdrawing from family, while for someone else it may include strong anxiety and depression. Some may experience more physical symptoms, while others may experience more mood related symptoms. The presence of underlying mental disorders such as bipolar disorder or depression can also affect one’s PMDD experience.
At what age does PMDD start?
Premenstrual disorder can start at just about any age that menses are experienced, whether the individual is 14 or 40. Typically, up to one week prior to the onset of a menses cycle is when PMDD symptoms may begin to be noticed.
What are the red flags for PMDD?
If you or a loved one experience PMDD, some red flags to keep an eye out for include:
- Extreme anxiety and panic attacks.
- Feeling like you’ve lost control.
- Severe depression or suicidal thoughts.
- Thoughts of harming yourself or others.
- Uncontrolled anger.
When is PMDD at its worst?
This depends on the individual, but PMDD symptoms are typically most pronounced in the week leading up to the start of a period and begin to level off during menstruation.
Is PMDD considered a mental illness?
The Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) considers PMDD to be a mental disorder, or more specifically a mood disorder. Within the DSM-5, PMDD is listed under the category of depressive disorders.
How to deal with a wife with PMDD?
If your partner has PMDD, one of the best ways to help is to offer patience and support. Ask them what they need. For example, depending on the individual, things like pain medication, ice packs, quiet and space from others, going for a walk together, taking on some of their daily tasks, making them a nutritious meal, or simply offering to listen can be helpful. If PMDD is taking a toll on your relationship, you and/or your partner may consider reaching out to a mental health professional for additional support.
Does PMS get worse with age?
Again, this depends on the individual, but research explored by Women’s Health indicates that PMS and its symptoms shift and can worsen as women near the years of perimenopause (usually reached around the mid 40’s). During this time, hormones can fluctuate greatly as the body begins preparations for menopause. This can trigger symptoms and exacerbate existing ones. PMS and PMDD risk factors include a family history of these disorders, the presence of other mental health conditions such as depression or bipolar disorder, and age.
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