How Can PMS Impact Your Mental Health?

Many of those who menstruate experience premenstrual syndrome (PMS), though symptoms and their severity can vary widely from person to person. PMS has the ability to impact an individual’s mental health, and it can also exacerbate existing mental health disorders.

Read on to learn more about the possible effects and how to cope with them.

What Is PMS?

While the exact causes of PMS are yet unclear, they may be linked to natural hormonal fluctuations that occur in the body during this time. PMS can affect people very differently. Some may experience several symptoms while others experience few or none, and their effects can be debilitating for one person and unnoticeable for another. 

Common Effects Of Premenstrual Syndrome

Premenstrual syndrome can manifest in many different ways, and the symptoms a person experiences may be relatively fixed each cycle or change over time. Physical PMS symptoms may include:

• trouble sleeping
• fatigue
• body aches
• abdominal cramps
• constipation, diarrhea, and/or nausea
• changes in libido
• changes in appetite
• abdominal bloating
• acne or oily skin
• breast tenderness

Mental health and mood symptoms of PMS may include: 

• mood swings
• low mood
• increased irritability
• increased anxiety
• emotional distress or an increase in emotional responses
• frequent crying
• social isolation or withdrawal
• trouble concentrating or focusing

Note that for transgender people, PMS and menstrual periods in general may be a source of gender dysphoria, which can lead to additional distress.

PMDD: A More Severe Form Of PMS

Although it’s talked about with even less frequency, premenstrual dysphoric disorder (PMDD) is a more severe form of PMS that some people may experience. Symptoms may be similar to those of PMS but are generally more serious and can be debilitating or even dangerous. They may include:

• nervousness
• agitation or anger
• insomnia
• depression
• severe fatigue
• confusion or forgetfulness
• poor self-image
• paranoia
• vision changes
• vomiting
• skin inflammation
• dizziness
• numbness, tingling, or heightened sensitivity of arms and/or legs
• heart palpitations
• muscle spasms
• decreased coordination
• suicidal thoughts

If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 988 and is available 24/7.

The causes of PMDD are not understood, though one theory is that it’s an abnormal reaction to hormonal fluctuations during a certain part of an individual’s cycle. It’s a serious, chronic condition that requires treatment, which may include lifestyle changes and/or medication.

How Premenstrual Syndrome Can Affect Mental Health

Both PMS and PMDD can impact a person’s mental health. First, physical symptoms like trouble sleeping, gastrointestinal distress, fatigue, discomfort, cramps, and body aches can affect mood and/or functioning. If symptoms make it harder or impossible for you to do something you want or need to, it can be distressing or lead to feelings of guilt or resentment. Some people may also experience a dip in self-esteem or the desire to isolate or withdraw socially due to physical symptoms or mood. Emotional symptoms such as irritability and mood swings may also negatively affect you. The potentially serious symptoms of PMDD in particular—such as paranoia and depression—can also have a direct influence on one’s state of mental health. Finally, any symptoms you experience may simply make you feel like you’re not yourself and can negatively impact your daily functioning, which can play a significant role in your mental health status. 

Premenstrual exacerbation (PME) is a related pms mental health condition that’s currently being studied. It refers to when PMS worsens symptoms of an existing mental health disorder. A 2021 paper on the topic estimates that around 60% of people who menstruate and also have a mood disorder report symptom exacerbation that coincides with their cycle, and that some with bipolar disorder report the same. More research is needed on the topic, but it seems likely that many of those who have already been diagnosed with a mental illness may experience worse symptoms because of PMS.

Tips For Managing Mental Health Symptoms Of PMS

How you manage mental health symptoms of PMS can vary depending on their severity. Again, if you’re experiencing suicidal thoughts or self-harming behaviors, please reach out to the National Suicide Prevention Lifeline any time 24/7 by dialing 988. If you’re experiencing other severe symptoms, meeting with your doctor and/or a mental health professional is generally recommended. For other mental health symptoms during PMS, the following tips may help.

Get To Know Your Cycle

Tracking your symptoms and how you feel day to day can give you more insight into how your body works and reacts at different times in your menstrual cycle. This practice can help you notice trends or patterns so you can be more prepared for when certain symptoms arise, and/or so you can give your healthcare provider accurate information about what you’re experiencing so they can help. Some people use apps or software to do this; others prefer to use a spreadsheet or keep track of the information on paper.

Practice Self-Compassion

Self-compassion and positive self-talk can be helpful during PMS and other emotional distress. For example, find yourself experiencing a high level of emotions or crying more frequently in the week or two leading up to your period. You might tell yourself, “It makes sense that I’m experiencing this right now because this is a pattern with my cycle. What can I do to support and be gentle with myself right now?" rather than being hard on yourself for not feeling well. Then, try practicing healthy coping and self-care skills such as taking naps, eating well, having a hot shower, doing yoga, or whatever methods work for you.

Take Care Of Your Physical Health

While taking care of your physical health may be more difficult when you’re experiencing symptoms of PMS or PMDD, it may make a difference in how you’re feeling mentally. Doing what you can to get enough sleep, eat a balanced diet, and exercise may help you maintain a more positive mental state during this time. A 2022 study found that aerobic exercise can help reduce both psychological and physical symptoms of PMS, and a 2013 study suggests that calcium supplementation may “effectively alleviate the majority of mood and somatic symptoms” of PMS. Experimenting with different ways to care for your body during this part of your cycle may help mitigate the mental health effects you normally experience.

Speak With A Therapist

If you’re experiencing severe mental health symptoms of PMS or PMDD, speaking with your doctor is generally advisable as a first step, and they may also recommend meeting with a mental health professional. Speaking with a therapist may be helpful for mild to moderate mental health symptoms caused by either of these conditions. They can provide you with a safe, nonjudgmental space to process your emotions and they may help you identify healthy coping mechanisms to help you get through the most emotionally difficult part of your cycle. If you already have or suspect you may have a separate mental health disorder, they can also help you identify and manage its symptoms, including if they’re exacerbated by PMS. 

If you feel more comfortable getting this type of support from your own home, online therapy is an option. With an online therapy platform like BetterHelp for adults or a virtual therapy platform like TeenCounseling for those ages 13–18, you can get matched with a therapist with whom you can meet via phone, video call, and/or online chat. They can help you handle the mental health effects you may be experiencing as a result of PMS, PMDD, or PME.