How to Deal with Anxiety Before Your Period

Even in the 21st century, experts don’t have a great understanding of premenstrual symptoms and conditions.

But most believe that PMS symptoms, including anxiety, arrive in response to changing levels of estrogen and progesterone. Levels of these reproductive hormones rise and fall dramatically during the luteal phase of menstruation.

Basically, your body prepares for pregnancy by increasing hormone production after ovulation. But if an egg doesn’t implant, those hormone levels drop and you get your period.

This hormonal rollercoaster can affect neurotransmitters in your brain, such as serotonin and dopamine, which are associated with mood regulation.

This may partly explain the psychological symptoms, such as anxiety, depression, and mood swings, that happen during PMS.

It’s unclear why PMS hits some people harder than others. But some people may be more sensitive to hormonal fluctuations than others, possibly due to genetics.

Severe premenstrual anxiety can sometimes be a sign of premenstrual dysphoric disorder (PMDD) or premenstrual exacerbation (PME).

PMDD

PMDD is a mood disorder that affects up to 5 percent of people who menstruate.

The symptoms are usually severe enough to interfere with your daily life and can include:

• feelings of irritability or anger that often affect your relationships
• feelings of sadness, hopelessness, or despair
• feelings of tension or anxiety
• feeling on edge or keyed up
• mood swings or frequent crying
• decreased interest in activities or relationships
• trouble thinking or focusing
• tiredness or low energy
• food cravings or binge eating
• trouble sleeping
• feeling out of control
• physical symptoms, such as cramps, bloating, breast tenderness, headaches, and joint or muscle pain

PMDD is closely associated with preexisting mental health disorders. If you have a personal or family history of anxiety or depression, you may have an increased risk.

PME

PME is closely related to PMDD. It happens when a preexisting condition, such as generalized anxiety disorder, intensifies during the luteal phase of your cycle.

Other preexisting conditions that can flare up before your period include:

• depression
• anxiety disorders
• migraine
• seizures
• substance use disorder
• eating disorders
• schizophrenia

The difference between PMDD and PME is that those with PME experience symptoms all month long, they just get worse in the weeks before their period.

There are a number of things you can do to lessen premenstrual anxiety and other PMS symptoms, most of which involve changes to your lifestyle and diet.

But don’t panic — they aren’t too drastic. In fact, you’re already working on the first step: Awareness.

Simply knowing that your anxiety is tied to your menstrual cycle can help you better equip yourself to deal with your symptoms as they arise.

Things that can help to keep anxiety in check include:

• Aerobic exercise. Research shows that those who get regular exercise throughout the month have less severe PMS symptoms. Regular exercisers are less likely than the general population to have mood and behavior changes, such as anxiety, depression, and trouble concentrating. Exercise may also reduce painful physical symptoms.
• Relaxation techniques. Using relaxation techniques to reduce stress may help control your premenstrual anxiety. Common techniques include yoga, meditation, and massage therapy.
• Sleep. If your busy life is messing with your sleep habits, it may be time to prioritize consistency. Getting enough sleep is important, but it’s not the only thing. Try to develop a regular sleep schedule in which you wake up and go to sleep at the same time every day — including weekends.
• Diet. Eat carbs (seriously). Eating a diet rich in complex carbohydrates — think whole grains and starchy veggies — can reduce moodiness and anxiety-inducing food cravings during PMS. You may also want to consume foods rich in calcium, such as yogurt and milk.
• Vitamins. Studies have found that both calcium and vitamin B-6 can reduce the physical and psychological symptoms of PMS. Learn more about vitamins and supplements for PMS.

The tips discussed above can help to manage active PMS symptoms and reduce your chances of experiencing them. But there’s not a whole lot else you can do about PMS.

However, you might be able to get more bang for your buck out of those tips by tracking your symptoms throughout your cycle using an app or diary. Add in data about your lifestyle changes so you can get a better idea of what’s most effective and what you can maybe skip.

For example, mark down days in which you get at least 30 minutes of aerobic exercise. See if your symptoms decrease overtime as your fitness level increases.

If your symptoms don’t improve after lifestyle changes or you think you may have PMDD or PME, it’s worth following up with your healthcare provider.

If you’ve been tracking your period and PMS symptoms, bring those along to the appointment if you can.

If you do have PME or PMDD, the first line of treatment for both conditions are antidepressants known as selective serotonin reuptake inhibitors (SSRIs). SSRIs increase serotonin levels in your brain, which may help decrease depression and anxiety.

A little bit of anxiety in the week or two before your period is totally normal. But if your symptoms are having a negative impact on your life, there are things you can try for relief.

Start by making a few lifestyle changes. If those don’t seem to cut it, don’t hesitate to talk to your healthcare provider or gynecologist.

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