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Periods can cause plenty of uncomfortable symptoms. These symptoms vary from person to person, but they often extend beyond physical discomfort, like cramps, fatigue, and headaches.

It’s very common to experience emotional distress during your period, including symptoms of depression.

You might notice:

Depression and other mood changes often show up in the days before your period starts, but they don’t automatically disappear once it begins. They can linger for a few days, if not longer — some people also experience depression after their period ends.

As you might already know, these mood symptoms can absolutely affect your day-to-day life. But what, exactly, causes symptoms of depression before, during, and possibly even after your period?

We’ve got an answer below, plus tips to cope and guidance on getting support.

While experts aren’t entirely certain about what causes mood changes during the menstrual cycle, they believe hormones have an important role.

Hormonal fluctuations happen naturally over the course of your cycle. Still, they can have an impact on other hormones in your body — notably the neurotransmitters dopamine and serotonin. Both hormones are known to play a part in depression.

Phases of the menstrual cycle

It can help to know a bit about the main phases of the menstrual cycle. Here’s a quick rundown:

  • Menstrual phase. You get your period during this first stage of the cycle. When your period is over, this stage ends.
  • Follicular phase. This phase also begins with the first day of your period, but it lasts until ovulation. During this phase, your body has lower levels of the hormones estrogen and progesterone. As your period ends, your body begins to rebuild the lining of the uterus in preparation for ovulation, or egg release, and hormone levels begin to rise once more.
  • Ovulation. This happens in the middle of the menstrual cycle. Your estrogen levels rise, reaching a high point just before ovulation, and then they drop immediately afterward.
  • Luteal phase. This phase begins after ovulation. The second half of your cycle involves a significant spike in progesterone, which helps prepare the uterus for pregnancy. When the released egg goes unfertilized, this peak is quickly followed by a drop, and your period begins.
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Before ovulation, dopamine levels increase alongside rising estrogen levels. Incidentally, this fluctuation could help explain why you might notice changes in working memory and concentration during your period.

Both dopamine and estrogen decline again after ovulation, and right before your period starts, there’s another drop in estrogen and progesterone.

For some people, the post-ovulation drop in estrogen leads to a corresponding drop in serotonin.

Research from 2017 also linked progesterone fluctuations to a decline in dopamine. Low progesterone, like low estrogen, can also contribute to mood changes, including symptoms of depression.

According to 2011 research, these hormonal changes can prompt mood symptoms, like depression and irritability. You’ll generally notice some improvement a few days after your period starts, when your hormone levels begin to rise once more.

Of course, not everyone experiences depression during their cycle. That’s because the story doesn’t end with hormones. Other factors, like genetics, can affect your sensitivity to hormonal changes and make premenstrual syndrome (PMS) more likely.

Certainly, for some people PMS involves nothing more than mild symptoms, like light cramping, bloating, or increased tiredness.

Keep in mind, though, that this isn’t the case for everyone. Many people who experience PMS have more intense symptoms, including:

These symptoms can easily affect your daily life. In other words, there’s no “just” about it.

Yet PMS, as uncomfortable as it can feel, isn’t the only explanation for depression during your period. Here are some other potential causes.

Premenstrual dysphoric disorder (PMDD)

You’ll often hear PMDD described as a more severe form of PMS.

This condition involves similar symptoms to PMS, but it causes much more distress. What’s more, PMDD typically requires medical treatment, unlike PMS.

Healthcare professionals typically diagnose the condition if you notice at least five of the following signs, during most of your periods, for a year:

  • depression
  • unusual anger and irritability
  • changes in mood
  • problems with concentration
  • decreased interest in your usual activities
  • feelings of overwhelm or losing control
  • sleep problems, including insomnia or needing more sleep than usual
  • appetite changes, including cravings or increases in appetite
  • physical symptoms, like:
    • head pain
    • cramps
    • bloating
    • tender breasts

Other serious symptoms of PMDD can include:

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PMDD symptoms don’t just feel intense and overwhelming. They also affect daily life, often by:

  • making you feel too unwell to go to work or school
  • creating tension or conflict in your relationships
  • disrupting concentration and focus
  • affecting your ability to complete daily tasks

These symptoms generally begin a week or two before your period and improve a few days after it begins.

If you have PMDD, you generally won’t experience mood symptoms between your period and ovulation — unless you have an existing mental health condition.

Premenstrual exacerbation (PME)

What if depression and other symptoms intensify just before your period starts, but don’t improve during your period? Or they show up at different times during your cycle, not only in the week or so before your period? If that’s the case for you, you might have PME.

PME can mimic PMDD, but the two conditions aren’t the same. With PME, the hormonal fluctuations related to your cycle can make symptoms of existing conditions worse.

This includes depression, as well as other mental and physical health conditions, like:

PME often goes unrecognized and untreated, in part because research on the condition and its causes remains fairly limited.

Since it can closely resemble PMDD, recognizing any patterns in your symptoms, such as when they get worse or improve, can help you get the right diagnosis and treatment.

Learn how depression impacts mothers and birthing parents.

If depression during your period is negatively impacting your life, know that there are treatment options.

A therapist or other healthcare professional can offer more guidance and support with finding a treatment that works well for you.

Therapy

Therapy can make a big difference in your ability to navigate depression symptoms, even if they only show up during your period.

A therapist can:

Connecting with a mental health professional becomes particularly important if, at any point in your cycle, you experience serious mental health symptoms, including:

Medication and supplements

If you’d like to try medication, a therapist or other healthcare professional can refer you to a psychiatrist who can recommend and prescribe antidepressants.

Research from 2011 suggested selective serotonin reuptake inhibitors (SSRIs) prove helpful in treating PMDD.

The most effective medication generally depends on a range of factors, including your health history and the underlying cause of your depression.

Your health professional can provide more information about medication options, from combination birth control pills to other treatments. They can also offer guidance on other potential remedies, including:

Remember: You know your body (and brain)

Know that, while some doctors might dismiss your symptoms as “not that bad,” others will listen and make a sincere effort toward helping you find relief. It’s often a matter of finding the right doctor, which can be a long, frustrating process.

If you can’t switch healthcare professionals, don’t give up.

Keep track of the symptoms you notice throughout your cycle in a journal. Bring this log to your appointments and show your doctor. This can better illustrate what you’re experiencing and help them narrow down a cause, whether that’s PMDD, PME, or something else entirely.

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Home remedies and other self-care strategies can sometimes help ease milder feelings of depression — but taking good care of yourself won’t always banish depression, or any mood symptoms, for that matter.

That said, self-care can make a difference in how you feel and improve your ability to cope. Here are a few ideas to try.

Physical activity

Exercising might feel like the last thing you want to do when you’re experiencing physical *and* emotional PMS symptoms, but physical activity can make a difference in your mood.

If you don’t want to do a full workout, try a low-key activity, like 30 minutes of:

Making exercise a part of your regular routine could also help improve depression over time, not to mention improve your sleep — another important foundation of self-care.

Relaxation

Stress can sometimes make your symptoms worse, so taking time for relaxation can be beneficial.

A few strategies to consider:

Emotional support

No matter the source of your depression, it often helps to share your feelings with someone you trust.

Your family and friends can:

Plus, opening up to loved ones about depression and other symptoms can also help them understand just how serious those symptoms are. After all, many people assume period-related depression is just a passing bout of PMS.

Depression during your period can have a few different causes, but it’s often much more than “just PMS.”

In fact, nearly all the mood symptoms associated with PMS can show up independently as symptoms of depression.

If depression lingers beyond your period and persists over time, connect with a therapist or doctor as soon as possible.

Looking for more premenstrual disorder support? Check out the International Association for Premenstrual Disorders for more resources, including a database of healthcare professionals who treat menstruation-related mental health symptoms.

Read this article in Spanish.

Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.