Premenstrual syndrome (PMS) is a collection of physical and emotional symptoms that start a week or so before your period. It makes some people feel more emotional than usual and others bloated and achy.
PMS can also make people feel depressed in the weeks leading up to their period. This may make you feel:
- uninterested in sex
- like sleeping too much or too little
- like eating too much or too little
Other reasons you might feel depressed before your period include:
- Premenstrual dysphoric disorder (PMDD). PMDD is very similar to PMS, but its symptoms are more severe. Many people with PMDD report feeling very depressed before their period, some to the point of thinking about suicide. While recent research estimates about 75 percent of women have PMS during their reproductive years, only 3 to 8 percent have PMDD.
- Premenstrual exacerbation. This refers to when symptoms of an existing condition, including depression, become worse in the weeks or days leading up to your period. Depression is one of the most common conditions that coexists with PMS. About half of all women who get treated for PMS also have either depression or anxiety.
Read on to learn more about the connection between PMS and depression.
Experts aren’t sure about the exact cause of PMS, but it’s likely linked to hormonal fluctuations that happen during the second half of the menstrual cycle.
Ovulation happens about halfway through your cycle. During this time, your body releases an egg, causing estrogen and progesterone levels to drop. A shift in these hormones can cause both physical and emotional symptoms.
Changes in estrogen and progesterone levels also influence serotonin levels. This is a neurotransmitter that helps regulate your mood, sleep cycle, and appetite. Low levels of serotonin are linked to feelings of sadness and irritability, in addition to trouble sleeping and unusual food cravings — all common PMS symptoms.
Your symptoms should improve when estrogen and progesterone levels rise again. This usually happens a few days after you get your period.
There’s no standard treatment for depression during PMS. But several lifestyle changes and a few medications may help relieve your emotional symptoms.
Track your symptoms
If you don’t already, start keeping track of your menstrual cycle and your emotions throughout its different stages. This will help you confirm that your depression symptoms are indeed linked to your cycle. Knowing that there’s a reason you’re feeling down can also help keep things in perspective and offer some validation.
Having a detailed log of your last few cycles is also handy if you want to bring up your symptoms with your doctor. There’s still some stigma around PMS, and having documentation of your symptoms might help you feel more confident about bringing them up. It can also help your doctor get a better idea of what’s going on.
You can track your cycle and symptoms using period-tracking app on your phone. Look for one that allows you to add your own symptoms.
You can also print out a chart or make your own. Across the top, write the day of the month (1 through 31). List your symptoms down the left side of the page. Put an X in the box next to the symptoms you experience each day. Note whether each symptom is mild, moderate, or severe.
To track depression, make sure to note when you experience any of these symptoms:
- crying spells
- food cravings or appetite loss
- poor sleep or too much sleep
- trouble concentrating
- lack of interest in your daily activities
- tiredness, lack of energy
Hormonal birth control
Hormonal birth control methods, such as the pill or patch, can help with bloating, tender breasts, and other physical PMS symptoms. For some people, they can also help with emotional symptoms, including depression.
But for others, hormonal birth control can make depression symptoms worse. If you go this route, you might have to try out different types of birth control before you find a method that works for you. If you’re interested in the pill, opt for a continuous one that doesn’t have a week of placebo pills. Continuous birth control pills can eliminate your period, which sometimes helps eliminate PMS, too.
A couple of vitamins may help relieve PMS-related symptoms of depression.
A clinical trial found that a calcium supplement helped with PMS-related depression, appetite changes, and tiredness.
Many foods are good sources of calcium, including:
- leafy green vegetables
- fortified orange juice and cereal
You can also take a daily supplement containing 1,200 milligrams of calcium, which you can find on Amazon.
Don’t be discouraged if you don’t see results right away. It can take about three menstrual cycles to see any symptom improvement while taking calcium.
Vitamin B-6 might also help with PMS symptoms.
You can find it in the following foods:
- chicken and turkey
- fortified cereals
Vitamin B-6 also comes in supplement form, which you can find on Amazon. Just don’t take more than 100 milligrams a day.
Several lifestyle factors also seem to play a role in PMS symptoms:
- Exercise. Try to be active for at least 30 minutes more days of the week than not. Even a daily walk through your neighborhood can improve symptoms of depression, fatigue, and trouble concentrating.
- Nutrition. Try to resist the junk food cravings that can come with PMS. Large amounts of sugar, fat, and salt can all wreak havoc on your mood. You don’t have to cut them out completely, but try to balance out these foods with fruits, vegetables, and whole grains. This will help keep you full throughout the day.
- Sleep. Not getting enough sleep can kill your mood if you’re weeks away from your period. Try to get at least seven to eight hours of sleep a night, especially in the week or two leading up to your period. See how not getting enough sleep affects your mind and body.
- Stress. Unmanaged stress can worsen depression symptoms. Use deep breathing exercises, meditation, or yoga to calm both your mind and body, especially when you feel PMS symptoms coming on.
If other treatment options aren’t helping, taking an antidepressant may help. Selective serotonin reuptake inhibitors (SSRIs) are the most common type of antidepressant used to treat PMS-related depression.
SSRIs block the absorption of serotonin, which increases the amount of serotonin in your brain. Examples of SSRIs include:
Other antidepressants that work on serotonin might also help treat PMS depression. These include:
- duloxetine (Cymbalta)
- venlafaxine (Effexor)
Work with your doctor to come up with a dosage plan. They might suggest you only take an antidepressant during the two weeks before your symptoms tend to start. In other cases, they might recommend taking them every day.
Your gynecologist might be the first person you turn to for help when PMS depression becomes overwhelming. It’s important that your doctor is someone you trust and who takes your symptoms seriously. If your doctor doesn’t listen to you, search for another provider.
You can also turn to the International Association for Premenstrual Disorders. It offers blogs, online communities, and local resources that can help you find a doctor familiar with PMS and PMDD.
If you or someone you know is having suicidal thoughts — related to PMS depression or not — get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
If you think someone is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
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