Why do I feel depressed during my period?

IT’S TIME TO STOP MINIMIZING THE RELATIONSHIP BETWEEN MENSTRUATION AND MENTAL HEALTH

Estimated read time: 3 minutes

By Jackie Menjivar

(Darya Sannikova / Pexels)

Snide jokes about “PMSing” and “that time of the month” were never funny. Even worse, they downplay the reality of menstruation and mental health. Your period can seriously impact your mental health, and for people with premenstrual disorders, the symptoms can be disabling. 

The majority of people with periods experience symptoms around their premenstrual cycle, so why aren’t more people talking about it? Here’s what you need to know about periods and mental health — including how to manage it. 

How does your period affect your mental health? 

There are all sorts of hormonal fluctuations happening over the course of your menstrual cycle. Although there’s still a lot we don’t understand about it, researchers point to the role of estrogen in regulating mood and producing serotonin and feel-good endorphins. Your estrogen shifts pretty drastically at different times of your cycle, which can impact the way you feel. On top of that, you might also be experiencing physical symptoms like cramps, bloating, and headaches — which can take their own toll on your mood.

The reverse is also true: your mental health can affect your period. Too much stress can shorten or stop your period altogether. People who are under a lot of stress or have a personal or family history of depression are also more likely to experience PMS symptoms. 

What is PMS actually?

PMS, or premenstrual syndrome, isn’t a punchline; it’s a real condition that impacts up to 75% of people with periods. It’s a combination of physical, emotional, and mental symptoms that happen in the 2ish weeks before your period starts (although sometimes it continues into the first few days of your period). 

PMS affects everyone differently, but there are some common symptoms. 

  • Mental symptoms: irritability, anxiety, restlessness, sadness, hypersensitivity, uncontrollable crying, shifting moods

  • Behavioral symptoms: fatigue, forgetfulness, insomnia, trouble concentrating

  • Physical symptoms: bloating, cramping, headaches, muscle aches, breast tenderness, food cravings, digestive issues, acne breakouts

When is it more than just PMS?

Between 3-8% of people with periods experience a more severe form of PMS called premenstrual dysphoric disorder (PMDD). The symptoms are similar to those of PMS, but much more frequent and intense. Where PMS symptoms may last a few days, PMDD symptoms last the entire 1-2 weeks, and they’re severe enough to disrupt your daily functioning. It’s a chronic condition that requires treatment. 

The main feature of PMDD is the way it affects you mentally. It can cause clinical levels of anxiety and depression, with symptoms like panic attacks, suicidal thoughts, severe mood swings, and paranoia. What sets PMDD apart from other mood disorders is that symptoms go away shortly after your period starts.

There’s also premenstrual exacerbation (PME), which worsens the symptoms of another mental health condition (like anxiety or depression) in the premenstrual phase. 

How can you manage your mental health during your period?

Talk to your doctor about medication. For some people, hormonal birth control can help with symptoms of PMS and PMDD.  If you’re experiencing serious psychological symptoms, your doctor may prescribe antidepressants for part or all of your monthly cycle (or adjust the dosage of any medication you already take). 

Plan around your cycle. Start by tracking your cycle and symptoms. You’ll get more familiar with the timing and impact of your cycle, and it can even help you find the right diagnosis. Then, plan around it. You can food-prep ahead of your fatigue, avoid setting deadlines during the times you feel unfocused, and plan something fun with a friend to stave off sad feelings. 

Get moving. Research shows that exercise can help reduce symptoms of PMS — and it’s also just good for your mental health in general. Stick to light cardio or low-volume strength training if you’re dealing with physical symptoms. Some people really benefit from yoga to manage their PMS. 

Prepare some coping strategies. It’s hard to remember the things that help you when you’re in the middle of a distressing moment. Make a toolkit of coping strategies that you can refer back to when you need them. Stock up on scrapbooking supplies, bookmark some guided meditation videos, and keep the bath bombs on standby. 

Ask for help. It’s okay to lean on other people when your symptoms make life hard. Find the people who you can help you — with either emotional support or by pitching in on daily tasks. Your loved ones will probably be down to walk the dog for you or pick up some extra things at the grocery store if you just ask. 

Find support. Even beyond friends and family, there are lots of support resources for people with premenstrual disorders. Whether it’s an online forum, a video support group, or a call with a friend, find a way to reach out and connect with other people.

 —

Too often, period-related pain (both physical and emotional) is dismissed as “not that bad,” or just a “normal” part of menstruation. But don’t get it twisted: it’s not normal to have suicidal thoughts before or during your period. It’s not normal to spend weeks in emotional distress. And it’s not normal to feel like your mind and body are out of your control. 

Treatment and recovery are possible. If you’re experiencing any of these symptoms, reach out to your health provider, and explore resources from the International Premenstrual Disorder Association. (You might also consider taking a free online mental health screen for other mental health conditions.) 

DepressionKristina Benoist