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 premenstrual syndrome (PMS) are yet unclear, they may be linked to natural hormonal fluctuations that occur in the body before and during the menstrual cycle. 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
In addition to physical symptoms like abdominal cramping or breast tenderness, individuals often experience mental health and mood symptoms of PMS these symptoms may include:
- mood swings
- low mood
- depression
- 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 are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.
The causes of premenstrual dysphoric disorder (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 a 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.
Takeaway
How does PMS affect your mental health?
Around 75% of people who menstruate experience some degree of premenstrual syndrome (PMS), which is characterized by mood symptoms like irritability, fatigue, mood swings, depression, and physical symptoms like tender breasts, food cravings, and bloating.
For many people, symptoms are predicable throughout the menstrual cycle, generally arriving before menstruation and dissipating within a few days of menstrual periods. While these symptoms are typically manageable, some people experience a more severe form of PMS called premenstrual dysphoric disorder (PMDD), which can cause disabling symptoms.
How does PMS affect daily life?
For many menstruating people, PMS does not significantly impact daily life, though symptom severity can vary significantly between people. However, for people with premenstrual dysphoric disorder (PMDD), PMS symptoms can be more severe and disruptive to daily functioning.
People with preexisting chronic conditions may experience worsening symptoms alongside PMS, called premenstrual exacerbation (PME). For example, someone with a depressive disorder or eating disorder may experience increased symptom severity before menstruation.
Can PMS make you depressed?
For some people, PMS can cause symptoms of depression, anxiety, or lead to worsening symptoms of existing mood disorders. For many people, these symptoms go away within a few days of starting their menstrual period, but for some, symptoms of depression may be serious enough to warrant treatments like antidepressants, hormonal birth control, or lifestyle changes.
Symptoms of depression to watch for include:
- Sadness
- Hopelessness
- Fatigue
- Difficulty sleeping or sleeping too much
- Restlessness
- Mood swings
- Irritability
If you’re experiencing PMS symptoms that cause you distress or disrupt your daily life, it’s a good idea to see a doctor who can evaluate and appropriately treat symptoms of mental health problems, premenstrual dysphoric disorder (PMDD), or underlying physical conditions.
How does the menstrual cycle affect mood?
During the last week of the luteal phase of the menstrual cycle (between ovulation and menstruation), many people develop symptoms of PMS. During this period of fluctuating hormone levels, food cravings, bloating, migraines, fatigue, and other physical symptoms are common.
After, estrogen and progesterone levels drop dramatically, resulting in mood symptoms for many people, such as irritability, depression, anger, or anxiety. For some, these symptoms are mild or nonexistent, whereas other people may experience debilitating PMS symptoms characteristic of premenstrual dysphoric disorder.
How does PMS affect the brain?
The menstrual cycle is marked by fluctuation of sex hormones (primarily estrogen and progesterone), and serotonin. It has been suggested that these hormonal fluctuations have a temporary impact on cognitive functioning. One study found that people experience changes in cognitive function throughout their menstrual cycle, such as improved implicit memory.
Why do I get so angry before my period?
Premenstrual syndrome (PMS) is known to cause both physical symptoms and emotional symptoms, like irritability or mood swings. These emotional changes are typically related to hormonal fluctuations, and most people find that their symptoms dissipate within a few days of starting their period.
Other emotional symptoms characteristic of PMS includes anxiety, sadness, and general moodiness. When symptoms are severe or disruptive to daily life, they may indicate premenstrual dysphoric disorder (PMDD).
At what age does PMS get worse?
According to the Office of Women’s Health, PMS tends to worsen in the 30s-40s. As women reach the end of their childbearing years and approach perimenopause, unpredictable and significant hormone fluctuations can exacerbate PMS symptoms.
Why do I cry so much before my period?
Many people who menstruate experience premenstrual syndrome (PMS) in the time leading up to their menstrual period. Common symptoms of PMS include:
- Sadness and crying
- Irritability
- Mood swings
- Bloating
- Tender breasts
- Food cravings
- Migraines
- Acne
- Fatigue
- Libido changes
These symptoms are often related to hormonal fluctuations, and many people find that their symptoms improve within a few days of starting their period. However, if your symptoms are causing you significant distress or interfering with your daily life, it’s a good idea to reach out to a medical practitioner or mental health provider.
Why do I get intrusive thoughts before my period?
In the weeks leading up to your menstrual period, your hormone (estrogen and progesterone) and serotonin levels change. These changes can lead to mood symptoms, like anxiety, mood swings, irritability, stress, and intrusive thoughts.
What foods are good for PMS mood swings?
According to Cleveland Clinic, there are some dietary habits that may help you manage PMS symptoms. These include limiting salt intake (which can contribute to bloating), reducing caffeine and alcohol consumption, and consuming a diet rich in fruits, vegetables, and whole grains. Other strategies, like getting daily exercise, can help you improve your mood too.
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