What To Know About Premenstrual Depression And How To Manage It

1033 depressed woman on the bed

Premenstrual Depression (PMD) is a collection of physical and emotional symptoms that start a week or so before your period. It makes some women feel more emotional than usual and others bloated and achy.

Many women in all parts of the world experience depression during their menstruating years. The key element that sets apart premenstrual depression (PMD)-related depression from other forms of depression is the timing of symptoms. More than 150 different symptoms have been ascribed to PMD, but the hallmark of PMD-related problems is their occurrence during the two weeks prior to the onset of menstruation (around the time of ovulation).

Causes of Depression During Period

What exactly causes depression due to PMD is not known, but it’s likely connected to fluctuations in the hormones that occur during the second half of a woman’s menstrual cycle. 

Changes in the levels of progesterone and estrogen also influence the levels of serotonin. Serotonin is a neurotransmitter, which helps in regulating your appetite, sleep cycle, and mood. Low serotonin levels may lead to the occurrence of feelings of irritability and sadness, unusual food cravings, and trouble sleeping, all of which are symptoms of PMD.

Why depression worsens during the period of a woman’s menstruation.

Apart from PMS, depression may also get worse during the period due to Premenstrual dysphoric disorder (PMDD) and premenstrual exacerbation of existing depression. PMDD is quite similar to PMD, but its symptoms are more severe. Many women who suffer from PMDD report extreme depression during period some to the point that they think about suicide. According to estimates around 75 percent of females have PMD in their reproductive years and 3 to 8 percent of women have PMDD. 

If you already have depression, then your symptoms may get worse before and during the period. Depression is among the common ailments that coexist with premenstrual syndrome. About 50 percent of all women who receive treatment for PMS also suffer from either anxiety or menstrual depression. 

How Depression Affects a woman’s Period

Depression may cause missed or irregular periods. During periods of stress and depression, the functioning of your hypothalamus is suppressed. Hypothalamus is the gland that controls the functioning of the pituitary gland, which in turn controls the ovaries. Ovarian dysfunction results in problems with production of estrogen and ovulation. When your ovaries don’t work properly, then the ovulation may be delayed or stopped. This may result in irregular periods or missed periods. Can depression stop your period? Yes, depression may stop your period. Absence of periods without pregnancy is known as amenorrhea. When the cause of amenorrhea is depression and chronic stress then it is known as hypothalamic amenorrhea.

How To Manage It

There’s no standard treatment for depression during PMD. 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.

To track depression, make sure to note when you experience any of these symptoms:

  • sadness
  • anxiety
  • crying spells
  • irritability
  • 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.

Natural remedies

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:

  • milk
  • yogurt
  • cheese
  • leafy green vegetables
  • fortified orange juice and cereal

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:

  • Fish
  • chicken and turkey
  • fruit
  • fortified cereals

Vitamin B-6 also comes in supplement form. Just don’t take more than 100 milligrams a day.

Lifestyle changes

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 PMD 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:

  • citalopram (Celexa)
  • fluoxetine (Prozac and Sarafem)
  • paroxetine (Paxil)
  • sertraline (Zoloft) . 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.


If your symptoms of depression during period become overwhelming, then your gynecologist may be the first person to whom you may turn for help. You may also refer to the International Association for Premenstrual Disorders. It offers online communities, blogs, and local resources, which may help you in finding a physician familiar with depression on period, PMD and PMDD. 

If you suffer from extreme depression during period and are having suicidal thoughts due to that then get help from a suicide or crisis prevention helpline. 

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