According to research, PMS symptoms are experienced by almost 90% of women during their reproductive years. For most, symptoms are mild, manageable, and temporary.
For some women, however, premenstrual depression can play havoc with their lives for a few days before their period. What is premenstrual depression? Is it normal? And how can you treat it?
What Exactly is PMS?
Premenstrual syndrome (PMS) is a common condition that causes a range of both physical and emotional symptoms approximately 7-14 days before menstruation. Symptoms can include breast tenderness, belly & back cramps, interrupted sleep, mood changes, headaches, acne, food cravings, and for some, premenstrual depression.
What Does Premenstrual Depression Feel Like?
Due to the hormonal fluctuations and chemical changes in the brain before a woman’s period starts, premenstrual depression can make some women feel as if they are overwhelmed by an unexplained sadness. They might also feel teary, exhausted, easily angered, and overly anxious about everyday life situations.
Premenstrual depression can also lead to absentmindedness and forgetfulness, as well as a lower level of energy toward hobbies, sex, family, friends, work, and life in general.
What Causes Premenstrual Depression?
Exactly what causes PMS, or the depression associated with it, is yet to be determined by scientists. However, several research studies suggest a connection between the cyclical fluctuations of hormones and the chemical changes in the brain pre-menstruation.
A decrease in the production of serotonin in the brain, for example, is known to cause food cravings, headaches, and sleep disruptions. While an increase in the hormones estrogen and progesterone is thought to contribute to mood swings, a heightened sense of stress, anxiety, or depression.
What Else Causes Premenstrual Depression?
As well as the hormonal fluctuations naturally associated with PMS, premenstrual depression can also derive from a more serious form of PMS known as Premenstrual Dysphoric Disorder (PMDD) or a condition known as Premenstrual Exacerbation.
Premenstrual Depression & PMDD
Recognized as a more serious form of PMS, PMDD is believed to affect approximately 5-8% of women in their reproductive years. In addition to the usual range of PMS symptoms, patients are known to suffer from extreme anxiety or depression, as well as occasional panic attacks and suicidal thoughts.
Although the severe drop in happiness and energy levels will generally subside as soon as menstruation begins, the depression experienced from PMDD can gravely affect women’s lives for up to 14 days beforehand.
Premenstrual Depression & Premenstrual Exacerbation
When women experience an exacerbation, or a worsening, of pre-existing conditions during the hormonal changes before their period, it could be a case of Premenstrual Exacerbation. Depression, anxiety, bipolar or eating disorders are known to worsen for many women with the onset of PMS.
Managing & Treating Premenstrual Depression
There is no one-method-suits-all type of treatment for premenstrual depression. For some women, medication is the answer, and for others, a combination of natural remedies and lifestyle awareness helps to manage symptoms.
The first thing women’s health experts recommend is to ensure that your bouts of depression are indeed linked to your menstrual cycle. Keeping a menstrual journal, or even using an App that allows you to track your symptoms on your phone, will provide both you and your medical practitioner with more insight before deciding on treatment options.
Be sure to make a note of when your depression symptoms appear, and whether they are mild, moderate, or severe at different times during your monthly cycle.
Several studies have shown that a daily dose of calcium can significantly help to relieve PMS symptoms such as depression, food cravings, fatigue, and anxiety.
In a recent study, women suffering from PMS symptoms who took 500 mg of calcium twice a day for three months claimed fewer changes in their appetite, fewer feelings of anxiety or depression, and more energy than the women who did not take calcium supplements.
The results of this study prompted health practitioners to recommend that women experiencing PMS symptoms, including depression, should try including 1200 mg of calcium either as a supplement or in their daily diet. This would be equivalent to four servings of milk, orange juice, leafy greens, or low-fat yogurt per day.
The same study into calcium for PMS found that the women who also had high dietary intakes of vitamin D, as well as calcium, experienced few to no symptoms of PMS. This is believed to be down to the fact that vitamin D helps calcium to absorb into the body.
Low vitamin D levels have also be tied to PMS symptoms like depression, breast tenderness, anxiety, and fatigue.
Also known as Agnus Castus or Vitex, chasteberry has been used since ancient civilizations to treat women’s reproductive conditions. These days, women’s health practitioners widely recommend chasteberry supplements to relieve PMS symptoms, including depression.
As well as improving moods, chasteberry also lowers stress levels, reduces sleep disruptions, lessens feelings of fatigue, and soothes PMS headaches.
In a recent study, 162 women were given one of three different daily doses of chasteberry or a placebo for three months. Results showed that the women who took a daily chasteberry supplement of 20 mg experienced significant relief in the intensity of their PMS symptoms, in comparison to the women who took 8 mg, 30 mg doses, or the placebo.
For optimal results, a chasteberry supplement, like the Chasteberry/Vitex Supplement from Intimate Rose should be ingested, with food, for at least three months. It should also be noted, however, that chasteberry can react with certain medications, so anyone already taking prescribed medication should check with their doctor before adding it to their daily intake of supplements.
What You Eat Can Boost Your Mood
As well as taking the right supplements and including foods that are rich in calcium and vitamin D, certain lifestyle changes can help relieve premenstrual depression too. What you eat, for example, can have an impact on your energy & happiness levels.
Sugar, for example, is craved by many premenopausal women due to the decreased levels of serotonin produced in the brain. Indeed, research has shown that women can consume up to 500 more calories a day during PMS. Sugar, which intensifies PMS symptoms like anxiety and depression, is not a great food choice, but you don’t have to avoid it completely. Instead focus on eating more complex carbohydrates, like beans, whole grains, and vegetables too.
Reducing caffeine, salt, and processed foods in the two weeks before menstruation can also help to relieve symptoms of PMS and depression.
Various studies have shown that women who suffer from premenstrual depression experience improved energy levels and sounder sleep when they have a regular exercise plan in place.
Aerobic exercise like brisk walking, cycling, swimming, cross-training, or jogging, all help to release endorphins and serotonin in the body, which not only improve energy and sleep but moods and happiness levels too.
When incorporated into daily life, exercise has been proven to be one of the most natural and significant boosters of a depressed mind.
Relaxation & Stress Management
Self-care is one of the best gifts women can give themselves during the luteal phase before menstruation, and after exercise, learning to relax and de-stress should be number one on that self-care list.
Yoga, meditation, and conscious breathing exercises have all been proven to reduce and release the feelings of despondency that come with premenstrual depression.
In extreme cases, doctors might prescribe a type of antidepressant known as Selective Serotonin Re-uptake Inhibitors (SSRIs) to relieve Premenstrual Depression. SSRIs are taken to block the absorption of serotonin, thereby maintaining the amount naturally produced by the brain during PMS.
For some patients, SSRIs may only be necessary during the luteal phase (before the period begins) and for others, doctors may recommend taking them every day.
Premenstrual depression can impact women’s lives in a temporary, mild, moderate, or severe way. While the natural remedies, supplements, and medication discussed in this article can provide relief for some, it is always advisable to discuss the best plan for you with your healthcare provider.
Should you, or anyone you know, experience suicidal thoughts or regular panic attacks in the 7-14 days before your period, talk to someone you trust about it, or seek some professional help. The National Suicide Prevention Lifeline in the US is 800-273-8255.
Cleveland Clinic – Premenstrual Dysphoric Disorder - https://my.clevelandclinic.org/health/articles/9132-premenstrual-dysphoric-disorder-pmdd
National Center for Biotechnology Information - Menstrual Cycle-Related Exacerbation of Disease -
Jama Internal Medicine - Calcium and Vitamin D Intake and Risk of Incident Premenstrual Syndrome - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486599
Reproductive Endocrinology - Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndrome -
National Center for Biotechnology Information - Mindfulness-based Stress Reduction as a Promising Intervention for Amelioration of Premenstrual Dysphoric Disorder Symptoms- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651211/
National Center for Biotechnology Information - The effect of 8 weeks aerobic exercise on the severity of physical symptoms of premenstrual syndrome: a clinical trial study