Severely Low Moods Before Your Period? It Could Be PMDD

During your menstrual cycle, hormone levels change drastically, first in preparation for a potential pregnancy, and then in shedding the uterine lining if no egg implants. While most women are aware the shift can cause physical symptoms like pelvic pressure and muscle cramps, many don’t know that it can also cause emotional challenges, such as depression and anxiety.

At Sidhu Psychiatric Clinic, board-certified psychiatric mental health nurse practitioner Kanwaljit “Kavi” Sidhu, NP-C, PMHNP-BC, and our team address both depression and anxiety at our office in Palm Harbor, Florida, no matter what’s causing them.

If you’re noticing severely low moods every month in the weeks leading up to your period, it may be more than just being anxious or depressed. You may have premenstrual dysphoric disorder (PMDD).

What is PMDD and what are its symptoms?

PMDD is similar to premenstrual syndrome (PMS) in that it occurs one to two weeks before you get your period, as hormone levels drop after ovulation. However, PMDD causes more severe symptoms than PMS, including intense depression, irritability, and anger. PMDD affects up to 5% of women of childbearing age.

Researchers aren’t certain what causes PMDD, or PMS for that matter. However, the prevailing theory is that the drop in hormones following ovulation affects your mood. In addition, serotonin, a brain neurotransmitter that helps regulate mood, is thought to play a role since levels of it also change during a woman’s cycle.

Symptoms of PMDD resemble those of anxiety and depression, both physically and emotionally. They include:

Persistent irritability or anger that can affect other people
Feelings of sadness or despair
Feelings of tension
Panic attacks
Mood swings
Lack of interest in daily activities, including relationships
Difficulty focusing
Fatigue
Food cravings or binge eating
Difficulty sleeping
Feeling out of control
Bloating, cramps, muscle and/or joint pain, breast tenderness, and/or headaches

You may have just one or two symptoms or a combination of many. It varies from person to person.

Diagnosing and treating PMDD

To start, we take a complete medical history. As part of that history, it helps if you keep a diary of what symptoms you have and when they occur. We also perform a physical exam to rule out any underlying physical causes.

To be diagnosed with PMDD, you must have five or more PMDD symptoms, of which one must be mood-related.

Treatments for PMDD can be divided into medication and lifestyle.

Medication

One of the most prevalent classes of antidepressant medication is the selective serotonin reuptake inhibitors (SSRIs). SSRIs change serotonin levels in the brain and may compensate for the altered levels during PMDD. The Food and Drug Administration (FDA) has approved three SSRIs to treat PMDD: sertraline, fluoxetine, and paroxetine HCI.

Birth control pills are another option. The FDA has approved a birth control pill containing drospirenone and ethinyl estradiol, which help regulate hormone levels.

For physical symptoms like cramps, headaches, and joint pain, over-the-counter (OTC) pain relievers such as ibuprofen or naproxen may help.

Lifestyle

For women who become anxious as a result of PMDD, stress management techniques can prove valuable. Relaxation, meditation, yoga, and engaging with hobbies can all help relieve tension and anger.

Making healthy changes to your lifestyle, such as eating a nutritious diet and exercising more, can help relieve some of the symptoms. However, in some women, PMDD is serious enough that you should make an appointment at Sidhu Psychiatric Clinic to discuss treatment options.

If you struggle with severely low moods every month for a couple of weeks before you get your period, Kavi and our team at Sidhu Psychiatric Clinic can help. Call our office at 727-382-1383 to schedule a consultation or contact us online today.