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Anxiety and Depression During Period: Causes, Detection, and Treatment

Many women experience symptoms of depression and anxiety during period. They often form a part of premenstrual syndrome (PMS). PMS is a combination of physical, emotional, and behavioral symptoms that occur in women during the premenstrual period of their cycle. Due to PMS, you may feel depression during period along with other symptoms such as food cravings, cramps, fatigue, tender breasts etc. You may also experience severe depression during period and before it due to premenstrual dysphoric disorder (PMDD). Due to premenstrual exacerbation of your existing depression, it may also happen that your depression worsens during period.
depressed woman on the bed

Causes of depression during period

What exactly causes depression due to PMS is not known, but it’s likely connected to fluctuations in the hormones that occur during the second half of your 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 PMS. Apart from these symptoms and depression while on period you may also have:

  • anxiety
  • increased anger
  • forgetfulness 
  • increased crying
  • absentmindedness
  • decreased libido
  • sleeping too little or too much
  • eating too little or too much
  • nausea
  • tiredness/fatigue 

Why does depression worsen during period?

Apart from PMS, your depression may also get worse during the period due to 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 PMS 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. 

Can depression affect your period?

Yes, depression may affect your 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. 

Mood changes in a woman in her day period

Signs of severe depression during period

As already stated, you may experience severe depression during period due to premenstrual dysphoric disorder (PMDD). PMDD is similar to PMS but it’s severe and sometimes disabling. PMDD may cause extreme mood shifts, which may damage your relationships and disturb your work. Symptoms may start seven to 10 days before the period begins and continue a few days after your period begins. Apart from severe depression during period other symptoms and signs of PMDD are:

  • tension or anxiety
  • feeling out of control or overwhelmed
  • extreme moodiness
  • marked anger or irritability
  • mood swings
  • social withdrawal
  • sudden tearfulness or sadness
  • hopelessness with thoughts of suicide
  • trouble concentrating
  • problems sleeping
  • binge eating or food cravings
  • fatigue 
  • lack of interest in relationships and daily activities
  • loss of interest in sex

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How can you fight depression on your period?

You may manage depression during period by making certain lifestyle changes and taking some medicines. 

Track your symptoms 

Keep a track of your symptoms throughout the different stages of your menstrual cycle. This may help you in confirming that your symptoms of depression are connected to your cycle. This detailed log of symptoms of your last few menstrual cycles also comes in handy when you want to discuss your symptoms of depression during period with your physician. Some stigma still surrounds PMS; hence, with documentation of the symptoms, you may feel confident while bringing them up to the physician. 

While tracking depression during period, make sure that you note the following symptoms:

  • sadness
  • crying spells
  • anxiety
  • irritability
  • appetite loss
  • food cravings
  • sleepiness or insomnia
  • trouble concentrating
  • lack of interest in daily activities
  • lack of energy, tiredness

Hormonal birth control

Hormonal birth control methods including the pill or the patch may help with physical symptoms of PMS such as tender breasts and bloating. For some women, they may also help in relieving the emotional symptoms such as depression during period.

For some, 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. 

Foods Highest in Vitamin B6 on wooden board.

Vitamins and supplements

Some vitamins may help in relieving symptoms of depression during period. In a clinical trial, it was found that a calcium supplement reduced PMS-related tiredness, appetite changes, and depression. You may eat foods rich in calcium including milk, cheese, yogurt, fortified cereal and orange juice and leafy green vegetables. You may also take a supplement of calcium daily. You may find improvement in your symptoms after about three menstrual cycles while consuming calcium. 
You may also take Vitamin B-6 to help improve your symptoms of depression during period. Eat foods rich in Vitamin B-6 including fish, fruits, turkey and chicken and fortified cereals. You may also take a Vitamin B6 supplement. 

Lifestyle changes

Make the following lifestyle changes to relieve the symptoms of depression during period:

  • Exercise: Try to be physically active for a minimum of 30 minutes on most days of the week. Even going for a walk daily through the neighborhood may improve your symptoms of fatigue, trouble concentrating and depression with period. 
  • Nutrition: Try and resist the cravings for junk food that may come with premenstrual syndrome. Eating a large number of foods rich in sugar, salt and fat may be detrimental to your mood. You don’t have to avoid these foods completely, but try and balance these foods with vegetables, whole grains, and fruits. Avoiding alcohol, stopping smoking and cutting back on caffeinated beverages may also help in relieving symptoms of depression with period.  
  • Sleep: Sleep for at least seven to eight hours per night particularly a week or two before your period. Not having enough sleep may make your depression worse during period. 
  • Stress: Unmanaged stress may worsen symptoms of depression during period. Use relaxation techniques including meditation, yoga, mindfulness and deep breathing exercises to calm your body and mind. Avoid emotional and stressful triggers such as arguments involving relationship problems or financial issues, whenever possible. 

Medicine

If other treatment methods aren’t working then taking an antidepressant medication may help in relieving depression during period. The most common antidepressant medicines that are used for the treatment of depression on period are selective serotonin reuptake inhibitors (SSRIs). SSRIs block serotonin absorption; thereby, increasing the amount of serotonin in the brain. You should work with your physician to find the right dosage plan that may work for you.

Finding support

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, PMS 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. 

Many women suffer from symptoms of depression and anxiety during period. It may form a part of premenstrual syndrome (PMS). The exact cause of depression due to PMS is unknown, but it may occur as a result of hormonal fluctuations during the second half of the menstrual cycle. Apart from PMS, your symptom of depression during period may also occur due to premenstrual dysphoric disorder (PMDD) and premenstrual exacerbation of existing depression. Depression may affect your period by causing missed or irregular period. PMDD may cause severe depression during period along with extreme mood shifts and even thoughts of suicide. You may manage symptoms of depression on period by making certain changes in your lifestyle and taking antidepressant medicines. 

https://www.healthline.com/health/pms-depression#why-it-happens
https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/expert-answers/pmdd/faq-20058315
https://www.everydayhealth.com/depression/pmdd-managing-monthly-depression.aspx
https://medlineplus.gov/ency/article/007193.htm
https://www.everydayhealth.com/pms/managing-stress-during-pms.aspx

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