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

    Updated 02 February 2023 |
    Published 02 January 2019
    Fact Checked
    Kate Shkodzik, MD
    Reviewed by Kate Shkodzik, MD, Obstetrician and gynecologist
    Flo Fact-Checking Standards

    Every piece of content at Flo Health adheres to the highest editorial standards for language, style, and medical accuracy. To learn what we do to deliver the best health and lifestyle insights to you, check out our content review principles.

    Depression and anxiety during periods are both common. These symptoms are often part of premenstrual syndrome (PMS). PMS is a combination of physical, emotional, and behavioral symptoms that occur during the premenstrual phase of the cycle and go away after the period begins. PMS can cause depression before and during periods, along with food cravings, headache, fatigue, and tender breasts, among other symptoms.

    However, severe depression during periods (or before) may be caused by premenstrual dysphoric disorder (PMDD). If you are already experiencing depression, it may be that your depression worsens before and during periods.

    Causes of depression during periods

    It’s not known exactly how PMS causes depression, but it’s probably connected to the hormonal fluctuations that occur during the second half of the menstrual cycle, sensitivity of the central nervous system to reproductive hormones, genetic factors, and psychosocial factors such as stress. 

    Changes in levels of progesterone and estrogen can affect levels of serotonin. Serotonin is a neurotransmitter that helps regulate appetite, sleep cycle, and mood. Low serotonin levels may lead to feelings of irritability and sadness, unusual food cravings, and trouble sleeping, all of which are symptoms of PMS. In addition to these symptoms and depression while on your 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 or fatigue ​

    Why does depression worsen during periods?

    Depression may also be exacerbated during your period due to PMDD. PMDD is quite similar to PMS, but its symptoms are more severe. Many people who experience PMDD report extreme depression before and during their periods. According to estimates, around 30 percent of people who get periods experience PMS in their reproductive years, and anywhere from three to eight percent experience PMDD. 

    If you already have depression, then your symptoms may get worse before and during your period. Depression commonly occurs alongside premenstrual syndrome. About 50 percent of people who receive treatment for PMS also experience either anxiety or menstrual depression.

    Can depression affect your period?

    Yes, depression may affect your period. Depression can cause missed or irregular periods. During periods of stress or depression, hypothalamus function is suppressed. The hypothalamus is the part of the brain that controls the functioning of the pituitary gland, which in turn controls the ovaries, so when the hypothalamus isn’t functioning correctly, it can lead to ovarian dysfunction. Ovarian dysfunction can affect ovulation and the production of estrogen. When the ovaries aren’t working properly, ovulation may be delayed or stopped. This may result in irregular periods or missed periods.

    Can depression stop your period? Yes, depression can stop your period. Not having your period for three months or more without pregnancy is called secondary amenorrhea. When the cause of amenorrhea is depression and chronic stress, it’s called functional hypothalamic amenorrhea.

    Mood changes in a woman in her day period

    Signs of severe depression during period

    You may experience severe depression before and during periods due to premenstrual dysphoric disorder (PMDD). PMDD is similar to PMS, but it’s severe and sometimes disabling. PMDD can cause extreme mood shifts, which can interfere with your daily life, relationships, and work. Symptoms usually start a week before menstruation and continue a few days after your period begins. Apart from severe depression before and during periods, 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 extremely negative thoughts
    • Trouble concentrating
    • Problems sleeping
    • Binge eating or food cravings
    • Fatigue 
    • Lack of interest in relationships and daily activities
    • Loss of interest in sex

    The Truth About Premenstrual Dysphoric Disorder (PMDD)

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    Coping with depression on your period

    You may manage depression during your period by making certain lifestyle changes and taking specific medications.

    Track your symptoms 

    Keep track of your symptoms throughout the phases of your menstrual cycle. This may help you determine whether your symptoms of depression are connected to your cycle. Having a detailed log of symptoms from your last few menstrual cycles can also come in handy when you want to discuss depression before and during periods with your health care provider. Thorough documentation of your symptoms may make it easier to explain t