Things to Know About Premenstrual Syndrome and Depression

Premenstrual syndrome (PMS) encompasses a range of potential physical and emotional symptoms in the weeks leading up to the menstrual period (week).

Some women are more likely to experience physical symptoms, while others experience emotional or mental problems that resemble depression symptoms.

According to the Office of Women’s Health, about 90% of women report experiencing the following PMS symptoms:

  • swelling
  • tiredness
  • irritability
  • anxiety

However, about 5-10% of women develop premenstrual dysphoric disorder (PMDD). PMDD is a severe form of PMS where you are more likely to experience mood disorders that can affect personal relationships. PMDD often comes with symptoms similar to those of clinical depression or anxiety.


PMDD is a more severe form of PMS. In PMS one may experience bloating and its other physical symptoms, but in PMDD the emotional and mental symptoms are much more severe and can cause additional symptoms of clinical depression or anxiety.

Someone experiencing PMDD may have one or more of the following symptoms:

  • mood change
  • irritability
  • depressed state
  • anxiety
  • feelings of hopelessness, worthlessness, or sadness
  • mood changes, with frequent tears
  • persistent anger or irritability
  • decreased interest in normal activities
  • tension or anxiety
  • feeling overwhelmed or out of control
  • difficulty concentrating
  • tiredness, lack of energy, or lethargy
  • excessive sleep or difficulty sleeping
  • excessive or insufficient
  • headaches
  • swelling and tenderness in the breasts
  • gaining weight
  • joint or muscle pain

One of the main differences between PMDD and clinical depression is that PMDD occurs at a certain time of the month. Symptoms typically begin 1-2 weeks before a period and end when the period begins. During the other weeks of the cycle, there are usually no symptoms of PMDD.

Women with an underlying mental health condition, such as depression or anxiety, may experience relief from certain symptoms during certain parts of their menstrual cycle. This may lead some to believe they actually have PMDD when they experience clinical depression, anxiety or similar mental health conditions.

It is recommended that women who experience any symptoms of depression that affect their interactions with others or their ability to participate in their normal activities speak to their doctor.


While healthcare professionals do not yet know the exact cause of PMDD, the consensus is that symptoms develop as a result of hormonal fluctuations due to the natural menstrual cycle. Fluctuating estrogen and progesterone levels can affect chemicals in the brain, including serotonin, which affects mood.

However, this is not the only reason. Women who experience PMS or PMDD are similar to those who do not have estrogen and progesterone levels. The most likely explanation is that those who experience PMDD are more susceptible to such hormone fluctuations.


Anyone who comes and goes with the menstrual cycle and experiences symptoms of depression or anxiety should speak to a doctor or other healthcare professional.

A doctor can diagnose PMDD by discussing the symptoms and learning when they occur.

Women diagnosed with PMDD generally:

  • Shows physical and emotional symptoms typical of PMS or PMDD
  • experience symptoms only in the premenstrual part of the cycle
  • symptoms resolve for at least a few days to weeks of the cycle

Usually, a doctor will recommend monitoring various symptoms for a month. The information recorded can help them understand whether the symptoms are due to PMDD, clinical depression, or something else.


The treatment plan for PMDD usually consists of home remedies. These may include:

  • consistent exercise
  • vitamin and mineral supplements
  • relaxation therapy

If these drugs do not have the desired effect, the doctor may recommend additional treatment options, including medication. They may prescribe one of the following:

  • Selective serotonin reuptake inhibitors : These are effective in treating the emotional symptoms of PMDD and PMS.
  • birth control pills : Some females find relief in symptoms while using birth control pills, while others may find their symptoms increase.
  • Gonadotropin-releasing hormone agonists : These drugs can temporarily prevent the ovaries from producing progesterone or estrogen.

Fatty acids, essential oils, and certain dietary supplements such as ginkgo biloba may also provide relief from PMDD symptoms. However, more research is needed to determine their effectiveness for this purpose.

One study also found that calcium supplementation can be an effective treatment for conditions such as depression and anxiety during PMS.

It’s important to talk to a doctor before trying any of these, as some can interact with other medications.

Is PMS depression or early pregnancy?

Sometimes it can be difficult to tell the difference between PMS, depression and early pregnancy symptoms. Mood swings, irritability, and some other symptoms can occur in all three conditions.

Often times, the only way to definitively detect pregnancy is to take a pregnancy test after missing a period. It is possible to do this at home, but it is better to see a doctor to confirm the results.

One of the indicators of PMDD is the full onset of symptoms during certain parts of the menstrual cycle. This means that it should be at least a few days during each cycle when symptoms are completely relieved.

Conversely, if someone is experiencing depression, symptoms may increase during PMS but do not disappear completely during other parts of the cycle.

If you are unsure of the symptoms or have concerns, it is best to talk to a doctor or healthcare professional. Doctors determine whether the symptoms are signs of early pregnancy, PMDD, or clinical depression.


PMS can cause symptoms similar to those of depression. Some symptoms may even interfere with normal daily life. It’s best to talk to a doctor or health care professional if women are experiencing any symptoms of depression that seem to come and go in their normal menstrual cycle.

It is also important to record symptoms that develop during the month. Knowing this can help doctors determine if there is a link between symptoms and the menstrual cycle.

There are some lifestyle changes that can help, such as getting more exercise, and certain medications can also help improve symptoms.

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