Discussing menstruation is something that is considered taboo in many circles, even though it’s a natural biological process. With that lack of dialog comes a blanket of silence about menstrual mood disorders and how they affect everyone who has a cycle. What are they, and how might they impact you?

What Are Menstrual Mood Disorders?

There are two different menstrual mood disorders, and most people — even those who do menstruate — have only heard of one.

First, there is premenstrual syndrome, or PMS. This is the mood disorder that is most often mentioned — usually in derisive terms — whenever you experience a mood swing or are irrational. PMS is something that is typically the butt of a joke in spite of being a mood disorder that can impact your mental health. It affects up to 75% of people who menstruate, regardless of age, culture, socioeconomic or ethnic background.

Second is premenstrual dysphoric disorder, or PMDD. While it only affects 3-8% of people who menstruate, it can have a severe impact on your quality of life.

Both mood disorders share similar symptoms — irritability, depression, anxiety, fatigue and bloating — but PMDD symptoms can reach clinical levels, making it difficult for you to go about your daily life. These symptoms can vary from sadness and hopelessness to changes in appetite, difficulty sleeping, or feeling like you’re overwhelmed or out of control.

PMDD can be challenging to diagnose because its symptoms mimic other mood disorders, including depression, anxiety and bipolar disorder. You may also experience these symptoms as part of perimenopause, which takes place during the last four to five years before this hormonal shift.

Menstrual Mood Disorders and Mental Health

Mood disorders like PMS and PMDD do affect your emotional state — even to the point of sharing symptoms with other diagnoses — but what do these mean for your mental health?

PMDD is listed as a mental health problem by the DSM-5, the manual used to diagnose and categorize mental illnesses. However, it’s considered an endocrine disorder because it’s related to your hormones. That designation doesn’t stop people with PMDD from experiencing everything from depression and anxiety and even suicidal ideation.

This also doesn’t mean that PMDD and other mental health diagnoses are mutually exclusive. You can experience PMDD during your cycle and still live with depression, anxiety or other challenges during the rest of the month. One may contribute to the other, and it’s essential to treat both problems at the same time if you seek mental health treatment.

Treating Menstrual Mood Disorders

PMS can impact your daily life, but for the majority of people that menstruate, it’s simply part of their monthly cycle. PMDD, on the other hand, may require a trip to your family doctor or even a psychologist or psychiatrist. It all depends on the severity of your symptoms. Treatment options will vary but might include using:

• Antidepressants or other mood-altering medications: These can reduce the symptoms of PMDD and may help treat any other mental illness or mood disorder that exists simultaneously with your PMDD symptoms.
• Hormonal birth control: Even if pregnancy isn’t a concern, hormonal birth control can be used to reduce the symptoms of PMDD or even stop your cycle entirely.
• Nutritional supplements: Some studies have shown that taking additional calcium, as well as supplements like vitamin B-6, magnesium and L-tryptophan, can help reduce the symptoms of PMS or PMDD. However, you shouldn’t start taking supplements before talking to your doctor.

You may also be able to reduce some of the symptoms of PMS and PMDD yourself by implementing diet and lifestyle changes. Stopping smoking and cutting back on both caffeine and alcohol can help ease the symptoms, as can avoiding stress whenever possible and getting enough sleep. Some studies have shown that aerobic exercise can also help reduce the symptoms of PMDD, as well as a diet high in protein and complex carbohydrates. Eating this way raises the body’s levels of tryptophan, a neurotransmitter that can help maintain your mental health.

Managing Menstrual Mood Disorders

PMS may be the butt of many jokes, but it and PMDD are not things to be taken lightly. These menstrual mood disorders can have a significant impact on your daily life. Keep in mind that the differential diagnosis for these menstrual mood disorders versus depression and generalized anxiety disorders is the temporal association of these symptoms with the menstrual cycle. If you’re experiencing symptoms of PMS or PMDD and they’re making it difficult for you to carry out your daily tasks or even get out of bed, make an appointment with your doctor to discuss possible treatment options.

While we might not know what causes PMS and PMDD, they’re common conditions that aren’t often spoken of because of the taboo surrounding menstruation.  Break the silence and start that conversation with your doctor. They will be able to help you make the changes you need to manage your symptoms.