For decades periods and our mental health have been punchlines for jokes. While we’ve struggled with our periods and mental health, society has laughed leading to menstrual and mental shame. That shame has left us overwhelmed and isolated. We have been made to feel that we should just deal with these things, or worse, that these weren’t ‘things’ at all. We’ve struggled with our periods and our mental health without treatment or support because we’ve been taught that menstruation is not mental.
But the medical world is starting to acknowledge a clear link between our periods and our mental health. In 2013, Premenstrual Dysphoric Disorder (PMDD) was included as a depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders. And with people becoming more vocal about their periods and mental health, research surrounding it is on the increase. And, as it turns out, we weren’t making mental mountains out of menstrual molehills.
Periods and mental health: What are the issues?
‘Normal’ emotional symptoms of your menstrual cycle include irritability, lack of patience, exhaustion, tearfulness and all of us, to a greater or lesser extent, will experience some of these. However, some people experience these symptoms and others to such an extent that it significantly affects their quality of life and their mental health. Most of us have heard of Premenstrual Syndrome (PMS) but fewer of us have heard of Premenstrual Dysphoric Disorder (PMDD). PMDD is more serious than PMS and can potentially be dangerous if not managed with your doctor.
What is PMDD?
PMDD is considered an a hormone disorder but there are connections between PMDD and low levels of serotonin. This shows that this physical disorder certainly affects and, is affected by, mental health. People with pre-existing mental health issues such as depression and anxiety and some personality disorders are more prone to PMDD but the reverse is also true. PMDD mimics symptoms of major depression, even if people have previously displayed no mental health issues.
What are the symptoms of PMDD?
Emotional experiences of PMDD include:
- Mood swings
- Feeling upset and tearful
- Feeling angry or irritable
- Feelings of anxiety
- Feeling hopeless
- Feeling of tension or being on edge
- Difficulty concentrating
- Feeling overwhelmed
- Lack of energy
- Less interest in activities you normally enjoy
- Suicidal feelings
Physical experiences of PMDD:
- Breast tenderness and swelling
- Pain in muscles and joints
- Changes in appetite e.g. overeating or craving specific foods
- Sleep problems
- Finding it hard to avoid or resolve conflicts
- Feeling very upset if you feel others are rejecting you
What to do if you’re struggling with your mental health during your period?
ASK FOR HELP
First, ditch the shame and the guilt surrounding any issues to do with your periods and mental health. This is a real thing and if your period is affecting your mental health then you need to seek help. Reaching out to your doctor is key if you think you are experiencing depressive episodes surrounding your period. If you are experiencing suicidal thoughts then immediate help can be found via The Samaritans.
Please remember, you are never the only one. People have been struggling with their periods and mental health silently for so long but they are starting to speak up. This article, for example, tells the story of Cat who was diagnosed with PMDD at 27. It’s often helpful to hear stories of people dealing with similar issues. We also have a 7 questions series on the blog that shares the wisdom of some pretty kick ass women that you may find interesting.
Studies have shown that eliminating caffeine and sugar and alcohol, can really help mitigate the feelings of PMDD. So, cutting down on these things and eating a healthy balanced diet can really help. I know it’s boring but it’s true!
Prioritising sleep in the run up to your period is essential in supporting your menstrual mental health. We operate far better has humans when we’ve have quality sleep so it makes sense that it’s even more important when we are vulnerable to our hormones and mental health during our period. And note the use of the word ‘quality’. Ten hours sleep (read: passed out) after a bender with friends or a string of late nights, even if you do get 8 hours sleep, does not count (sorry!). The hours before midnight are the best quality sleep you’ll get so early nights are the name of the menstrual mental health game.
While many people are sceptical of the effect of supplements, there is evidence to suggest that the right ones can support you if you’re struggling with your period and mental health. Vitamin B6 has long been lauded as a key supplement when it comes to supporting people mentally during their period. There is also evidence to suggest that Magnesium and Vitamin E can help people manage their mental health linked to hormones. And, as with everything, please consult your GP if you have concerns about these supplements, especially if you are already taking medication.
CBT and Psychotherapy have shown to be useful in helping people manage their period and mental health. Both therapies support by providing tactics and techniques to deal with symptoms of PMDD as well as discussing issues surrounding the root of the problem too. Stress and interpersonal trauma can exacerbate PMDD and therapy can help manage these issues.
Medication can treat PMDD. And to be clear, PMDD is real and is nothing to be ashamed of. People with PMDD or PMS are not weak or struggling to cope with their period and mental health. These people are struggling with a mental health issue and may require medication to make them better. If you think you have PMDD please seek help from your GP and be prepared to stand up for your menstrual mental health if you encounter resistance.