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PMS, PMDD And Period Mood Swings: What's Normal And When To Get Help

All PMS jokes aside, mood swings shouldn’t be ruling your life. 

Thanks to several pop-culture references and a generally apathetic attitude towards premenstrual mental health, PMS (premenstrual syndrome) has been reduced to the butt of too many moody-women-on-their-periods jokes.

This has only made it more challenging for people to seek medical treatment for serious premenstrual symptoms, as it’s difficult to take yourself seriously (and get to a doctor) when you’re belittled for experiencing PMS in the first place. In this article, we'll debunk common myths about PMS (premenstrual syndrome) and PMDD (premenstrual dysphoric disorder) and share more detailed information about period mood swings.

The impact of period mood swings (PMS)

Mood swings are a reality for women across all the stages of our development. From early puberty to pregnancy and menopause, swiftly-changing from happy to sad and tearful in-between is something few women are stranger to.  That doesn’t make them any easier to cope with, though. And sometimes, rapidly changing moods can become sources of disruption and anxiety, especially if they’re no longer limited to certain points in your menstrual cycle.

More information about period mood swings

Here are some key things to think about when going through PMS.

Know what's normal for you

Anxiety, nervousness, irritability, tearfulness, aggression and anger are just some of the emotions you might experience during a mood swing. When you’re PMSing, you might find that you’re mostly tearful and anxious, while your best friend could personify the stereotypical raging PMS monster. It is important to be aware of how your mood swings typically present themselves, so that you’re able to pick up anything out of the ordinary.

Moodiness isn’t limited to PMS

In terms of hormonal impact on your emotions, mood swings can occur during other times in your life, as well. Pregnancy can play havoc with some expectant mothers’ emotions, with the first trimester and its surge of pregnancy hormones often causing mood swings. Similarly, perimenopause and menopause can come with its fair share of mood swings as well, with many women feeling as if they are experiencing a ‘second puberty’. 

Rule out any medical conditions

The parameters of normal and abnormal shift from person to person. If you’ve gone from never experiencing rapid mood changes to cycling from anger to sadness to irritability in a single day, it might be an idea to keep a journal and track the ebbs and flows of your emotions. This way, if it’s something that continues, you can approach a medical professional about investigating the possibility of underlying causes, such as a mood disorder, anxiety or even PTSD (Post Traumatic Stress Disorder). 

Know your family history

Certain medical conditions that contribute to moodiness or even mood disorders (such as Depression or Bipolar Disorder) are hereditary, and as such it can be helpful to know if anybody in your family has a history of experiencing them. That way, if you’re experiencing anything out of the ordinary for you, or sustained periods of depression, anxiety or even mania, you’ll also know whether or not you’re genetically susceptible to them. This is information that can provide important context for a medical professional who might be trying to narrow down a possible cause for your mood swings. 

Although this might be a challenge for people who don’t know their birth parents, or whose parents have passed away, if you can, try to speak to a family member such as your grandparent or aunt or uncle. 

What counts as ‘abnormal’?

If you find yourself in a sustained period of sadness, elation or anxiety, you may need to watch that it does not develop into something more serious, or cause you to do things that are out of your control. If you feel as if your emotions are ruling your life, or that you’re doing things that you wouldn’t normally do (overspending, saying things you don’t mean, drinking excessively) then it is definitely worth taking the next step and making an appointment with a doctor or speaking to a nurse at your clinic. 

What red flags should I look out for?

If you’re feeling tempted to self-harm, especially if you’ve never done so, hurt those around you or take your own life (suicidal ideation).

If you can’t get out of bed in the morning because life just seems unbearable and your periods are painful.

If you’ve stopped socialising, doing things that you’d normally enjoy doing (exercising, hobbies, reading) and are noticing changes in your sleeping and eating patterns (over or under-eating and sleeping). 

If you’re unable to focus at work, take care of your children or look after yourself (losing the will to maintain personal hygiene is a big sign that something is wrong).

If you’re feeling on top of the world, but to the point where you’re interrupting everybody, making rash decisions and taking unreasonable risks, spending large amounts of money or gambling, shopping or engaging in risky behaviour (like unprotected sex or substance abuse). The above behaviours and feelings can be symptoms of a health condition and should not be ignored. Make note of your feelings, speak to your partner or somebody you trust, and see a medical professional as soon as possible. 

SADAG Suicide Helpline 0800 567 567

PMS and PMDD myths debunked

Myth #1: PMS is just in your head

PMS, or premenstrual syndrome, is actually a host of physical and emotional symptoms that occur before the onset of menstruation (hence the ‘pre’). These can include tender or sore breasts, bloating, fatigue, irritability and sadness. For some people, these occur two weeks before their period, while others experience PMS symptoms closer to a week, or a couple days before they bleed.

Myth #2: Mood swings don't happen if you don't menstruate

Premenstrual symptoms are different for everybody. While one person might experience rapid mood changes, someone else might get a bloated tummy. Because this happens when you menstruate, logic follows that if you don’t get periods, you shouldn’t get mood swings or other premenstrual symptoms. However, the opposite can be true: if you have been diagnosed with amenorrhea, the medical term for absent periods, you might still experience mood swings and feel enormous physical discomfort, even if these symptoms aren’t isolated to the menstrual phase of your menstrual cycle.

Myth #3: PMS is no big deal

While hormones can make you react differently to or even feel more strongly about certain things when you’re on your period, reducing PMS to a mere mood swing can delegitimize the reality of feeling more irritable or upset. Your anger, sadness, irritability or grumpiness may be caused by your period, but that doesn’t make these premenstrual symptoms any less real. And yes, that means there is absolutely zero need to fight the urge to curl up on your couch and cry to something soppy on Netflix next time you’re PMSing.

Myth #4: Premenstrual syndrome can't impact your mental health

Tell that to my tears (or my hanger, or my simmering silence). Your menstrual cycle can impact your mental health, whether or not you have underlying mental health conditions. Blame it on hormones if you want to, but many people report feeling lower moods, sadness or increased aggression and anger before they start their period.

Myth #5: PMS only happens when you menstruate

PMS actually happens before you menstruate, which is why many people who have PMS-related depression or PMDD (premenstrual dysphoric disorder) experience a cessation in their symptoms as they start to bleed. That your period can make you feel better may sound counterintuitive, but plenty of people who experience intense PMS find that they feel a lot happier while they menstruate (as opposed to the flames PMS shows them before).

Myth #6: PMDD is a real condition

What is interesting about premenstrual dysphoric disorder is that it is considered to be an endocrine disorder. Its constellation of mental, emotional and physical symptoms are brought on during the luteal phase of the menstrual cycle, and dissipate soon after menstruation. So, rather than being a case of the blues, it’s an actual physiological reaction to the oestrogen and progesterone released during the menstrual cycle, which can present as any number of symptoms (which we go into a little lower down). Like any mental health condition that is listed in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), a diagnostic tool that mental health practitioners use in psychiatric diagnoses, PMDD (and its mental health component) is a legitimate health condition, and should be treated as such.

PMDD is characterised by the following:

  • Feelings of sadness, hopelessness or depression.
  • Mood swings (rapid changes in mood)
  • Appetite changes (either eating more, or less)
  • Changes to sleep (insomnia or sleeping more)
  • A marked decrease in things that once interested you
  • Fatigue, tiredness and irritability
  • Agitation, anger and arguing with people
  • Problems with concentrating
  • Anxiety and panic attacks

You may experience PMDD symptoms like depression and anxiety in the luteal phase of your menstrual cycle, and notice a cessation in these symptoms when you start your period. The presentation of symptoms during certain times of your cycle is what sets PMDD apart from other mental health conditions, such as clinical depression. If you suspect that you may have PMDD, or find that your pms is worsening to the point of interfering in your daily life, please consider chatting to a doctor.

Myth #7: PMDD is super bad for PMS

The onset of PMDD symptoms may align with the luteal phase of your period, but that doesn’t minimise the impact of these symptoms on your overall health and wellbeing. If you find that changing moods, menstrual-related depression or anxiety becomes unmanageable over the course of your period, it’s really important that you speak to your doctor. The same goes for If you find that you’re more anxious than usual, suffering from panic attacks or having depressive or suicidal thoughts during your period. Please know that no person deserves to feel any sort of pain, anguish or sadness, whether it’s caused by your period or not.

Myth #8: PMDD is not treatable

Er, *buzz*, wrong! PMDD is a treatable condition. Although it may seem daunting at first, you really need to seek medical attention for symptoms of PMDD. Whether your condition requires medication, hormonal treatment or lifestyle changes, or a combination of all three, is up to you and your doctor. Bear in mind that this is a recognised condition and there is help available for you.

Myth #9: PMS can't make depression worse

We really wish this one wasn’t true. If you have pre-existing mental health conditions like anxiety, OCD (obsessive compulsive disorder) or depression, it is highly possible that your symptoms intensify over the course of your period. Many people report feeling a definite reduction in their ability to concentrate before and while they’re menstruating (phew, it’s not just us). It’s also possible that if you experience irregular bleeding, menorrhagia (heavy bleeding) or dysmenorrhoea (painful periods), you may struggle with additional fatigue, insomnia and anxiety.   

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