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Periods are a natural part of life for many women, but they can sometimes have a significant impact on mental health, particularly for those with preexisting depression.

Monthly Periods and Depression

Many people who experience periods also suffer from depression. For some, the timing of their depressive symptoms follows a predictable pattern, worsening around their menstrual cycle. This phenomenon is known as premenstrual exacerbation (PME). Unlike premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), PME specifically refers to the worsening of an existing mental health condition, such as depression, around the time of menstruation.

So, Can Periods Worsen Depression?

Yes, periods can indeed worsen depression. Research indicates that those with PME experience an increase in depressive symptoms like guilt, sadness, and worthlessness during the days leading up to and during their period. These symptoms often return to their usual severity after menstruation ends. According to Rubiahna Vaughn, MD, MPH, a reproductive psychiatrist with the Montefiore Health System, many women may be conflating different syndromes under the umbrella of PMS, which can lead to confusion and mismanagement of their symptoms.

Understanding PME

PME affects a significant portion of those with periods and depression. A 2004 study found that about 60% of women with depression reported a worsening of their symptoms around menstruation. Despite its prevalence, PME is not yet a diagnosable condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Experts like Tory Eisenlohr-Moul, Ph.D., from the University of Illinois at Chicago, emphasize the importance of recognizing PME to develop specific treatments and provide necessary support to those affected.

Coping Strategies

For those who suspect they have PME, tracking symptoms over several cycles can be enlightening. Documenting daily feelings and behaviors in a journal or app can help identify patterns and provide useful information for healthcare providers. Advocating for oneself in medical consultations is crucial, as many healthcare professionals may not be familiar with PME.

Managing depression through established treatments, such as medication and therapy, remains essential. Since no specific treatments for PME of depression are approved, addressing the underlying condition is vital. Additionally, lifestyle adjustments, such as planning ahead for vulnerable times in the menstrual cycle, can make a significant difference. Engaging in activities that enhance mood and seeking social support can also help alleviate the impact of PME on daily life.