Many women report mood changes linked to their monthly menstrual cycles. Between 3% and 9% of women of reproductive age experience premenstrual dysphoric disorder (PMDD), often with severe depression symptoms.
How are these monthly mood changes -- mild or severe -- affected by seasonal weather and activities? When should you talk to a doctor and seek treatment for depression?
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"When we screen women to get into our studies of PMDD, many of them mention that they generally feel somewhat better in the summer, and worse in the winter," says Jean Endicott, PhD, professor of clinical psychology in psychiatry at Columbia University College of Physicians and Surgeons. "We'll sometimes get phone calls in the summer from women saying 'It's not so bad now, but will you be taking new patients in November?'"
Endicott doesn't know of any scientific studies that specifically link severity of cycle-related mood changes to the seasons, but says it makes sense.
"In addition to the effect that light has on mood and depression, there's the fact that women could be outdoors and exercising more during the summer months, and exercise can help with depressive symptoms linked to the hormonal cycle," she says.
The link also makes biologic sense, adds Dorothy Sit, MD, assistant professor of psychiatry at the University of Pittsburgh Medical Center. "People who have changes in mood related to season may experience this partially due to changes in circadian rhythm," she explains. "Estrogen and progesterone fluctuations have also been shown to advance and delay circadian rhythms."
Whether these cyclic changes are enough to bring on or worsen mood changes or PMDD symptoms probably depends on the individual woman, and how sensitive she is to estrogen and progesterone.
Is It PMDD or Depression?
Before you conclude that your mood changes or depression are definitely linked to your menstrual cycle, try keeping a diary for three months, suggests Nada Stotland, MD, MPH, professor of psychiatry and obstetrics and gynecology at Rush Medical College in Chicago.
"Many women who think they have PMS [actually] have symptoms that have nothing to do with their cycles at all," she says. "We tend to blame everything on that."