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    Seasonal Mood and Hormonal Changes

    Do your menstrual cycle and the seasons affect your mood?

    Is It PMDD or Depression? continued...

    Buy a calendar and chart your daily moods -- up, down, happy, sad, tired, euphoric, angry, irritable, or fatigued. But make sure it's a page-a-day calendar, not a monthly one.

    "If you're looking at a monthly calendar, you anticipate your period and are thinking, 'That's when I'm going to feel bad,'" Stotland says. "In order not to prejudice yourself, find a way to keep track of your moods day by day and not pay attention to where you are in your cycle. You can put that together later."

    Do You Need Treatment?

    If your diary does indeed reveal that your ups and downs are linked to your cycle, how do you know if you should seek treatment? Consider some of these questions:

    • Are you not just irritable at these times, but having the worst fights ever with your partner or children?
    • Do you find yourself unable to enjoy work or family life at these times?
    • Do you experience major disruptions in your ability to function, your eating habits, or your sleep patterns?
    • Do you have extreme levels of anxiety and self-criticism?
    • Do you have morbid thoughts about death, dying, or wanting to die?

    If you answer yes to several of these questions (especially the last one), call your doctor. "If your cyclic symptoms really start to impair your work or personal life significantly, it's time to seek professional help," says Sit.

    Treating PMDD

    There are several options for treating PMDD, from cognitive behavioral therapy and light box therapy to medications such as antidepressants, anxiety medicine, birth control pills, or other hormone treatments.

    Some women are given antidepressants called SSRIs (selective serotonin reuptake inhibitors) to take just before they start menstruating. Typically treatment is started on cycle day 14 and stopped when menstrual bleeding starts. Generally, it takes several weeks for these antidepressants to have an effect, but for women suffering depression linked to menstrual cycles, the medicine seems to work more quickly.

    Cognitive Behavioral Therapy
    Cognitive behavioral therapy can help you develop skills to manage depression and mood changes linked to your menstrual cycle, says Catherine Monk, Herbert Irving Assistant Professor of Clinical Psychology in the departments of psychiatry and obstetrics at Columbia University College of Physicians and Surgeons.

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