Seasonal Mood and Hormonal Changes
Do your menstrual cycle and the seasons affect your mood?
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
"You can learn to have resources in place for when you go into your
vulnerable period," she explains. That may mean knowing not to schedule tough
work deadlines during those days, or making sure to plan for a massage or not
to miss your yoga class.
"Ahead of time, you should write a list of things that you really enjoy and
that allow you to move outside yourself," says Monk. "This may include books
and DVDs that keep you from ruminating, or activities that energize you, like
running or painting. Make the list ahead of time, because if you don't, you
won't have the energy to do it when you're feeling down. Then commit yourself
to trying them even if you don't want to."
Light Box Therapy
Studies have also found that light box therapy -- a specific treatment that
mimics outdoor light and causes biochemical changes in the brain that improve
your mood -- may be effective for women with PMDD. It may be that light therapy
improves melatonin levels, which have been found to be abnormal in women with
Whatever treatment may work for you, it's important not to dismiss your
symptoms as "just PMS."
"If we're in a situation where we're fortunate, we tend to think we couldn't
possibly be depressed and have no right to be," says Stotland. "Or if our
circumstances are lousy, we say, 'No wonder I feel bad.' But if you're out in
the cold and you get frostbite, you don't say, 'No wonder I have frostbite' --
you treat it. If you're depressed, it's important to do the same thing."