An introduction to depression and PMS
The phrase ‘I am depressed’ is often loosely used when people are feeling a bit down or low in mood, or when facing a stressful period in their lives.
So, it is important to distinguish between these changes of mood which are part of the ‘normal experiences’ we face from time to time, and true depression, a mental disorder which is associated with distinct chemical imbalances in the brain and could severely affect the emotional wellbeing of a person.
PMS is rarely a direct cause of depression. But, it can make someone who is already feeling down or fed-up feel worse. Symptoms worsen a week or so before a period is due and shortly after your menstrual bleed starts, things begin to improve. However, your mood never really returns to normal.
Why does PMS worsen your mood?
Basically, this is because the female hormones have a big influence on the level of chemicals (known as neurotransmitters) in the brain. This is especially true of serotonin, also known as the ‘happy chemical’.
A change in oestrogen and progesterone levels leading up to the period cause levels of serotonin to fall. This is the reason that women are more prone to feeling ‘down’ or low during this time of the month. For most, these feelings are part and parcel of the normal spectrum of emotions.
However, for someone already prone to depression, hormonal changes before a menstrual period starts can make things feel a lot worse. In addition, changes in other chemicals in the body such as endorphins and prostaglandins also contribute to the worsening of depression symptoms.
What treatments are there for depression?
If you are suffering from true depression, whether or not associated with PMS, you should see your doctor. The condition needs to be diagnosed and managed by a doctor.
Your doctor will ask you about your symptoms, when they occur and how they manifest themselves, if you have a family history of depression and a whether you have suicidal thoughts.
If your doctor decides that you are suffering from depression then there is a range of possible treatments. These include:
- Cognitive Behavioural Therapy – this is a talking therapy which focusses on altering your approach, outlook, responses and reactions to specific circumstances. In mild to moderate cases of depression , this may be all that you need to improve your symptoms. For others, the therapy may need to be used alongside anti-depressants
- Bright Light Therapy – this exposes the sufferer to a certain frequency of light in order to boost the production of serotonin and limit the production of melatonin in order to raise your mood
- Anti-depressants – these classes of drugs can be used to alter the chemical profile or activity in the brain. For some people, they can be the most effective form of treatment. For others, associated side-effects may outweigh the benefits. You may need to try a few types of medication before finding the one most suited to you
- Hormonal treatment – if your symptoms of depression or worsening of symptoms coincide with phases in your menstrual cycle, your doctor may suggest using hormonal treatment such as the oral contraceptive pill.
If your doctor decides that you are not suffering from depression but experiencing mood swings, anxiety or stress, then other forms of treatment may be recommended.
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Are there herbal remedies to help me?
Herbal remedies should not be used as self-medication in depression. However, they may be taken if recommended by, or used under the instruction of a doctor or medical herbalist.
If you are suffering from low mood associated with PMS, there are several herbs that may be helpful to you. These include Agnus castus, which addresses the issue of PMS directly, as well as St. John’s wort which treats low mood and mood swings.
Do not use Hypericum or Agnus castus if you are already taking prescribed contraceptives.
What to look out for?
Make an appointment to see your doctor if you think you are suffering from depression, whether or not associated with PMS, if your mood symptoms do not improve. In addition, you must seek help if you have suicidal thoughts or thoughts of self-harm.
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