Beyond Blue

Beyond Blue

Menstruation and Depression

Here’s an interesting article on WebMD by Miranda Hitti about the relationship between depression and menstrual cycles.

Jan. 28, 2005 — Most women with depression get worsening symptoms prior to their periods, researchers say.
In a new study, 64% of women with major depression said their symptoms get worse five to 10 days before their period. Women whose symptoms worsened had depression for a longer duration of time than women whose depression symptoms did not change because of the onset of menstruation.
The news could help doctors evaluate, treat, and set standards for the treatment of depression. Nearly 19 million American adults have depression in any given year — about 9.5% of the population. Women experience depression about twice as often as men, says the National Institute of Mental Health (NIMH).


That may be partly due to factors that are unique to women. However, men are less likely to admit depression and doctors are less likely to suspect it in their male patients, says NIMH.
Depression can strike at any age. Everything from genetics to stress can play a role. According to researchers more then 20% of women will experience depression at some time during their lifetime. But the childbearing years may be a particularly vulnerable time for women.
The study appears in the January issue of Psychological Medicine. It’s the work of researchers including Susan Kornstein, MD, of Virginia Commonwealth University (VCU).
Tracing Depression
The participants were 433 women with major depression. None had gone through menopause or were taking oral contraceptives. They had enrolled in a larger depression study backed by the National Institute of Mental Health that’s still underway.
Premenstrual worsening of depression was reported by 64% of the women. These women also reported a longer current depressive episode — nearly 30 months, compared with 13.5 months for women who said their depression didn’t worsen before menstruation.
“Based on our findings, this type of symptom pattern is very common, especially in women who have chronic courses of depression,” says Kornstein, in a news release.
Kornstein is a psychiatry and obstetrics-gynecology professor at VCU’s medical school. She is also the executive director of the university’s Institute for Women’s Health and Mood and Disorders Institute.
The news could mean that the menstrual cycle should be considered in depression treatment.
“For example, if you start a depressed woman on an antidepressant medication and she comes back a week later feeling worse, it may be because she is premenstrual now and not that it was the wrong choice of antidepressant,” says Kornstein, in the news release.
The women whose depression worsened before menstruation also had a couple of other things in common. They were slightly older and tended to be in worse health. In particular, they were more likely to have body aches and pains, gastrointestinal problems, and muted moods.
However, there was no difference among the women regarding suicidal thinking or changes in sleep, appetite, or sexual interest.
They say the next step of their research will be to determine whether there are differences in response to treatment to various types of medications and psychotherapy in women with and without worsening of symptoms prior to menses.

  • TJ

    hey “original TJ”–it’s me again–TJ the 2nd…
    i have a calendar (Catholic even) posted on the wall right above the TP dispenser…i write my doctor appts, etc on it…i also track my periods on it…i put a “P” on the day it comes…that helps me be aware of the timing of my cycles (roughly every 25 days), as well as raise awareness of a pending PMS episode…
    it works for me! take care, dear one…tj

  • Patrice

    For what it’s worth, people, a lady physician in Britain made the connection, did the research, and it’s standard of care now, for severe PMS depression/irritability often hitting the wk. pre-period: Progesterone rectal suppositories. They saved my sanity before my hysterectomy at menopause age after decades of endometriosis. Certain pharmacies out there are advertized as “compounding pharmacies,” meaning that they make up medications the old-fashioned way—–by hand. They compound things like this (Progesterone supps.) Sometimes those pharmacies also compound specifically for veterinary practices as well as human med needs. A good example of this type in Anchorage, Alaska, where I reside, is Geneva Woods Pharmacy. Some hospitals will have such a pharmacy, such as the Medical Arts Pharm. at Providence Alaska Medical Center up here. If Alaska has more than 4 of these I have to think you can locate one wherever you are. These places have websites. The profound drop in Progesterone pre-period, which must occur, rapidly or not, for the bleeding to occur, is felt to affect the mood for some people. I nursed OB over 12 years, and saw a couple of ladies right after delivery drop into severe involutional melancholic states within 1/2 hour post delivery of the placenta. That organ cranks out a LOT of hormones to maintain the attachment to the uterine wall so pregnancy stays viable. Once it’s gone hormones drop quickly. Part of “postpartum blues” is related to this. Until the pituitary recognizes that drop and makes signals cuing ovaries to pick up the slack and recreate the hormones the body requires for homeostasis, keeping eveything level, calm, “on track” as it were, the moods can shift downward on a new mother and stay that way for weeks, sometimes. Tell me some of you reading this don’t know what I’m talking about here! In the cases of fetal-position melancholia I witnessed, they were given injections of Progesterone-in-oil, and within an hour the funk was lifting, they started asking about their babies, realized they seriously needed a shower and a meal, ceased soiling themselves, and came out of the state they’d descended into. It is an amazing thing to witness; just miraculous. If I hadn’t utilized Progesterone suppositories when needed myself over many years—not necessarily every month—just some of them—I couldn’t have imagined the difference it would make. Talk to your OB/GYN or nurse practitioner/PMD, and at least know what you are saying “no” to, if you don’t choose to go with a cycle’s trial of Progesterone; if your practitioner agrees it might be useful in your particular case. suppositories.

  • Amber

    I get really depressed 3-5 days before my period. I am only 20. This has been happening to me since I started when i was 12. I get very emotional and very depressed 3-5 days before my period. I do not use a contreceptive. I am considered heatlhy. I am not depressed any other time of the month. I also get very paranoid and have mood swings before my period.
    I do have gastrointestinal problems and achs and pains as well. I remember being depressed when I was around 4 years old though as well. I have very high anxiety all the time, but it gets worse around my cycle. my cycle is very REGULAR, unlike my friends. Two of my best friends have depression. I guess that doesn’t surprise me, but they’re bodies are not like mine and they use contreceptives to regulate they’re cycle. I took an herbal supplement for awhile that helped my mood swings and my depression, it was called PMS. It was expensive at about a dollar a pill, I havn’t used it for awhile.
    I hope this helps the research! Please consider me part of it because I am different from what you have reported (that i’ve read) and I am searching for a safe solution to this temporary but deep emotional disorder that happends on time every month!
    best reguards,

  • rajashri

    hi,i am rajashri .I do suffer with the same problem.Before 5 to 7 days of my menstruation,i feel very depressed i dont even feel to do anything.i feel like i should commit a suicide.i get annoyed very easily.I cry whole day and night.
    Do you have any suggestion?

  • Menstruation cycle

    Scientists are not entirely clear how premenstrual hormonal changes affect depression. One theory is that, in some women, estrogen and other hormones may interfere with serotonin (a neurotransmitter that controls mood). Because not all women experience depression with their menstrual cycles, scientists also believe some women may be genetically predisposed. There is also the possibility that some women may produce too many hormones, or be overly sensitive to their effects. Diet and health status may also influence hormone production and contribute to premenstrual and menstrual depression.

  • kuala

    i’ve been experiencing these depression ever since i started menstruating…i really don’t understand why i am always moody everytime i have my period….my mother used to tell me that what i am experiencing is what other women used to experience when they have their periods too…is this normal?….does all the women who have their menstrual period experience this too?..

  • kuala

    i’ve been experiencing these depression ever since i started menstruating…i really don’t understand why i am always moody everytime i have my period….my mother used to tell me that what i am experiencing is what other women used to experience when they have their periods too…is this normal?….does all the women who have their menstrual period experience this too?..

  • Daisy

    I am suffering from a very bad (year long) episode of depression. It is getting worse, despite being on pretty high levels of combined anti-depressants. My period started two days ago and the last two days have been the worst I have experienced. If anyone else has had this experience I would like to know as most of these studies relate to pre-menstrual problems while mine definitely gets worse at the onset of my period. Any input will be grateful received!

  • http://AddaURLtothiscomment Evonne

    I have a serious problem with depression about one week before my period every month and it seems to be getting worse as I get older. I also have
    bipolar disorder and I know my hormone fluctuations a part of the problem.
    It’s so discouraging and it interferes with my being able to function. I feel the worse not being all that I can be for my three little ones who are 8yrs old, 4yrs old and 10 months old. I know I must see my psychiatrist but just haven’t felt good enough to go see her. Are there any special programs out there or research study that may be of help. Please advise or include me in your study. Thanks.

  • http://AddaURLtothiscomment Your Name

    I have suffered with major depression for over 28 yrs. In the last year and half , I have moved in with my daughter and her family, instead of working at my field, In watch my grandchildren while she works . Also it has been a year and a half since I had my menustration . Since having these changes, I have not had a depression , could my menustration have had that bad of an effect on me?
    Thank you

  • http://kimberlylampkin27 kimberly lampkin

    I’m having that problem now I just wish it would just go away every time I start my depression is servere all these suicidal thoughts

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