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PMS & PMDD Depression

PMS, PMDD & Depression: Way More Than Just the Blues

by Dr. Daniel J. Heller
Dr. Daniel J. Heller Dr. Daniel J. Heller

Dr. Heller is a family practitioner who specializes in helping patients with hormonal conditions like PMS & PMDD; diabetes and prediabetes; and other chronic diseases. He is the founder, formulator, and clinical director of PMS Comfort. [more]


When Melanie, a 32-year old single professional woman, came in to talk to us about her moods (especially moods before her period), she told a story we'd heard many times before, and that we think is familiar to many women. She began by describing what it's like for her for a week or more out of most months: "It literally feels like I'm in a brain cloud or fog—it's hard to think clearly or to concentrate. I feel a lot of sadness and can cry at the drop of a hat. I don't want to deal with anyone, and I'm really on edge and anxious."

She went on to describe how her PMS depression takes a toll on her life. "I don't want to get out of bed in the morning, and I just don't have motivation, even for things that usually interest me. It's all I can do to get up, go to work, and make it through the day—I just have no energy. All my relationships suffer, including romantic ones. Then a day or two after I get my period, I feel like myself again: I'm happy, energetic, I'm calling friends, getting things done. I wish I could crawl into a hole for those days and just surface when the real me comes back."

PMS and PMDD depression symptoms can also include feeling on edge and anxious; angry and irritable; and having trouble with focus and concentration (many patients report: "I'm in a brain cloud"). Sleeping too little or too much, change in sex drive, and social withdrawal—avoiding friends, family, partners, coworkers, or all social contact—are additional signs of PMS and PMDD depression.

Even in moderate intensity PMS, these symptoms can have a real impact on your ability to function and your quality of life. In severe PMS and PMDD, depression symptoms can bring your life to a standstill.

PMS, PMDD, or Depression? How to Tell the Difference

The main difference between PMS or PMDD depression as compared to other types of depression is the premenstrual pattern: PMS and PMDD symptoms occur before the period, and get much better once the menstrual flow begins. PMS and PMDD symptoms are intimately tied to your hormonal cycle.

However, there is still so much overlap between the symptoms of depression, and the symptoms of PMS and PMDD, that it can be hard to tell them apart unless you keep a daily symptom log or journal. Over several months, this can help clarify whether your moods before your period follow your menstrual cycle. Almost every symptom of depression is part of the spectrum of PMS and PMDD as well.

Another helpful tool is our PMS Comfort Self-Assessment Quiz, a free online tool that allows you to rate the severity of your own PMS symptoms and which can help you better understand yourself and your symptoms. We also recommend you read about the range of PMS symptoms and PMDD symptoms. These and other articles on our site can help you put your own premenstrual symptoms in perspective.

The Symptoms of Depression are Symptoms of PMS and PMDD

Below is a list of the most common symptoms of depression. It is persistent, rather than occasional symptoms that identify true depression.

  • Decreased appetite with weight loss or increased appetite
  • Decreased enjoyment of hobbies, interests, and usual activities
  • Difficulty concentrating, thinking, remembering, and making decisions
  • Fatigue, lack of energy, or feeling tired frequently
  • Feeling guilty, worthless, or helpless; low self-esteem and self-deprecating thoughts
  • Feeling hopeless or overwhelmingly pessimistic and negative
  • Feelings of sadness, anxiety or emptiness
  • Persistent thoughts of death and dying or suicide
  • Restlessness (need to move around or fidget) and irritability
  • Sleeping too much or too little (hypersomnia or insomnia); waking early morning
  • Slow or labored thinking, speech, and motion
  • Unexplained medical problems that don't respond to treatment

Nearly every woman will experience one or more of these symptoms, to some degree, at some point in her life. Depression symptoms, by themselves, are not the same as depression. These symptoms can also be caused by other conditions. For instance, attention deficit disorder can cause difficulty concentrating, and anemia can cause fatigue.

Causes of Depression

Depression can be exogenous and endogenous, which simply means it can be caused by external or internal factors. For instance, losing a job, change in relationship status, loss of a loved one, or troubles at work or school can be highly distressing and can lead to depression. Exogenous depression usually gets better when circumstances change or with the passage of time. Endogenous depression, on the other hand, is caused by internal factors, so that it occurs even when things are going well.

Over the years, many theories of endogenous depression have been proposed, and there is no single cause or correct theory that explains all types of depression. The best explanations for depression include chemical and genetic factors, but also take into account social and psychological elements.

Fifty years ago, most doctors thought depression was caused by forgotten childhood memories, and required psychoanalysis, an intensive form for counseling. Over the past 20 years, with the advent of more effective medications for depression, brain-based theories of depression have carried the day, usually focusing on mood-regulating brain chemicals such as serotonin and dopamine. In their drive to promote antidepressant medication, pharmaceutical companies and concerned organizations have helped de-stigmatize depression. Where depression used to be seen as a character flaw, it is now more often correctly viewed as a complex condition with multiple causes.

There is more than one approach that can bring relief from depression. While psychoanalysis has largely fallen out of favor, various forms of counseling clearly help depression. While drugs often work wonders for depression, the initial enthusiasm for the SSRI drugs has been tempered by experience and ongoing research, so that it is looking more and more like those drugs are not a cure-all after all. Of course, many people prefer to avoid medications because of concerns about side effects and other problems.

Natural remedies can truly help PMDD depression—and PMS depression too. Diet, exercise, nutritional and herbal supplements, counseling, and lifestyle changes can all help lift the cloud of depression—they are more powerful than people often suspect. In fact, a combination of natural therapies, as part of a holistic program, often works better than any one treatment alone.  In the next section of this article, we'll discuss some specific ways you can naturally relieve depression.

Real, Natural Relief—So You Can Feel Great All Month Long

PMS and PMDD misery aren't always taken seriously enough by doctors, family, and friends. At PMS Comfort, our whole purpose is to empower and educate you about premenstrual symptoms, and to provide real, natural relief so that you can feel great all month long. Our all-natural doctor-designed programs are based on decades of experience helping thousands of women recover from what you've been going through. Our Herbal Relief formula, when combined with our diet and lifestyle guidance, addresses more than just your symptoms—it can help bring your body and mind back into balance, and help you get and stay healthy. Plus, we're here to support you, every step of the way.

To learn more about your PMS and PMDD symptoms, take the PMS Comfort quiz. Or, start feeling better today, for as little as 89 cents per day.

We want to help. Give us a call at 1-800-731-6327, drop us an e-mail, or send us your question.

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Principal Author: Daniel J. Heller, N.D.
Last Modified: April 3, 2014

PMS, PMDD & Depression—Reference Documents and Further Reading


The information and contents contained in this Web site has not been evaluated by the FDA. Products are not intended to diagnose, treat, cure, or prevent any disease. If you are pregnant, intend to become pregnant, or nursing, please consult a physician before taking any dietary supplement. If taking prescription drugs, consult your healthcare practitioner prior to use. You must be 18 years or older to purchase products. Individual results do vary.

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