Ask The Therapist: “I have been experiencing sudden depressive episodes…it happens every month, a week or two before my period. Is it normal to feel this way during PMS?”

In 2016, the number of people estimated to be suffering from mental health issues like depression and anxiety amounted to roughly 1.1 billion. Since then, numbers have likely continued to rise. Moreover, studies have also shown women especially on average are a) more likely to suffer from mental health issues, and b) less likely to talk about them. The taboo in Pakistan surrounding depression and anxiety disorders only serve to aggravate the individuals suffering even more. For the women who cannot seek out full time therapy, we’ve enlisted the help of a trained therapist. You sent us in your questions – here are the answers!

‘For years I have been experiencing sudden depressive episodes. Most of the time I am a cheerful optimistic person, but suddenly it gets really bad and I find myself feeling a weird emptiness that I can’t even describe. I used to think it was random but I started noticing a pattern recently. This extreme mood swing happens every month, a week or two before my period. I want to know if this is a normal thing for every girl – to feel so hopeless and sad during PMS, or is it something more serious and if so, how exactly should I cope with it? My energy is completely drained and I feel dead inside. I don’t know what to do.’

Shahrukh’s Response:

Dear Anon,

I can only imagine how difficult it must be to go through these episodes every few weeks. While a PMS has been known to affect one’s moods, and can even result in prolonged periods of sadness, irritability and anger, if you’re noticing this go beyond a couple of days, it’s possible that there might be more that’s happening. Though if it’s within the range of a few days, then this could be considered “normal” in the world of PMS symptoms. Let’s look into this further and see if we can help you understand what’s happening and explore ways that’ll help manage some of the symptoms.

PMS: What’s Happening In My Body?

As women, most of us face a variety of difficult emotions every month due to our cycle, and while we know this, it’s also important to understand what’s happening in the body on a biological level, and what’s causing these mood swings. 

While there aren’t any definitive causes, studies have suggested that during the latter half of one’s menstrual cycle, dopamine and serotonin levels begin to fluctuate and this tends to have a direct effect on one’s emotional state and motivation. The level of severity in terms of the impact of this fluctuation can vary from person to person, and pre-existing mental health conditions and environmental factors can also play a role here.

Okay Yeah, I Understand What’s Happening. Now What?

While the idea that we’re not alone in our suffering can be comforting, it still doesn’t take away from the pain and emptiness, does it? So, what to do about this?

There are several ways that you can manage symptoms of PMS, and this would involve certain things that need to be consistently integrated into one’s lifestyle as they can have an impact on the severity of the symptoms.

  • Stay mindful of what you eat (especially in the latter half of your cycle): in terms of physical and emotional symptoms, it is advised to minimize/avoid caffeine and alcohol intake, and stay extra mindful of water intake. In addition, consuming foods that have high levels of complex carbohydrates (whole grain foods, fruits and vegetables) are also recommended, as well as foods high in calcium and magnesium and low in salt. It might also help to take some Vitamin D supplements. 
  • Movement: regular movement and exercise can really help with the management of these symptoms. This can be anything from running to kick boxing to yoga. Try to incorporate this into your routine as much as possible.
  • Sleep routine: try to keep to a consistent sleep cycle of about 7-9 hours. This consistency can help relieve several symptoms of PMS, and can have an overall positive impact on one’s mental and physical health.
  • Be kind to yourself: sometimes the mood swings can be really intense, and it can be extremely challenging to make room themes. Try to keep in mind that you might need to take it easy for those few days where you’re feeling low. Treat yourself as you would someone who you have a lot of love and compassion for. 
  • Do things that make you feel good: whether it’s watching a light-hearted movie, taking a hot shower, or reading a good book – engage in activities that you enjoy. 
  • Reach out: if you feel like the symptoms are getting too difficult to manage, you may need to reach out for help. It can be support from family or friends, ones who are able to hold space and comfort you during difficult times. If you feel like what you’re experiencing goes beyond your regular symptoms and you sense that there is a deeper cause, you can always explore the option of mental health counselling. 

Anon, while depressive episodes are considered to be a symptom of PMS, if you suspect that there might be something more at play here, I would encourage you to explore this further and see if you need any extra support. I do hope that you were able to find the answers that you were looking for in this article. I wish you all the best on your journey towards healing and grounding. Best of luck and stay in your power!

The above article is written by Shahrukh Shahbaz Malik who is trained in humanistic integrative counselling at CPDD in the UK and currently has her own private practice in Karachi. The views expressed in this article are those of one expert. They do not necessarily represent the views of Mashion, nor do they represent the complete picture of the topic at hand. This article is for informational purposes only and is not a substitute for medical diagnosis, treatment or therapy.

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