Is It PMS or Depression? Emotional Distress in Women

Q: Is It PMS or Depression? Emotional Distress in Women

Hello： Typical premenstrual dysphoria begins with mood disturbances about a week before menstruation, with mood improvement occurring once menstruation starts. <br>Depression, on the other hand, is characterized by a persistent state of sadness, where mood remains depressed even

Is it premenstrual syndrome or depression?

Hello, Dr.
Liang.
My girlfriend and I are both 25 years old and have been in the workforce for about a year.
Over this past year, she has intermittently exhibited symptoms similar to depression, such as sudden, uncontrollable feelings of sadness, feelings of worthlessness, sensitivity to others' comments, and often crying on the phone after holding back her emotions until she gets home.
She is aware of these symptoms, which seem to coincide with her menstrual cycle, particularly during her period and the week before.
However, these symptoms were not as pronounced during our college years, and their intensification after entering the workforce has raised my concerns.

Excluding physiological factors, I feel that I might also be contributing to her stress.
She perceives a gap in our relationship regarding our abilities and achievements; she prefers to earn a modest salary and live a simple life, avoiding jobs with responsibilities (like managerial positions), while I have a different outlook.
I used to criticize her negative mindset, but after she changed jobs four times and her emotional state became more apparent, I realized I needed to stop that behavior.
Generally, she is cheerful and laughs, but during her menstrual cycle, she tends to magnify these issues.
I'm uncertain whether this is purely a premenstrual symptom or if I am contributing to it.
I would like to ask you: 1.
How can I distinguish whether she is experiencing premenstrual syndrome (PMS) or has tendencies toward depression? Should she see a psychologist or a psychiatrist for this behavior? 2.
If it is a physiological issue, would medication suffice? If it is a psychological issue, does medication only address the symptoms? Thank you very much!

Hi, 20~29 year old female. Ask Date: 2017/04/18

Dr. Liang Sunyuan reply Psychiatry

Hello: Typical premenstrual dysphoria begins with mood disturbances about a week before menstruation, with mood improvement occurring once menstruation starts.
Depression, on the other hand, is characterized by a persistent state of sadness, where mood remains depressed even after menstruation begins.
Regardless of the condition, if you feel troubled, you can seek medical assistance.
During the consultation, the physician will assess your situation in person and discuss the available intervention options with you.

Reply Date: 2017/04/18

More Info

Understanding the distinction between premenstrual syndrome (PMS) and depression is crucial, especially when emotional distress is involved. Your girlfriend's symptoms, which include sudden feelings of sadness, self-doubt, and heightened sensitivity, are indeed concerning. It’s important to approach this situation with empathy and a willingness to support her in seeking the help she may need.

1. Distinguishing PMS from Depression:
PMS is a collection of physical and emotional symptoms that many women experience in the luteal phase of their menstrual cycle, typically one to two weeks before menstruation. Symptoms can include mood swings, irritability, anxiety, and sadness, which often resolve shortly after the onset of menstruation. In contrast, depression is a more pervasive condition that can last for weeks or months, regardless of the menstrual cycle. Symptoms of depression include persistent sadness, loss of interest in activities, feelings of worthlessness, and difficulty concentrating.
To differentiate between the two, consider the following:
- Timing: If her symptoms consistently appear in relation to her menstrual cycle and resolve shortly after, it may indicate PMS. If the symptoms persist beyond her menstrual cycle or occur at other times, it may suggest depression.

- Intensity and Duration: PMS symptoms are typically less severe and short-lived compared to the symptoms of depression, which can be debilitating and long-lasting.

- Impact on Daily Life: If her emotional distress significantly interferes with her daily functioning, relationships, or overall quality of life, this could be a sign of depression.

2. Seeking Help:
Given the complexity of mental health issues, it’s advisable for her to consult a healthcare professional. A psychologist or psychiatrist can provide a thorough evaluation. If her symptoms are primarily linked to her menstrual cycle, a gynecologist may also be involved in her care.
- Psychological Support: If her symptoms are determined to be related to depression, therapy (such as cognitive-behavioral therapy) can be beneficial. Therapy can help her develop coping strategies, address negative thought patterns, and improve her emotional regulation.

- Medication: If depression is diagnosed, medication may be prescribed. Antidepressants can help manage symptoms, but they are often most effective when combined with therapy. For PMS, hormonal treatments or lifestyle changes may be recommended, depending on the severity of her symptoms.

3. Understanding Treatment:
- For PMS: Treatment may include lifestyle modifications, dietary changes, exercise, and possibly hormonal contraceptives to regulate hormonal fluctuations. In some cases, over-the-counter pain relievers or supplements may be suggested.

- For Depression: While medication can alleviate symptoms, it is often considered a short-term solution. Therapy addresses the underlying issues and equips individuals with tools to manage their mental health in the long run.

4. Your Role: As her partner, your support is invaluable. Encourage her to seek professional help and be there to listen without judgment. It’s essential to create a safe space where she feels comfortable discussing her feelings. Avoid placing blame or making her feel inadequate; instead, focus on understanding her experience and validating her feelings.

In conclusion, while PMS can cause emotional distress, persistent symptoms that interfere with daily life may indicate depression. A professional evaluation is essential for an accurate diagnosis and appropriate treatment. Your girlfriend’s well-being is paramount, and with the right support and intervention, she can navigate these challenges more effectively.

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