Menstrual Mood Swings: Causes and Solutions for Emotional Distress

Menstrual depression

Hello, doctor.
I'm not sure if I can get a response through this channel 😅.
This issue has been bothering me for a long time, and I've considered whether I should seek medical help, but I feel like it might not be that serious.
During my menstrual period, I often cry uncontrollably, sometimes hysterically.
In the past, it might have been triggered by minor issues, and I thought it was just hormonal sensitivity.
However, in the past few months, I've experienced sudden crying spells that seem completely unprovoked, almost like a reflex, similar to sneezing, and I can't control it.
After my period, I return to normal without any issues.
Recently, these crying episodes have occurred in happy environments, so there shouldn't be any reason for emotional instability.
Could this be considered a form of dissociative identity disorder? During these crying episodes, I can still reflect on why I'm behaving this way, and while I ponder these questions, the tears fall uncontrollably, as if they have a mind of their own.
This behavior does not occur in the presence of others; it usually happens when I'm alone.
I can assure you that it's not triggered by recalling something sad or stressful; it happens when my mind is blank.
If possible, I would like to understand this behavior better and hope to find effective methods for improvement.
I've searched online for various symptoms and theories related to premenstrual depression, but none seem to fully align with my recent experiences.
Additionally, it seems that the age at which these symptoms typically manifest is usually after 26, so is my hormonal development unusually early? 🤔 To add a bit more context, I generally have an optimistic and humorous personality, so I feel that the term "depression" shouldn't really apply to me.
I truly want to improve this issue 🥲.
Thank you for your help 🙏🏻.

wen, 10~19 year old female. Ask Date: 2021/07/23

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Based on your description, it seems that you are experiencing a more severe form of premenstrual syndrome known as Premenstrual Dysphoric Disorder (PMDD).
Literature reports that this condition is caused by a rapid decline in cyclical hormones after ovulation, leading to an imbalance of neurotransmitters in the brain, such as dopamine and serotonin, which affects emotional expression.
This is indeed something beyond your control.
It is advisable to seek appropriate outlets for expression and psychological support during times of significant symptoms.
If necessary, you may consider trying suitable hormonal medications to alleviate premenstrual symptoms, or a mental health professional may evaluate you and prescribe selective serotonin reuptake inhibitors (SSRIs) as a treatment option.
Thank you for your inquiry, and I wish you health and happiness.

Reply Date: 2021/07/23

More Info

Menstrual mood swings can be a significant source of emotional distress for many individuals, and your experience of uncontrollable crying during your menstrual cycle is not uncommon. This phenomenon is often linked to hormonal fluctuations that occur in the body during the menstrual cycle, particularly the changes in estrogen and progesterone levels. These hormonal shifts can affect neurotransmitters in the brain, such as serotonin, which plays a crucial role in regulating mood.

Your description of crying without an apparent trigger, especially in a joyful environment, suggests that your emotional responses may be heightened during this time. This is not indicative of a personality disorder or dissociative identity disorder (previously known as multiple personality disorder), but rather a manifestation of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). PMDD is a more severe form of PMS that can cause significant emotional and physical symptoms, including severe mood swings, irritability, and depression.

It's important to note that while hormonal changes are a primary factor, other elements can contribute to emotional distress during menstruation. Stress, lifestyle factors, and underlying mental health conditions can exacerbate these symptoms. Your self-awareness during these episodes, where you can reflect on your feelings even while crying, indicates a level of emotional intelligence that is beneficial for managing your mood.

To address these emotional swings, consider the following strategies:
1. Track Your Cycle: Keeping a diary of your menstrual cycle and mood changes can help you identify patterns and triggers. This information can be valuable if you decide to consult a healthcare professional.

2. Healthy Lifestyle Choices: Regular exercise, a balanced diet, and adequate sleep can significantly impact your mood and overall well-being. Exercise, in particular, releases endorphins, which can help improve your mood.

3. Mindfulness and Relaxation Techniques: Practices such as yoga, meditation, or deep-breathing exercises can help you manage stress and emotional responses. These techniques can provide a sense of calm and help you regain control during emotional episodes.

4. Seek Professional Help: If your symptoms persist or worsen, consider consulting a healthcare professional, such as a gynecologist or a mental health specialist. They can provide a comprehensive evaluation and discuss potential treatment options, which may include lifestyle changes, therapy, or medication.

5. Support System: Engaging with friends or family members who can provide emotional support can be beneficial. Sometimes, simply talking about your feelings can alleviate some of the distress.

6. Consider Nutritional Supplements: Some studies suggest that certain vitamins and minerals, such as magnesium, vitamin B6, and omega-3 fatty acids, may help alleviate PMS symptoms. However, consult with a healthcare provider before starting any supplements.

7. Cognitive Behavioral Therapy (CBT): If you find that your mood swings are significantly impacting your daily life, therapy, particularly CBT, can help you develop coping strategies and change negative thought patterns.

In summary, while hormonal fluctuations during your menstrual cycle can lead to emotional distress, there are effective strategies to manage these symptoms. Understanding your body and its responses is the first step toward finding relief. If you feel that your emotional responses are becoming unmanageable, seeking professional help is a proactive step toward improving your mental health and overall quality of life.

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