PMS and depression: what to know

Premenstrual mood symptoms may appear in the days before bleeding and ease after the period starts. Depression can also occur independently of the menstrual cycle, so timing alone cannot establish the cause. Notice whether sadness, anger, anxiety, poor concentration, tiredness, sleep changes or reduced interest affect work, relationships or self-care. Some people experience severe premenstrual symptoms that need a formal assessment. A clinician may ask about mood across several cycles, medicines, contraception, thyroid symptoms and previous mental-health history.

Keep a daily record of mood, bleeding, sleep, pain and functioning for several cycles. Regular meals, movement, sleep routines and time away from stressful demands can support coping. Discuss treatment options with a clinician rather than starting hormonal or psychiatric medicine without advice. If symptoms continue outside the premenstrual phase, arrange an assessment for depression or another condition. Support from a trusted person can make it easier to notice changes and seek help.

Contact a clinician promptly when low mood is persistent, interferes with daily life, or comes with hopelessness, withdrawal or inability to care for yourself. If you think about self-harm or suicide, feel unable to stay safe, or notice severe agitation or confusion, seek emergency help now and stay with a trusted person while arranging it.

Do my symptoms fit a premenstrual pattern or depression outside the cycle? What should I record? Could medicines or contraception affect my mood? Which treatment and follow-up plan fits my health history?