Depression and PMS remedies: what may help

Premenstrual symptoms can include irritability, low mood, anxiety, tiredness, sleep changes and difficulty concentrating in the days before a period. They may improve after bleeding starts. Depression is more persistent and can affect mood, interest, energy, sleep and daily functioning throughout the cycle. Some people have both a depressive illness and a cyclical worsening before their period.

A symptom diary across several cycles helps show whether changes follow a consistent menstrual pattern. It is also useful to record bleeding dates, sleep, pain, medicines, alcohol and stressful events. A clinician may check for other explanations, including thyroid problems, anaemia, medication effects or an underlying mental-health condition.

Keep regular meals, movement, sleep and social contact where possible. Gentle exercise, relaxation practice and reducing alcohol may make symptoms easier to manage. Treating pain and protecting sleep can also reduce the emotional burden. Avoid starting supplements or changing hormones without advice, because products and medicines can interact or may not suit you.

Bring your diary to a clinician. Depending on the pattern and severity, care may include talking therapy, an antidepressant, hormonal treatment, or a plan for symptoms that occur only in part of the cycle. If you already take psychiatric or hormonal medicine, discuss changes before making them.

Book a clinical assessment when low mood, irritability, anxiety, fatigue or sleep problems disrupt relationships, work, study or self-care, or continue after the period begins. Seek urgent help if you have thoughts of suicide, feel unable to stay safe, or develop severe physical symptoms. Tell someone you trust and contact local emergency services if immediate safety is at risk.

Do my symptoms follow a premenstrual pattern? Could depression be present outside that pattern? Which treatments are suitable with my current medicines or contraception? How should I track symptoms, and what changes require urgent help?