What should you know about PMDD and depression?

PMDD is a severe premenstrual condition in which mood and physical symptoms appear during the premenstrual phase and ease after menstruation starts. Depression can cause low mood, loss of interest, guilt, hopelessness, sleep changes, fatigue or difficulty concentrating across much of the month. A person can have both, and one does not rule out the other.

Irritability, feeling anxious, difficulty sleeping, daytime sleepiness and fatigue may occur in either pattern. The key clues are the symptom diary, how symptoms change after menstruation, how long they have been present and their effect on daily activities.

Record mood, interest, sleep, energy, concentration, physical symptoms and period dates each day for at least two cycles. Arrange a GP or mental health assessment, especially if symptoms affect relationships, work or self-care. Share previous depression, anxiety, medication and hormonal treatment history.

Keep regular sleep and meals, reduce avoidable demands during predictable difficult days, and use support from trusted people. Do not stop antidepressants or other prescribed treatment suddenly.

Seek urgent help for thoughts of suicide or self-harm, a plan to act, feeling unable to stay safe, severe confusion or losing touch with reality. Prompt clinical review is also needed when low mood is worsening, lasts beyond the expected premenstrual phase or prevents eating, sleeping, working or basic self-care.

Ask whether your symptoms show a cycle-linked pattern, whether depression or another condition may also be present, and which treatments suit your health and pregnancy plans. Ask when to seek urgent support and how progress will be reviewed.