Reproductive Mood Disorders include perinatal as well as menstrually-related emotional distress.
Most of us have heard of Premenstrual Syndrome (PMS). PMS symptoms occur due to normal hormonal changes during the luteal phase of the menstrual cycle in about 80% of individuals who menstruate (or 16 in 20) . Symptoms include bloating, headaches, tender breasts, pelvic pain, fatigue, sleep disturbances, appetite changes, and food cravings on the physical level; and anger (ranging from irritability to rage), anxiety (ranging from overwhelm to panic), sadness and depressed mood, hopelessness, inability to concentrate, impulsiveness, increased sensitivity to rejection, mood swings, tearfulness, and self-critical thoughts that lead to feelings of shame. These symptoms are on a continuum, and not all individuals experience all symptoms every month.
Premenstrual Dysphoric Disorder (PMDD) has been described as PMS x 10, and occurs in a smaller, though significant, number of individuals who menstruate - current estimates are 5% (or 1 in 20). Mood disruptions that are uncomfortable but manageable in PMS, disturb work and damage relationships for a PMDD sufferer. Those with PMDD experience an abnormal response to normal hormonal changes of the luteal phase, due to genetic predisposition, stress, and/or trauma.
Women who suffer from Premenstrual Exacerbation of Existing Disorders (PME) experience a worsening of their already current symptoms during the luteal phase of their menstrual cycle. (See ‘Common Co-occurence’ below for more information.)
Perimenopause is the transitional time in a woman's life from normal menstruation to no menstruation at all, and may be when premenstrual symptoms begin to surface or worsen. It typically spans about ten years, and can start as early as age 35 (yet this is unusual). The cycle and its accompanying hormones become increasingly erratic during this stage, causing those with hormonal sensitivity to experience even more intense symptoms with a decreased ability to anticipate them. Many women with no prior history of hormonal sensitivity or mental health problems experience the onset of clinical depression and/or anxiety symptoms during these years.
Some level of “baby blues” is common within the first couple weeks after giving birth, however 20% of people who give birth will experience a lingering and more impactful decline in mood. PMAD symptoms include anxiety (often coupled with Obsessive-Compulsive qualities) and depression during pregnancy and/or the postpartum period (up to two years after the birth). In more extreme and rare cases (about 5% of mothers), Postpartum Psychosis can cause thoughts of suicide or harming one's baby - this is a very serious condition needing immediate attention! I also treat people coping with distress and trauma due to pregnancy loss or termination, as well as infertility issues. PMADs are the most common, undiagnosed health issue among women in the United States today. Of note, research indicates that the very same sensitivity to hormones found in women with PMDD is indicated in PMADs.
The earliest calendars discovered in the world were animal bones upon which ancient women tracked their moon cycles. The only way to be certain about whether you are experiencing a reproductive mood disorder, aside from those who have symptoms soon after giving birth, is to start tracking your menstrual cycle. This is important because it allows you to see patterns from month to month, that might otherwise fly under the radar. It is important to capture daily details such as the day number of your cycle, the date, any physical, mental, emotional, spiritually, relationally, or professionally significant observations, along with how many hours you slept, what you ate, any exercise you did, any medications or supplements you took, as well as any other substances you used. This might seem like a lot, however after a few months it will become second nature and you will learn so much about yourself and your cycle! Your notes can also be helpful to bring to a doctor or therapist as you explore your particular path to healing.
Studies are beginning to show that trauma is strongly implicated in women with reproductive mood disorders. Trauma can be recent and acute, historical and chronic, birth-related and developmental, or even intergenerational. The nervous system dysregulation found in Posttraumatic Stress Disorder (PTSD) mirrors the symptoms of hormonal sensitivity in many respects, such as hyperarousal of the nervous system, rage, panic, and extreme mood swings.
Women with a reproductive mood disorder commonly have a higher rate of experiencing Attention-Deficit Disorder (ADD), Borderline Personality Disorder (BPD), and/or an eating disorder (ED) such as Anorexia Nervosa, Bulimia, or Binge Eating. Difficulty controlling impulse and coping with stress are common in all of the above conditions, and clients coping with one (or more) of these can experience premenstrual, perinatal, or perimenopausal exacerbation of their already existing symptoms.