If you look online for information that ties depressive feelings to the menstrual cycle, you will find plenty of outdated or misinformed sources, citing anecdotal or incorrect evidence. But in the last few decades, scientists and psychologists have looked more closely at the relationship between hormones, menstruation, and negative feelings. They have found that there is, in fact, a link.
However, it’s not as simple as every woman following the same pattern at the same point in their cycles. As with anything involving moods and emotions, it is complicated by many other factors in a person’s life. So today, let’s dig a little deeper into what is really going on with depression before, during, or after your period, and what we can say with confidence about how to overcome or mitigate it.
Hormone Fluctuations During the Menstrual Cycle
As we’ve mentioned before in our past blog “Why Depression Happens”, one of the main factors behind depressive disorders is an imbalance of hormones or neurotransmitters. Most often, this can be traced to levels of dopamine and serotonin, which help to regulate mood. When compared with the menstrual cycle, these two compounds can sometimes correlate to the amount of estrogen and progesterone at different points.
In the days after the menstruation phase of your cycle, both hormones are at low levels. As ovulation approaches, the amount of estrogen rises before falling again immediately after; progesterone rises throughout the second half the of cycle, and then drops off again when your period begins.
These large peaks and valleys in hormone levels may affect the production of dopamine and serotonin in certain people. A 2017 study linked rising estrogen to rising dopamine, as well as noticeable effects it can cause, like improved memory or concentration. Conversely, it also found that falling progesterone could reduce dopamine, too, contributing to the mood changes and symptoms of depression right as your period begins. If you’ve ever felt sad or irritable for no discernible reason around this time – perhaps enough to qualify for the chronic disorders known as premenstrual syndromes (PMSs) – that plunge of progesterone could be the reason why.
In more severe cases, this can be qualified as premenstrual dysphoric disorder (PMDD), leading to greater irritability, anxiety, food cravings, difficulty sleeping, and emotional distress. Many of these symptoms are common between PMDD and depression.
As for why these specific hormones affect these neurotransmitters so much, it’s still not completely understood. One theory says that it might be because progesterone triggers the amygdala, a part of the brain that deals with ‘fight-or-flight’ responses, anxiety, and emotional reactivity. But it is also just a hard time for your body in general, as it sheds tissue and replenishes what it’s losing. You can be forgiven for feeling a bit fatigued!
Other Factors in Depression
Of course, these hormone levels can combine with other reasons to contribute to greater feelings of depression, and research shows that women are simply more likely to develop a depressive disorder than men, thanks to overall hormones, socialization differences as we grow up, differences in early diagnosis, and several other influencing factors. Lack of sleep or ongoing stress, distractions, or chronic pain can also play a role in depression, and these are all common at different stages of the menstrual cycle.
Treatment of Depression Around Ovulation
One of the most effective methods of treatment for depression after ovulation are selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant. But many women don’t want to take these unnecessarily, as they can reduce estrogen levels and cardiac health, as well as increasing the risk of osteoporosis.
One study in the early 2000s showed that cognitive behavioural therapy can also have a beneficial effect for women with depressive symptoms due to their menstrual cycle. This was expanded on in research from 2015, but there is still not enough data to totally confirm the findings beyond doubt. The best we could say is that cognitive behavioural therapy is a proven method for treating symptoms of major depressive disorders, so it stands to reason that it may be able to help with the common symptoms of PMSs and PMDD as well.
If you have questions about depression near ovulation, or you would like more information on how our therapeutic approaches can help, feel free to reach out and ask. We are always thrilled to guide people in Calgary to live their best and happiest lives!
If you’re interested, we have an in-depth blog post on Everything You Need To Know About Depression.