Reviewed by Dawn Brown, LPC, NCC
The phrase “PMS” is ubiquitous; you would be hard-pressed to find anyone unfamiliar with the term and its corresponding behaviors. Although Premenstrual Syndrome has garnered something of a humorous reputation, often used as a punch line to a joke, or an indictment of a woman’s mood, it is a very real condition many women find themselves exhibiting symptoms of, and it can cause legitimate distress. One of the many possible symptoms of PMS is feelings of distress or anxiety. How, then, do you determine the difference?
What Is Premenstrual Syndrome? How Does Anxiety Come Into Play?
To identify the difference between PMS and anxiety symptoms, a thorough understanding of Premenstrual Syndrome is essential. PMS has an interesting history. Its origins extend further back than the term “PMS,” beginning with the notion of “hysteria,” a condition that was believed to be unique to a woman’s experience. Hysteria was seen as a woman’s issue, brought about by her monthly cycle, and characterized by wild, out of control behavior, whether that meant excessive anger, uncontrollable crying, or a series of wild mood swings. This formed the basis for identifying hormone or cycle-based changes to a woman’s behavior and mental faculties.
The term “Premenstrual Syndrome” and the symptoms it describes are much younger than the notion of hysteria, with the term only coming into common use in the 1980s. During this decade, PMS was catapulted to the public consciousness as a result of a criminal case in the United Kingdom, which utilized the notion of PMS to reduce the charges against two women, citing PMS as a contributing factor in their criminal activity. Since then, PMS's notion has continued to enjoy a controversial stance in medical and mental health literature. Some people assert that there is little proof to suggest that PMS is a real condition, while others point to a veritable mountain of evidence to suggest that hormonal changes during a female’s menstrual cycle have a significant physical and emotional impact.
So what exactly is PMS? The term is used to describe a series of symptoms brought about by rising and falling hormone levels during different periods of a female’s menstrual cycle—and in particular, just before and during menstruation. PMS is a blanket term used to describe physical, emotional, and mental changes during a female’s menstrual cycle. PMS is a small term used to describe large changes that cover cognitive function, physical changes, and emotional upset.
Common PMS Symptoms - Is Anxiety One of Them?
PMS's most common symptoms are divided into two camps: physical symptoms and emotional/mental symptoms. The physical symptoms of PMS typically include:
- Weight gain or fluid retention. Many people with PMS first experience symptoms in the form of fluid retention. Pants might fit just a little bit tighter, or they may no longer fit into clothing as well as they used to.
- Acne outbreaks. Many menstruating females find that their skin erupts in acne during certain periods of their menstrual cycles, including cystic acne and whiteheads.
- Muscle aches and headaches. PMS can cause headaches and muscle aches, including muscle cramping of the uterus, lower back, and legs.
- Increased fatigue. Because the body is undergoing many changes during an individual’s menstrual cycle and hormone levels are changing, menstruating people may find themselves needing more or less sleep throughout their cycle.
- Bowel changes. Constipation and diarrhea have both been known to make an unwelcome appearance during menstruation and can contribute to the overall feelings of malaise experienced in PMS.
In addition to physical changes, PMS is known for the mental and emotional changes it brings. The emotional and mental changes triggered by a female’s menstrual cycle include (but are not limited to):
- Mood swings. Mood swings are perhaps the most frequently identified PMS symptoms and the most frequent sources of humor. Menstruating females may find themselves experiencing dramatic shifts in mood, seemingly without cause or reason.
- Increased irritability. Menstruation can also bring about an increased sense of irritation, and anger may be more easily triggered.
- Depressed mood. Depression symptoms may flare up when PMS is at play, including feelings of restlessness, apathy, and overwhelming sadness or grief.
- Feelings of tension or anxiety. Like depression, anxiety can flare up during PMS and can make it difficult to carry out standard, day-to-day functions.
- Difficulty concentrating. During a PMS bout, it can be more difficult to focus or attend to tasks, which can further aggravate depression and anxiety symptoms.
Anxiety And PMS
Although mood swings are the primary changes to a menstruating individual’s mental and emotional function that others easily recognize, they are far from the primary symptom set recognized by mental health and medical professionals. Anxiety is a common side effect or symptom of PMS, perhaps due to all of the other changes brought about by PMS. Bodily changes—acne, weight gain, and soreness—can inspire anxiety, onset, mood, and cognitive changes.
Although anxiety is not a guaranteed symptom of PMS, it is a common one. It can inspire some confusion: is the anxiety a product of PMS, or an ongoing issue, further exacerbated by PMS? Determining the answer to this requires a thorough understanding of your own medical history and how your body handles the changes brought about by menstruation. PMS is not the only source of mood, and bodily changes brought about by an individual’s menstrual cycle; there are other potential reasons for severe emotional and mental upset during an individual’s menstrual cycle.
Other Sources Of Menstrual-Related Anxiety: PMDD
Although the premenstrual syndrome is a legitimate reason for the onset of anxiety symptoms, another disorder is known for its links to both menstruation and anxiety. This disorder is known as Premenstrual Dysphoric Disorder (PMDD) and typically has symptoms that exceed PMS in scope and severity, with a heavy emphasis on mental and emotional changes. PMDD differentiates itself from PMS primarily because it seems to target mood rather than physical symptoms. PMDD has been linked to clinical levels of depression and anxiety and could be the source of ongoing mental health issues during an individual’s menstrual cycle.
PMDD is not common, affecting between 5 and 10 percent of menstruating females. Nevertheless, it can be debilitating and can cause serious distress in relationships, work, and school. It is more common in people with a family history of PMS or PMDD and people who have their own history of struggle with mental health, whether that involves a diagnosed disorder or a general mental health struggle. While it is not as readily recognized as PMS, PMDD is a recognized disorder and can require intervention to manage symptoms. PMDD is typically treated with a combination of lifestyle changes, talk therapy, anti-anxiety or anti-depressant medications, and anti-inflammatory medication.
Treating PMS-Based Anxiety
Treating anxiety that is centered on PMS can prove difficult, as it may not be as simple as addressing anxiety; instead, it may require an investigation into the hormonal processes involved in menstruation, in addition to standard methods of anxiety treatment. Some people suffering from PMS find that lifestyle changes are enough to alleviate many of PMS symptoms, including anxiety. In contrast, others find a combination of therapy, lifestyle changes, and medical intervention, such as hormone therapy, necessary to combat PMS symptoms. Fortunately, PMS symptoms are typically far less difficult to treat and far less severe than the symptoms of clinical anxiety or PMDD. They may not require dedicated medications at all.
Anxiety Or PMS?
In some cases, anxiety is its own unique disorder, rather than a symptom of PMS. In these cases, anxiety will operate outside of PMS confines, with symptoms that extend past standard hormone cycles. In clinically recognized anxiety disorders, anxiety must cause significant impairment, with symptoms lasting for six consecutive months, if not longer. Anxiety typically requires ongoing therapeutic intervention and pharmaceutical intervention, which work in tandem to relieve anxiety symptoms and improve quality of life. Conversely, PMS's anxiety will ebb and flow alongside the changes brought about by an individual’s menstrual cycle. This, alone, typically provides enough to differentiate between PMS-induced anxiety and a dedicated anxiety disorder.
Regardless of the source of anxiety—PMS, PMDD, or a diagnosed disorder—anxiety can be debilitating and can have a very real, negative effect on a person’s life. Seeking treatment is the most effective way to manage anxiety symptoms and even heal from those symptoms. Through therapy, medical intervention, pharmaceutical intervention, and lifestyle changes, most people with anxiety disorders or anxiety symptoms can enjoy a rich, beautiful life, filled with the same joys, successes, and goals as their abled peers. If you are unsure about your own anxiety symptoms and whether they are symptomatic of an anxiety disorder, PMS, or PMDD, online tests and professional evaluations can bring clarity and comfort and give you a clear path toward treatment and eventual healing.