Can menstruation cause depression?

Question:

I know menstruation comes with a lot of baggage including the telltale signs of premenstrual syndrome characterized by mood swings, cramps, pain and cravings. However, I find that when I’m experiencing my menses, I get very emotional, feel sad and miserable. Sometimes I even find it difficult to get out of bed. Can menstruation cause depression considering these are its signs? – Concerned girl

Answer:

Premenstrual syndrome, or PMS as it is commonly referred to, can take its toll on even the strongest of women. PMS manifests itself in many ways, some of which you have mentioned above.

In 2013, experts entered another form of PMS into the list of Diagnostic and Statistical Manual of Mental Disorders. It is known as premenstrual dysphoric disorder or PMDD. PMDD is described as a severe and debilitating form of PMS. This simply means that for women suffering from PMDD, the condition can be so severe, as to cripple their day-to-day living. This is due to heightened pain, anxiety and other symptoms of PMS.

It is estimated that about three to eight per cent of women suffer from PMDD. Researchers are not too sure what causes it, but experts believe sufferers experience extra sensitivity to the normal hormonal imbalances that occur during the menstrual cycle. It is not something many women are aware of and identifying it requires a medical examination. In 2016, renowned Nigerian author Chimamanda Ngozi Adichie (pictured above), wrote an extensive piece in The Guardian about her struggle to come to terms with the condition, especially being an African.

While PMDD does exhibit physical symptoms, its debilitating aspect tends to be the psychological part of it. Some victims have confessed to suicidal thoughts, anxiety, severe irritability and immobility in regard to doing even the basic of things, like in your case getting out of bed.

PMDD usually begins after ovulation and ends a few days after menstruation. The symptoms can last from six days to two weeks. For one to be diagnosed with PMDD, you have to meet certain criteria as outlined in the Diagnostic and Statistical Manual of Mental Disorders and a doctor should do the
diagnosis.

The criteria are in seven classes and one needs to have at least five of the 11 mentioned symptoms in Criterion A and notably the first four. The list though is not exhaustive. One also has to have undergone the symptoms for about a year.

Criterion A

Marked lability (exaggerated changes in mood or affect in quick succession) e.g. mood swings
Marked irritability or anger, depressed mood, anxiety and tension
Decreased interest in usual activities
Difficulty in concentration
Lethargy and marked lack of energy
Hypersomnia or insomnia
Feeling overwhelmed or out of control

There are several ways to deal with PMDD including homeopathic cures, medicine such as antidepressants and in severe cases, hysterectomy – a surgical operation to remove all or part of the uterus.