Premenstrual Moods

Colette Dowling, LCSW

New York Psychotherapist

Colette Dowling, LCSW

Colette Dowling, LCSW, author of the following article on premenstrual moods, is a psychotherapist in Manhattan. She has written 8 books on women's psychological issues, including "You Mean I Don't Have to Feel This Way?": New Help for Depression, Anxiety and Addiction, and The Cinderella Complex.

Premenstrual moods, including premenstrual depression, anxiety, and irritability result from the impact of reproductive hormones on the brain.

When you experience Premenstrual Mood Change (popularly known as PMS, medically known as PMDD), your brain is telling you that it's unable to maintain its usual chemical balance during the last week of the cycle. How magical it seems when your brain recovers its intrinsic regulating abilities, within a day or two after menstruation begins, and suddenly the premenstrual moods are gone and you feel normal again!

Every woman who suffers from PMS knows what it's like to feel ashamed, helpless and out of control. Her mood swings may feel profoundly disorienting. Who she IS, during that week or 10 days before her period, doesn't quite feel like the "real" her. Irritability plagues her. She may fight with her husband, say terrible things to her children. She has no patience with the bank teller and chews out the school crossing guard. Moreove, she knows her irritabilty is irrational and hates herself for it.

Today it's known that up to 60 percent of women suffer from premenstrual moods. The symptoms of PMS--which may include depressed mood, anxiety and irritability, in addition to physical symptoms such as bloating and breast tenderness--are actually caused by neurotransmitter changes in the brain.

These changes are triggered by the drop in estrogen that occurs after a woman ovulates. Lowered estrogen causes mood-altering serotonin levels to drop, too, and that's where the difficulty begins.

"Hormones are, by definition, substances that act as messengers at target organs", doctors Severino and Moline wrote in their 1989 book, Premenstrual Syndrome. In this syndrome the "target organs" are the brain, breasts, and uterus, with secondary effects occurring at the thyroid and the adrenal cortex. The regulation of menstrual hormones involves complex interactions among brain neurotransmitters, pituitary hormones, and ovarian hormones. Thus, it isn't simply the woman's ovaries that cause her premenstrual difficulties. Her serotonin, dopamine, and norepineprhine are part of the action as well. Somehow, the ovarian hormones interact with the brain's neurotransmitters and the end result is a definite shift in mood.

WE mayh wonder why Betty binges through her periods and Helen finds that she becomes moody and irritated. Why is one woman beleaguered by the hanges only one week out of every month and another three weeks? Why do some experience a mild feeling of being in the dumps and others have severe, life-disrupting mood drops? And why do some swing through the whole cycle, as a minority do, as free and easy as a woman in a Maxithin commercial?

One theory is that women who have low serotonin levels to begin with are likely to have their serotonin drop below a tolearble level when their estrogen declines Though physical in origin, the mood shifts and sometimes extreme behaviors many women experience, premenstrually, may benefit from a psychiatrist's help. If youj're considering antidepressant medication for premenstrjual mood changes (and some women feel like this medication returns their lives to normal),a psychiatrist is more experienced at prescribing medication and proper dosing for the treatment of PMS than an OB/GYN or family practioner.

Women struggling with the effects of premenstrual moods can also be helped by psychotherapy.Self image tends to be altered by the once-a-month downturn in self esteem and the consequent relationship difficulties. This can be effectively addressed by someone who understands both the physical and emotional components of PMS, or PMDD.

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A discussion of premenstrual moods can be found in Colette Dowling's book, "You Mean I Don't have to Feel This Way?": New Help for Depression, Anxiety and Addiction.

See Colette's article on how to deal with premenstrual moods and cravings.

Colette Dowling, LCSW, received her MSW degree at The Smith College School for Social Work. Subsequently, she completed psychoanalytic training at The Institute for Contemporary Psychotherapy, in New York. Ms. Dowling is a licensed clinical social worker with a private therapy practice in Manhattan. She specializes in the treatment of women and couples. For further information, or to arrange a consultation, call Colette at 718-594-0201, or write

To hear Colette speaking about what it's like starting therapy with someone new, click the audio button.

Click here to learn about Colette's psychotherapy practice.

Information on premenstrual moods and treatment and other mental health issues can be found at Colette's website.

Copyright Colette Dowling, 2006-2010