May is Mental Health Awareness Month! One lesser-tackled mental health topic (in my opinion) is that of periods and mental health.

Invalidation: Public and Self

We often see in media the idea that a woman on her period is “crazy”- invalidating language that means it’s ok for others to ignore her feelings. I think it’s important to recognize that the hormonal changes we experience don’t suddenly make us different people. I, for one, become rather cranky, but not because I’ve developed a new set of preferences and opinions; I just have a lower tolerance for irritation. A much, much lower tolerance. Things that at any other time would simply make me shake my head suddenly either make me briefly, intensely angry or likely to burst into tears.

I find myself downplaying the effects of my period on my mental health all the time. I think it stems from its temporary nature. I know that it won’t last long, so it seems silly to let it take up much space on my list of mental difficulties. When I’m seeing red because somebody put a spoonful of cooked rice in the dishwasher and ran it, I invalidate myself. I tell myself that how I feel doesn’t matter because it’s caused by temporary hormones and my reaction is disproportionately intense. And it is temporary and more intense than is warranted. But the reality is, it’s extremely uncomfortable to experience month after month. Each small instance of unreasonable mood swinging adds up to something with tangible impact.

But it’s ~Natural~

Having a healthy menstrual cycle is a positive thing! If women for millennia have been dealing with theirs, why should I let mine be a roadblock for me? I’m sure women millennia ago thought it sucked just as much as we do, if not more. Modern methods of dealing with it hygienically and the availability of painkillers probably makes menstruating a good deal more comfortable for us. (Of course, there’s a conversation to be had about poverty’s restriction of women’s access to these modern resources. Not everyone enjoys the comforts of disposable period products. Here’s a good resource for learning about period poverty.)

There are definitely positive ways of talking about periods; their position in the menstrual cycle plays a vital role in fertility and reproduction, after all. That doesn’t eliminate the damage that periods can do to our mental health, however. We can recognize the beauty of a natural, cyclical process while also shaking our collective fists at Mother Nature.

PMS and Depression

As many as 3 in 4 women experience PMS. Symptoms include mood swings, irritability, crying spells, social withdrawal, and a host of uncomfortable physical symptoms. That alone is more than enough to be impactful when it comes to a person’s periods and mental health. And what about people who have a mental health diagnosis in addition to PMS? According to the Office on Women’s Health, “Many women seeking treatment for PMS have depression or anxiety. Symptoms of these mental health conditions are similar to symptoms of PMS and may get worse before or during your period.”

Personally, I can say with certainty that when I’m really struggling with my depression, my suicidal thoughts and the urges to self harm are worst leading up to and during my period. In fact, my period started a few days into my hospitalization in 2019 – a connection that I only made later on. The effects of the hormonal changes may be temporary, but my period is a setback to my mental health on a regular basis. And with an extremely serious thing like suicidal ideation, any factor that worsens it is nothing to be dismissed. Sometimes, even when things are getting better, I have sneaky, destructive thoughts because of hormonal fluctuations.

In those cases, it is helpful to remember that my period is to blame and that it will pass. I have to strike a balance, though. It’s easy for me to bully myself into feeling bad about slip ups and setbacks because “it’s just my period.” Hormones are powerful and their effects are very real, no matter how temporary.

Managing Periods and Mental Health

There are many ways to manage PMS for a better relationship between your periods and mental health. Many people find that lifestyle changes through diet, exercise, and healthy sleep are enough to improve their PMS, but your doctor might suggest other options as well. Hormonal contraceptives can help even out the dramatic peaks and valleys of hormone changes. For some people, PMS rises to the level of PMDD, or premenstrual dysphoric disorder. This can be treated through a variety of interventions.

It’s unfortunate that conversations about the mental health effects of the menstrual cycle are reserved only for certain private settings and are kept to a quiet minimum. Periods are a fact of life for many people. We should be able to discuss them openly as a legitimate factor affecting mental health. A survey of 1,500 women found that 58% have been embarrassed about their period at one point or another. 62% of respondents were uncomfortable even using the word “period.” Thankfully, there are many initiatives fighting stigma and working to provide resources to women and girls around the world, and we can keep the conversation going.

How does your period impact your mental health? Have you experienced period shame?