[40F] Experiencing severe premenstrual symptoms including depression, anxiety, and nausea

What might be happening

Based on the symptoms you described, here are some possible explanations:

• Premenstrual Dysphoric Disorder (PMDD): PMDD is a severe form of premenstrual syndrome (PMS) that includes emotional and physical symptoms such as severe depression, anxiety, irritability, and physical symptoms like nausea and body aches. These symptoms typically occur in the luteal phase of the menstrual cycle (the time between ovulation and the start of menstruation) and improve within a few days after the onset of your period.

  • Treatment: PMDD is often treated with lifestyle changes, dietary adjustments, stress management techniques, and sometimes medications like antidepressants or hormonal treatments.

• Major Depressive Disorder (MDD): Given your history of MDD, it's possible that your symptoms are related to a depressive episode, which can be exacerbated by hormonal changes during your menstrual cycle.

  • Treatment: Treatment for MDD typically includes a combination of medication (such as antidepressants) and psychotherapy. Your current medications may need to be reviewed and adjusted by your healthcare provider.

• Generalized Anxiety Disorder (GAD): Your symptoms of anxiety, insomnia, and restlessness could be related to GAD, which can also be influenced by hormonal changes.

  • Treatment: Treatment for GAD often includes medications such as SSRIs or benzodiazepines, as well as cognitive-behavioral therapy (CBT).

• Hormonal Imbalances: Hormonal fluctuations during the menstrual cycle can cause significant physical and emotional symptoms. Conditions like polycystic ovary syndrome (PCOS) or thyroid disorders can also contribute to these symptoms.

  • Treatment: Hormonal imbalances can be managed with medications, lifestyle changes, and sometimes hormone therapy.

What you can do

1. Consult Your Healthcare Provider: It's important to discuss your symptoms with your healthcare provider. They can perform a thorough evaluation, including blood tests to check for hormonal imbalances and other underlying conditions.
2. Track Your Symptoms: Continue tracking your symptoms, noting their severity and timing in relation to your menstrual cycle. This information can be very helpful for your healthcare provider.
3. Lifestyle Adjustments: Consider making lifestyle changes that may help alleviate your symptoms, such as:
   • Regular exercise
   • A balanced diet rich in whole foods
   • Stress management techniques like yoga, meditation, or deep breathing exercises
   • Ensuring adequate sleep hygiene
4. Medication Review: Discuss your current medications with your healthcare provider to ensure they are still appropriate and effective for your symptoms.

What you should look out for

Seek immediate medical attention if you experience any of the following:

• Severe Depression or Suicidal Thoughts: If you ever feel like harming yourself or have thoughts of suicide, seek help immediately by calling a crisis hotline or going to the nearest emergency room.
• Severe Headaches or Vision Changes: These could be signs of a more serious condition that requires prompt medical evaluation.
• Significant Weight Changes: Unexplained weight gain or loss should be evaluated by a healthcare provider to rule out underlying medical conditions.

Remember, while this information can be helpful, it is not a substitute for professional medical advice. Please consult with your healthcare provider for a formal diagnosis and appropriate treatment plan.