Premenstrual Dysphoric Disorder

Hey Mighty fam 🌸

For many women, the days leading up to menstruation can feel like an emotional rollercoaster. Irritability, sadness, or even old memories resurfacing can catch even the most self-aware off guard. While these shifts are often chalked up to “hormones,” the reality is a fascinating interplay of brain chemistry, emotions, and psychology. Whether you’re a mental health professional or someone navigating these changes, understanding the science behind premenstrual emotional shifts can foster empathy and offer strategies for support. Here’s a look at what’s happening in the brain and body, and why these feelings matter.

Hormonal Changes and Brain Chemistry

The emotional fluctuations before menstruation are driven by shifts in estrogen and progesterone, hormones that influence key neurotransmitters like serotonin and dopamine. These neurotransmitters regulate mood, motivation, and emotional balance. Research shows that serotonin levels can drop by up to 30–40% during the luteal phase (the premenstrual period), contributing to irritability or low mood in about 20–40% of women with premenstrual syndrome (PMS) and 3–8% with premenstrual dysphoric disorder (PMDD) (Eriksson et al., 2008; American Psychiatric Association, 2013). Dopamine, linked to feelings of reward, also dips, which can make everything feel a bit heavier.

Why Old Memories Resurface

Ever notice how unresolved emotions or past experiences seem to bubble up before your period? This isn’t random. The amygdala, the brain’s emotional center, becomes more reactive when serotonin levels drop, while the hippocampus, responsible for memory, may pull up unresolved or traumatic memories. For women who’ve worked through therapy, these moments can feel frustrating, like revisiting emotions you thought were resolved. This is because hormonal changes temporarily reduce the brain’s ability to regulate emotions, making it harder to keep those feelings in check.

The Role of Emotional Regulation

The prefrontal cortex, which helps us make decisions and manage impulses, takes a hit during the premenstrual phase. Lower serotonin and dopamine levels impair its ability to “calm” emotional reactions, which is why even small triggers can feel overwhelming. For those with therapy experience, this can be a humbling reminder that biology doesn’t always bend to self-awareness. Still, understanding this process can help—knowing it’s your brain, not a personal failing, can make these moments easier to navigate.

A Deeper Perspective: Emotional Reflection

For some, these emotional shifts feel like more than just a biological quirk, they can be a chance for introspection. Many women, especially those who practice mindfulness, describe this time as an opportunity to revisit past experiences or emotions, almost like a monthly reset. While science doesn’t fully explain this, it’s possible that hormonal changes amplify emotional processing, allowing us to confront unresolved feelings. For others, particularly those without access to therapy or coping tools, these shifts can feel intense or even debilitating, especially in cases of PMDD.

Strategies for Navigating Emotional Shifts

Whether you’re a professional supporting clients or someone experiencing these changes, here are evidence-based ways to manage premenstrual emotional shifts:

• Mindfulness and Journaling: Practices like mindfulness meditation or writing can help process emotions and reduce reactivity.

• Cognitive-Behavioral Therapy (CBT): CBT can build skills to manage negative thoughts and emotional triggers (Yonkers et al., 2008).

• Lifestyle Adjustments: Regular exercise, sleep, and a balanced diet can stabilize mood by supporting neurotransmitter function.

• Medical Support: For severe symptoms like PMDD, consult a healthcare provider about options like selective serotonin reuptake inhibitors (SSRIs).

Premenstrual emotional shifts are more than “just hormones” they’re a complex dance of brain chemistry, psychology, and personal experience. By understanding how hormones affect serotonin, dopamine, and brain regions like the amygdala and prefrontal cortex, we can better support ourselves and others.

Whether you’re a clinician researching PMS/PMDD or someone seeking to understand your own cycle, recognizing these dynamics can empower you to approach these shifts with compassion and practical tools.

Key Takeaways: Hormonal fluctuations reduce serotonin and dopamine, driving emotional sensitivity in 20–40% of women (PMS) and 3–8% (PMDD).

The amygdala and hippocampus may trigger unresolved memories, even in those with therapy experience.Strategies like mindfulness, CBT, and lifestyle changes can help manage these emotional waves.

PMS isn’t just hormones, it’s your brain and heart navigating a complex cycle. From serotonin dips to resurfacing memories, these shifts affect 20–40% of women with PMS and 3–8% with PMDD. Whether you’re a clinician or riding these waves yourself, tools like mindfulness, CBT, or a chat with a doctor can help.

Let’s approach these moments with kindness and curiosity. I’d love to hear from you, what’s been your experience with premenstrual shifts?

#MentalHealt #WomensHealth #PMS #PMDD #emotionalWellbeing #neuroscience #MindBodyConnection

Yesterday I met with my gynecologist to discuss different birth control methods. She wants me to stop taking estrogen due to hypertension and interactions with certain meds I’m on. We discussed the iud, implant, shot, and proestrogen only pill. I’m use to having periods only every 3 months and their lighter. Don’t want periods every month nor intermittent spotting. I got put on birth control for my pmdd and to help with bad cramping 20 years ago. I get yeast infections easily espically in the summer with excessive sweating. I don’t want weight gain. I’m already obese and having hard time losing. I already have depression and anxiety along with other health conditions including pots. Don’t want increased risk of breast cancer. It runs in my family. My pots is always worse when I’m on my period making me more dizzy and feeling like I’m going to faint more along with worse nausea. I have back pain but it’s worse when on my period along with bloating. I’m torn between the shot and implant. I have been doing research and both sound good except the weight gain with the shot. I have pain management procedures every couple of months besides other procedures, bloodwork, scans, etc. please help me decide between the shot and implant! #MajorDepressiveDisorder #GeneralizedAnxietyDisorder #PremenstrualDysphoricDisorder #POTS #ReflexSympatheticDystrophySyndrome

I’m here because I’ve been living with anxiety, depression, ADHD, and PMDD — and honestly, the past few years have been a lot. I’ve been working really hard on understanding myself better and rebuilding after trauma, chronic illness, and burnout.
Some days I feel like I’m moving forward. Other days I feel completely alone in it.I joined The Mighty to connect with people who understand how overwhelming things can get — and who believe healing isn’t linear.
If you’re here trying your best too, I already feel connected to you.#MightyTogether #Anxiety #Depression #ADHD #PremenstrualDysphoricDisorder

Hi, my name is SPICYCUPCAKE111. I've been diagnosed with

#MightyTogether #BorderlinePersonalityDisorder #Anxiety #Depression #OCD #PremenstrualDysphoricDisorder

Hello, I am 23 and have PMDD and my symptoms have been awful. I am back to crying five times a day, angry even though I am not an angry person at all, having panic attacks, feeling very hopeless, and more. I’ve been like this for the last 9 years and my providers either think what I go through is normal or want to involuntarily hospitalize me, no middle ground. Can anyone relate? I feel so alone in what I go through. #PremenstrualDysphoricDisorder ashley

hi fellow humans 🙂 I’m Mandy

#MightyTogether #Anxiety #Depression #ADHD #PremenstrualDysphoricDisorder

Here I am done it again. Why can’t I just get better at handling my emotions? I’m sitting here on the bathroom floor after hurting my myself and now hating myself. I tried to make a phone call (which I have anxiety and social phobia so this is hard for me) to schedule an appointment with psychiatry through a new provider. Long story short I freaked out at my job of 12 yrs and took a medical leave of absence, collecting STD…my employer ended up terminating me (is that even legal?!?!) so I lost my insurance. I had been seeing the same psych dr. for years…now I have my husband’s insurance which is not covered by that provider…so the switch is necessary and I hate it! Anyway the lady on the phone informed me that my new insurance does not cover anything for psychiatry or behavioral health…wtf…how is that a thing????? So what I get no help…cut off from mental health services…this thing is going to be eventually kill me. I hung up the phone and just started bawling…then I got mad. I can’t believe I hurt myself again. Feels like there’s no hope for change.
#BorderlinePersonalityDisorder #BipolarDisorder #PremenstrualDysphoricDisorder

Hi I’m Amy and I’m here because I’m struggling with #BipolarDisorder #BorderlinePersonalityDisorder #PTSD #SocialAnxiety #PremenstrualDysphoricDisorder

Did you know more 80% of of mental health providers are not trained in treating race-based trauma? Source: https://projects.apnews.com/features/2023/from-birth-to-death/mental-health-black-children-investigation.html#:~:text=Most%20mental%20health%20care%20providers,%2C%20said%20Kniffley%2C%20the%20psychologist.

My name is Jasmin Pierre. I’m a mental health advocate, peer support specialist, and the creator of The Safe Place, a culturally aware mental health app for the Black community.

When I was a little girl, I really needed mental health resources. Trigger Warning: I was molested by my brother and stepsister. I also experienced other family issues with my mom and stepmom (they could both be verbally abusive and manipulative at times). However, it was the molestion from my siblings that impacted my mental health the most.

I have depression, anxiety ptsd, and a physical disorder called Premenstrual Dysphoric Disorder (PMDD for short). I’ve also experienced severe suicidal ideation due to PMDD and the trauma of being molested by my family.

However, I kept most of this inside until adulthood. A culturally aware therapist helped me put things into perspective. I started being honest with myself and cut off toxic family members for the sake of my mental health.

When I was a little girl in the 90s, talking about mental health was very taboo. Especially in my community. Many Black people have been made to believe that we don’t go through mental illness or need therapy services.

Growing up, I wasn’t sure why we felt that way in my community; I just knew that we did. We have been taught to be strong, pray, and read our Bible to get over things.

Now, as an adult, I know this way of thinking in my community comes from systemic racism. Psychology has a deep history of racism towards Black people dating all the way back to slavery.

For example, the mental illness called Drapetomania was created by an American physician by the name of Samuel A. Cartwright. What is Drapetomania? If a Black person ran away, they would be considered mentally ill and captured back into slavery.

While Drapetomania is no longer considered a mental illness, Black people with mental health disorders are still severely over policed in the mental healthcare system. Black people in a mental health crisis have a higher chance of being overly retrained by law enforcement …or even murdered.

When I ask many of my mental health colleagues, “Have you ever heard of drapetomania?” Many tell me “No. ” This is not surprising. Racism in psychology is not required in the healthcare field.

I’m working to change that. My app recently launched a mental health training called “Art Exposing Psych Racism.”

Through facts, canvas art that I created, and storytelling, healthcare workers can learn more about racial disparities during slavery, the Civil rights era, etc. And how all of it still impacts Black people trying to navigate the mental healthcare system in modern-day society.

I created this training because racism in psychology is still a serious problem. Also, only 4% of mental healthcare providers are Black. We need more cultural competency.

Here is a short instagram video that tells more about the training and how healthcare providers can take it.

https://www.instagram.com/reel/Cz55s2DuRWe/?igshid=MzRlODBiNWFlZA==

Hi, my name is NiftyArmadillo687. I'm curious about anyone else with premenstrual dysphoric disorder

#MightyTogether #Anxiety