In the dark days of winter, we all start feeling caged in and sick of the cold.
It is normal to feel moody, irritable, anxious, sad, depressed, less motivated and even overwhelmed. Some days we would just rather stay in bed and hide from the world under the covers.
If you have the misfortune to suffer premenstrual syndrome, or premenstrual dysthymic disorder, the winter will seem even longer.
Many women suffer mild mood changes such as irritability during their monthly period, after the birth of a baby or around the time of menopause.
In a normal menstrual cycle, estrogen drops slowly before the period starts. Mood changes are tied to estrogen level changes and, as another cycle begins, estrogen rises and mood changes go away.
What are not as common are mood changes that affect relationships, work behavior or lifestyle habits such as use of alcohol. This happens to women who suffer from these premenstrual syndromes.
The way this works is our brain chemical balance is influenced by estrogen. We each are unique in our chemistry. Our brain chemical balance is a big part of our personality—how we cope, our sex drive, our behavior in general.
Banking with brain chemicals
A couple of brain chemicals to pay attention to are gamma-aminobutyric acid and serotonin.
Gamma-aminobutyric acid is the brain chemical that helps with concentration. Some brains do not make enough of it and this contributes to symptoms of attention deficit disorder.
Serotonin is the brain chemical many women depend on to feel normal. One way to think about serotonin is like money in the bank. Picture a bank balance sheet. We make serotonin during sleep.
Due to genetics, some women make more serotonin than others. Serotonin goes in the “deposit” column of your balance sheet. Serotonin is “spent” on each life event. Unresolved issues or emotional challenges like elder parent care or a difficult job situation “costs” more serotonin than, for example, being late for work or not having any clothes that fit.
When estrogen is low—right before a menstrual period—serotonin is spent more quickly. Something needs to happen to rebuild your balance.
A real life example
A patient of mine I’ll call Mary came to me at the urging of friends.
Mary’s behavior had changed significantly. At Mary’s appointment, we assessed the situation. Her periods were slightly irregular, but still came every month. She had been noticing more headaches, bloating and fatigue around the time of her period. Overall, she thought she was doing well but agreed her moods had been worse.
I asked her what had changed in her life. Mary confided that normally when she was in a bit of a bad mood, she could still “act happy.” Lately, however, she seemed unable to control what came out of her mouth. She worried about everything, particularly—and needlessly—about money or future plans.
Too many nights she could not sleep because her mind simply would not stop. Her weight and sex drive had changed for the worse. Mary simply did not feel connected and often felt sad and she did not know what to do about it.
We talked about how brain chemicals and estrogen are closely related. Because of her lower estrogen level right before periods, she spent her brain chemicals too fast. Also because of low estrogen, she couldn’t sleep well before a period, and therefore didn’t make enough brain chemicals.
Mary had fallen into a vicious cycle.
She hesitated to consider taking medication to help. I reminded her that women 75 years ago would have given anything for the medical options we have today. Women now do not have to suffer like in years past. Times have changed for the better.
Mary did choose to take advantage of medicine that raised her brain chemical serotonin. After three months, she felt like her normal self. She was more active, had started walking again every day and wanted to go out with her friends.
So pay attention, ladies: Bad moods can be a symptom of changing hormone levels, but they do not have to be suffered in silence. Please talk to your doctor and get help.