Updated 05 August 2016

The link between PMS, depression and suicidal thoughts

The symptoms of premenstrual dysphoric disorder (PMDD) are similar to those of PMS, but generally more severe – and could include depression and even thoughts of suicide.

Most women experience mood swings and a feeling of irritability in the days before the onset of their period, but for some the symptoms can be severe. The physical and psychological symptoms of PMS usually end with the onset of a period. 

What is premenstrual dysphoric disorder (PMDD)?

For between two and five percent of menstruating women, premenstrual symptoms can be sufficiently severe to be debilitating, and to stop them from carrying out their normal daily activities, according to the Victoria State Government’s BetterHealth website. These symptoms can have a serious effect on the state of a woman’s mental health.

Read: Mental health screening online

This condition is called premenstrual dysphoric disorder (PMDD).

What causes PMDD?

As in the case of PMS, the exact causes of PMDD are not known, but they both occur between ovulation and the onset of a period. Many women with this disorder suffer from anxiety, severe depression and seasonal affective disorder (SAD), a type of depression that usually occurs during winter, according to the National Institutes of Health.

Other factors that could play a role include alcohol or substance abuse, thyroid disorders, being overweight, having a mother with the disorder and a lack of exercise.

What are the symptoms of PMDD?

The symptoms of PMDD are similar to those of PMS, but generally more severe. These could include panic attacks, a lack of interest in daily activities, binge eating, feelings of hopelessness and possibly thoughts of suicide, anxiety, bloating, headaches, and a feeling of being out of control.

Read: Suicide warning signs

It is interesting that the symptoms of PMDD are remarkably similar to those listed in the DSM-IV for Major Depressive Disorder, leading to some controversy on whether the condition does in fact exist, comments Jennifer Daw, writing for the American Psychological Association.

PMDD and suicidal thoughts

Suicide in women with depression is more likely to occur during the second half of their menstrual cycle, according to the NIH.

“It is true that patients who already suffer from depression and possibly already have suicidal thoughts can definitely experience a worsening of their symptoms as a result of mood fluctuation caused by PMS,” says Dr Ulla Botha, psychiatrist and senior lecturer from the Department of Psychiatry at the University of Stellenbosch.

Read: An Unquiet Mind

The jury is still out on whether women with already existing depression are more likely to experience the debilitating symptoms of PMDD. Whatever the conclusion, it is clear that women suffering from these severe symptoms need to seek medical help if serious depression and suicidal thoughts have become a part of their monthly menstrual cycle.

The NHI says that treatment for PMDD includes lifestyle changes, medication and therapy:

  • Eating healthy foods such as whole grains, fruit and vegetables and cutting down on salt, sugar, alcohol and caffeine
  • Getting regular exercise throughout the month
  • Trying to get into a healthy sleeping pattern
  • Taking antidepressants
  • Going for therapy

Read more:

Severe PMS lasts longer than thought

Manage the PMS blues

Natural approach to PMS


The National Institutes of Health:;

U.S Department of Health and Human Services:

Victoria State Government (BetterHealth):