Do You Also Become a Monster During PMS?

Are you one of us with ADHD who, in the week before your period, feel like life becomes completely unmanageable? And that it only gets worse with age? Does your partner think you’re being unreasonable and crazy, and do you feel like they might be right, at least partly? In this article, we’ll dive into why you might feel like this, tag along!

Perhaps you recognize this anger from better times, but the difference is that during those times you can work proactively. That you can remove yourself from dangerous situations, and manage your relationships at least somewhat?

Many women with ADHD often experience mood and emotional swings that can be sudden and intense. 

In addition, ADHD can lead to increased sensitivity to hormonal changes.

The Monthly Cycle Explained

Simply put, two hormones, estrogen and progesterone, fluctuate during the menstrual cycle in a recurring pattern:

• Follicular phase: Estrogen levels gradually rise, causing an egg to mature in the ovary.
• Ovulation: Estrogen levels peak, the egg is released, and the follicle transforms into a corpus luteum.
• Luteal phase: The corpus luteum produces progesterone, which increases until menstruation begins.
• Menstruation: Both estrogen and progesterone drop to low levels.

The connection between ADHD and hormones, however, seems to involve more than just hormone levels.

It appears that many with ADHD are particularly sensitive to hormonal changes, especially when progesterone drops. 

Recognizing PMS and PMDD Symptoms

Women with ADHD also report more frequently experiencing premenstrual syndrome (PMS) compared to women without the diagnosis.

PMS involves physical and psychological symptoms that worsen before menstruation. This can include increased tearfulness, irritability, cravings for sweets, fluid retention and tender breasts. 

PMS symptoms usually disappear when menstruation starts. However, since hormones affect the brain with a slight delay, some may continue to experience discomfort even during the first few days of their period.

About 3-5% of all menstruating women experience symptoms similar to depression or anxiety, which subside when menstruation begins. This more severe form of PMS is called premenstrual dysphoric disorder (PMDD). 

Both PMS and PMDD can worsen over time, and many report that the problems become more severe after giving birth.

Support and Help Do Exist

Unfortunately, there are many misconceptions about PMS and PMDD. Some believe that no help is available. While others feel like failures or are ashamed of their strong emotional reactions. 

But help is available, and it’s important to know that it can come from various sources. 

One key solution for managing PMS and PMDD may be a hormonal treatment that prevents ovulation. Your midwife can help you find a contraceptive that suits you. If you take ADHD medication, you and your doctor may need to adjust the dosage depending on your hormonal cycle. 

Some may also benefit from taking antidepressants during the period between ovulation and menstruation.

CBT in PMS and PMDD Management

Cognitive behavioral therapy (CBT) can also be helpful for PMS and PMDD. The goal is not to change your hormones or your sensitivity to their fluctuations but to understand your reactions and develop strategies to handle the symptoms more effectively. 

In CBT, you work on identifying triggers and risk situations that precede strong emotional outbursts. Once you recognize these, you can either try to avoid them or find ways to manage them better.

During PMS, it is common for one’s way of interpreting and perceiving situations to become more negative. 

Something that would normally not be so stressful can, during certain phases, feel like a major crisis. This can often lead to feelings of guilt or shame over one’s reactions, which in turn can amplify the negative thoughts. 

The treatment focuses on learning to identify these thoughts and test whether there are other, more reasonable ways to view the situation.

Managing Negative Thoughts

Many with PMDD also tend to stop doing things they normally enjoy during the weeks when they feel the most anxious or depressed. Unfortunately, this can lead to feeling even worse.

It can therefore be helpful to make a list of things that you typically enjoy and ensure that you follow it, even during the difficult weeks. 

Physical activity and exercise can also reduce the symptoms. So it can be useful to plan for this and perhaps get a friend to help ensure you follow through with your workouts.

Building Skills Over Time: Patience is Key

The treatment of PMS and PMDD often takes place in small steps with a psychologist. It can feel like “two steps forward and one step back”. And it’s common to forget to use the new strategies in the moment. 

Then, together with the psychologist, you review the situation to see what can help next time. 

Many also find relief by reducing stress and using techniques such as Mindfulness or relaxation.

We know managing PMS and PMDD, especially with ADHD, can feel overwhelming. However, with small steps forward it’s possible to take back control and find more balance. 

And remember, Letterlife and the Community are here to support you during each cycle!