Having a mood disorder is one of the greatest risk factors for developing PMS and PMDD (which is itself characterized as a mood disorder). Women are nearly twice as likely as men to develop a mood disorder. Researchers believe that genetic, biological, hormonal, psychological, social, and interpersonal factors play a role in why women are more likely to become depressed. The fluctuations of a woman’s reproductive hormones impact mood, and mood disorders tend to present differently across genders. For example, women are more likely to suffer from depression, while men are more likely to experience mania.

PMS and PMDD expert Jean Endicott, Ph.D., of New York’s Columbia University, believes that during the premenstrual phase her cycle, a woman is more vulnerable to severe depression or the worsening of an ongoing period of depression.

The main mood disorders include:

• Major depressive disorder

• Bipolar disorder

• Seasonal affective disorder

• Schizoaffective disorder

Depression

Clinical depression, also known as major depression, is of sadness and despair so acute it disrupts an individual’s to participate in daily activities and function socially. More just a feeling of being depressed, clinical depression is diagnosis. Someone who is clinically depressed must have a loss of interest or pleasure in all daily activities or a depressed mood for at least two weeks. Depression is associated with PMS. (Chapter 8 covers depression and its PMS in more detail.)

Symptoms of clinical depression include (but are not limited to):

• Change in appetite

• Fatigue

• Marked weight gain or loss

• Feelings of overwhelming sadness, fear, or emptiness

• Anxiety

• Trouble concentrating

As noted earlier, the association between depression and very strong. Depression first hits many women when they’re thirties. This is also the time when many women first experience PMS symptoms.

Bipolar Disorders

Unlike depression with its constant and overwhelming feelings of helplessness and anxiety, bipolar disorders feature alternating episodes of mania and depression. Bipolar disorder is caused changes in a person’s brain chemistry. Women who have bipolar disorder are more likely to have PMS.

During a manic state, the person will have a severely elevated mood—high energy, talkative, and hyperactive but frequently grandiose, irritable, and belligerent. Many times, individuals with bipolar disorder will experience rapid cycling, or quick shifts, between the two extreme states, anywhere from having four episodes per year moods that cycle daily or even hourly.

Not surprisingly, there is a spectrum of bipolar disorders; some patients have the most severe symptoms, including hallucinations and delusions, while others experience hypomania, a more mild form of mania in which the individual experiences mostly feelings of euphoria. Some bipolar disorders may include mixed states (some manic symptoms along with some depressive symptoms).

Symptoms of bipolar disorder include:

• Elevated mood

• Irritability

• Racing thoughts

• Grandiose thinking

• Religiosity

• Disrupted sleep patterns

• Obsessional traits

Seasonal Affective Disorder

Seasonal affective disorder, or SAD, is a type of depression brought on by a deficiency of sunlight. Having SAD is a risk factor for PMS. As the name suggests, SAD is seasonal, occurring during fall and winter. The disorder affects up to 10 million people each year— 75 to 80 percent of whom are women thirty and older. Some symptoms of PMS are similar to those of SAD, including depression, fatigue, trouble concentrating, and an increased appetite, especially for carbohydrates.

So what, exactly, is the connection between a lack of sunshine depression and PMS? In one word: serotonin. Sunlight helps the produce serotonin, and during the shorter, cloudier days of winter, serotonin levels fall, while levels of the sleep hormone rise. As a result, those with SAD feel depressed, tired, and Women with SAD can also feel more intense PMS or PMDD symptoms.

Postpartum Depression

Postpartum depression affects between 10 and 15 percent mothers. It’s caused by the rapid and severe hormonal changes take place just after childbirth. Postpartum depression, or PPD, severe form of the “baby blues” that commonly affects many moms. It can occur anytime in the first six months after childbirth. untreated, PPD may last up to a year.

There is research that shows a link between the PMS and PPD. In fact, one of the risk factors for PPD is having severe PMS. According to the American Psychiatric Association, typical PPD symptoms include a loss of interest in life, less motivation to do things, a loss of appetite, feeling restless, irritable, or anxious, and in severe cases, being afraid of harming yourself or the baby.

Schizoaffective Disorder

This psychiatric illness combines the symptoms of schizophrenia and the symptoms of a mood disorder. As with other mood disorders, it is a risk factor for PMS. Psychotic symptoms include delusions, hallucinations, and disorganized speech (for example, incoherence), while affective symptoms include depression or mania. A person with schizoaffective disorder suffers from depression or bipolar disorder but also experiences psychotic symptoms without prominent mood symptoms for at least two weeks. More women than men are diagnosed with schizoaffective disorder, and the illness tends begin between the ages of sixteen and thirty.

Researchers are relatively certain that schizoaffective disorder involves a chemical imbalance of neurotransmitters, and stress seems to serve as a trigger, but they’re not sure what causes this disorder. Some argue that schizoaffective disorder is linked to schizophrenia, while others link it to mood disorders. However, both genetic and environmental factors are thought to be involved.

Why You Shouldn’t Worry

Having PMS does not mean you have a mood disorder. While mood disorders are a PMS risk factor, only a very small number women are affected. Remember, only 3 to 8 percent of all women with PMS symptoms have PMDD, which is considered a mood disorder, and fewer than half of a percent of this small number have different mood disorder, such as depression, that is misdiagnosed as PMDD. So if you’re feeling irritable and upset, it’s far more likely that you have PMS than a serious mental illness like depression or an anxiety disorder.