You know the feeling: sweaty palms, knots in your stomach, of being woozy or lightheaded. Anxiety is common—it caused by social situations, stress, medical conditions, or PMS. brain and nervous system regulate anxiety, and any disturbances, such as the complex interactions of hormonal fluctuations, chemicals, and behaviors that characterize the premenstrual can increase a woman’s anxiety levels.

However, if you suffer from unrelenting and intense anxiety, kind that causes you to withdraw emotionally or prevents you participating in normal day-to-day activities, you may suffer anxiety disorder.

Anxiety disorders can have multiple causes, including trauma, abuse, brain chemistry, low self-esteem, and even life experiences such as poverty. PMS can worsen the symptoms an anxiety disorder. Talk to your doctor if you suspect you have an anxiety disorder.


Anxiety is a sense of apprehension or unease, often combined with fear and worry accompanied by physical sensations such as heart palpitations, chest pain, and shortness of breath. It can either be acute, with brief or intermittent episodes, or persistent and chronic. Acute anxiety can last for several hours or weeks.

The physical symptoms of anxiety include:

  • Rapid or irregular heartbeat

  • Nausea or a feeling of butterflies in the stomach

  • Sweating

  • Feeling cold or clammy

  • Diarrhea, irritable bowel syndrome

  • Headaches

  • Dizziness or feeling lightheaded

  • Shortness of breath

  • Shaking, trembling, or twitching

  • Insomnia

  • Hot flashes or chills

  • Rubbery legs

  • Tingling in fingers or toes

    Cognitive symptoms include:

  • Fearfulness

  • Worry

  • Panic

  • Dread

  • Obsession

  • Compulsion

  • Nervousness

  • Irritation

  • Isolation from others

  • Feeling intensely self-conscious or insecure

  • Having a strong desire to escape

What Causes Anxiety?

Biology, genetics, and environment determine how people respond to stress. Anxiety is thought to be caused by a deficiency in serotonin (which modulates anxiety), and some people's genes simply make them more vulnerable to anxiety than others. In 1997, German scientists discovered there are variants in the gene that transports serotonin: one variant leads to more serotonin; the other variant leads to less. People whose genes make less serotonin are likelier to be anxious. Even with biology and genetics in play, environment plays a key role— people growing up in stressful circumstances, such as abuse or poverty, are more vulnerable to anxiety disorders, as are people who do not have self-confidence or who lack certain coping skills.


Anxiety also has medical causes, which must be considered before a person can be diagnosed with an anxiety disorder. Two of the most frequently cited medical causes of anxiety are hyperthyroidism and Cushing's disease.

Anxiety Disorders

Anxiety during the premenstrual phase may be related to PMS, or it may be caused by a separate anxiety disorder. It's important to discern whether your anxious feelings are indeed PMS-related or if you need treatment for a specific disorder. There are five major types of anxiety disorders: generalized anxiety disorder (GAD), social anxiety disorder, panic attack disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). According to the National Institute of Mental Health, these disorders affect about 40 million people, age eighteen and older, the majority of them women.

Anxiety disorders combine physical and cognitive symptoms that can be aggravated by caffeine, drugs, or even over-the-counter cold medications. These disorders are usually treated with prescription medication, therapy, or both.

GAD: Constant Worry and Tension

Generalized anxiety disorder (GAD) is just one of the several anxiety disorders that may be confused with PMS-related anxiety. More than 6 million people in the United States have generalized anxiety disorder in any given year, and it usually affects more women than men. A person with GAD worries excessively, for periods up to six months or more, for no discernible reason and has symptoms such as restlessness, fatigue, irritability, and muscle tension.

Because this anxiety is not related to a particular traumatic event (as it is in PTSD) or marked by phobias or rituals, some women who believe they suffer from severe PMS-related anxiety may actually have generalized anxiety disorder.

The National Institute of Mental Health has a list of statements help determine if you suffer from generalized anxiety disorder. If any of these statements applies to you over the past six months, you may have GAD.

  • I never stop worrying about things big and small.

  • I have headaches and other aches and pains for no reason.

  • I am often tense and have trouble relaxing.

  • I have trouble keeping my mind on one thing.

  • I get crabby or grouchy.

  • I have trouble falling asleep or staying asleep.

  • I sweat and have hot flashes.

  • I sometimes have a lump in my throat or feel like I need throw up when I am worried.


GAD can start in childhood, adolescence, or adulthood, but it first seems to strike women when they are in their twenties.

Social Anxiety Disorder

Many women with PMS are anxious about social situations, relatively few will have social anxiety disorder. A person with anxiety disorder worries about being embarrassed in public, this condition goes beyond acute embarrassment, the kind you want the floor to swallow you up. Social anxiety disorder restrict a person’s life by making it impossible to participate situations or maintain normal relationships. People with this worry about interactions others take for granted, such as:

  • Being in a crowd

  • Attending a party

  • Eating and drinking in front of others

  • Being at work

  • Doing an activity in front of others, such as purchasing at a store

  • Shaking hands

  • Being judged or evaluated by others

Social anxiety disorder, like other anxiety disorders, caused by chemical disturbances in the brain or may be genetic. study by Harvard researcher Jerome Kagan, Ph.D., found that shy infants have a higher-than-normal chance of developing anxiety disorder as adolescents.

Panic Attacks/Panic Disorder

PMS-related anxiety can be severe, but unless you have panic disorder, you may not suffer the intense and often terrifying panic attacks that are symptoms of some anxiety disorders. Panic attacks are recurrent episodes of anxiety in which the person experiences chest pains, rapid breathing, dizziness, and tingling in fingers or toes and other physical symptoms. People with panic disorder develop a phobia of having panic attacks, which may lead them to avoid the situations and circumstances that they associate with the attacks, such as enclosed places.


According to the National Institute of Mental Health, panic disorder affects about 2.7 percent of people age eighteen and older in any given year. Panic attacks can be terrifying and can also lead to other complications, such as depression, phobias, or substance abuse.

Panic attacks can occur without warning; many people initially mistake a panic attack for a heart attack. There are three different types of panic attacks: spontaneous, specific, and situational. Spontaneous attacks come at any time regardless of the place or what the person is doing. Specific attacks are those related to specific feared situations or places, such as a public speaking engagement. Situational attacks are those in which a person is predisposed to have an attack in a certain situation or place even though they are not afraid of that particular place or situation. For example, a woman might be predisposed to having panic attacks in elevators, even though she not actually afraid of elevators or enclosed places.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder can be readily distinguished from PMS-related anxiety because it is brought on by a trauma of some kind, such as a serious accident, personal assaults such as rape, military combat, or terrorism incidents. People suffering from PTSD can have flashbacks of the traumatic event, have trouble sleeping, and feel isolated and detached; the condition frequently leads to problems in the person’s personal life and substance abuse.

Obsessive-Compulsive Disorder

Most women who experience anxious feelings during PMS do not have the intrusive thoughts and compulsions that characterize obsessive-compulsive disorder. OCD is a condition in which a person experiences disturbing, unwanted thoughts and impulses to perform rituals (such as hand washing, counting, or cleaning) as a way to stop those thoughts. More than 3 million people have OCD, and it tends to run in families.

Anxiety Treatments

Anxiety disorders require medical attention and treatment. severe, PMS-induced anxiety can be managed by several strategies:

  • Relax. Remove the stressors in your everyday life.

  • Avoid caffeine.

  • Visualize calming thoughts.

  • Reduce noise. Turning down the television and stereo have a calming effect.

  • Exercise. This will help burn off pent-up energy and edge off your anxiety.

The three main ways of treating more complex anxiety disorders include cognitive therapy, behavioral therapy, and medication. therapy helps identify the triggers of anxiety so that the can remove them from his or her life. Behavioral therapy gradually exposes the person to the causes of anxiety in a controlled It can also include using relaxation therapy to calm the Finally, medications may include antianxiety medication, antidepressants, or beta-blockers, which regulate heartbeat.

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