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A Complicated Relationship

Your body responds to how you think and feel; in effect, there’s connection between your mind and your body. If you’re depressed and anxious, your body aches too.

PMS illustrates this dynamic perfectly. Not only does premenstrual syndrome include both physical and mood symptoms, its cyclical pattern means that even as you start to feel better with the onset of your period, the knowledge that you'll experience your symptoms again in a few weeks can make you stressed, depressed, and anxious. This sets the stage for an exhausting pattern: The more you dread PMS, the worse you actually feel.

Understanding the mind-body connection in PMS is important because it will help you understand if there is something besides PMS at work. It will also help target the type of treatment. For example, if your lifestyle or personal situation is highly stressful— because work, a life change like divorce, financial problems, or other problems— treating PMS with medications may help, but relieving the source of the stress will help more.

Essential

Stressful events, as well as depression and anxiety, can cause a host of physical symptoms including appetite changes (either overeating or a loss of appetite), chest pains, constipation, diarrhea, headaches, fatigue, back pain, high blood pressure, shortness of breath, palpitations, and sexual problems.

Yet this is where it gets tricky. Doctors, often the first health-care professionals women with PMS turn to, are great at diagnosing and treating medical problems. Unfortunately, they’re not necessarily the best authorities on the psychological and social aspects, and PMS is more than a medical problem. It has a full complement of mood symptoms, some of which are better addressed by a psychologist even a psychiatrist, and it is exacerbated by lifestyle issues such poor diet and lack of exercise. Even your OB-GYN may not ultimately be the best PMS expert for you, although he or she is probably your best first point of contact when seeking help. How do you know if you should see a doctor or a psychologist? Should you go into therapy? should you join a self-help group? Maybe you should see a nutritionist to improve your diet or get involved in an exercise program instead. As you navigate your treatment options, consider which symptoms are more bothersome or painful, and let that help guide your treatment.

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