Mood Swings: A Panic Attack

Modern biology has given countless magnitudes to the improved and impeccable understanding of human physiology establishing the fact that reproductive physiology is not only multifarious but more byzantine in females. Role of hormones in the physiological processes can’t be discounted as they take charge over a number of processes for instance from premenstrual syndrome (PMS) to perimenopause and finally menopause in females. Hormonal ups and downs sometimes bring mood alterations, anxiety and behavioural outbursts in a woman. Hormones controlling premenstrual syndrome (PMS) not only affect mood, body weight, food preferences but also the sexual desire of a woman. Many women easily accept this unexpected hormonal change but for others it is an appalling nightmare.

Christiane Northrup, MD and author of The Wisdom of Menopause and Women’s Bodies Women’s Wisdom elucidates that a high proportion of women are affected by hormonal fluctuations and sometimes the condition worsens so bad as they lose control over their lives. She also advocates that hormonal influx evokes by dieting, stress, anxiety, depression, exercise altering female physiological cycles but the condition can be kept under check by picking up the opportunities to feel better. Sometimes a smallest change can bring a huge difference. Just like Northrup, other top women psychologists and physicians help them to escape from the hormonal dreadfulness of mood swings and menstruation.

Premenstrual syndrome (PMS)

Steven R. Goldstein, MD, professor of obstetrics and gynecology at NYU Medical Center in New York city says anything happening right before period for example, cramps, diarrhea and breast tenderness can be a premenstrual syndrome (PMS) but for majority of women mood issues define PMS including symptoms like mild to moderate depression, anxiety, mood swings, melancholia, sensitivity, full blown anger and even self-hatred. Christiane Northrup also comments that premenstrual women are even apt to perceive positive comments in a negative way. Experts clarify that mood swings and other PMS symptoms never mean abnormal hormonal levels. Nanette Santoro, MD, Director of Division of Reproductive Endocrinology at Montefiore Medical Center and Albert Einstein College of Medicine in New York City strongly emphasizes that every study done on premenstrual syndrome of women clearly specifies that hormonal level remains normal. However, some researchers believe that certain hormone metabolites in brain or some women metabolize hormone differently are the root cause of mood swings but no one can tell whether it is true or not as more study is required.

Menstrual Cycle and Mood Swings

Ovaries episodically secrete hormones into the blood stream answerable for alteration of thinking and behaviour of a girl. A review of 47 studies as well as Sarah Romans, MB, MD, Department of Psychological Medicine, University of Otago, Wellington, New Zealand advocate that hormone-mediated mood swings are not inevitably restricted to a few days before period but may even continue till commencement of period. Many women experience mood swings at some point while most are predisposed during their menstrual cycle. Menstrual cycle is often linked with mood swings as monthly hormonal fluctuations affect serotonin levels in brain causing a marked effect on female’s emotional stability. Mood swings are difficult to handle as they are impulsive as well as inconstant in rigorousness. Mood can also be linked with lifestyle and stressful circumstances and changes in the emotional state of a woman can happen without any reason where she is unable to understand why she is sad or angry.

Causes of Mood Swings

Although researchers fail to provide the precise reason behind PMS but rise and fall in hormonal level can be a cause. Some studies suggest that hormonal levels remain unaffected while others acclaim a general increase in hormonal level. PMS occurs before the commencement of menstrual cycle bringing changes in mood vacillating from depression to anger to rage. Majority of females suffer from this emotional instability but not all. Estrogen brings these atrocious changes as in first stages of menstruation estrogen levels rise producing good feelings making a girl feel good but the levels of endorphins, serotonins and encephalins also increase. During the menstruation cycle female’s body prepares her for pregnancy so brain chemicals are also secreted at elevated levels and failure of pregnancy brings an abrupt declination in level of these chemicals causing mood alterations or mood swings.

Carol Livoti, MD, New York City gynecologist and fellow of the American College of Obstetricians and Gynecologists enlightens that PMS occurs during the last (luteal) phase of menstrual cycle starting after ovulation 14-28 days of a women’s monthly cycle and once menstruation starts mood swings withdraw routinely. External stressors for example, a divorce or a loss of job are also responsible for mood alterations. Lower serotonin levels bring depression, irritability and carbohydrate cravings. Some pre-existing conditions like lupus, sleeping problems like insomnia and sleep apnea can also alter behaviour. Daily stress and fatigue may also cause emotional instability. Alcohol, caffeine and other stimulants like sugar can also bring about changes in emotional state.

Symptoms

When estrogen production is high and uterine lining is increasing women can experience headache, cramps, bloating, cravings, sore breasts and overall tension. These symptoms can promote amount and intensity of mood swings during period and most of these symptoms clinch irritability, anger, depression, crying, over-sensitivity, nervousness and anxiety with alternating sadness and rage.

How to overcome

Changing lifestyle can be a remedy against PMS for some females however, in other cases medication substantiates more success. Herbal, dietary supplements, medicines and other natural remedies are now a days available to fight mood fluctuations. Essential fatty acids are key precursors for keeping the mood in a balanced state during menstrual cycle.

Vitamins, Diet and Supplements

Flaxseeds provide essential fatty acids for a balanced hormonal level for keeping mood alterations under control. Dairy products, soya yoghurt, miso, wheat germ, brown rice, nuts, chickpea, lentils and other beans also fight hormonal imbalance. Vitamin B and E are effective antioxidants for tracking hormonal level and emotional state. Vitamins C, B6, magnesium and zinc also have the same function. Milk is an outstanding source of calcium effective against emotional instability. A double-blind clinical trial conducted among college women with PMS in 2009 indicates women supplemented with 500 mgs of calcium twice a day suffered less depression and fatigue than those who didn’t. Mayo clinic recommends 1200 mgs of calcium intake every day for women. Livoti also recommends that plenty of calcium can help to overcome mood changes related to PMS.

Vegetables especially peppers, Brussels sprouts, cantaloupe and cranberries are effective over mood alterations. Good low glycemic carbohydrate increases serotonin levels and increase positive emotions during menstrual cycle. Consumption of small meals throughout the day rather than taking two or three heavy meals during a day also refrain PMS symptoms. A large meal loaded with high percentage of carbohydrates can cause sugar swings worsening PMS. Livoti further explains that low blood sugar levels can result in crying spells and irritability in women with PMS six small meals must be taken to keep a balanced blood sugar level.

Avoiding coffee and other caffeinated drinks for at least two weeks prior to period can make a difference in mood as caffeine increases anxiety, nervousness and insomnia. Staying away from alcohol can be helpful as alcohol acts as a depressant. Keeping a distance from candies, soda and other sugary foods especially a week before period can help to lessen PMS symptoms. Leading nutritionist Neha Chandna says that due to hormonal changes females tend to crave for sweets and they can taste a little but over consumption of sweets and chocolates can be disastrous so instead of jumping towards sugary items it is beneficial to look for naturally available healthy sweet foods like dates and jaggery. Consumption of large amount of fiber filled foods like salads, fruits and nuts also stabilize blood sugar levels. A woman must take a balanced diet to overcome hormonal changes and blood loss by eating foods from all groups maintaining iron level to escape anemia.

Herbal Remedies

Numerous herbal remedies are available to fight mood swings. St. John’s Wort is a very common herb used for treating depression. Vervain tea is used as an anti-anxiety serum which relaxes nervous system and controls mood swings. Ginger, raspberry, black cohosh, dandelion herbs are also recommended for restoring hormonal balance and emotional setback. Chaste tree berry ( Agnus castus) is also used but can be precarious especially if family history carries ovarian cysts and is available in the form of tablets. Other herbs used to fight mood changes include chamomile, fennel, birch leaf, dong quai, ginkgo, raspberry leaf and lemon balm.

Exercise

Physical activity mends mood changes and overcomes depression. Studies indicate that endorphins (feel good brain chemicals) are released during exercise helping to encounter bad mood triggering PMS symptoms. Livoti says exercise boosts energy and helps to fight cramps and bloating. Aerobic exercise like walking, running, bicycling or swimming are also effective. ‘Just Breathe’ is a very common advice during irritation. Studies have proven that breathing deeply and meditation have a control over emotions. It is advisable to sit in a comfortable place by closing the eyes and breathing deeply. Holding the breath for five counts and breathing out just for five minutes every day makes a great difference. Amulya R., a leading yoga expert says exhaling action of breath when extended activates parasympathetic nervous system which is the counterpart of the sympathetic nervous system bringing the body into the ‘rest mode’. The sympathetic nervous system prepares body for ‘fight or flight’ and hence, by activating parasympathetic nervous system one can enjoy the relaxed state. Getting adequate amount of sleep minimum of 8 hours also keeps emotions under check Massage or even water aerobics can also be tried.

Stress Management

Stress makes PMS symptoms worse. Medication, deep breathing, yoga and individual or group therapy is often effective to beat PMS. Antidepressants better known as the selective serotonin reuptake inhibitors (SSRIs) change serotonin levels in brain and are effective against PMS symptoms and premenstrual dysphoric disorder (PMDD). The U.S. Food and Drug Administration have approved three medicines namely, Zoloft (sertraline), Prozac or Sarafem (fluoxetine) and Paxil CR (paroxetine) for treating PMDD. ‘PMS Escape’ is effective over a carbohydrate drink and Pamprin is more effective for PMS than Midol. Tylenol and NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) reduce pain during period reliving mood fluctuations. L-tryptophan increases serotonin levels. Birth control medication prevents buildup of hormones and shedding of uterine lining but this is only an option for women lacking the desire to get pregnant.

Premenstrual Dysphoric Disorder (PMDD)

Sometimes if a woman is experiencing intense emotional mood bursts there is a possibility of Premenstrual dysphoric disorder (PMDD) and a physician or an alternative remedy must be tried out as intense panic attacks, bad depressions, suicide trials, anger may persist longer than normal. A Mayo Clinic study defines PMDD as a severe form of PMS responsible for extreme mood shifts disrupting personal and professional life of a female. About 30% of the menstruating females have PMS and up to 8% of them have PMDD but the exact reason behind PMDD is still unclear.

Premenstrual dysphoric disorder (PMDD) can be cured by using antidepressants especially the selective serotonin reuptake inhibitors (SSRIs) like fluoxetine and sertraline as they reduce emotional symptoms, fatigue, food cravings and sleep problems. Birth control pills stop ovulation and stabilize hormonal ups and downs but a physician must be consulted first prior to their usage. Calcium, Vitamin B-6, magnesium and L-tryptophan also may also be tried after a physician’s advice. Chaste berry can be an option in PMDD but more research is required. Regular exercise, minimum uptake of caffeine, eating carbohydrates in small more frequent meals can keep a control over mood fluctuations.

Mood swings are a just a hormonal breakthrough happening in the lives of women so they should not be afraid as they are strong enough to overcome any situation. Slight alertness and a minor change in life style can bring revolution making females happier ever after. Dear Ladies, you are victors not victims so don’t be afraid of mood swings, you can overcome and succeed. No need to worry, mood swings are in control.