Why Do I Feel So Angry or Depressed Before My Period? Understanding PMS vs. PMDD

Imagine this: it’s the week before your period, and suddenly you don’t recognise yourself. You snap at people you love, cry at the smallest trigger, or feel an overwhelming heaviness that makes everything in life feel harder. Then, a few days later, once your period starts, you feel like yourself again — lighter, more rational, and wondering what just happened.

If this sounds familiar, you’re not alone. Many women experience mood changes before their period. But for some, these changes are far more severe than “typical PMS.” If you’ve ever wondered why you feel so angry or depressed before your period, the answer may lie in understanding the difference between PMS and PMDD.

Mood Changes Before Your Period: What’s Normal?

Premenstrual Syndrome (PMS) is very common, affecting up to 3 in 4 women at some point in their lives. PMS can include symptoms like:

• Mild irritability or mood swings
• Bloating and fluid retention
• Food cravings
• Breast tenderness
• Fatigue

While PMS can be uncomfortable, the symptoms are usually manageable and don’t significantly disrupt daily life. Importantly, PMS symptoms typically ease once menstruation begins.

When It Feels More Than PMS

But what if your experience feels extreme? Perhaps you feel:

• Sudden rage or outbursts that shock even you
• A deep sense of hopelessness or depression
• Intense anxiety, panic attacks, or paranoia
• Thoughts of self-harm or feeling you “can’t go on”

These aren’t just inconvenient symptoms. They can disrupt relationships, work, and your overall sense of stability. Many women describe feeling like they are “two different people” — one version of themselves in the first half of the month, and another consumed by emotional chaos in the second half.

This is where Premenstrual Dysphoric Disorder (PMDD) comes in.

What Is PMDD?

PMDD, or Premenstrual Dysphoric Disorder, is a severe form of premenstrual mood disturbance that affects around 1 in 20 women.

While PMS and PMDD share some physical symptoms, PMDD is primarily marked by severe emotional and psychological changes. The key differences are:

• Severity: PMS may cause irritability, but PMDD can trigger full-blown rage, despair, or suicidal thoughts.
• Impact: PMS is inconvenient; PMDD can feel life-shattering, disrupting relationships, careers, and day-to-day functioning.
• Timing: PMDD symptoms always occur in the luteal phase (the 1–2 weeks before menstruation) and disappear once bleeding starts.

Why Does PMDD Happen?

Scientists are still exploring the exact causes, but current research suggests PMDD isn’t about having “too much” or “too little” hormone. Instead, it’s about how sensitive your brain and nervous system are to normal hormonal changes in the menstrual cycle.

• Hormones like estrogen and progesterone interact with brain chemicals such as serotonin and GABA, which regulate mood. In women with PMDD, these interactions are far more intense.
• Stress, unresolved trauma, and nervous system dysregulation can amplify symptoms, making premenstrual changes feel overwhelming.
• Genetics may also play a role, with some women more predisposed to this heightened sensitivity.

As trauma specialist Bessel van der Kolk famously said, “The body keeps the score.” For women with PMDD, the menstrual cycle can act as a monthly stress test, bringing unresolved emotional pain to the surface.

PMS vs. PMDD: How to Tell the Difference

Here’s a simple way to think about it:

• PMS: symptoms are mild to moderate, you might feel grumpy or bloated, but life goes on.
• PMDD: symptoms feel unbearable, overwhelming, or destabilising, and they return in the same pattern every month.

One of the best ways to determine which you’re experiencing is to track your symptoms. Use a diary or app to note your moods, energy levels, and physical symptoms over 2–3 cycles. If you notice a recurring pattern of severe emotional changes that lift after your period starts, it may point to PMDD.

What Can You Do If This Sounds Like You?

First and most importantly: you are not broken, and you are not alone. If your premenstrual mood swings feel unbearable, it’s worth seeking help.

Here are some supportive next steps:

• Medical support: Speak with your GP or gynaecologist. There are both medical and natural options available.  As a qualified naturopath who’s fully recovered from PMDD myself, I support women with a natural, holistic approach at www.pmddnaturopath.com
• Nutrition and lifestyle: Anti-inflammatory foods, regular movement, and adequate rest can help regulate your body’s response to hormones.
• Therapeutic support: Trauma-informed therapies such as Family Constellations, Rapid Core Healing, or somatic therapy can help calm the nervous system and reduce reactivity.
• Tracking tools: Symptom diaries or apps can provide clarity, helping you and your practitioner identify patterns and choose the best support

Final Thoughts

If you find yourself angry, depressed, or hopeless before your period, it’s worth considering that you may be dealing with more than PMS. PMDD is real, and help is available. Understanding the difference between PMS and PMDD is the first step in reclaiming peace in your cycle — and your life.

You don’t have to accept premenstrual suffering as “just part of being a woman.” With the right support, healing and stability are possible.

Photo by MART PRODUCTION