Anxiety, Depression, and PMS: Why Timing Matters

I’ve worked with many young women who believed they had two separate problems.

Anxiety.

Depression.

And then “bad PMS.”

But what if those experiences are more connected than we realize?

A recent study of 624 female university students found that higher levels of anxiety and depression were strongly associated with more severe PMS symptoms. Even after accounting for other factors, anxiety and depression remained significant predictors of PMS severity. The authors suggest that mental health screening should be a routine part of PMS care.

This doesn’t mean anxiety or depression cause PMS, and it doesn’t mean PMS is “all in your head.”

It highlights something many clinicians already see in practice: mental health and menstrual health influence one another, and treating them as separate issues can leave important pieces of the picture unexplored.

For therapists, this might mean asking a few additional questions:

Do your mood symptoms change across your menstrual cycle?

Are there certain weeks each month that feel noticeably harder?

Have you ever tracked your symptoms over time?

These simple conversations can help identify patterns that clients may never have noticed themselves.

When we understand when symptoms occur, we’re often in a much better position to understand why they’re happening and how to support them. Women’s mental health deserves a more integrated approach.

Link to the study: https://link.springer.com/article/10.1186/s12888-025-07250-z