Diagnosis
The diagnosis of a premenstrual syndrome is often made through diaries. Women should write down over a few weeks when they have their period and when the symptoms occur. What can be signs of depression? A diagnosis of depression is usually made by a psychiatrist and the diagnosis is made through interviews and standardized questionnaires. Particularly in the combination of a premenstrual syndrome and a depressive episode, the diagnosis is not a physical finding and cannot be clarified with laboratory values or X-rays, but is based almost exclusively on the stories of the people affected.
Therapy
The treatment of premenstrual syndrome with depressive episodes depends on the extent of the symptoms. At first, an attempt is usually made to control the symptoms with relaxation exercises, exercise and a balanced diet. If this attempt fails, there is the possibility of hormonal treatment.
Hormonal contraceptives are used to prevent ovulation and provide the body with a constant hormone dose. In this way, the hormone fluctuations that are often the cause of ovulation can be prevented and the symptoms should decrease. In this case, the pill should be taken permanently and without a break.
Medication can also be used directly to treat certain symptoms. Commercially available painkillers, such as ibuprofen or paracetamol, can help to relieve the pain. Diuretics can be prescribed for water retention.
A combination therapy of psychotherapy and medication is usually used to combat depressive moods. Mood-lifting agents such as sertraline or citalopram can be used. However, this is only used if the symptoms cannot be combated in any other way, as these preparations are associated with many side effects.
Natural St. John’s wort also helps against mild depressive moods. This has fewer side effects, but not none at all.The therapies should be discussed together with the gynecologist and psychiatrist in charge. You can find more information about the pill here.
In cases of severe depressive moods associated with premenstrual syndrome, drug therapy may be necessary. In this case, antidepressants from the group of selective serotonin reuptake inhibitors can be used. These include the preparations citalopram, sertraline and paroxetine. Since antidepressants are drugs with many side effects, they should only be used if all other therapy options have not brought about an improvement in the symptoms and the symptoms have a significant limitation in everyday life.
