the Connection Between Seasonal Depression and PMDD
Seasonal Affective Disorder (SAD) and Premenstrual Dysphoric Disorder (PMDD) can create a challenging combination during darker months. Research shows that 46% of individuals with SAD also experience PMDD, making this overlap significant for many.1,2,3 Let’s explore how seasonal depression and PMDD interact and what you can do to manage symptoms effectively.
What is Seasonal Affective Disorder?
Seasonal Affective Disorder is a type of major depressive disorder that occurs in a seasonal pattern. To be diagnosed with SAD, you must experience depressive episodes during specific seasons for at least two years, with more seasons of depression than seasons without depression over your lifetime.4 While SAD can occur in the summer season, it most commonly affects people during the darker, colder months of fall and winter.
Common symptoms include:
- Feeling sad or depressed
- Loss of interest in activities
- Changes in appetite (typically increased in winter SAD)
- Changes in sleep patterns (typically increased need for sleep)
- Fatigue
- Difficulty thinking and concentrating
- Reduced libido
The SAD-PMDD Connection
When seasonal depression and PMDD coincide, the luteal phase (10-14 days before menstruation) during winter months can be particularly challenging. Think of it as experiencing a “double winter” – the natural decrease in energy and mood from seasonal changes combined with premenstrual symptoms can intensify both conditions
.
Understanding Your Body’s Natural Rhythms
It’s crucial to recognize that our bodies aren’t designed to maintain the same energy levels year-round or throughout our menstrual cycle. We have two primary biological rhythms at play:
- Circadian Rhythm (24-hour cycle)
- Infradian Rhythm (monthly menstrual cycle)
These rhythms naturally affect our energy, mood, and overall well-being. Expecting to feel the same every day sets unrealistic expectations and can lead to frustration.
The Role of Light
Light plays a crucial role in managing both seasonal depression and PMDD.5 Here’s why:
- The sun is an essential nutrient that triggers the production of mood-boosting endorphins
- Morning sunlight exposure helps regulate our circadian rhythm6
- UVB rays are crucial for vitamin D production
- Natural light exposure can help improve sleep quality
- Increased nighttime light exposure was associated with higher risks of several psychiatric conditions, including depression, anxiety, PTSD, psychosis, bipolar disorder, and self-harm behaviors.7
Research shows that women with PMDD are more sensitive to nighttime light than women without PMDD, especially during certain phases of their menstrual cycle.8 This suggests that managing light exposure is particularly important for those with both conditions.
Natural Management Strategies
Here are evidence-based approaches for managing the combination of seasonal depression and PMDD:
1. Optimize Light Exposure
- Get outside within an hour of waking for natural morning light9
- Spend time outdoors during daylight hours, even on cloudy days
- Use a red and NIR light therapy device. I recommend starting with this one because it is portable.
- Consider using circadian-supportive lighting in your home
- Reduce blue light exposure in the evening by dimming lights or putting screen filters on your devices.
- Wear blue light blockers when on screens especially in the morning and evening. I use these. Code HERMOODMENTOR will save you $ on your order if you decide to try them!
2. Support Your Circadian Rhythm
- Maintain a consistent sleep-wake schedule10,11
- Align meal timing with natural light cycles
- Create an evening routine that signals rest to your body
3. Focus on Nutrition
- Emphasize seasonal, local foods
- Ensure adequate vitamin D through food sources and appropriate supplementation12
- Pay attention to mineral balance, especially electrolytes. Find my SAD supplement protocol here. Only available for US residents-sorry!
4. Movement and Cold Exposure
- Regular exercise, particularly during daylight hours
- Consider appropriate cold exposure especially if you have a an uncoupled mitochondrial haplotype13,14
- Practice gentle movement during more sensitive phases
Access more Support
While lifestyle modifications can help significantly, working with a practitioner who understand both SAD and PMDD is important. Consider:
- Getting comprehensive blood work to check 25-Hydroxy Vitamin D and mineral levels15
- Working with a provider who can help interpret results from a functional medicine perspective. HI, THAT’S ME!
- Tracking symptoms to identify patterns and triggers
Join our FREE PMDD Community for:
- Full SAD & PMDD training
- Downloadable resources
- Support from others who get it
- Expert guidance & protocols
Find us at @hermoodmentor for more education + resources.
Remember
Managing SAD and PMDD isn’t about maintaining the same energy levels year-round – it’s about working with your body’s natural rhythms while providing the support needed to minimize symptom severity. Be patient with yourself as you implement changes, and remember that what works best may vary from person to person.
Both SAD and PMDD are real, biological conditions that deserve attention and care. By understanding how they interact and implementing appropriate support strategies, you can better manage symptoms and maintain better well-being throughout the changing seasons.
[Disclaimer: This information is for educational purposes only and should not replace medical advice. Always consult with healthcare providers about your specific situation.]
- Praschak-Rieder, N., Willeit, M., Neumeister, A., Hilger, E., Stastny, J., Thierry, N., Lenzinger, E., & Kasper, S. (2001). Prevalence of premenstrual dysphoric disorder in female patients with seasonal affective disorder. Journal of Affective Disorders, 63(1–3), 239–242. https://doi.org/10.1016/S0165-0327(00)00176-2 ↩︎
- Portella AT, Haaga DA, Rohan KJ. The association between seasonal and premenstrual symptoms is continuous and is not fully accounted for by depressive symptoms. J Nerv Ment Dis. 2006 Nov;194(11):833-7. doi: 10.1097/01.nmd.0000244488.17025.0e. PMID: 17102707. ↩︎
- Maskall DD, Lam RW, Misri S, Carter D, Kuan AJ, Yatham LN, Zis AP. Seasonality of symptoms in women with late luteal phase dysphoric disorder. Am J Psychiatry. 1997 Oct;154(10):1436-41. doi: 10.1176/ajp.154.10.1436. PMID: 9326828. ↩︎
- Melrose S. Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depress Res Treat. 2015;2015:178564. doi: 10.1155/2015/178564. Epub 2015 Nov 25. PMID: 26688752; PMCID: PMC4673349. ↩︎
- Dollish HK, Tsyglakova M, McClung CA. Circadian rhythms and mood disorders: Time to see the light. Neuron. 2024 Jan 3;112(1):25-40. doi: 10.1016/j.neuron.2023.09.023. Epub 2023 Oct 18. PMID: 37858331; PMCID: PMC10842077. ↩︎
- Lam RW, Carter D, Misri S, Kuan AJ, Yatham LN, Zis AP. A controlled study of light therapy in women with late luteal phase dysphoric disorder. Psychiatry Res. 1999 Jun 30;86(3):185-92. doi: 10.1016/s0165-1781(99)00043-8. PMID: 10482337. ↩︎
- Burns, A.C., Windred, D.P., Rutter, M.K. et al. Day and night light exposure are associated with psychiatric disorders: an objective light study in >85,000 people. Nat. Mental Health1, 853–862 (2023). https://doi.org/10.1038/s44220-023-00135-8 ↩︎
- Parry BL, Meliska CJ, Sorenson DL, Lopez A, Martínez LF, Hauger RL, Elliott JA. Increased sensitivity to light-induced melatonin suppression in premenstrual dysphoric disorder. Chronobiol Int. 2010 Aug;27(7):1438-53. doi: 10.3109/07420528.2010.503331. PMID: 20795885; PMCID: PMC3038841. ↩︎
- Parry BL, Meliska CJ, Martinez LF, Lopez AM, Sorenson DL, Dawes SE, Elliott JA, Hauger RL. A 1-week sleep and light intervention improves mood in premenstrual dysphoric disorder in association with shifting melatonin offset time earlier. Arch Womens Ment Health. 2023 Feb;26(1):29-37. doi: 10.1007/s00737-022-01283-z. Epub 2022 Dec 15. PMID: 36520251; PMCID: PMC9908689. ↩︎
- Meers JM, Nowakowski S. Sleep, premenstrual mood disorder, and women’s health. Curr Opin Psychol. 2020 Aug;34:43-49. doi: 10.1016/j.copsyc.2019.09.003. Epub 2019 Sep 23. PMID: 31610482. ↩︎
- Baker FC, Driver HS. Circadian rhythms, sleep, and the menstrual cycle. Sleep Med. 2007 Sep;8(6):613-22. doi: 10.1016/j.sleep.2006.09.011. Epub 2007 Mar 26. PMID: 17383933. ↩︎
- Slominski AT, Chaiprasongsuk A, Janjetovic Z, Kim TK, Stefan J, Slominski RM, Hanumanthu VS, Raman C, Qayyum S, Song Y, Song Y, Panich U, Crossman DK, Athar M, Holick MF, Jetten AM, Zmijewski MA, Zmijewski J, Tuckey RC. Photoprotective Properties of Vitamin D and Lumisterol Hydroxyderivatives. Cell Biochem Biophys. 2020 Jun;78(2):165-180. doi: 10.1007/s12013-020-00913-6. Epub 2020 May 22. PMID: 32441029; PMCID: PMC7347247. ↩︎
- Wallace DC. Mitochondrial DNA variation in human radiation and disease. Cell. 2015 Sep 24;163(1):33-8. doi: 10.1016/j.cell.2015.08.067. PMID: 26406369; PMCID: PMC4743751. ↩︎
- Rymaszewska J, Lion KM, Pawlik-Sobecka L, Pawłowski T, Szcześniak D, Trypka E, Rymaszewska JE, Zabłocka A, Stanczykiewicz B. Efficacy of the Whole-Body Cryotherapy as Add-on Therapy to Pharmacological Treatment of Depression-A Randomized Controlled Trial. Front Psychiatry. 2020 Jun 9;11:522. doi: 10.3389/fpsyt.2020.00522. PMID: 32581890; PMCID: PMC7296110. ↩︎
- Ahmed A, Saleem MA, Saeed F, Afzaal M, Imran A, Akram S, Hussain M, Khan A, Al Jbawi E. A comprehensive review on the impact of calcium and vitamin D insufficiency and allied metabolic disorders in females. Food Sci Nutr. 2023 Jul 26;11(9):5004-5027. doi: 10.1002/fsn3.3519. PMID: 37701195; PMCID: PMC10494632. ↩︎