Ever notice how your negative thoughts or inner critic get particularly loud during certain times of your cycle? Those persistent negative thoughts aren’t just in your head – they’re a real phenomenon called Automatic Negative Thoughts (ANTs), and they have a fascinating relationship with PMDD.

What Are Automatic Negative Thoughts (ANTs), Anyway?

ANTs are like little mental saboteurs that show up uninvited in your mind. Just as real ants can invade your kitchen without warning, these thought patterns creep into your consciousness and can quickly multiply if left unchecked. 

These thoughts are automatic and negative in nature. They are most often directed at ourselves or those closest to us. Here’s a deeper look:

Common Types of Automatic Negative Thoughts (ANTs):

• Mind Reading: “They’re all judging me right now”
• Fortune Telling: “I just know I’m going to fail this presentation”
• Catastrophizing: “If I make one mistake, my whole career is over”
• Black and White Thinking: “If I can’t do it perfectly, there’s no point trying”
• Emotional Reasoning: “I feel like a failure, so I must be one”
• Should Statements: “I should be further along in life by now”
• Labeling: “I made a mistake, so I’m totally incompetent”
• Overgeneralization: “Nothing ever works out for me”

Examples of ANTs:

• “I’m not good enough”
• “Everyone hates me”
• “I’m always messing things up”
• “I’m a burden to others”

What makes ANTs so powerful:

They build on each other rapidly

They feel automatic and beyond your control

They often sound like your own voice of reason

They can feel deeply true in the moment

They often show up during vulnerable times

Automatic Negative Thoughts and the PMDD connection

Here’s where things get interesting. During PMDD, hormonal changes affect your brain in many surprising ways. This creates the perfect storm for negative thoughts. It’s like turning up the volume on your inner critic to maximum levels.

Studies show that during the late luteal phase (roughly 7-10 days before menstruation), those of us with PMDD commonly experience more intense negative thought patterns and repetitive worrying compared to those without PMDD. ¹ The luteal phase can trigger increased negative emotions while simultaneously reducing positive emotional experiences.²

Numerous research studies suggest this pattern is connected to differences in how certain areas of the brain – particularly those involved in managing emotions – function in people with PMDD compared to those without the condition.³ These brain differences may make those of us with PMDD more vulnerable to experiencing and getting caught in cycles of negative thoughts.

Why Your ANTs Get Worse During PMDD

It’s not just your imagination – there’s actual science behind why these negative thoughts intensify during your luteal phase:

• Hormonal fluctuations mess with your serotonin⁴,⁵
• Your brain becomes more sensitive to stress resulting in negative thoughts⁶,⁷
• An increased sensitivity in emotion processing areas of the brain⁸
• It’s more difficult to regulate your emotions during the luteal phase⁹
• Maintaining perspective feels impossible because of increased negativity bias during the luteal phase¹⁰
• Brain changes in our ability to accurately recognize facial expressions of others resulting in negative thoughts and feelings¹¹
• We more commonly experience negative depressive/irritable spirals after perceived failures¹²
• Impaired cognitive performance during the luteal phase resulting in negative thoughts about ourselves¹³

The PMDD–ANTs Loop: A Vicious Cycle

Here’s something most doctors never tell you: PMDD doesn’t just cause mood swings or irritability — it can train your brain to default to automatic negative thoughts (ANTs), again and again, month after month.

This isn’t your fault. It’s not a mindset issue. It’s a nervous system pattern.

When hormones shift during the luteal phase, your brain becomes more sensitive to emotional triggers. The stress response (hello, cortisol) is heightened, and your window of tolerance narrows. This creates the perfect storm for ANTs to thrive.

These thoughts might show up subtly at first:

• “I can’t handle this week.”
  
  
• “Everything feels too hard.”
  
  
• “I always mess things up.”
  
  

But once you start believing them, your body responds as if they’re true. Your muscles tense. Your breath shortens. Your sleep gets lighter. Your emotional threshold drops even further. And suddenly, the PMDD symptoms feel 10x louder — because now you’re not just tired or bloated… you’re also telling yourself that you’re failing.

This is the PMDD–ANTs loop.

The negative thoughts feed your symptoms, and the symptoms feed more negative thoughts. Left unchecked, this cycle can lead to panic, disconnection, hopelessness, or even suicidal ideation in severe cases.

The good news? You can interrupt the loop.

You don’t need to “think positively” or fake gratitude. But you can start by spotting the ANTs. Just noticing when they arise — without judgment — already begins to take away their power.

The practice isn’t about silencing your thoughts. It’s about disidentifying from them.

You might start asking yourself:

• Is this thought actually true?
  
  
• Is it helpful?
  
  
• Is it something I would say to someone I love?
  
  

Even small awareness shifts like this can signal safety to your brain. And when your brain feels safer, your body softens — and your cycle becomes just a little more manageable.

Taking Control: Practical Strategies That Actually Work

1. Name Your Critic
   Give that negative voice a name (I call mine “The Gremlin”). It sounds silly, but this simple act helps you recognize these thoughts aren’t really you. Access more tips to transform these thoughts in my Tame Your Inner Critic Workbook.
2. Map Your Cycle
   Understanding your patterns helps you prepare for the tough days. When you know the ANTs are coming, you can set up your defenses in advance. Get our FREE Symptom Mapping Kit.
3. Build Your Support Squad
   Having people who understand can make all the difference. Whether it’s friends, family, or a PMDD support group, don’t go through this alone. Join our PMDD community.
4. Cognitive Behavioral Therapy (CBT) Therapy Find a counselor who is trained in Cognitive Behavioral Therapy. ¹⁴

Automatic Negative Thoughts (ANTs) + PMDD: Journal Prompt Sheet

Name your thoughts. Reclaim your peace.

Use this template during your luteal phase (typically days 15–28 of your cycle) to spot and soften automatic negative thoughts (ANTs) that may arise with PMDD.You can print the following for each day or reuse this as a reflection template.

📅 Date: _______________

🩸 Cycle Day: _______________

😶‍🌫️ Mood in 1 word: _______________

1. What thought is looping in your mind right now?

Write it exactly as you’re thinking it — even if it feels irrational, dramatic, or painful.

Example: “I ruin everything,” “Nobody really cares about me,” “I’m too much,” “This will never get better.”

✎ ____________________________________________________________________
✎ ____________________________________________________________________

 2. Is this an automatic negative thought (ANT)?

Ask yourself:

• Did this thought come up quickly and automatically?
• Is it extreme or absolute (e.g., “always,” “never”)?
• Does it trigger anxiety, shame, or hopelessness?
  
  

☐ Yes
☐ Not sure
☐ No

 3. What’s the emotion behind this thought?

Choose as many as needed:

• ☐ Fear
• ☐ Shame
• ☐ Guilt
• ☐ Sadness
• ☐ Loneliness
• ☐ Anger
• ☐ Overwhelm
• ☐ Emptiness
  
  

You can also write your own:
✎ ___________________________________________________________

4. Could this thought be reframed?

Try one of these soft, realistic alternatives:

• “I’m having a hard moment — not a hard life.”
  
  
• “This feeling is temporary.”
  
  
• “I’m allowed to rest and take up space.”
  
  
• “This might not be true, even if it feels true right now.”
  
  

Write your own gentle reframe:
✎ ____________________________________________________________________

 5. What do I need right now?

This could be something physical (food, water, movement), emotional (connection, calm), or sensory (cozy blanket, fresh air, no screens).

✎ ____________________________________________________________________

Closing Thought:

What would I say to a friend who was thinking about what I just wrote above?

✎ ____________________________________________________________________
✎ ____________________________________________________________________

A Note of Hope

Remember: These thoughts can feel overwhelming, but they’re symptoms, not truths. While living with PMDD isn’t easy, understanding how it affects your thinking is the first step toward taking back control.

[If you’re experiencing thoughts of self-harm, please reach out to emergency services or your local crisis hotline immediately. You’re not alone in this.]

Citations:

1. Gao M, Qiao M, An L, Wang G, Wang J, Song C, Wei F, Yu Y, Gong T, Gao D. Brain reactivity to emotional stimuli in women with premenstrual dysphoric disorder and related personality characteristics. Aging (Albany NY). 2021 Aug 4;13(15):19529-19541. doi: 10.18632/aging.203363. Epub 2021 Aug 4. PMID: 34349039; PMCID: PMC8386568. ↩︎
2. Beddig T, Reinhard I, Ebner-Priemer U, Kuehner C. Reciprocal effects between cognitive and affective states in women with Premenstrual Dysphoric Disorder: An Ecological Momentary Assessment study. Behav Res Ther. 2020 Aug;131:103613. doi: 10.1016/j.brat.2020.103613. Epub 2020 Apr 8. PMID: 32497737. ↩︎
3. Petersen N, Ghahremani DG, Rapkin AJ, Berman SM, Liang L, London ED. Brain activation during emotion regulation in women with premenstrual dysphoric disorder. Psychol Med. 2018 Aug;48(11):1795-1802. doi: 10.1017/S0033291717003270. Epub 2017 Nov 17. PMID: 29145910; PMCID: PMC9196139. ↩︎
4. Hantsoo L, Epperson CN. Premenstrual Dysphoric Disorder: Epidemiology and Treatment. Curr Psychiatry Rep. 2015 Nov;17(11):87. doi: 10.1007/s11920-015-0628-3. PMID: 26377947; PMCID: PMC4890701. ↩︎
5. Rapkin AJ, Akopians AL. Pathophysiology of premenstrual syndrome and premenstrual dysphoric disorder. Menopause Int. 2012 Jun;18(2):52-9. doi: 10.1258/mi.2012.012014. PMID: 22611222. ↩︎
6. Beddig T, Reinhard I, Kuehner C. Stress, mood, and cortisol during daily life in women with Premenstrual Dysphoric Disorder (PMDD). Psychoneuroendocrinology. 2019 Nov;109:104372. doi: 10.1016/j.psyneuen.2019.104372. Epub 2019 Jul 23. PMID: 31357135.
   ↩︎
7. Protopopescu X, Tuescher O, Pan H, Epstein J, Root J, Chang L, Altemus M, Polanecsky M, McEwen B, Stern E, Silbersweig D. Toward a functional neuroanatomy of premenstrual dysphoric disorder. J Affect Disord. 2008; 108:87–94. 10.1016/j.jad.2007.09.015
   [DOI] [PubMed] [Google Scholar] ↩︎
8. Gingnell M, Bannbers E, Wikström J, Fredrikson M, Sundström-Poromaa I. Premenstrual dysphoric disorder and prefrontal reactivity during anticipation of emotional stimuli. Eur Neuropsychopharmacol. 2013 Nov;23(11):1474-83. doi: 10.1016/j.euroneuro.2013.08.002. Epub 2013 Aug 17. PMID: 24001875. ↩︎
9. Petersen N, Ghahremani DG, Rapkin AJ, Berman SM, Liang L, London ED. Brain activation during emotion regulation in women with premenstrual dysphoric disorder. Psychol Med. 2018 Aug;48(11):1795-1802. doi: 10.1017/S0033291717003270. Epub 2017 Nov 17. PMID: 29145910; PMCID: PMC9196139. ↩︎
10. Rubinow DR, Smith MJ, Schenkel LA, Schmidt PJ, Dancer K. Facial emotion discrimination across the menstrual cycle in women with premenstrual dysphoric disorder (PMDD) and controls. J Affect Disord. 2007 Dec;104(1-3):37-44. doi: 10.1016/j.jad.2007.01.031. Epub 2007 Mar 26. PMID: 17367867; PMCID: PMC2692989. ↩︎
11. Rubinow DR, Smith MJ, Schenkel LA, Schmidt PJ, Dancer K. Facial emotion discrimination across the menstrual cycle in women with premenstrual dysphoric disorder (PMDD) and controls. J Affect Disord. 2007 Dec;104(1-3):37-44. doi: 10.1016/j.jad.2007.01.031. Epub 2007 Mar 26. PMID: 17367867; PMCID: PMC2692989. ↩︎
12. Śliwerski A, Bielawska-Batorowicz E. Negative cognitive styles as risk factors for the occurrence of PMS and PMDD. J Reprod Infant Psychol. 2019 Jul;37(3):322-337. doi: 10.1080/02646838.2018.1543943. Epub 2018 Nov 23. PMID: 30468400. ↩︎
13. Reed SC, Levin FR, Evans SM. Changes in mood, cognitive performance and appetite in the late luteal and follicular phases of the menstrual cycle in women with and without PMDD (premenstrual dysphoric disorder). Horm Behav. 2008 Jun;54(1):185-93. doi: 10.1016/j.yhbeh.2008.02.018. Epub 2008 Mar 7. PMID: 18413151; PMCID: PMC2491904. ↩︎

Christensen AP, Oei TP. The efficacy of cognitive behaviour therapy in treating premenstrual dysphoric changes. J Affect Disord. 1995 Jan 11;33(1):57-63. doi: 10.1016/0165-0327(94)00073-i. PMID: 7714309. ↩︎