I’ve come to realize that once a month for about a week’s time I become very depressed. It always falls in line with my menstrual cycle but is much stronger than your regular “PMS.”

During these times I have difficulty concentrating, find myself crying constantly for up to an hour, become very very angry for minimal reasons, have rather acute acne, and have very negative thoughts (of worthlessness, thinking that I’m ugly/stupid/worthless, etc.). Sometimes I injure myself (not cutting – slapping mainly) and/or think about ending my life.

I think this has been a problem for me for many years, but now I think it’s actually interfering with my ability to work (maybe it did before but I just didn’t notice).

I guess there are two problems here: one, something happens to me physically and two, I have very negative thoughts…I would like to know what this might be classified as and what I can do to help myself…I’m worried that it will get worse.

A: You need to see your doctor for a referral to a psychiatrist who has expertise with women’s issues. The symptoms you are reporting are consistent with a diagnosis of Premenstrual Dysphoric Disorder. Feeling depressed and irritable, having self-deprecating thoughts, and not being able to concentrate are all characteristics of this disorder. Often the symptoms become significant enough to interfere with one’s ability to work or to participate in usual social activities. Please get this checked out. If this is what is going on, there is treatment that can give you relief.

I wish you well.
Dr. Marie