You wake up feeling bloated and crabby. Everything seems to take longer than it should. You’re not quite on the ball at work, and for some reason that makes you want to cry and throw a chair through a window at the same time. You’ve eaten three chocolate bars from the vending machine, and your anxiety and OCD symptoms are through. The. Roof.

Sound familiar? If you have OCD and get a period, it might.

For many of us who experience the sheer joy of menstruation (sarcasm), PMS is not a joke. It makes your moods go haywire, and you feel physically miserable. And once you realize what’s going on, you realize that this is just the tip of the iceberg, and the worst — the cramps and other physical discomforts of your actual period on top of all the emotional drama — is yet to come.

So it may not come as a surprise to you to know that PMS and menstruation can have a negative effect on mental illnesses, including OCD.

About half of those of us blessed with both a womb and OCD (sarcasm again) see our symptoms worsen during menstruation, menopause, or pregnancy, although some see an improvement in OCD symptoms during pregnancy.

Premenstrual dysphoric disorder could only partly explain a premenstrual exacerbation of OCD symptoms. Exacerbation of OCD could be related to reproductive events in a considerable number of patients, especially the premenstrum.

This actually answers a question I’ve had for a while. I had severe OCD symptoms (and probably mood disorder symptoms, too) for a while several years ago, and just when they were getting bad enough for me to try therapy, I snapped out of it and was fine for a couple of years. That’s when things got bad again, and I started therapy.

Looking back, that “remission” came not long after my gynecologist prescribed me birth control I could take for six months at a time without placebos, since she had noticed my anxiety and a few physical symptoms got worse right before my period.

Now I wonder if getting my hormones under control may have shaken me loose from OCD for a year or so, though it didn’t last. I definitely think switching from one form of birth control to another (the pill I was on is not a good one for people with migraines) is messing with my moods a bit right now, though my SSRI seems to have my OCD symptoms under good control.

It’s definitely something I will ask my psychiatrist about when I meet with him next week. In the meantime, if you menstruate and notice your anxiety or OCD seems worse when you’re also dealing with PMS, you may be right.


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