PMS: A Natural Threat to Sobriety

By Kristen Rybandt 09/15/14

I remember slamming things around the kitchen one night and feeling like I’d lost my mind. I was angry about something so minor, I literally can’t remember what it was and I don’t know that I knew then either.


Depending on your take, PMS may seem like a running joke, a quasi-scam. Maybe you see it as a treatable or at least manageable condition affecting millions of women every month. Maybe you don’t think about it much at all, which is where I was until a few years ago. Now I see it as a monthly threat to my sobriety until I recognize it for what it is: powerful but temporary.

I used to brag I didn’t get PMS. It’s more likely that I self-medicated every month by drinking through the worst of it. When I got sober and started experiencing sudden shifts in mood, I didn’t notice that it happened every month with almost clockwork regularity and thought something was wrong with me.

My normally sunny outlook clouded over. I felt morose, irritable, hopeless. It reminded me a lot of how I felt in my later drinking days, so naturally I questioned why I didn’t at least get to drink. For months I woke up roughly every 28 days and white knuckled through the day without questioning why my life suddenly sucked, so complete was the transformation. The change would come on so suddenly, at least a week before my period was due, and the depression would lift so gradually that it often took a well-meaning but unwelcome comment from my husband to recognize it was PMS.

I remember slamming things around the kitchen one night and feeling like I’d lost my mind. I was angry about something so minor, I literally can’t remember what it was and I don’t know that I knew then either. I only remember how out of control I felt until my husband asked that ill-advised but in this case dead-on question: Is your period almost here?

This was not the first time he’d said this to me, though it was maybe the first time it dawned on me that he was only trying to help both of us. Something clicked in my brain and the sense of relief was sudden and sweet. I was not going crazy. My life was not suddenly, irreversibly terrible. I had PMS… and it would pass.

PMS, or premenstrual syndrome, was coined in 1953 by British physician Katharina Dalton to describe a variety of physical, mental and cognitive symptoms that many women experience during the last phase of the menstrual cycle.

Physical symptoms of PMS include cramping, bloating and insomnia, while the emotional symptoms include irritability, sadness, and mood swings. The American College of Obstetricians and Gynecologists estimates that at least 85 percent of menstruating women have at least one PMS symptom as part of their monthly cycle.

The last, or luteal, phase starts around 16 days into a normal 28 day menstrual cycle. PMS symptoms typically hit 5-11 days before menstruation starts, long before it’s even on most women’s radar.

PMS symptoms are believed to be caused by an imbalance in hormone levels. Progesterone and estrogen levels that peaked during ovulation drop off when the egg isn’t fertilized. This rise and fall of hormones is believed to lower levels of neurotransmitters like serotonin and GABA, which leads to feelings of depression and anxiety.

I guess I always knew hormones were to blame, but finally seeing the monthly shift in my own mood and emotions made me realize I drank through PMS for years. I recall drinking with more intensity on certain days and wish I’d been tracking cycles to see if there was a pattern.

In a normal brain, alcohol floods the feel-good receptors with serotonin and dopamine for a sense of well-being and euphoria. In long-term, chronic drinkers, it appears that neurotransmitter levels become depleted so that any relief is fleeting and dependent on the next drink. The healing brain of a woman in recovery may be especially sensitive to PMS symptoms.

Once while talking to an old sponsor about how moody I got during PMS, she matter-of-factly told me “You have to track your periods. That’s a big relapse time for women.” It now reminds me of the time she told me she too had struggled with sugar binges in early sobriety. Both times, I went from feeling helpless and abnormal to feeling reassured that my struggle was normal and hopefully temporary.

Cycles are easy enough to track. With apps like Clue, iPeriod, and Period Tracker, women can keep track of dates, symptoms and moods throughout the month. A plain old wall calendar works equally well for tracking dates and could serve as a useful warning to bewildered spouses. If you wait long enough, they figure it out on their own, but being prepared is the most important step in any battle.

There are a number of dietary and lifestyle changes that have been linked to PMS relief. Supplements with B-6, calcium, magnesium and iron may help with cravings and mood swings. I’ve experimented with a few and haven’t found my miracle cure yet, but I may be sabotaging any benefits with poor diet.

Those sudden cravings for cake and chips during PMS may be my body’s way of going for a quick serotonin boost, but the insulin spike is short-lasting and never makes me feel good about what I just ate. I know that going for complex carbs from whole grains, vegetables and beans will give a more gradual, steady rise in blood sugar and satisfy cravings longer. I just wish they looked better during an actual craving.

Craving chocolate during PMS? Good news. Go for dark chocolate, which contains more serotonin-boosting cocoa than milk chocolate .

And skip that extra cup of coffee. Chronic coffee intake increases our receptors for serotonin and GABA, which elevate mood and make us feel energized. Over time, though, too much caffeine can limit how receptive our brains are to these neurotransmitters and how much we produce naturally.

Exercise can be a great way to boost mood naturally. If eating perfectly and exercising through PMS sounds annoying, the good news is you may benefit the most from exercising at a level you’re already comfortable with. Low intensity activities like walking and yoga are recommended over high intensity workouts. Regular exercise can also increase deep sleep cycles and improve insomnia, another side effect of PMS.

Insomnia feels like an especially cruel blow since lack of sleep tends to make me feel even more irritable and depressed. The anxiety I feel from knowing I probably won’t fall back to sleep when I wake too early is self-fulfilling. I feel relief when I recognize it as a temporary state and make plans for a low key night and early bedtime.

Better diet, exercise and a solid night’s sleep are all great mood-enhancing tools to have on hand during PMS. My problem has been actually using them. When I track my cycle, I have a better chance of noticing changes in mood. This awareness, which mimics mindfulness, has surprisingly provided the most relief.

Mindfulness is the practice of observing and accepting thoughts and feelings without judgment. Because PMS is a natural state, I find relief when I accept that my mood is caused by hormone fluctuations. This reminds me that the uncomfortable feelings are temporary. They are normal, but not permanent, and knowing this feels oddly empowering.

A recent Australian study on PMS touched on the feminine ideal of being efficient, nurturing multi-taskers and the reality that many women cope with PMS by limiting social contact and avoiding stressors. Instead of viewing this need to isolate and scale back as a failure to cope, accepting the experience as it is may actually reduce premenstrual distress and severity of symptoms.

I am much more likely to make healthy choices and take care of myself when I’m not feeling overwhelmed and depressed. This is the catch-22 of PMS and possibly why mindfulness has felt like such a breakthrough for me personally.

When I track my dates, I generally know when to expect the storm. When I see it coming, I feel better prepared emotionally. I can slow my schedule down temporarily, or at least give myself some outs. When it hits, I can observe my thought patterns and behaviors as objectively as possible. If I eat or sleep poorly, I can accept that it happened and take steps to get back on track. I can remind myself that a lot of how I feel is due to a natural state. Like every craving or bad day, I can ride it out because it will pass.

Kristen Rybandt is a sober mom and wife who lives in West Chester, Pennsylvania. She blogs at

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