If you experience suicidal thoughts before your period, during PMS, or PMDD, you are not alone. It can be an exhausting battle to face the many symptoms of our luteal phases while searching for support and treatments to help us feel better. 

Though it may feel very dark right now, there is hope! Many people who struggle with intense premenstrual symptoms will find a combination of therapy, treatments, and self-care works for them to feel better and live a good life. Right now, there are also people all over the world (scientists, doctors, advocates, loved ones, and an incredible community of fellow warriors) working together for better treatments, more awareness, and a brighter future for all people with PMDD. 

With community and hope in your heart, read on for suggestions on how to move through the dark moments and cope with suicidal thoughts before your period. Thank you so much to the wonderful members of the IAPMD Patient Insight Panel (PIP) for sharing your stories and tips to create this guide.

ACTIVITY

If you’re feeling up for it, getting active and getting outside can help lift your mood and lift intrusive thoughts. This might be as simple as taking 5 minutes to sit in the sun and feel its warmth on your skin. You could also take a short walk around the block or a longer walk with your dog or a friend. For lower impact activity, you might take an online yoga class to relax, gently move the body, and pass some time. It can also help to meditate either by focusing on your breathing (try breathing in for 4 counts, hold for 7 counts, and out for 8 counts) or listening to a guided meditation on an app like Insight Timer. A member of the PIP also shared that when she is struggling with suicidal thoughts, it helps her to stick to her daily routine and tasks as best she can, especially if it is PMDD-friendly. 

DISTRACTION

Distraction is a helpful tool for suicidal thoughts with PMDD because often it is about letting yourself move through the difficult time in your cycle, knowing it will pass and you will feel better soon. PIP members shared that they turn on their comfort shows like Schitt’s Creek or Parks and Recreation or play their favorite movies to zone out, laugh, or cry. Podcasts, music, and audiobooks are other go-to distractions. “If I constantly feed my brain with input, it can’t go its own way that much,” explained one member of the PIP. “As much as I normally love daydreaming and letting thoughts flow, it is something I try to avoid at all costs during the luteal phase.”

INSPIRATION

Maybe the music, movies, and podcasts you turn to aren’t just for distraction but to inspire you and remind you of hope. PIP members shared that they like to listen to inspiring songs or music written by artists who understand mental health struggles. Musical soundtracks are a go-to for some members of the PIP. Other members like to read inspiring books or poetry.

COMPANY

Being around other people can be very helpful when struggling with suicidal thoughts. You might tell your partner, a loved one, or a friend about the thoughts you’re having so that they can help you stay safe, talk you through, and support you. Some PIP members shared that they have a protocol in place with their partners, so their partners know what to say and how to comfort them in these times. Or you don’t have to go deep at all; just let the company and conversation with another person keep you occupied. If you can’t be with someone physically, even having a texting conversation can help so that you can go back and forth for a few hours as the thoughts pass. There are also free services like Crisis Text Line and suicide lifelines where you can talk with a trained crisis counselor who can help you navigate the most difficult moments until they pass. They always pass.

COMFORT

Don’t underestimate the power of physical comfort when you are feeling suicidal. You can love on your pets, take a warm bath with Epsom salts or essential oils, or eat a small comfort food. Many PIP members shared that they find it helpful to get into bed and bury under the covers or a weighted blanket when they are struggling. What are some things that make you feel comfortable?

MEDICATION & SUPPLEMENTS

Some medications and supplements can be helpful to take as needed when thoughts and emotions feel extreme. Multiple PIP members shared that they take prescribed anti-anxiety medications like Xanax or clonazepam, or sleep aids, that help them to feel calm or fall asleep when things get really intense. Other members drink Ashwagandha tea for a more mild relaxation feeling, or use cannabis products, either with CBD, THC, or both that can help them feel calmer and get through difficult times with suicidal thoughts. If you feel these would be helpful for you, you can talk with your doctor about an as-needed prescription. 

EXPRESSION

Another avenue for coping with suicidal thoughts is through expression. Some PIP members use art to get out their emotions, which could be anything from drawing, painting, writing, dancing, or whatever medium feels most comfortable to you. Others like to get in their car where they can sing at the top of their lungs to let out some of the pent-up energy inside. There’s also power in letting it all out through crying and tears. You don’t have to keep it all inside. Feel your feelings! Let it out and see how it feels to emote and express.  

MENTAL EXERCISES & REMINDERS

Some members of the PIP find it helpful to think about the reasons they have to be hopeful and hold on. What is one thing you are looking forward to, one thing you are grateful for? You might find that more than one thing comes to mind even when your mind feels so dark and clouded by the pain. It can also be helpful to know that there are many treatment options out there for PMDD, many that you might not have tried and that could be just the thing you’re needing. There are also researchers studying PMDD right now and working towards better, more targeted, and effective treatments that will be coming soon. We don’t know what the future holds and while our minds might imagine the worst-case scenarios more readily, the best-case scenarios are equally possible. When you allow yourself to play the hopeful, best case scenario in your mind, it may surprise you how it can change your thoughts and feelings even in this moment. 

One PIP member shared a helpful tapping technique she uses to stay grounded in the present moment. “I will tap my thighs with my palms alternating sides (right hand softly to right thigh, left hand softly on left thigh) while naming positive and descriptive things “My loving, beautiful, sweet black cat. You are soft. You are comforting. The smell of this warm tea and the way it feels on my throat. The feel of my blanket is so soft and its weight feels like I’m held and safe.” What are three things around you that you can describe and be present with?

LET IT PASS

When it comes to pre-period suicidal thoughts, sometimes the most helpful thing of all is to know that they will pass. The hormone changes during our luteal phases, and at other points in our cycles, can affect the neurochemicals in our brains causing intense emotions and thoughts, especially when we are particularly sensitive to these changes. Often people with PMDD will feel like they are in a darkness that will never pass and then their period arrives and they feel shockingly better, their anguish a distant memory. For some, this lift comes suddenly with the start of bleeding and for others it may take a few days, but it always comes. The most painful feelings do not last forever. 

There is no shame at all in doing what you need to do to get through the dark moments, even if that is to go to bed and sleep. Sleep was mentioned by so many members of the PIP as their most trusted technique for coping with suicidal thoughts. It helps the time to pass and gives your mind and body a rest, which may also be what it is needing as it prepares for the release of your period. 

GET SUPPORT

We hope the tips in this blog can help you cope in the moment with suicidal thoughts, but know that there is support available so that these moments can be less intense, arise less often, and even go away. Many members of the PIP found therapy helpful in reducing their suicidal thoughts. Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are two such therapies to explore. CBT for suicidal thoughts involves working with a therapist through risk assessment, safety planning, and risk reduction, as well as learning behavioral strategies and cognitive techniques to help you develop coping skills and change unhelpful thoughts and beliefs. DBT is a therapy specifically designed to help with suicidal thoughts, created by Marsha Linehan, a psychologist who also struggled for many years with feeling suicidal. It teaches various skills in distress tolerance, emotion regulation, mindfulness, and interpersonal effectiveness to identify contributors to feeling suicidal and practice more helpful problem-solving techniques. 

Medications to treat PMDD or underlying mental health challenges can also make a difference in alleviating suicidal thoughts. You can read more about treatment options on our website, or search for a provider in your area who has experience with PMDD in our Provider Directory. 

CONCLUSION

Suicidal thoughts can often arise before our periods for those of us who are sensitive to hormone changes or live with PMDD. They can be distressing and painful, but there are many things we can do in the moment to cope and allow them to pass. 

They always pass. 

Through the darkest moments, remember that there is hope, there is help, and you are not alone. 

MEET THE PIP

The IAPMD Patient Insight Panel is a diverse group of individuals living with PMDD and/or PME who play an important advisory role at IAPMD, helping us better understand and serve the needs of patients and families by bringing their unique, and invaluable perspectives directly into IAPMD’s work.