How to manage pre-menstrual depression the holistic way

Do you have times of the month where you feel so low that you wish you were dead? Do you find yourself desperate to find something that will make you better? You may have tried various remedies and you’re wondering whether to go on medication to relieve the unbearable thoughts and feelings, then suddenly you don’t feel so bad, and you leave it for another month.


The common psychological and behavioural symptoms often experienced pre-menstrually are:

  • mood swings
  • depression
  • tiredness
  • fatigue or lethargy
  • irritability
  • anxiety
  • feeling out of control
  • reduced cognitive ability
  • aggression/anger

In this article, I write about managing menstrual depression from a holistic perspective as a wise woman, Red School graduate, mind/body practitioner, counsellor/psychotherapist, and mother/daughter coach, with lived experience of PMDD (pre-menstrual dysphoric disorder).

I understand the loss of self, and debilitating depression experienced by many women pre-menstrually. I also understand the desperation of wanting to be happy and free of the shameful behaviour that wrecks your life uncontrollably, and I have spent years learning to heal the destruction.

For some, menstruation can ruin a *woman’s quality of life, interpersonal relationships, or ability to attend work or school. The hardest thing is not being understood (even by the GP) and feeling like you’re completely on your own. I am speaking about young girls as well as grown women, because my depression and menstrual hell began in my teens, and it is vital that young girls are supported and taken seriously instead of being told that it is ‘just their hormones’ and ‘all part of being a woman.’ 

Here is a guide for our young teens: A Young Person's Guide: Premenstrual Syndrome. Kim McCabe also offers training, and groups to support with guiding girls through adolescence. You can also buy her brilliant book From Daughter to Woman: Parenting girls safely through their teens.

How we nurture our menstruating teens will determine how well they are able to navigate the monthly challenges that can rock their already difficult worlds. Given gentle, loving support and acceptance, our young women will be likely to have a far better cycle experience and learn to accept themselves and not feel so alone; not always easy when you have your own menstrual or menopausal symptoms wiping you out. What is/was your relationship like with your own mother? How is/was menstruation talked about? How supported do/did you feel?

I was desperate for an overnight cure for my premenstrual mania, and I believed that if I had a diagnosis and knew exactly what was wrong with me, I would be able to do something about it and change. Many gain relief from having a diagnosis of PMDD, for some it helps you to understand what you are going through and have hope that you will then be given the right support. When I was diagnosed with PMDD it didn’t make a difference: I still felt alone and depressed even on medication.

Holistic approaches to treating PMDD

I have found a few things that have helped me over the years, I have needed different things at different times and there is no overnight cure. I found solace in holistic therapies such as Reiki, breathwork, mindfulness, menstrual cycle awareness (MCA), and art therapy.

I learned to look at my whole cycle and everything that contributed to my experience, and not just what was going on during the pre-menstrual phase.

The menstrual cycle is shaped by several things:

  • the status of your overall health
  • your character and personal history
  • your lifestyle practices (healthy diet, sufficient sleep, exercise, are you fulfilled in what you do?)
  • your age
  • your relationships (are you sufficiently acknowledged and met in your relationships?)
  • your children
  • the larger cycles of life
  • your gender identity

There are many wonderful treatments that can ease symptoms, such as reflexology, Reiki, acupuncture, aromatherapy, and practices such as:

  • A regular healthy sleep routine – this should be top of everyone’s list. 
  • Yoga Nidra – a wonderful deep meditative process.
  • Earthing – get outside and walk barefoot on the earth, sit, and relax touching nature.
  • Emotional Freedom Technique (EFT) – an easy practice that releases stress and blocked emotions which can in turn help you to heal.
  • Yogic breathing e.g. alternate nostril breathing.
  • Exercise and natural light.
  • Silence – (my favourite) give yourself technology free time. Wonderful though technology is, it does agitate our systems, so turn everything off.
  • Eat a non-inflammatory diet. Avoid coffee, sugar, and junk food. Eating the right diet for you can soothe your system, reduce anxiety, and reduce menstrual problems (and all other health issues too). 
  • Eat lots of calcium-rich foods, such as yoghurt, broccoli, leafy greens, and sardines. Calcium has been shown to help with a range of PMS symptoms.

There are also many alternative remedies and supplements that can ease symptoms, a good naturopath or nutritionist will help you choose what is right for you. Some popular ones are:

  • Vitamin B6
  • Magnesium
  • Agnus Castus
  • St John’s Wort
  • Evening Primrose Oil (can be taken in liquid form if it’s hard to swallow capsules)

You can find a free course called ‘Hormone Harmony’ on the Red School website, which will give you lots of brilliant information.

How to build a relationship with your menstrual cycle

The menstrual cycle is an energy and stress-sensitive system that gives you feedback on how you are doing emotionally and physically. Knowing your cycle is your means for managing stress, creating well-being and helping you to connect to yourself and understand yourself at any one moment.

The simple act of charting your cycle starts a process of change, building your relationship with your cycle, day by day, month by month.

Chart/record your cycle daily

On the first day of your period, record keywords that capture your thoughts and feelings on ‘day one’ of the menstrual chart (the first day of your period is the day when the blood starts to flow and doesn’t refer to the odd spotting that can occur).
Or, if you are starting mid-cycle, start recording from that day, making sure you have noted the date even if you don’t know what day of the cycle it is yet.

  • Record your experiences at the end of each day.
  • Begin a new chart at the start of each period.
  • It’s well worth committing to a whole year of charting.
  • Print off new charts as you need them.


The thing that helped me the most is my commitment to personal development, self-awareness, my spiritual path and therapy. Through my training with Red School and my reflexive research, I came to understand that the cause of my menstrual depression was trauma. Working intimately with my cycle, getting to know my nervous system responses, the depth of the trauma held in my body, and facing every shadow and all my different parts, allowed me to heal.

During the cycle, old emotional wounds/traumatic experiences can resurface again and again along with thoughts, feelings and emotions that can be overwhelming and unbearable, leading to shame and embarrassment. In response, our nervous system, triggered by these wounds/traumas, will go into complete overload, sending us into fight or flight mode, feeling unable to control our emotions or behaviour. We then begin the spiral of self-blame, shame, self-destruction and sabotage.

Working with a menstrual cycle, trauma-informed therapist will help you to recognise triggers, emotional and physical reactions, and to regulate your nervous system. I work with the sensations and emotions that are stuck in the body, presence (the here and now), the felt sense, energy, grounding and imagery. Therapy is centred around your lived experience and the impact of your cycle and what is beneath your symptoms i.e. what are they telling you, what changes do they need you to make in your life, what do they need you to hear, etc.

In this space I will:

  • help you learn to know and understand yourself and your cycle deeply, so that you can manage difficult emotions
  • help you to tune into the changing pattern of energy and mood through the menstrual month so that your level of stress starts to fall away
  • help you to understand and connect to the hidden power behind your symptoms and use them to speak your truth
  • help you learn to embody and channel these powers (particularly the premenstrual ones)

I am a healer, however, "A healer does not heal you. A healer is someone who holds space for you while you awaken your inner healer, so that you may heal yourself." – Maryann Hasnaa.

Don’t leave it another month. You don’t have to be alone. Reach out, be supported, and don’t wait until you don’t know what else to do.

*Not everyone who menstruates identifies as a woman. I honour and support trans and non-binary lives.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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Southend SS9 & Chelmsford CM1
Written by Hayley Barker-Smith, BA (Hons), MBACP - Psychotherapist & Breathwork Facilitator
Southend SS9 & Chelmsford CM1

Hayley has a passion for empowering women and teens to live the life they desire by shedding shame and shining. She has lived with PMDD (pre-menstrual dysphoric disorder) and experienced pre-menstrual depression since her teens, and has spent a lifetime dedicated to healing herself and others. She works spiritually and creatively to guide you.

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