Feeling Moody? Your Hormones May Be Behind Those Swings

It started with bouts of dizziness when Amanda Mae Renkel, founder of the running blog Mae's Miles and Music, was 16 years old. From there she began to experience severe social anxiety to the point where she says she’d take her glasses off so that she didn't have to see anyone; she feared if they noticed her and made eye contact, they'd want to talk.

Then came the brain fog. “I became excessively forgetful, at times panicking because I thought I hadn't remembered to put on clothes after I'd already been out of the house for hours. I couldn't even recognize my own reflection in the mirror,” she says. 

Finally, after experiencing these symptoms one week per month for three months, she went to a gynecologist who diagnosed her with Premenstrual Dysphoric Disorder (PMDD), a hormone disorder that manifests as a severe and destabilizing iteration of more common premenstrual mood fluctuations. While her doctor was able to help her address the severe social anxiety, the mood fluctuations persisted. “Instead of being a little upset or disappointed, everything that bothered me became a monumental, emotional event.”

While the exact cause of PMDD isn’t known, it’s thought to be a reaction to hormonal changes that happen with the menstrual cycle. And while not always as severe as Amanda’s early PMDD experience, hormones play a surprising role in mental health and mood.

Feeling Moody? Blame It on Your Hormones

Your mood and your hormones are inextricably linked in surprising ways, but it’s important to be specific about the type of hormone that might be causing an issue. As Dr. Arti Thangudu, board-certified endocrinologist and CEO & founder of Complete Medicine says, “Hormone imbalance is a non-specific term that gets thrown around but it’s actually not a true diagnosis. We must be specific when discussing hormones because there are so many with so many actions.”

These three different types of hormones can mess with your emotional state and mood:

Reproductive Hormones

This week at 34-weeks pregnant, I cried tears of joy when my husband brought me a Sprite; I told him I was “so touched” even though I had specifically asked him to get it for me. If you’ve ever gotten a period or gone through pregnancy or menopause, you’ve likely noticed the link between hormones and your own mood.

“Reproductive hormones such as estrogen and progesterone can cause irritability, depression, and anxiousness when the levels are high or low. Abnormal levels of testosterone have been associated with depression and anxiety,” says Dr. Barrie Weinstein, board-certified endocrinologist and medical director of Well By Messer.

In addition to these, other symptoms you can experience before your period arrives are a sense of overwhelm, difficulty sleeping, and increased fatigue, otherwise known as the not-so-fun building blocks of PMS.

But you can’t blame these unpleasant changes entirely on your reproductive hormones. It’s not so much that these hormone themselves that cause mood swings, but the fact that a drop in estrogen and progesterone after ovulation is associated with a drop in the feel-good chemical, serotonin.

“It is thought that the fluctuations of serotonin levels contribute to low mood, crying, sleep disturbance, and changes in eating,” says Jess Diller Kovler, psychologist with Well By Messer whose research examines hormone-secreting tumors and how they impact one's mood.

Thyroid

The thyroid, a small butterfly-shaped gland in the base of the neck, also produces hormones that can affect mood.

“Hypothyroidism (low thyroid) often causes depressed mood and fatigue while hyperthyroidism (excess thyroid hormone) causes anxiety, irritability, and insomnia,” Dr. Thangudu says. Sometimes symptoms of depression or anxiety can be reduced by correcting thyroid levels.

Cortisol

Cortisol is the body’s (necessary) stress hormone and Kovler adds that it also regulates blood sugar levels and impacts immunity. “Someone with elevated cortisol levels, e.g., Cushing's Disease (caused by a tumor) or Cushing's Syndrome, might experience lower immunity, low mood, mood swings, brain fog, and anxiety,” she says.

Too much cortisol can lead to high blood sugar and insulin levels. “This has been associated with depression and anxiety,” Dr. Weinstein says. Insulin resistance may also cause unexplained weight gain which can have negative effects on mood.

Hormones Having a Bad Day? Get to the Root of the Issue

In addition to an irritable, depressed, or anxious mood, you’ll usually notice other symptoms that either stay stable or ebb and flow throughout the month that may point to hormones being the cause of your mental health woes.

According to Weinstein, there are a few common symptoms that can tip you off. If you notice any of these simultaneously — or even on their own – it might be a good idea to get checked out:

• Irregular periods

• Weight gain or loss

• Hair loss

• Dry Skin

• Hot Flashes

• Vaginal dryness

• Elevated heart rate

• Infertility

• Constipation or diarrhea

• Difficulty concentrating

• Heat or cold intolerance.

Next Step: Boost Your Mood by Wrangling Your Hormones Back Into Balance

First things first, no one should be told to “just deal” with a low mood, even if it is tied to “normal” hormonal fluctuations.

“I recommend that if patients notice that their mood challenges occur cyclically in the week leading up to their period, they should pay extra close attention to self-care,” says Dr. Thangudu.

Your mood-friendly self-care routine should include the following:

• Sleep hygiene: “Getting 7-9 hours of restful, uninterrupted sleep in a cool dark room can make a big difference,” Thangudu says.

• Eating healthy: Whenever possible, try to focus on whole plant foods and avoid sugar. 

• Regular exercise: moving your body can help increase feel good chemicals that will enhance your mood.

• Talk to your doctor: In some cases, Weinstein says estrogen and progesterone can be prescribed together or individually to help keep your mood steady.

• Tell your partner how you’re feeling: It can be helpful to give your partner or anyone you live with a heads up about where you are in your cycle, and give them suggestions for how to support you, whether you need extra affection or to be left alone.

• CBT therapy or DBT therapy: “These are skills-based treatments that can help you to regulate your mood, recognize how you are feeling, and learn the skills to more effectively navigate the impact of mood shifts, low mood, and anxiety,” Kovler says.

Renkel has found some relief from her PMDD through trial and error. “At this point in my life at the age of 31, I've found a birth control that works with me so that my mood is fairly stable. I practice yoga five days a week to try to stay grounded, and I'm a marathon runner. so I'm always working to get the endorphins flowing as often as I can,” she says.

Testing Can Also Be a Huge Help

It’s not fair to suggest that you can cure all hormonal mood shifts by meditating and skipping dessert (though lifestyle changes certainly can help).

By getting some simple blood work done, you can help isolate the exact hormones that may off balance and causing a problem. Veracity’s at-home Hormone Wellness Test examines five hormones (plus your pH level). Another option is to take your concerns to your doctor. If you go this route, be aware that, depending on who your doctor is, you may have to advocate for yourself to get the green light to have all the necessary hormones checked.

“Checking your hormone levels with a blood test can help distinguish between a chronic imbalance versus the product of your natural monthly cycle fluctuations.” Weinstein says.  “Depending on the results, your doctor may require further testing including more blood work and/or imaging of the ovaries/pelvis and pituitary gland.”

Anything from a funky mood to all out depression can be caused by hormone levels in the body, even if this link isn’t regularly discussed. If you suspect your hormones are to blame for how you’ve been feeling, track your mood each week of your cycle, experiment with some lifestyle and self-care tweaks, and seek out therapy and arrange for hormone testing. Most importantly, remember that your mood swing problems aren’t you, they’re your hormones!