Dear Alice,

I think I have severe PMS. I get so angry at times that I want to throw things and hit. I have no patience with my kids. It only lasts a couple of weeks, but I am worried I might hurt my children. I always manage to stop myself and leave the room, but what happens if I can't stop myself next time?

Please help.

— PMS?

Dear PMS?,

Feeling out of control must be frightening, and you deserve lots of credit for reaching out. Premenstrual syndrome, also known as PMS, has a variety of physical and emotional symptoms, including feeling irritable or angry. People with PMS may experience mood swings causing them to feel happy one moment and anxious the next. In rare cases, people may experience a severe form of PMS called premenstrual dysphoric disorder or PMDD. There are also several other conditions, such as depression, anxiety, bipolar disorder, and perimenopause that share symptoms of anger. Even though it can be difficult to ask for help, talking with a health care provider may the best way to determine the cause of your anger (which may or may not be linked to PMS), and then get the proper support.

Changes in hormone levels during the menstrual cycle can have a range of physical and emotional effects. For some, these can lead to mild PMS and, for others, more intense symptoms of PMDD. These can include:

  • Physical symptoms: lack of energy (fatigue), bloating, breast tenderness, changes in appetite, headaches, muscle pain
  • Emotional symptoms: depression, loss of hopefulness, extreme anger, mood swings, trouble concentrating, anxiety

Adapted from UpToDate.

To be diagnosed, both physical and emotional symptoms need to be present five to seven days before the menstrual period begins. This means that if symptoms continue after the period begins, it may not be PMS or PMDD. A health care provider can diagnose your symptoms and make sure that you’re getting support that’s appropriate for you.

To better understand why you’re feeling angry, you might want to start keeping track of your symptoms. You could try writing down when you experience symptoms, how long they last, and what happens before they occur. You may also want to take some time to reflect on some questions about yourself and your anger. For example, do you tend to get angry when you’re feeling rushed or stressed? Do you notice that you’re angrier when you’re tired from lack of sleep? What support do you need to navigate the stresses of parenting? Learning more about what triggers your anger may help you to better understand your emotions and work towards managing them. Also, having a log of your symptoms and their context can be helpful as you work with a health care provider in finding the best help for you.

Just about everyone feels angry from time to time. In fact, it can be healthy to express your emotions rather than bottle them up. However, when emotions start to hinder your relationships or pose a physical threat to yourself or others, it may be beneficial to seek support. Parental emotions can impact how children internalize and process their emotions. Finding ways to control your temper may improve children’s temperament and irritability and prevent them from adopting similar behavioral responses. To manage anger, the American Psychological Association recommends a combination of expressing, redirecting, and calming techniques. These can include breathing exercises, slow yoga, or leaving the room to cool down (as you’ve been doing). Talking with a mental health professional or joining anger management group therapy may help you find ways to better communicate with your kids or to reframe your angry thoughts.

Parenting can be stressful, and it’s not uncommon for anyone to lose their temper sometimes. You may be surprised by the sense of relief and weight off your shoulders that you may feel if you choose to work collaboratively with a health care professional. They may help you find ways to strengthen your coping mechanisms and take good care of yourself and your family. No one can do everything on their own. If having some intentional individual support sounds at all interesting to you, it may be worth checking out!

Alice!

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