There’s no evidence that nutrition, exercise, or supplements can have really curative effects in PMS/PMDD/perinatal depression/perimenopausal depression. Some studies show that they might help a bit, as you’d expect, but not as much as SSRIs or hormone stabilization (via many different possible methods). When it comes to more “holistic” approaches to treating reproductive mood disorders, the best bet is to target stress physiology by getting some therapy focused on concrete skills for stress reduction (usually cognitive behavioral therapy or mindfulness-based stress reduction). 

There’s some evidence that stress exacerbates or initiates hormone sensitivity in females, and there’s lots of ongoing experimental work focused on how reducing stress might de-escalate the risk of negative reactions to hormone changes in reproductive mood disorders. But overall, I’d say if it’s severe enough, seek treatment from someone who can walk you through an established set of scientifically-backed guidelines (e.g., the RCoG guidelines for severe PMS/PMDD— just google the green top guidelines). 

Beyond making some basic healthy changes that would make all of us feel a bit better, don’t worry that it’s just something you’re not doing right with your diet, etc, because that’s just buying into the stigma that mental health problems are your fault. 

Updated 22 December, 2018 by Tory Eisenlohr-Moul, PhD