In part one of this blog, we covered the basics of how your menstrual cycle impacts mood. Today we will cover DBT skills that might act as support tools to reduce the impact of menstruation on your mood and behavior. If you have concerns over how your menstrual cycle is impacting your life, please consult with your physician.
DBT for Menstruation (Days 1-5)
With the drop of estrogen and progesterone, fatigue and low energy is common. Emotional sensitivity increases here and your mood might dip lower than in other parts of the cycle. Physical symptoms such as bloating, cramping, and headaches are also common, further increasing vulnerability to emotional dysregulation.
Self Soothe
This skill asks us to focus on comfort by using each of our five senses. The goal here is to intentionally find time to seek comfort and soothe any emotional or physical discomfort we might be dealing with. Some examples of self-soothing during menstruation include:
Taste: A warm beverage or comfort food
Touch: A heated blanket or bath
Mindfulness of Current Emotions
During menstruation, we can feel a wide range of emotions. Being aware of how our emotions are presenting can be an excellent way to improve our ability to navigate or change how we feel. To use this skill, notice body sensations and see if you can name them, it might be helpful to imagine them as a color or texture. We then work to allow them to pass while also considering if we need to practice another skill or self care strategy to support our needs.
DBT for the Follicular Phase (Days 1-14)
As estrogen rises, serotonin does as well. Many report an increase in positive mood between days 6-13. An increased sense of confidence can be felt here, but some report they experience an increase in anxiety or variability (swinging) in mood.
Wise Mind
Wise mind is a great skill to use at any time of the menstrual cycle, but one that may be especially helpful in the in-between of menstruation and ovulation. Wise mind asks us to seek balance between our Emotion mind – where emotions rule our decisions and our Reasonable mind – where facts and logic rule without considering the things we care about. During the follicular phase, we may need to be mindful of what plans we commit to or tasks we assign ourselves with our increase in energy.
Building Mastery
This skill looks to help build our sense of confidence in our skills and abilities. With menstruation behind us, this might be an excellent time to return to building the skills and habits we’re working towards. Keep in mind that, with building mastery, the idea is to choose a goal that is challenging while still realistic to achieve. Using your wise mind will be key here when choosing a focus to best support you during this time.
DBT for Ovulation (Days 14-17)
With the rise of estrogen and testosterone, energy rises and some report feeling more confident and social during this phase of the cycle. Mood is less likely to be more dynamic but an increase in already occurring symptoms can sometimes be experienced.
Mindful Participate
Now that ovulation is here we’ll have more energy and ability towards living the way we want. To be mindful is to be present and in the moment. Mindful participation is to dive head first into something (ideally something we enjoy) and experience it without self-consciousness or distraction.
Cope ahead
If you’re someone who experiences an increase in symptoms during the luteal phase, the skill of “cope ahead” might be a way to plan ahead and prepare. Cope ahead asks us to imagine the worst-case scenario, e.g. “I have to miss this event because I don’t feel well,” and imagine yourself getting through it. Picture what thoughts, emotions, and urges you might have and hold in your mind you are dealing with the problem effectively. This could also be a time to problem-solve and get, in effect, extra support for yourself before dipping into the lower energy of the luteal phase.
DBT for the Luteal Phase (Days 15-28)
With the seesaw effect of progesterone and estrogen, mood can greatly vary. This is the phase often referred to as premenstrual syndrome (PMS). Irritability, fatigue, mood swings, anxiety, and depression symptoms can all occur during this flux. Serotonin levels also contribute to mood changes at this time.
PLEASE
This skill asks us to pay attention to how our physical health impacts our mood. This can be a vital skill to use when in the luteal phase and acts as a prep for menstruation, which can further exacerbate physical discomfort.
PL: (Treat) Physical Illness
- Being aware of how feeling physically unwell can impact mood.
- During your luteal phase this might mean staying in to rest or taking medications that help you manage symptoms.
E: (Balanced Eating)
- Eating patterns might look different during this phase, finding a balance to best suit your nutritional needs will better support emotion regulation at this time of the cycle.
A: (Avoid) Mood Altering Substances
- This part of the PLEASE skill asks us to be mindful of the substances we can consume and how they might affect our mood.
- During this phase, we might need to avoid or reduce what we consume to better manage mood variability seen during this phase of the cycle.
S: (Balanced) Sleep
- Sleep is always important but especially so when our body is experiencing hormonal changes.
- You might notice an increased need to sleep or rest during this phase.
E: Exercise
- Movement is important in any part of the menstrual cycle but we will more than likely have to change our expectations depending on where we currently are.
- During this phase, gentle movement might best support your needs compared to more intense work. Listen to your body and go with what makes the most sense for you.
IMPROVE
Another skill that involves multiple methods towards improving your mood. Though each of the IMPROVE techniques are useful, I’d like to highlight just a few that are especially useful during this phase of the cycle.
R: Relaxation
- Relaxation asks us to spend time on things that relax us. Maybe that’s your favorite breathing technique or maybe it’s scheduling a massage ahead of time. Intentionality is important here and planning to relax during this phase of the cycle can greatly impact our mood during this time.
V: Vacation
- While a full vacation would be best, it’s not always realistic in our busy lives. Vacation means taking time away to support ourselves when our emotions (or physical discomfort) are high. This can look like planning a free weekend intentionally or planning gaps in your routine to rest while your body preps for the beginning of the cycle all over again.
If you want more help with skills like this, join our skills training groups or schedule with a therapist at CCDBT. We’d love to go more in-depth with this skill and many more like it!