PMDD, Perimenopause & Menopause

Telehealth Evaluation & Medication Treatment in Michigan for women experiencing mood, anxiety, rage, or behavioral changes tied to their menstrual cycle or hormonal transition — from PMDD through perimenopause, menopause, and beyond

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What Skye Treats in Women's Hormonal Mental Health

  • PMDD (Premenstrual Dysphoric Disorder)

  • Perimenopausal mood and anxiety symptoms

  • Menopausal depression and irritability

  • Postmenopausal psychiatric symptoms

  • Cyclical mood swings tied to the menstrual cycle

  • Rage, irritability, or emotional volatility that feels out of character

  • Anxiety that worsens or newly appears around hormonal shifts

  • Brain fog and cognitive changes during hormonal transition

  • Sleep disruption tied to hormonal changes, hot flashes, or night sweats

  • Improving mood stability across the cycle or hormonal transition

  • Increasing quality of life and relationships affected by hormonal symptoms

Note: Skye does not prescribe HRT — hormone replacement therapy should be managed by your OB-GYN. Skye's role is the psychiatric evaluation and treatment of the mood, anxiety, and behavioral symptoms that accompany these hormonal transitions.

Don't Blame It on "Hormones"

10 Warning Signs That Women Should Not Ignore 

  • Severe mood symptoms in the week or two before your period that disrupt daily life: Ordinary PMS causes mild irritability or discomfort. PMDD is different — it produces severe depression, rage, anxiety, or hopelessness in the days before your period that significantly disrupts work, relationships, or daily functioning, and typically resolves once menstruation begins. This pattern is a recognized, treatable psychiatric condition, not something to just push through every month.

  • Rage or irritability that feels disproportionate or out of character: Sudden anger, snapping at family or coworkers, or feeling like a different person during certain weeks of your cycle or during perimenopause is a common and treatable symptom of hormonal mood dysregulation — not a personality flaw or something you have to manage through willpower alone.

  • Anxiety or panic that has intensified or newly appeared during perimenopause: Many women experience new-onset or significantly worsened anxiety during the hormonal shifts of perimenopause, even with no prior history of an anxiety disorder. This is a recognized pattern tied to fluctuating hormone levels and responds to psychiatric treatment.

  • Persistent low mood, tearfulness, or hopelessness during perimenopause or menopause: Depression during the menopausal transition is not something to simply endure as "part of aging" or "the change." Persistent sadness, tearfulness, or loss of interest lasting more than two weeks during this life stage warrants the same evaluation and treatment as depression at any other age.

  • Thoughts of hopelessness, worthlessness, or not wanting to be here: PMDD and hormonal mood disorders are associated with a real increase in suicidal thinking, particularly in the days before a period. Any thoughts of hopelessness, worthlessness, or not wanting to be here should always be taken seriously and should prompt evaluation right away. If there is any immediate concern for safety, call or text 988 (Suicide & Crisis Lifeline) or go to the nearest emergency room.

  • Sleep disruption tied to hot flashes, night sweats, or racing thoughts: Difficulty falling or staying asleep due to hot flashes, night sweats, or a racing mind is common during perimenopause and menopause, and it compounds mood and anxiety symptoms. This is addressable through psychiatric care alongside any gynecologic management.

  • Brain fog, memory lapses, or difficulty concentrating: Trouble concentrating, word-finding difficulty, or forgetfulness during perimenopause or menopause is a real and common symptom — not early dementia and not something to dismiss as "just getting older." It frequently overlaps with, and improves alongside treatment of, anxiety and mood symptoms.

  • Withdrawal from relationships, work, or activities you used to enjoy: Pulling away from friends, family, or activities that once brought you satisfaction can be an early sign of depression or anxiety tied to hormonal changes, rather than simply a busy season of life or normal aging.

  • Family members or partners noticing cyclical or hormonal changes you haven't connected yourself: It's common for a partner or family member to notice a predictable monthly pattern, or a shift since perimenopause began, before the woman experiencing it has connected her mood changes to her cycle or hormonal transition. This kind of outside observation is often the first step toward getting an accurate picture and appropriate treatment.

  • Current psychiatric medications that aren't working or need reassessment as hormone levels shift: An antidepressant or anti-anxiety medication that worked well in the past may become less effective — or symptoms may resurface — as hormone levels shift during perimenopause or menopause. A psychiatric reassessment can determine whether a dosage change, medication switch, or additional treatment is appropriate.

Questions? Text us at 248-587-8267

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Frequently Asked Questions

  • Yes. Skye Psychiatry accepts most major Michigan insurance plans, for psychiatric care delivered entirely by telehealth, with no requirement to visit a physical office.

  • Ordinary PMS causes mild discomfort, while PMDD causes severe depression, rage, anxiety, or hopelessness in the days before your period that significantly disrupts daily functioning and resolves once menstruation begins. If your symptoms follow this pattern, it's a recognized, treatable psychiatric condition — not something to just push through every month.

  • Skye treats PMDD, perimenopausal and menopausal mood and anxiety symptoms, postmenopausal psychiatric symptoms, cyclical mood swings, rage and irritability, brain fog, and sleep disruption tied to hormonal changes.

  • No. Skye does not prescribe HRT — that should be managed by your OB-GYN. Skye's role is evaluating and treating the mood, anxiety, and behavioral symptoms that accompany these hormonal transitions.

  • Darla Dane, PMHNP-BC, is Skye's specialist in women's hormonal and reproductive psychiatry, treating PMDD and perimenopausal, menopausal, and postmenopausal psychiatric symptoms.

  • Yes. Perimenopause can begin years before menopause is officially reached, and mood, anxiety, or cognitive symptoms during this transition can be evaluated and treated without waiting for a formal menopause diagnosis.

  • Skye's telehealth visits take place over video from home and can be joined from a phone, tablet, or computer — there's no physical office to visit..

  • Consider an evaluation if you experience severe mood symptoms tied to your cycle, rage or irritability that feels out of character, new or worsening anxiety, persistent low mood, significant sleep disruption, or any thoughts of hopelessness or not wanting to be here.

  • Antidepressants or anti-anxiety medications that worked well in the past may become less effective, or symptoms may resurface, as hormone levels shift during perimenopause or menopause. A psychiatric reassessment can determine whether a dosage change, medication switch, or additional treatment is appropriate.