What Can Be Done For My PMS?

QUESTION:

Dear Dr. Heller,

I have a question concerning PMS.  I have been on the antidepressant, Celexa, for 6 months now, but it seems to have no effect on my PMS symptoms, (severe depression).  I am being treated by an Osteopath at the moment, but wondering if I should see a different kind of doctor, and if so, what kind?

ANSWER:

I believe PMS is primarily fluid retention, and a survival advantage thousands of years ago.  It worsens underlying mental health diagnoses.  I go into it at length in "Biological Unhappiness."

If you have a condition that's effectively treated by Celexa, you likely need a powerful diuretic (water pill) to get the improvement you're looking for. 

PMS is treated by gynecologists, family physicians, internists, and psychiatrists.  There is no consensus on treatment however.