Tearfulness

11 February 2017.

Tearfulness is crying that is difficult to stop, or at unexpected times. It can be a sign of depression [1], but is also a common experience during the menstrual cycle, or pregnancy [2].

Whilst crying is not a necessarily a ‘symptom’ or negative experience, it can be distressing if you feel unable to control it- especially in cultures where (adult) crying is erroneously associated with being ‘less competent’ [3]. Sometimes your eyes will tear up just because you are full of joy, or have been moved by something beautiful- Lucky you! Cherish these moments. It is not a sign of weakness, merely that you are a fully functioning human being…

Many people notice that their emotional responses will vary, depending on multiple factors; such as hunger (known as being ‘hangry‘), tiredness, mental/ physical health, joyful experiences, being in love, or stress levels.  Hormonal changes can effect all of these factors, making it more likely that you’ll become tearful (especially just before menstruation, or during pregnancy).


Managing hormone-related tearfulness:

Try a hormone-balancing diet– As outlined in this blog, a vegetable-based ‘anti-inflammatory’ diet can significantly improve all hormone-related symptoms. We highlight a few of the key steps that are especially relevant for those suffering from tearfulness, below;

  1. Eat lots of fresh fruit and vegetables
  2. Eat lots of fibre (and drink plenty of water, too)
  3. Eat oily foods (mainly unsaturated fats)
  4. Reduce meat and dairy products
  5. Avoid sugary foods and drinks
  6. Avoid caffeine
  7. Avoid alcohol– It has been shown to make low mood/ depression/ tearfulness worse [4].
  8. Take nutritional supplements- various mineral deficiencies are associated with low mood/ tearfulness, especially; Co- enzyme Q10 [5]; omega 3 fatty acids (found in fish and some seed oils)[6-7]; Magnesium [8-9]; and B-vitamins [10]. Research also shows that Vitex Agnus Castus (200-500 mg of extract daily) [11] can be beneficial for hormone-related low mood/ tearfulness.

NoteVitex Agnus Castus is not suitable for those who are under 18; using hormonal medication (or devices); are pregnant, trying to conceive, or breast-feeding; or have a pituitary problem.


Exercise regularly– Regular exercise, particularly aerobic exercise, may help you combat stress and release tension. It also encourages your brain to release serotonin, which can improve your mood [12].

Research has shown that regular exercise, (more specifically cardio-respiratory fitness), and a healthy BMI (Body Mass Index), significantly reduces the risk of menstrual cycle-related health issues, including low mood [13].


Boost self-esteem- Low self-esteem has been found to increase the risk of developing depression, so it’s worth making sure that your self-esteem is OK, and if not, to do something about it [14].

Cognitive behavioural therapy (CBT) is one of the most effective treatments for depression, and building self-esteem, and is available on the NHS. Research shows that the benefits of CBT may last longer than those of medication, although no single treatment is best for everyone. CBT helps you to understand how your problems, thoughts, feelings and behaviour affect each other. It can also help you to question your negative and anxious thoughts, to improve the way you see yourself, and reduce damaging internal thought processes. CBT usually involves meeting with a specially trained and accredited therapist for a one-hour session every week for 10-12 weeks [12].

NoteThe Oxford Cognitive Therapy Centre produces highly effective (and cheap!) booklets on managing the symptoms of low self-esteem and depression through Cognitive Behavioural Therapy (CBT) approaches; e.g. ‘Building self-esteem‘ and ‘Managing depression‘.


Reduce stress hormones- Research shows that Mindfulness-based Cognitive Behavioural Therapy (MCBT) is highly effective in reducing menstrual cycle-related low mood, anxiety, and other symptoms [15]. Mindfulness works by focusing your awareness on the present moment and by acknowledging and accepting certain feelings. Being mindful can teach you how to overcome negative thoughts – for example, being able to challenge hopeless feelings.

This practice has been found to reduce ‘stress reactivity’, stopping the vicious cycle of low mood and anxiety constantly triggering the ‘fight or flight’ HPA (Hypothalamic Pituitary Adrenal) stress response- leading to tearfulness and anxiety/ low mood [16].


If you have tried the suggested tips and tricks for at least 3 months, and your symptoms do not improve, please consult your doctor.

If you have any suggestions, or tips, for managing tearfulness- please let us know– we can share them with others!


Further information:


Page last reviewed and updated: June 2018


References:

1. NHS. 2016. Symptoms of depression. [ONLINE] Available at: http://www.nhs.uk/Conditions/Depression/Pages/Symptoms.aspx. [Accessed 8 October 2017]

2. Yonkers KA, O’Brien PM, Eriksson E. (2008) Premenstrual syndrome. Lancet Apr 5;371(9619):1200-10. doi: 10.1016/S0140-6736(08)60527-9. PubMed PMID: 18395582; PubMed Central PMCID: PMC3118460.

3.  van de Ven N, Meijs MH, Vingerhoets A. (2017) What emotional tears convey: Tearful individuals are seen as warmer, but also as less competent. Br J Soc Psychol Mar;56(1):146-160. doi: 10.1111/bjso.12162. Epub 2016 Oct 6. PubMed PMID: 27709633; PubMed Central PMCID: PMC5363367

4. Boden JM, Fergusson DM. (2011) ‘Alcohol and depression’ Addiction May;106(5):906-14. doi: 10.1111/j.1360-0443.2010.03351.x. Epub 2011 Mar 7. Review. PubMed PMID: 21382111

5. Maes M, Mihaylova I, Kubera M, Uytterhoeven M, Vrydags N, Bosmans E. (2009) ‘Lower plasma Coenzyme Q10 in depression: a marker for treatment resistance and chronic fatigue in depression and a risk factor to cardiovascular disorder in that illness’. Neuro Endocrinol Lett. 2009a;30:462–469

6. Sublette ME, Hibbeln JR, Galfalvy H, Oquendo MA, Mann JJ. (2006) ‘Omega-3 polyunsaturated essential fatty acid status as a predictor of future suicide risk’ Am J Psychiatry. 163:1100–1102

7. Sinclair AJ, Begg D, Mathai M, Weisinger RS. (2007) ‘Omega 3 fatty acids and the brain: review of studies in depression’ Asia Pac J Clin Nutr 16(Suppl 1):391–397

8. Cheungpasitporn W, Thongprayoon C, Mao MA, Srivali N, Ungprasert P, Varothai N, Sanguankeo A, Kittanamongkolchai W, Erickson SB. (2015) Hypomagnesaemia linked to depression: a systematic review and meta-analysis. Intern Med J. Apr;45(4):436-40. doi: 10.1111/imj.12682. Review. PubMed PMID: 25827510

9. Rajizadeh A, Mozaffari-Khosravi H, Yassini-Ardakani M, Dehghani A. (2017) ‘Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial’. Nutrition  Mar;35:56-60. doi: 10.1016/j.nut.2016.10.014. Epub 2016 Nov 9. PubMed PMID: 28241991.

10. Sánchez-Villegas A, Doreste J, Schlatter J, Pla J, Bes-Rastrollo M, Martínez-González MA. (2009) ‘Association between folate, vitamin B(6) and vitamin B(12) intake and depression in the SUN cohort study’. J Hum Nutr Diet Apr;22(2):122-33. doi: 10.1111/j.1365-277X.2008.00931.x. Epub 2009 Jan 16. PubMed PMID: 19175490

11. Atmaca, M., Kumru, S., & Tezcan, E. (2003) ‘Fluoxetine versus Vitex Agnus Castus extract in the treatment of Premenstrual Dysphoric Disorder’ Human Psychopharmacology 18(3): 191-5. PubMed PMID 12672170

12. NHS. (2016) Clinical depression. [ONLINE] Available at: http://www.nhs.uk/Conditions/Depression/Pages/Introduction.aspx. [Accessed 17 April 2017]

13. Haghighi ES, Jahromi MK, Daryano Osh F. (2015) ‘Relationship between cardiorespiratory fitness, habitual physical activity, body mass index and premenstrual symptoms in collegiate students’ J Sports Med Phys Fitness Jun;55(6):663-7. PubMed PMID: 26205766

14. Sowislo JF, Orth U. (2012) ‘Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies’ Psychol Bull. Jan;139(1):213-40. doi: 10.1037/a0028931. Epub 2012 Jun 25. PubMed PMID: 22730921

15. Panahi F, Faramarzi M. (2016) ‘The Effects of Mindfulness-Based Cognitive Therapy on Depression and Anxiety in Women with Premenstrual Syndrome’ Depress Res Treat. 9816481. doi: 10.1155/2016/9816481. Epub 2016 Nov 29. PubMed PMID: 28025621; PubMed Central PMCID: PMC5153465

16. Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., … Simon, N. M. (2013). Randomized Controlled Trial of Mindfulness Meditation for Generalized Anxiety Disorder: Effects on Anxiety and Stress Reactivity. The Journal of Clinical Psychiatry, 74(8), 786–792. http://doi.org/10.4088/JCP.12m08083


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