PMDD stands for premenstrual dysphoria disorder, and it affects an estimated 3-8% of people who menstruate. Usually symptoms present in twenties, but there have been cases of teenage women having symptoms of PMDD. As it overlaps with normal symptoms of PMS and exacerbates symptoms of mood disorders such as anxiety or depression, it can often be misdiagnosed. Let’s break down the symptoms, causes, and types of treatments available for PMDD.
What does PMDD look like?
PMDD presents as a more severe form of premenstrual syndrome, or PMS. Though PMS can cause bloating, pain, exhaustion, and changes in sleeping or eating habits, PMDD is characterized by severe changes in emotion or behavior. Extreme mood changes leading up to your period, in addition to average PMS symptoms, can be a strong indicator of PMDD. Some of the emotional and behavioral changes to look for include extreme sadness or hopelessness, anger, anxiety, or irritability. These symptoms are often so severe that they affect one’s ability to function in their normal job, relationship, or living situation.
What causes PMDD?
Though there is no one definitive cause of PMDD, there are a few things that may make you more likely to be diagnosed.
- Those who have a history of PMDD and severe PMS in their family are likely to inherit the same problems surrounding their period.
- Smoking and obesity have been linked to PMDD
- Some speculate that PMDD is an expression of different mood disorders that are triggered monthly by changes in hormones.
- In recent years, however, scientists have found more definitive proof of PMDD in genes: “Researchers at the National Institutes of Health (NIH) have found that women with PMDD have an altered gene complex that processes the body’s response to hormones and stressors”.
This discovery is validating for those who suffer from PMDD, reassuring the afflicted parties of the very real biological basis for their feelings.
How is PMDD treated?
As underlying depression and anxiety are common in those who suffer from PMS and PMDD, treating those issues first may lessen the severity of your symptoms. Oftentimes people who are treated with anti-depressants and anti-anxiety medication find a lessening in the symptoms they usually endure around the time of their period. A psychiatric evaluation can be helpful in determining these underlying mood disorders that are contributing to PMDD.
Lifestyle changes have also been shown to lessen the symptoms of PMDD. Regular exercise and a well-balanced diet, including specific vitamins, can increase endorphins, alleviate pain associated with your period, and stabilize your mood. Birth control is also an option, as it can help regulate hormones and even stop menses.
How is it commonly misdiagnosed?
There is no official test made to diagnose PMDD; because the symptoms so closely resemble other disorders, the most important factor in determining the diagnosis is the timing of the symptoms as they relate to your period cycle. If these symptoms are not occurring regularly in the week or so leading up to your period, you probably are suffering from a mood disorder that is unrelated to the hormonal changes you experience during menstruation. On the other hand, if you do not take note of when your symptoms happen, you may be misdiagnosed with a mood disorder when your suffering may be related solely to your period.
Five or more of the following symptoms must be intensely present before your period to determine a diagnosis of PMDD:
One group of symptoms include mood swings (suddenly being tearful or very sensitive to rejection), marked irritability or anger, marked depressed mood (feelings of hopelessness or self deprecating thoughts), marked anxiety, tension, and or feelings of being keyed up or on the edge.
The other category of symptoms includes a decreased interest in activities, difficulty in concentration, severe fatigue or lethargy, or marked change in appetite. Sleep changes, a sense of being overwhelmed and physical symptoms such as breast tenderness, swelling, joint muscle pain, bloating, weight gain, and severe cramping may also be present.
If you are concerned that you may have PMDD, it is important to track your cycle and your symptoms. The timing of the symptoms is very important to differentiate PMDD from other mood disorders such as anxiety, depression, or bipolar. Bringing this information to a medical professional will help them make a correct diagnosis and hopefully get you the help you need. Please contact me if you would like to discuss your symptoms in more detail.