That Time of the Month…Is it PMS or PMDD?

If you have experienced menstruation or know someone who has, you have likely heard the term “PMS,” also known as Premenstrual Syndrome.  This term explains symptoms that occur with a person’s period, such as irritability, bloating, mood swings, and being emotional.  Unfortunately, this phrase often labels women as erratic or crazy.  As a result, the symptoms accompanying a person’s period are constantly belittled and downplayed.  It makes it difficult for a person to feel validated or willing to discuss when something feels off.  Despite this, the changes in hormones and the body throughout a woman’s cycle can cause various symptoms that can interfere with daily functioning and mental health and, in some cases, can be classified as PMDD.

What is PMDD?

1 in 20 women worldwide is affected by Premenstrual Dysphoric Disorder, also known as PMDD.  Those affected by this disorder experience the symptoms of PMS significantly more intensely and chronically.  While it is still unclear what the exact cause is, research has found that hormone changes can cause a serotonin deficiency.  As a result, those afflicted can experience several symptoms, including:

  • Insomnia
  • Anger/irritability
  • Difficulty concentrating/brain fog
  • Anxiety
  • Confusion
  • Severe fatigue
  • Acne
  • Fainting
  • Headache
  • Heart palpitations
  • Easy bruising
  • Swelling of hands/ feet ankles
  • Breast tenderness and swelling
  • Bloating
  • Constipation
  • Pelvic heaviness or pressure
  • Decreased coordination
  • Hot flashes
  • Increased appetite
  • Appetite changes
  • Lack of interest in activities once enjoyed
  • Feeling out of control or overwhelmed

How do I know if I have PMDD and not PMS?

For someone to receive a formal diagnosis of PMDD, at least five symptoms must be present for approximately a year during most menstrual cycles.  These symptoms must interfere with the person’s ability to function in social or work settings and cannot be explained by another medical condition. 

Treatment of PMDD

If you suspect that you or someone you know might meet the criteria of Premenstrual Dysphoric Disorder, it is essential to seek medical treatment and support.  Several treatment options have shown some success in relieving or decreasing symptoms, such as:

  • changes in diet and lifestyle, including regular exercise, increased protein intake, and reduced alcohol, caffeine, and sugar. 
  • Use of birth control pills
  • SSRIs- Selective serotonin reuptake inhibitors
  • Stress management through the support of therapy

Those that experience PMDD may need to change the course of medications throughout their lifetime depending on hormone changes in the body. 

PMDD and Mental Health

PMDD is classified under the DSM-5 as a depressive disorder due to emotional symptoms, including anxiety, panic attacks, and bouts of depression symptoms.  A critical difference between PMDD and depression is that symptoms typically happen 7-10 days before a woman’s period and often decrease around day 2 of the menstrual cycle.  Similar to treatment in psychotherapy during a depressive episode, support from mental health professionals during this time will often spend a lot of time on the use of self-care.  Below are some tips to help get started if you suspect you are suffering from PMDD:

  • Schedule medical appointments and advocate for yourself and your symptoms to receive proper medical support. 
  • Saying no is a complete sentence– when you notice an increase in symptoms, it is okay to put yourself first.  When you don’t listen to your body, you just become more drained.
  • Practice using mindfulness– Meditation and seek out small ways to be present in your body; this is especially important during episodes with increased confusion and feeling disoriented. 
  • Ask for help If symptoms are unmanageable, or you are experiencing thoughts about self-harm, reach out to friends, family, and your care team. 

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