When It’s More Than PMS: Premenstrual Dysphoric Disorder, or PMDD

Most women deal with at least some of the symptoms of Premenstrual Syndrome, or PMS, during their lifetimes, with symptoms sometimes beginning as early as their first period. PMS symptoms may involve physical changes, such as acne, cramping, bloating, and breast tenderness; emotional changes, such as mood swings, angry outbursts or crying jags, and behavioral changes, such as social withdrawal and changes in libido. These symptoms are usually mild. They may begin 1 to 2 weeks before the onset of a woman’s period and tend to resolve within four days after menstruation begins.

A small percentage of women, however, experience chronic and severe premenstrual symptoms that interfere with their ability to function. This severe form of premenstrual syndrome is called premenstrual dysphoric disorder, or PMDD. The Harvard Women’s Health Watch estimates that 5-8% of women suffer from PMDD. The disorder causes disabling levels of depression, anxiety, and irritability or anger during the one to two weeks before one’s period. In addition, women who suffer from PMDD may have difficulty concentrating on everyday tasks. They may feel as though they have no energy, and may either sleep more than usual or struggle with insomnia. They may feel overwhelmed or out of control, and subsequently withdraw from their partners, family, and friends.

Where the physical symptoms of PMS tend to be mild, women who suffer from PMDD tend to have more acute physical symptoms before their periods. These may include nausea, vomiting, dizziness, fainting, migraine headaches, heart palpitations, muscle spasms, body aches, moderate to severe breast tenderness and abdominal cramping, and weight gain.

If you feel you may be suffering from PMDD, it’s important to track your symptoms for at least one to two cycles. Doing so is critical to receiving the correct diagnosis. Record how you are feeling each day, including notes on your emotional, physical, and behavioral wellbeing. Be sure to make note of the days you are actively menstruating in your log. Then discuss your symptoms and concerns with your doctor. If you are diagnosed with PMDD, your doctor will likely recommend a combination of lifestyle changes and medications such as birth control pills and/or an antidepressant. These approaches have been proven extremely effective for alleviating PMDD symptoms, making it so that those with PMDD can live their best lives all month long.