PMDD is a severe form of PMS with intense physical and emotional symptoms. Learn how to recognize the signs and manage it effectively.

 

What is PMDD?

 

Premenstrual dysphoric disorder (PMDD) can start a week before your actual period! PMDD is similar to PMS (Premenstrual Syndrome), except it is a lot more extreme, especially in the mental toll that it can take on a person. PMDD usually occurs during the luteal phase (the stage before the period) of someone’s cycle. 

 

Emotional Symptoms of PMDD

 

It’s important to note that PMS and PMDD are both very similar in terms of symptoms. Some symptoms are rarer than others while some people with PMDD have more emotional than physical signs, and vice versa. 

Emotional Symptoms Include:

• Severe Fatigue 
• Mood changes, including irritability, nervousness, depression, and anxiety
• Crying spells
• Forgetfulness 
• Panic Attacks 
• Feeling out of Control and Overwhelmed 
• Paranoia  
• Sadness
• Thought of Suicide 
• Loss of interest in activities and relationships 
• Moodiness
• Trouble focusing and Concentrating 
• Sensitive to rejection 
• Self Image issues

… And Much More

 

Physical Symptoms of PMDD

 

Physical symptoms for those with PMDD can be extremely brutal, causing people with PMDD to have problems at work or school. 

Physical Symptoms Include:

• Acne 
• Back Pain
• Bloating
• Breast Swelling and Tenderness 
• Numbness
• Headaches 
• Hot Flashes
• Dizziness
• Gastrointestinal Issues
• Fainting spells
• Vision changes 
• Cramps 
• Painful Periods
• Reduced Sex Drive
• …And Much More

 

What’s the Difference Between PMDD and PMS?

 

PMS is usually considered mild in comparison to PMDD.  About 75% of people with periods feel uncomfortable and in pain during their period. With PMDD, symptoms are usually amplified by a lot more and cause problems even after the pads are put away until the next cycle. To quote Stephanie Samar, a clinical psychologist, “We all can have mood swings before the start of our periods, but in the case of PMDD we’re talking about feeling like a different person,”. 

Daily examples of what someone with PMDD struggles with:

• Symptoms interfere with activities, work, school, or relationships
• Symptoms are not due to a cyclical exacerbation of another disorder
• Documentation of daily symptom ratings for at least two menstrual cycles

 

Causes

 

PMDD is said to be caused by abnormal fluctuations in estrogen and progesterone in the menstrual cycle, which can trigger mood symptoms, including depression, anxiety, irritability, sensitivity to social rejection, and hypersensitivity to one’s environment. Similarly to PMS, these symptoms start during the luteal phase and fade when their period ends and can last up to 14 days of the month! This affects serotonin levels which can cause the mood symptoms mentioned above. 

 

Diagnoses

 

PMDD is usually diagnosed after doing blood tests and physical exams to identify other conditions.

 

 Other conditions similar to PMSS include:

• Chronic Fatigue Syndrome
• Endometriosis 
• Fibroids
• Fibromyalgia
• Hormone Problems
• Major Depression
• Migraine Disorder
• Menopause
• Gastrointestinal Issues
• Panic Disorder 

 

Treatment, Both Medicinal and Natural

 

PMDD can be treated in several different ways to both minimize and handle the effects.  A patient should discuss with their healthcare specialist to come up with the best treatment for them. Every person is different and will feel differently about the changes from the treatment. 

 

Natural Treatments for PMDD include:

• Getting regular and frequent exercise, this can even just be a 30-minute walk around your area 
• Keeping stress factors in check and handling them.  You can also do yoga or meditate to help keep stress at bay
• Moderate the consumption of sweet and savoury snacks and caffeine and alcohol Eating for your mood, meaning food that gives you complex carbs and protein, such as red or white meat, grains, and nuts 
• Cognitive Behaviour Therapy (CBT)
• Herbal supplements – talk to your doctor about a recommended dose

PMDD can be treated with medicine. However, you must talk to your doctors about proper treatment.  There are two types of medicine, those that affect ovulation and those that affect the central nervous system. Antidepressants and hormone medication are often used. The most common type of antidepressant is selective serotonin reuptake inhibitors (SSRIs), which work by increasing serotonin levels in the brain.

 

Some SSRIs used include:

• Citalopram (Celexa)
• Escitalopram (Lexapro)
• Fluoxetine (Prozac, Sarafem)
• Paroxetine (Paxil, Pexeva)
• Sertraline (Zoloft)

Other antidepressants include:

• Buspirone
• Duloxetine (Cymbalta)
• Venlafaxine (Effexor)

Hormone Medication Includes: 

• Birth control, which  can make things better or worse depending on the individual
• Gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide, can stop your ovaries from producing estrogen and progesterone. However, it can temporarily put you into menopause and cause the following symptoms.

• Anxiety
• Depression
• Trouble focusing 

 

 

How To Support and Care For Someone with PMDD

 

PMDD can be tough on a person, and the best way to help and support someone with PMDD is to be patient and supportive. Saying things like ‘Just get over it, it’s normal and you’re being dramatic’ doesn’t help and can make things worse. It’s important to validate and support people with PMDD. One way to do this whilst someone is dealing with complex emotions is simply stepping away and coming back to re-address the situation and communicating in a way that helps people deal with their emotions.  

 

Another way to help someone with PMDD includes:

• Encouraging them to take it easy during periods
• Take PMDD seriously 
• Be a shoulder for them to use
• Take care of your mental health. Examples being

• set boundaries when needed 
• possibly get others to help so you are not on your own
• talk to others about how you are feeling. 

• Try to understand and ask them about their symptoms
• Ask them what they would like during rough days and what would help
• Be patient 
• Reassure them when self-esteem drops
• Plan around their cycle 
• Support them to seek help

 

Outlook Overall On PMDD

 

PMDD tends to resolve on its own once you hit menopause and stop menstruating. You might also find that your symptoms change over time, sometimes for the better. Following along with your symptoms can help you get a better idea of how your symptoms change over time and which treatments work best. Remember, you may need to try several treatments before you find what works for you. This can be a stressful process, so don’t hesitate to reach out to others online or in your community. Whether it’s to talk about your frustrations or a potential treatment option, connecting with others can help make the process a little easier.

 

Summary

 

PMDD can be tough on a person. Mental symptoms include severe fatigue, mood changes including irritability, nervousness, depression, anxiety, panic attacks, feeling out of control and overwhelmed, and paranoia. Physical symptoms can also be tough as they involve headaches, hot flashes, dizziness, gastrointestinal issues, and even fainting spells! The difference between PMS and PMDD is that PMDD interferes more with personal life and can be more painful. To get diagnosed, doctors perform blood tests and physical exams. Treatment for PMDD can be natural or medical. Medicinal treatment includes medicine that affects your hormone and cognitive nervous system. Caring for someone with PMDD involves being patient, communicating with them, as well as understanding that PMDD is a serious part of their lives. PMDD can improve naturally, but overall it’s difficult to get through.

 

Works Cited

Benndorf, Natalie. “Their PMS Mood Swings Were Terrible. It Was PMDD.” Washington Post, 24 Aug. 2022, www.washingtonpost.com/lifestyle/2022/08/24/pmdd-mood-swings-pms/. Accessed 27 Oct. 2022.

Harvard Health Publishing. “Treating Premenstrual Dysphoric Disorder – Harvard Health.” Harvard Health, Harvard Health, Oct. 2009, www.health.harvard.edu/womens-health/treating-premenstrual-dysphoric-disorder.

“Helping Someone with PMDD.” Www.mind.org.uk, www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/for-friends-and-family/#:~:text=Reassure%20them. Accessed 27 Oct. 2022.

Miller, Caroline. “What Is Premenstrual Dysphoric Disorder (PMDD)?” Child Mind Institute, Child Mind Institute, 18 Oct. 2018, childmind.org/article/what-is-premenstrual-dysphoric-disorder-pmdd/. Accessed 27 Oct. 2022.

“Premenstrual Dysphoric Disorder (PMDD): A Severe Form of PMS.” Mayo Clinic, www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/expert-answers/pmdd/faq-20058315#:~:text=Premenstrual%20dysphoric%20disorder%20(PMDD)%20is. Accessed 26 Oct. 2022.

“Premenstrual Dysphoric Disorder: Symptoms, Causes, and Diagnosis.” Www.medicalnewstoday.com, 10 July 2018, www.medicalnewstoday.com/articles/308332.

Watson, Stephanie. “PMDD: A Comprehensive Guide to Premenstrual Dysphoric Disorder.” Healthline, 15 Jan. 2019, www.healthline.com/health/pmdd.