Is PMDD Just "Bad PMS"? Understanding Premenstrual Dysphoric Disorder

For many women, the days leading up to their period can bring on a wave of uncomfortable symptoms – bloating, mood swings, and fatigue. But for some, this experience is far more intense, disrupting their daily lives and relationships. If this sounds familiar, you might be dealing with more than just premenstrual syndrome (PMS). You could have Premenstrual Dysphoric Disorder (PMDD), a more severe and debilitating condition.

This blog post will explore the key differences between PMS and PMDD, and provide a comprehensive guide to understanding and managing this challenging condition.

What is PMDD?

Premenstrual Dysphoric Disorder (PMDD) is a severe, often disabling extension of PMS. While up to 75% of menstruating women experience some form of PMS, PMDD affects a smaller percentage, around 3-8% of women. The key difference lies in the severity of the symptoms, particularly the emotional and psychological ones. PMDD can cause extreme mood shifts that can damage relationships and interfere with your ability to function at work, school, or home.

Symptoms of PMDD

The symptoms of PMDD typically appear in the week or two before your period and start to improve within a few days of your period starting. To be diagnosed with PMDD, you must experience at least five of the following symptoms, with at least one being a significant mood-related symptom:

Mood & Emotional Symptoms:

• Feelings of sadness, hopelessness, or even suicidal thoughts

• Anxiety, tension, or feeling "on edge"

• Extreme mood swings, often with frequent crying

• Marked irritability, anger, or increased conflicts with others

• Feeling overwhelmed or out of control

Other, Physical & Behavioural Symptoms:

• Decreased interest in usual activities (work, school, hobbies)

• Fatigue or low energy

• Difficulty concentrating

• Changes in appetite, such as overeating or specific food cravings

• Sleep problems (insomnia or hypersomnia)

• Physical symptoms like bloating, breast tenderness, headaches, or joint and muscle pain

Why It Happens

The exact cause of PMDD is not yet fully understood, but it's believed to be a severe reaction to the natural hormone fluctuations that occur during the menstrual cycle. It's not a hormonal imbalance, but rather a sensitivity to these changes. Other contributing factors may include:

• Serotonin Levels: The hormonal changes that trigger a menstrual period may also cause a decrease in serotonin, a brain chemical that helps regulate mood, sleep, and appetite.

• Genetics: PMDD may run in families.

• Stress: High levels of stress can worsen PMDD symptoms.

• Past Trauma: Some research suggests a link between a history of trauma and PMDD.

The Impact of PMDD on Daily Life

Living with PMDD can be incredibly challenging. The emotional and physical symptoms can make it difficult to maintain relationships, perform well at work or school, and engage in daily activities. Many women with PMDD report feeling isolated and misunderstood.

If you are struggling with the impact of PMDD, it's important to remember that you are not alone and that help is available. You may find our post on building a strong support system helpful.

Diagnosis

If you think you may have PMDD, it's essential to speak with a healthcare professional. To diagnose PMDD, your doctor will likely:

• Discuss your symptoms: They will want to know about the type, severity, and timing of your symptoms.

• Ask you to track your symptoms: You will likely be asked to keep a daily record of your symptoms for at least two menstrual cycles to confirm that they are linked to your cycle.

• Rule out other conditions: Your doctor may perform tests to rule out other medical conditions that could be causing your symptoms, such as thyroid problems or mood disorders.

Treatment for PMDD

The good news is that there are many effective treatments for PMDD. The best approach is often a combination of lifestyle changes, therapy, and, in some cases, medication.

Lifestyle Changes:

• Diet: Eating a balanced diet with plenty of fruits, vegetables, and whole grains can help. Reducing your intake of sugar, salt, caffeine, and alcohol may also make a difference.

• Exercise: Regular aerobic exercise, such as brisk walking, jogging, or swimming, can help reduce symptoms of depression, anxiety, and fatigue.

• Stress Management: Techniques like yoga, meditation, and mindfulness can help you cope with stress and reduce the severity of your symptoms.

Therapy:

• Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that can help you learn to identify and change negative thought patterns and behaviours that may be contributing to your PMDD symptoms.

Medication:

• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) are often the first-line treatment for PMDD.

• Contraceptive Pills: Certain types of birth control pills can help regulate your hormones and reduce PMDD symptoms. For some, this is the most desirable treatment.

• Other hormonal medications: For treatment resistant cases, specialist care is recommended.

For more detailed information on treatment options, we encourage you to explore our guide to holistic mental wellness.

When to Seek Help

If you are experiencing symptoms of PMDD that are interfering with your daily life, it's important to seek help from a healthcare professional. You should also seek immediate help if you are having thoughts of harming yourself.

Trusted Services and Organisations:

• International Association for Premenstrual Disorders (IAPMD): https://iapmd.org/ - An excellent resource for information, support, and advocacy for those with PMDD.

• Jean Hailes for Women's Health: https://www.jeanhailes.org.au/ - A national not-for-profit organization dedicated to improving women's health.

• Beyond Blue: https://www.beyondblue.org.au/ - Provides information and support to help everyone in Australia achieve their best possible mental health.

• Black Dog Institute: https://www.blackdoginstitute.org.au/ - A world leader in the diagnosis, treatment, and prevention of mood disorders.

Lunea's Role

At Lunea, we understand the unique challenges that women face when it comes to mental health. Our team of compassionate and experienced therapists is here to support you on your journey to wellness. We offer a range of services tailored to meet your individual needs, including a comprehensive assessment and management plan for you and your GP to follow.

If you are struggling with PMDD or any other mental health concern, we encourage you to contact us today to learn more about how we can help. You don't have to go through this alone.

References:

• Mayo Clinic. (2021). Premenstrual dysphoric disorder: Different from PMS?. https://www.mayoclinic.org/diseases-conditions/premenstrual-syndrome/expert-answers/pmdd/faq-20058315

• Mind. (n.d.). Symptoms of PMDD. https://www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/symptoms-of-pmdd/

• Womenshealth.gov. (2021). Premenstrual dysphoric disorder (PMDD). https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome/premenstrual-dysphoric-disorder-pmdd

• Jean Hailes for Women's Health. (2024). PMS, PMDD and you. https://www.jeanhailes.org.au/news/pms-and-pmdd-and-you

Disclaimer: This blog post is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.