Premenstrual Dysphoric Disorder, or PMDD, is a condition that is characterized by severe depression symptoms. These symptoms are very similar to the symptoms of Major Depressive Disorder. The only difference is premenstrual dysphoric disorder exhibits symptoms cyclically, occurring once a month at the start of your menstrual cycle. The DSM-IV specifies PMDD as a “depressive disorder not otherwise specified.” There is some controversy over PMDD’s validity as a disorder depending on who you ask. Researchers, psychologists, and physicians fall on different sides of the divide. Some research suggests a link between depression and PMDD, and researchers suggest that maybe women are just depressed and that PMDD is a “culture-bound,” disorder that depends on our cultural belief that women go crazy once a month.
Some psychologists argue that it is easier for us to believe that than to acknowledge the prevalence of depression in women. Is it easier to legitimize the reality of the physical discomfort women experience during their period if we as a culture attribute it to a mental disorder? Studies show that there are no significant differences when comparing hormone levels of women diagnosed with PMDD and women who have not been diagnosed with PMDD. Doctors say this is because even though all women go through the same types of hormone fluctuations each month, some women are more sensitive to these changes in hormone levels. These sensitivities are thought to be inherited, or triggered by environmental stress. Having a history of traumatic stress has been associated with premenstrual dysphoric disorder.
Over 3 million cases of premenstrual dysphoric disorder are diagnosed every year. PMDD is diagnosed only when you are experiencing serious premenstrual distress that is causing a decrease in your functioning. Despite the fact that clinically significant problems with premenstrual mood and behavior have been acknowledged since ancient times, PMS and PMDD are relatively new concepts (PMDD was added to the Diagnostic and Statistical Manual of Mental Disorders V in 2013), and can sometimes be difficult to diagnose. The exact pathogenesis of PMDD is not clear and is still being actively researched.
The symptoms of PMDD are like PMS symptoms mixed with symptoms of major depression. The symptoms of PMDD are broad and far-reaching, and can only be used to diagnose PMDD if the symptoms appear right before and at the beginning of your period, and disappear soon after the start of your period. Common PMDD symptoms are:
- Changes in Appetite
- Diminished Sex Drive
- Economic Dysfunction Due to Symptoms
- Feeling Overwhelmed
- Food Cravings
- Hypersomnia (Excessive sleepiness)
- Increased Sensitivity to Rejection
- Insomnia (Inability to sleep)
- Lack of Concentration
- Loss of Interest in Usual Activities
- Mood Swings
- Muscle Aches
- Painful Menstruation
- Pain in Breasts
- Pain in Pelvis
- Panic Attacks
- Self-Critical Thoughts
- Social Dysfunction Due to Symptoms
- Suicidal Thoughts
- Water Retention
- Weight Gain
Clinical psychologists, gynecologists, and primary care physicians can all diagnose your PMDD. Doctors perform certain lab tests for PMDD including complete blood count (CBC), thyroid function tests, follicle stimulating hormone level test (FSH). These tests are designed to rule out disorders that have similar symptoms to premenstrual dysphoric disorders such as anemia, menopause, perimenopause, and thyroid disorders.
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- Cognitive Behavioral Therapy
- Light Therapy
- Relaxation Techniques
- Sleep Deprivation
- Talk Therapy
Medication based therapies are also available to you. These therapies include the use of the following medications:
- Mood Stabilizers
- Non-Steroidal Inflammatory Drugs (nSAIDS)
If you have the following disorders in your family members of family history you are at risk for PMDD:
- Mood Disorders
- Post-Partum Depression
Unfortunately, there is no evidence in the medical community that PMDD can be cured at this time. You just need to find a combination of treatments that are right for you. You can talk to your doctor about the right treatments for your specific symptoms. Your doctor can help you by discussing your options with you and answering any questions you have about premenstrual dysphoric disorder. Together you can decide on an option, and whether it is medication-based, homeopathic, talk-therapy based, relaxation-based, or any combination of these.