What is premenstrual dysphoric disorder (PMDD)

For most people these symptoms are mild. But around 5% of women experience a more severe form of PMS, known as premenstrual dysphoric disorder, or PMDD^[1].  

PMDD is a hormone-related disorder (also known as an Endocrine disorder) that can have a serious impact on a person’s life. It can make it difficult to work, socialise and maintain healthy relationships due to the emotional and physical symptoms that can greatly affect someone’s mental health.

At the moment, we don’t understand what exactly causes PMDD. It is thought to be the result of an increased sensitivity to the normal hormonal changes that occur during the menstrual cycle. There is also evidence that it may be related to genetic variations, having a family history of depression or having experienced stressful or traumatic past events.

By learning more about little known conditions like PMDD, we can help more people to recognise the symptoms and get the support they need to live fearlessly.

The unique aspect of premenstrual dysphoric disorder is that it occurs monthly around your menstrual cycle, typically a week or two before your period starts. You might start to feel better on day one of your period, and have no symptoms by the time it ends.

People with PMDD might experience some of the following symptoms^[2].

Emotional experiences 

• Mood swings
• Feeling upset or tearful
• Feeling angry or irritable
• Feelings of anxiety
• Feeling hopeless
• Feelings of tension or being on edge
• Difficulty concentrating
• Feeling overwhelmed
• Lack of energy
• Less interest in activities you normally enjoy
• Suicidal feelings

Physical or behavioural experiences 

• Breast tenderness or swelling
• Pain in your muscles and joints
• Headaches
• Feeling bloated
• Changes in your appetite such as overeating or having specific food cravings
• Sleep problems
• Finding it hard to avoid or resolve conflicts with people around you
• Becoming very upset if you feel that others are rejecting you

PMDD can be frustrating and difficult to deal with, especially if you don’t yet understand everything about it, or have any support in place. If what we’ve described sounds like what you experience or  you think that you might have premenstrual dysphoric disorder, book an appointment with your doctor to talk to them about it. They’ll be able to diagnose your condition, and help you better manage your symptoms going forward, so you don’t have to face your period with dread. 

PMDD can be scary, especially if you’re going through it alone, so try to reach out to the people who can help you. If you find yourself having suicidal thoughts, seek help immediately by either talking to someone you trust or phoning a helpline. 

There are a variety of treatment options for premenstrual dysphoric disorder available, and ways to help manage the symptoms. Things that work for some people include talking therapies, taking antidepressants, using hormonal contraceptives or taking painkillers.

In order to identify if your symptoms align with your menstrual cycle, you may want to track your period alongside keeping a record of your symptoms and how you’re feeling at different parts of your cycle. Collecting all this information can help you to establish a pattern.

Once you work out when PMDD might happen, you can plan ahead. Some people reschedule events or important tasks that may be stressful, and instead make time for things that calm them down. 

It’s important to look after both your emotional and physical health, whether this is getting enough sleep, taking on some gentle exercise, spending time in nature or practising mindfulness to relax. Our advice on how to deal with PMS has some starting points for some lifestyle changes that may help.

[References]

^[1] https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome

^[2] https://www.mind.org.uk/information-support/types-of-mental-health-problems/premenstrual-dysphoric-disorder-pmdd/about-pmdd/