You’ve likely heard of premenstrual syndrome or PMS, but what about premenstrual dysphoric disorder or PMDD? Most menstruating women experience at least some PMS symptoms, but when those issues start to restrict your daily activities and occur every month, you might have a more serious condition.
PMDD symptoms are similar to PMS, but they’re substantially more severe. For example, PMS cramps might rate a 3 out of 10 on the pain scale, but pain from PMDD could come in at a 7 or worse. If you think you might have PMDD symptoms, it’s important to get a diagnosis as quickly as possible.
What Is Premenstrual Dysphoric Disorder (PMDD)?
Approximately 5% of women of childbearing age experience PMDD symptoms. PMDD is PMS taken to an extreme. Where PMS might mean taking pain medication regularly and paying attention to your mood, PMDD is much worse. It’s more than just feeling irritable or having intermittent cramps. PMDD can feel like overwhelming floods of emotion, digestive upset and even severe physical pain. Remember that PMDD is a serious medical condition, so getting treatment is the first step in managing the condition and getting relief.
PMDD Symptoms and Signs
To get PMDD treatment, you need to know what to look for so you can get a diagnosis. PMDD symptoms can include emotional, physical and cognitive changes. Typically with premenstrual dysphoric disorders, symptoms occur during the luteal phase of the menstrual cycle, which is the period after ovulation and before menstruation. During this timeframe, if you have PMDD, you may notice:
- Severe mood swings. You feel happy one minute only to have a hard crash into sadness or depression the next.
- Irritability. You explode in anger or frustration at the slightest inconvenience.
- Anxiety. You feel scared or helpless without any specific trigger.
- Difficulty concentrating. You feel foggy for days on end or struggle to stay on task.
- Forgetfulness. You might not remember important appointments or deadlines.
In addition to these cognitive and emotional symptoms, periods can also come with a long list of physical complaints. Breast tenderness, bloating and headaches are common to many women during their period, and joint and/or muscle pain can also occur. Fatigue and sleep disturbances can also impact day-to-day life while dealing with PMDD.
PMDD vs. Everyday Emotions
For a PMDD diagnosis, it’s critical to understand the difference between this condition and the common emotional fluctuations everyone experiences. Some of the best ways to differentiate rely on your ability to recognize the duration and severity of emotional fluctuations. If you have a moment of irritability, it likely means you’re dealing with standard PMS. If you have mood swings that can last for hours or days and disrupt your everyday life for a week or more each month, it’s more likely to be PMDD.
In addition, PMS and normal periods don’t have a significant impact on your ability to function. You have experience regulating your everyday emotions and a lot of practice keeping them under control. PMDD can make maintaining relationships, performing at work or handling routine activities challenging. Another way you can detect PMDD is by determining how often these symptoms occur and when. If you have these symptoms at times that are consistent within your menstrual cycle, it’s likely time to seek out help from a medical professional.
Other Similar Conditions
While no other disorder is an exact match for PMDD, several conditions have very similar symptom lists. Some of the most common include:
- PMS (premenstrual syndrome). While PMS and PMDD share some symptoms, PMS is generally less severe and doesn’t have the same level of impact on daily life.
- Depression and anxiety disorders. These can occur independently of the menstrual cycle and persist throughout the month, while PMDD symptoms are cyclical.
- Bipolar disorder. Characterized by extreme mood swings, this disorder’s mood changes are not typically linked to the menstrual cycle.
- Thyroid disorders. Hypothyroidism or hyperthyroidism can cause mood changes, fatigue and other symptoms similar to PMDD.
It’s important to discuss your symptoms with a health care professional to rule out other conditions and ensure an accurate diagnosis. Thyroid disorders can often be diagnosed or ruled out with a blood test, but other conditions might take more time to rule out. A good rule of thumb is that if the symptoms aren’t linked to your menstrual cycle, you might need to explore alternatives to PMDD.
Next Steps to Take
If you suspect you have PMDD, the first step is to seek professional help. To help your doctor, track your symptoms for a month or two so your medical provider can get a better understanding of the severity and regularity of your symptoms.
You’ll want to show your symptom tracker to your primary care doctor or a gynecologist. You may need to work with your health care provider over several visits to rule out similar conditions and get a PMDD diagnosis. Once diagnosed, treatment is likely to include several therapies offered at the same time, including:
- Lifestyle changes. Regular exercise, a healthy diet and sufficient sleep can help manage symptoms.
- Medications. Antidepressants (SSRIs), hormonal treatments (like birth control pills) and nonsteroidal anti-inflammatory drugs (NSAIDs) are all possible treatment options.
- Therapy. Cognitive behavioral therapy (CBT) can provide strategies to cope with mood swings and uncontrolled emotions.
- Nutritional supplements. Calcium, magnesium and vitamin B6 taken as a combo can help with symptoms such as headaches and general fatigue.
To keep your symptoms under control, it’s important to schedule regular follow-ups with your health care provider. You may need to adjust your treatments as symptoms change in severity or duration. It’s also critical to have a reliable support network of friends and family to help you as you start your treatment.
Remember, seeking help is a sign of strength, not weakness. PMDD is a medical condition, and there’s no shame in needing and asking for support. Whether you reach out to a friend, family member or health care professional, the important thing is to take that first step.
Get Help for Your PMDD at the Mental Health Hotline
With the right care and support, managing PMDD symptoms is possible. Call the Mental Health Hotline to talk with trained counselors and get help finding local mental health care professionals who can help you with the emotional symptoms of PMDD.
