Premenstrual Dysphoric Disorder, more commonly known as PMDD, is a severe form of PMS that includes physical and psychological symptoms that usually resolve within a few days of the onset of a woman's period. Although regular PMS and PMDD have many overlapping symptoms, PMDD causes these symptoms to present in extremes and can disrupt your daily functioning. PMDD typically emerges in a woman's late teens and early twenties, a time which is typically already chaotic enough without a serious form of PMS thrown in.
1. It can be debilitating
While many of the symptoms of PMDD overlap with those of PMS, PMDD leaves you feeling completely debilitated. The symptoms are both psychological and physical, and they affect daily living as well as threaten the sufferer's well being. PMDD can leave you bedridden or feeling like you have completely lost your mind.
2. Only about 5% of women experience symptoms severe enough to classify as PMDD
The symptoms that they suffer also last far longer than normal PMS. Typically, the symptoms begin to show up about 1-2 weeks before your period and then usually they subside within a few days of the onset of your period. This leaves sufferers of PMDD in pain for about half of every month. Because so few women experience this disorder, this is not a lot of research surrounding it which leaves many unanswered questions and a lot of trial and error when it comes to treatment.
3. There are a variety of symptoms associated with PMDD and each case tends to present a unique combination
Physical: severe fatigue, heart palpitations, coordination difficulties, abdominal bloating, nausea, change in appetite, headaches, hot flashes, dizziness, muscle spasms, cramps, easy bruising, backache, joint pain, heightened physical sensitivity
Psychological: irritability, nervousness, anxiety, panic attacks, depression, crying fits, emotional sensitivity, difficulty concentrating, paranoia, forgetfulness, issues with self-image, decreased libido, insomnia, restlessness, apathy towards usually enjoyed activities, suicidal thoughts
4. The specific cause of PMDD is still unknown
There are a few things that tend to be risk factors for women who experience PMDD such as a personal or family history of postpartum depression, mood disorders, depression, or other mental illnesses. However, it is also thought that PMDD could stem from the brain's abnormal response to a woman's fluctuation of normal hormones during her menstrual cycle which could lead to a deficiency in the neurotransmitter Serotonin causing many of the psychological symptoms.
5. PMDD is not diagnosed lightly
Guidelines from the American Psychiatric Association (APA) are used to determine if the symptoms constitute PMDD. The symptoms must be present for at least two menstrual cycles, be present a week before the onset of your period, resolve after the start or within a few days of your period, and interfere with normal daily living. You also must present a certain amount of the criteria laid out by the APA. It is only after this that you can be properly diagnosed with PMDD and begin treatment for it.
6. PMDD is very treatable
For the most part, prescription medication is necessary. The symptoms tend to be too severe to treat using over the counter drugs and home remedies, while these can be a helpful supplement, they are not typically a complete solution. In most cases, an SSRI antidepressant (Prozac, Zoloft, etc.), a birth control pill, or a combination of the two may be prescribed in order to combat the symptoms of PMDD. In addition, most doctors will also suggest taking supplements such as calcium, magnesium, and vitamin D.
7. Certain lifestyle changes can be effective in reducing the severity of PMDD symptoms
While there is not enough scientific research to dictate whether these methods are actually effective, many people have found that yoga and general exercise throughout the month lessened their symptoms. Some people have also said that decreasing the amount of processed sugar, caffeine, and alcohol in their diet, particularly in the days leading up to their period has helped. Traditional home remedies that people use for generic PMS can sometimes alleviate PMDD symptoms as well, such as using a heating pad, taking a hot bath/shower, and taking over the counter pain relievers for muscle aches.
8. Be kind to yourself, especially in the days leading up to your period
A big part of PMDD is feeling isolated and having a suffering body image, so it is really important to make sure that you are taking care of yourself emotionally. Let those around you know what you are going through so that they can be there to support you. Allow yourself time to just do something you enjoy and that relaxes you.
9. If you think you have PMDD, speak up
Talk to your family doctor or your gynecologist or a mental health professional. Tell someone what you are going through so that if it is PMDD you can start treating it, or if it's something else you can get the help you need for that. Don't suffer in silence or assume that it is "just PMS."
PMDD can be debilitating, especially when there is comorbidity between it and another mental health issue. I started out a Friday night a few weeks ago having what I thought was a normal panic attack, which usually subsides and is gone by the next morning. But it only continued to get worse and lasted for about five more days, I was nauseous and had no appetite, I was exhausted and couldn't sleep, my entire body was on high alert. I could not stop crying, I wasn't interested in anything I normally am, death crossed my mind a lot more than I would care to admit, and if I was a weaker person I'm not sure I would have survived it.
I happened to be seeing a psychiatrist for a preexisting mental health issue about 6 days after this episode started. The morning of my appointment, I woke up and realized I had gotten my period and it was like a switch flipped. I still did not feel like myself, but a lot of the symptoms felt duller and less present. When I got to the doctor's office, I explained what had happened. There was no question that what I had was PMDD. My symptoms were severe and debilitating and I'm still scared that they might come back each month, but the monster I was facing now has a name. The worst part about the entire experience was that I thought I was going crazy — I didn't know what was wrong with me and I felt alone. Learning that what I was going through had a medical name and that other people had gone through it validated everything I was feeling and allowed me to feel not so crazy.
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