Sitcoms, as well as movies, poke fun at PMS (Premenstrual Syndrome) and female moodiness, but PMDD is not a laughing matter. PMDD (Premenstrual Dysphoric Disorder) is a major depressive disorder gaining more attention since the latest version of the Diagnostic and Statistic Manual of Mental Disorders defines it. PMDD is a mental illness that involves mood changes occurring exclusively during the two weeks prior to menses. 80% of women experience some level of physical and emotional problems during this time, but only 3%-8% meet the definition of PMDD. It is most commonly seen in women who are in their late 30s through their mid 40s.
PMDD symptoms mimic symptoms of major depression with the most common feeling reported being irritability, but unlike depression they are accompanied with breast pain and bloating. Women suffering from PMDD also have an increased risk of suicide during the two weeks they are affected. Also, unlike major depression, it is relieved once menses begins. During this two-week period other symptoms are experienced as well, including the following:
- Anxiety and a feeling of being on edge.
- Severe mood swings up and down with tears, extreme sensitivity to abandonment, and rejection.
- Anger and increased conflict.
- Decreased interest in usual activities.
- Feelings of being overwhelmed as well as feeling out of control.
- Physical symptoms, including joint and muscle pain, as well as weight gain and headaches.
Diagnosing PMDD requires a complete history from the patient. The symptoms must occur only during the two weeks prior to menses for at least two consecutive cycles. It does not classify as PMDD when it happens in conjunction with another illness. Risks and prognostic factors in the DSM V lists two main areas:
Environmental: situations that accompany PMDD are stress, a history of interpersonal trauma, seasonal changes, and socio-cultural; meaning women are affected, not men.
Genetic: It is unknown if PMDD is hereditary, but we do know that premenstrual symptoms are. Between 30%-80% of women who suffered from PMS said other women in their family suffered as well.
If you or someone you love suffers from PMDD, the following suggestions may help relieve the symptoms of depression.
- Exercise helps to relieve the anxiety and depression.
- Dietary changes may help as well, especially eliminating caffeine, alcohol and consuming less salty foods.
- Anti-depressant, as well as anti-anxiety medications prescribed by your doctor; help minimize the depression and anxiety.
- Cognitive behavioral therapy can help by teaching healthy ways to manage anger, frustration, stress, and irritability.
- Seeing your health care provider is important if you suffer from this disease. They help validate that what you have is a real condition, and also will help you feel better with medications and referrals to other health care professionals to improve your quality of life. Suffering in silence or telling yourself what you’re feeling is all in your head is never the best way to advocate for yourself.
PMDD is a mental health issue that women and the men who love them should be aware of. Hormones affect many body functions, and if you’ve noticed that your personality changes two weeks prior to your menses making life and your relationships deteriorate, it’s time to make an appointment with your doctor. Allowing two weeks of each month of your life (and those who love you or work with you) to be chaotic and traumatized by how you feel is not acceptable. –Mary Jo Rapini
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