When PMSing takes an extreme turn

If you’ve been menstruating for a while, you’ve probably experienced premenstrual syndrome (PMS) at some point.  

PMS affects up to 75 per cent of menstruating individuals, according to a report published by UpToDate. It causes physical and behavioural symptoms, like fatigue and irritability, that will usually begin during the 14th day of a menstrual cycle and can last until seven days after the start of menstruation. 

Usually the symptoms are mild or moderate, but for some these symptoms can be much more serious. Premenstrual dysphoric disorder (PMDD) is a severe form of PMS that causes symptoms and intervenes with daily functioning. 

Here is some information to learn more about PMDD, how to recognize symptoms and options for treatment. 

What is PMDD?

PMDD is a chronic condition that affects around three to eight per cent of menstruating individuals, according to UpToDate. There are many symptoms associated with PMDD, both physical and emotional. Some of the physical symptoms can include nausea, diarrhea, painful periods and headaches. Emotional symptoms of PMDD can range from depression, paranoia, feeling out of control and can even trigger thoughts of suicide. In a study published by Social Psychiatry and Psychiatric Epidemiology, it was found that those with PMDD are three times more likely to attempt suicide. It can be a very serious disorder and any related symptoms shouldn’t be ignored. 

What makes PMDD different from PMS?

PMS sucks, there are no arguments there. It can have you wrapped up in a blanket cocoon with a heating pad glued to your belly while nursing some painful cramps. PMS and PMDD do share many characteristics but the main difference is that the symptoms of PMDD are amplified and chronically impair daily functioning, while symptoms of PMS do not. If you find that your PMS symptoms are extreme and are impacting your ability to perform normal activities, it could be a sign to meet with a doctor. 

What causes PMDD?

There isn’t a conclusive answer to what causes PMDD, but many experts believe that it is biologically driven as people around the world have been diagnosed with the disorder. The most agreed upon explanation is that people with PMDD are more sensitive to normal levels of hormone fluctuations, particularly estrogen and progesterone, which triggers biochemical events in the nervous systems and produces the symptoms. 

It’s also important to note that PMDD mood symptoms are only present in menstruating individuals and don’t occur during pregnancy or after menopause, while other mood disorders are usually present throughout a person’s life. 

How is PMDD diagnosed?

To be diagnosed with PMDD, a person must display five or more symptoms—including one mood-related symptom—that are disturbing their ability to function in day-to-day life. A health care provider would likely ask them to track their menstrual cycles for a few months and keep a record of symptoms prior to diagnosis, to rule out the possibility of other affective disorders like depression or anxiety. 

While individuals with other affective disorders can experience worsening symptoms during the pre-menstruating portion of their cycle, they won’t experience the symptom-free interval during the mid-follicular phase that those with PMDD do. To keep track of your symptoms you can use a calendar, a journal or an app. 

Don’t force yourself to “grin and bear it”

PMDD has historically been downplayed. In 2014, the Journal of Clinical Psychiatry conducted a literature review of previous approaches to PMDD and found that individuals have been massively under-treated and accused of fabricating their symptoms. PMDD is serious—don’t downplay your symptoms and don’t allow anyone else to. 

Options for treatment

There are many treatment options available and there isn’t a right answer for everyone. If diagnosed, your doctor may recommend that you partake in daily exercise, implement a caffeine-free diet or introduce vitamin supplements, such as calcium or vitamin B6. Other options include individual or group counselling, which allows you a chance to vent your feelings and meet people with shared experiences. Birth control pills containing drospirenone and serotonin antidepressants have also been found to treat PMDD symptoms.

You can’t make PMDD disappear, but you can learn ways to reduce the severity of your symptoms and continue to enjoy the activities you love.