Trigger warning: this article discusses a depressive disorder and suicidality.
If you are someone who menstruates, it is very likely that you have experienced premenstrual syndrome (PMS). This can usually include mood swings, headaches, nausea, bloating, etc. However, premenstrual dysphoric disorder (PMDD) is much more extreme. Symptoms include drastic drops in mood and a lack of interest in activities. The way you are feeling, in this case, may get in the way of your daily functioning.
What is PMDD?
Psychiatrists classify PMDD as a “depressive disorder” and emphasize emotional and cognitive-behavioural symptoms.
According to the DSM-5, the symptoms include a depressed mood, anxiety, and a decreased interest in activities. They regularly occur a week before your period starts and usually halt within the first few days of bleeding. They also normally do not reappear until at least the date of ovulation (the 13th day of the cycle).
The DSM also says that these symptoms must be severe enough to pointedly interfere with work, school, or usual activities and must be entirely absent for at least one week after period bleeding.
The Difference between PMDD and PMS
What may be frustrating is that some of these symptoms sound a lot like signs of PMS. Aside from the distinct timeline of PMDD, the marked difference between PMS and PMDD is that, in the updated DSM-5, PMDD is now classified as a disorder. This has been such an essential development for those who have felt the difference, definitively, in their everyday lives.
PMS affects up to 75% of people who have their periods. It is much more common, and the symptoms experienced are much less severe. Symptoms include mood changes, bloating, fatigue, headaches, muscle/joint pain, insomnia, etc.
Though PMS and PMDD symptoms may align, the intensity of the experience of these symptoms is marginally different.
Symptoms of PMDD
Below is a list of symptoms of PMDD. If you have 5 or more of these, it is advised that you speak to a doctor. Please note, however, that at least one of them should be from the first four.
(1) marked affective liability (mood swings and feeling suddenly sad, tearful, or having increased sensitivity to rejection)
(2) marked irritability, anger, or increased interpersonal conflicts
(3) marked depressed mood, feelings of hopelessness, or self-deprecating thoughts
(4) marked anxiety, tension, and feelings of being “keyed up” or “on edge”
(5) decreased interest in usual activities (work, school, friends, and hobbies)
Other symptoms may include difficulty in concentration, marked lack of energy (easy fatigability), marked changes in appetite (overeating or specific cravings), hypersomnia or insomnia, and a sense of being overwhelmed or out of control. Physical symptoms include breast tenderness or swelling, joint or muscle pain, bloating, and weight gain.
What can trigger PMDD?
PMDD is not simply an exacerbation of the symptoms of another disorder such as major depressive disorder or panic disorder. However, if you already have a mental health problem, they may compile and, therefore, your experience may worsen.
The brain circuit is made up of receptors and neurotransmitters, one of which is serotonin, which dictate mood/thinking. They function differently in people with PMDD, hence resulting in different emotions.
The Effects of PMDD
According to the National Association for Premenstrual Syndrome, PMDD affects about 8-10% of women (research states “women” but this could also be referring to people with the female anatomy). Furthermore, we must take into account the numbers that have not been reported, especially those from ethnic minorities as well as those who do not identify with their assigned gender.
In addition, according to reports from the International Association For Premenstrual Disorders, PMDD can cause severe emotional, professional, and personal harm to those who have it. Those with PMDD report damaging and impulsive behaviours that may include suddenly leaving a job or a relationship. Others report sudden and increased thoughts about suicide and self-harm. It is thought that around 15% of those with PMDD may attempt suicide at least once.
What can be done?
Our hormones are so commonly irregular that it is hard to feel relieved about our symptoms even with copious amounts of google searches and at-home remedies. A lot of the time, it may be hard to explain our “irregularities”. However, if you feel like you have a lot of these symptoms, we urge you to seek help from your doctor and get the treatment you may need.
More than anything, pay attention to your body and be kind to it. Take the time necessary to help it heal. Understand that, even though things are not always straight forward, you are not alone.