What is PMDD?

Premenstrual Dysphoric Disorder affects only 3-8% of women. It is a severe form of Premenstrual Syndrome or PMS. Almost all women suffer some kind of symptoms when their menstrual period is due. They may become snappy and grumpy, they may deal with cramps, backache or tender breasts, however, PMS sufferers can manage these symptoms effectively and their lives are not disrupted by their menstrual period.
PMDD sufferers experience many if not all possible physical symptoms, but the distinguishing factor of PMDD is the extreme swings in mood and how they feel about themselves and others.

PMDD is a cyclical disorder. It will affect a woman every single month. Most ladies with PMDD will experience physical discomfort and emotional changes that begin around a week before their period, lasting till bleeding commences. However, due to being sensitive to hormone changes, some women experience symptoms during the ovulatory phase of their cycle too.
It is thought that a women with PMDD is more sensitive to the body's naturally changing hormones. It is also thought that these changes can bring about a drop in serotonin in the brain, which can cause a number of unpleasant symptoms. Serotonin is the body's natural feel good hormones, and many PMDD sufferers experience symptoms of low serotonin.

Physical changes and symptoms can include the following:

Abdominal cramps, period pain, backache, hip pain, tender breasts, nausea and sickness, lethargy, fatigue, insomnia, changes in appetite, sensitivity to sound and smell, headaches, memory loss, bloating, loss or boost to libido and weight gain.

Emotional changes and symptoms can include:

Markedly depressed mood, feelings of hopelessness, heightened anxiety, increased tension, sudden shifts in mood, tearfulness, overly sensitive, persistent angry or irritable outbursts, increased personal conflicts, frustration, panic attacks, persecutory delusions, racing thoughts, feeling overwhelmed or out of control, indecisiveness, and confusion.

Lifestyle changes:

Loss of interest in usual activities, unable to think clearly to make simple decisions, cancelling outings or events, hiding indoors and avoiding contact with others, damaging relationships via texts, online or verbally, losing friends, being unable to cope with usual tasks or requests, difficulty in keeping employment, difficulty focusing on studies or work.

An important note on Dysphoria.

PMDD is distinguished from PMS by the use of the word dysphoric. PMDD sufferers often describe their symptoms as a feeling of 'going mad' or 'going insane'. They feel out of control of their emotions and find their minds full of racing negative thoughts. Some say it feels like being possessed and many women will describe themselves as Jekyll and Hyde.
The dysphoria element is often overlooked yet is one of the hardest things for a woman to deal with. For a certain amount of days or weeks out of the month right before their period and/or around ovulation, a PMDD sufferer will experience a complete shift and change in being.
Dysphoric states bring about a complete change in perception for the sufferer. They may believe they are being persecuted in some way. That friends and family are fed up with them and dislike them. They may feel panic over not being believed or understood. They feel a great amount of frustration that despite whatever attempts they made during the rest of the month to 'help themselves get better' the feelings and depression are back, with full force and they are yet again caught up in the whirlwind of dysphoria.

A women with PMDD is faced with an eternal cycle of symptoms. The PMDD 'episodes' or 'states of dysphoria' will turn up without fail every month. The only thing that seems to change is the severity. Some months will pass without too much damage to relationships, work or the self, but other months will be explosive and destructive, to the sufferer and those around them.

How do you know if it's PMDD and not something else like depression?

PMDD is characterised by is cyclical nature and the fact that for at least 7-10 days of the month between periods, the woman has no symptoms. They are, for want of a better word, 'normal'. Many women call this their 'good' days or 'up' time. They can maintain relationships, cope with life, home, kids, and work. They are confident, happy and organised. They feel normal, stable and able to cope. They can go out and socialise, answer the phone and participate online. They have a clarity of mind to know what they want and can make decisions again. It really is like a black cloud has lifted and they are able to function normally again.
Depression will not lift in this way. If you suffer from depression, every day is a 'down' day or 'downtime'. PMDD sufferers may experience depression during their 'down' days, but it is a feeling that always lifts, and relief is found.

PMDD is often misdiagnosed as bi-polar disorder due to the extreme changes in mood. Bi-polar sufferers may suffer a couple of episodes a year of extreme up's or downs. These episodes can last months, but when the Bi-polar sufferer becomes stable again they are able to maintain a 'normal' life, sometimes for months, between episodes. The closest form of Bi-polar to PMDD is rapid-cycling Bi-polar, where the diagnosis is for 4 or more episodes in a year. PMDD sufferers don't get a few months between down times, they suffer every month, 12 times a year, double that if they are affected at ovulation as well.

If there is underlying depression or mental health problems, you may then experience PME, Premenstrual Exacerbation. This is a worsening of your current condition due to and during the changes in the menstrual cycle.

Basically, if you feel fine for at least 7-10 days of the month and you have no symptoms, no mood swings, no negative effects to your life, yet a week before menstruation you sink into a depression, find your self anxious and unable to leave the house, or angry with volatile outbursts, then you are probably suffering PMDD. PMDD will lift once your period starts. Some ladies will get relief right from day 1, where as some will find the black cloud lifts on day 5 or 6. One thing is for sure, all the crazy feelings and emotions will pass, and most women just hang on for dear life until their period has ended and they are back into a couple of weeks of feeling stable and happy.

I think I have PMDD, how do I get my doctor to give me a diagnosis?

For PMDD to be diagnosed, you will need to be experiencing at least 5 of the above symptoms every month. They may not always be the same symptoms every month, but currently, the diagnosis is for a combination of at least 5 symptoms. These symptoms have to be extreme enough to interfere significantly with daily life, work, relationships, studies or social activities.

You will need to chart your symptoms for at least 2 months. Charting means keeping a track of all your symptoms throughout the month to build up a picture of your up and down times. If you have PMDD you will be able to see an obvious rise in symptoms during the last part of your cycle, and maybe at ovulation.

You can find mood charts online that you can download and print off. Some websites allow you to track symptoms online, and there are many iPhone and Android apps for keeping track of your cycle. How ever you do it, make sure you can take an actually paper copy in with you to your GP. For me, printing off a chart and filling it in worked better. Simple and not usually anything more that colouring in or ticking boxes.

Visit your GP, and take along some print outs about PMDD. There are many GP's who have still never heard of PMDD. That doesn't mean that they wont want to help, so it's always worth helping your doctor get you the right diagnosis. Start a chart as soon as you can, as you will need 2-3 months worth for your doctor to diagnose you correctly.

Have a look through the links on this blog.. there is lots of information here to get you started.


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Marci Ramirez said...

Pmdd hurts, and I find relief in paroxitine and Yaz

Marci Ramirez said...

I knew it was pmdd, never hear of it like that but it hurt 1-2 wks before my menstrual, I felt mad, like a Maf lady, crying having negative thoughts, empty, very Depressed!!, my heart would beat uncomfortably!! Found relief in the Almghty and Yaz! ! , & paxil, whewww;)

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Suzann Schenkel said...

Described perfectly...I've never read a more accurate description of what I feel like.

Suzann Schenkel said...

Described perfectly...I've never read a more accurate description of what I feel like.

Rayven Jones said...

I absolutely love this and agree with sooooo much written here! I have a blog of my own and am going to link yours in one of my posts about PMDD, as I think it perfectly describes what it's like. Like so many have already stated, this is a perfect description of what it feels like to be me. I am so glad I'm not alone.

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lisa green said...

This is a really well written article! I was diagnosed today so I found it incredibly helpful. I just wanted to say though that bipolar isn't quite as simple as it's made out to be, I hate the fact people don't understand PMDD and wouldn't want people to get the wrong impression of bipolar either.

People with the condition get extreme highs and lows,instead of feeling "normal" and depressed. They can also hear voices and have hallucinations, which my friend had and was incredibly scared.

Thanks again for the article and it's nice to read so many positive comments

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Unknown said...

thanks for your post. is there any recommendation for spouses on how to support their women during this phase? my husband has not been very supportive and instead made it worse for me. it's ruining our relationship. I have even sent him articles to explain what I'm going through, I even took him to a mental health discussion panel
it's like he's lost interest in me because of this stupid disorder. what if it is just all on my head and it's not real??

Amanda said...


Unknown said...

This really helped me.wow

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The Shepherd said...

I don't know if this is still relevant, as this post lies back a few months... But whatever happens in your head IS real to you, and you need to respect it for that. So what you can to make your burden lighter, maybe psychological help could be your friend. If your husband has continued to be such a jackass, he will probably be running your relationship into an unsustainable place anyway, and there's only so much you can do to save it. Do what's best for you! Wish you the best

The Shepherd said...

I don't know if this is still relevant, as this post lies back a few months... But whatever happens in your head IS real to you, and you need to respect it for that. So what you can to make your burden lighter, maybe psychological help could be your friend. If your husband has continued to be such a jackass, he will probably be running your relationship into an unsustainable place anyway, and there's only so much you can do to save it. Do what's best for you! Wish you the best

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Chopper Chic said...

Googling PMDD led me here. I am 48 years old and am ecstatic that this blog exists. I have been suffering from this disorder since I got my first period. I truly don't know how I am here today after surviving the monthly escalated mood swing a week before, days approaching or day of my period. In my 20s every month I wanted to end my life. I had a wonderful husband two beautiful children and a very comfortable life. But that week before the devil came I was a mess. WTH? I diagnosed myself in my mid 30s knowing myself and knowing the definition of PMS I was fed up with the cycles and wanted to know more. I knew PMS, bi-polar disorder, etc. was not characteristics of my problem. After digging and researching I believe maybe in 2008 I found something finally that described my issue a lot better. Research was just touching on the subject back then. Now as I am older, and get older, the symptoms seem to be watered down a bit. I hope this can be a sign of hope for some. Today there is so much more research happening! I am so happy to see it. Please know if your dealing with this disorder you are not alone and more and more women are sharing their experiences and will help you understand how to help yourself. Don't left people label you that your just having some bad PMS. I cringe when I hear this. This is a serious disorder! Take care of yourself, eat healthy, exercise, calendar your period and episodes, take natural supplements and monitor yourself. No medications are proven to magically cure your symptoms. Its up to you to take charge and help yourself and find support. Good luck!

Ale G. said...

I have PMDD and it's The worst shit ever. Every month it's like having labor pains. It's like a demon takes over and I can't do nothing about it.Yes my Dr. Gives me meds but they make me feel worse. Some meds make me numb and some make me feel like I'm on meth. That's why I decided not to take them at all. So now every month I have to deal with the pain.

Robert Youngs said...

One of the best things is to opt for - natural remedies for pms. Not only these are highly effective but also come with zero side effects.

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Micah Jasz said...

Great post. It described everything to the tea. I would drink more around the time I was having episodes which made thing so much worse. I completely tore up an almost perfect relationship. That's all I think about on my good days. This month was probably the worse episode I had. Thanks for posting. Just seeing that I'm not the only one suffering gives a little relief.

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hazelii said...
This comment has been removed by the author.
hazelii said...

I too, have self-diagnosed myself to have PMDD. Every month before my period I have bouts of severe anxiety. I get extremely irritable and can not focus, think nor remember the simplest things. I am so emotional and sensitive. I get very mean and nasty which has caused a strain on my relationship. Fortunately, I finally discovered that I have this disorder after finding out my niece was diagnosed with it when she began attempting suicide. I then realized I've had suicide thoughts myself. I've never reacted on it but always felt worthlessness and feeling that I should give up on life when I'm going through this phase. I am also in the perimenopause stage of life so my periods fluctuate causing me to have a roller coaster of normalcy and feelings of an emotional train reck. I refuse to take any prescribed medicines that I've learned can make you feel like a zombie. So I've done some research and found a natural remedy online called HTP-5. I take 50 mil of Natrol HTP-5 at night and 50 mils in the morning and have been feeling great. My anxiety has gone away and I can focus and feel normal. This all natural plant made pill gave me my life back!! I recommend it to anyone who has PMDD. Please research this pill because I've read that you should not take it with any depression prescribed medicine for PMDD.

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Marry Davis said...

Many women are concerned they’re pregnant if they have cramps at the end of a period or cramping a week afterward. This is a very, very rare occurrence. Stomach pain after your period could be your body simply readjusting out of your cycle.

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