These symptoms typically occur in the week before menstruation and improve within a few days after the period starts. To be classified as PMDD, at least five of these symptoms should be present.
The 11 symptoms of Premenstrual Dysphoric Disorder (PMDD) as classified by the DSM-5 are:
- Severe mood swings: Extreme and unpredictable changes in mood.
- Depression or feelings of hopelessness: Intense sadness, despair, or worthlessness.
- Marked anxiety or tension: Constant worry, nervousness, or feeling on edge.
- Persistent irritability or anger: Heightened irritability leading to conflicts.
- Decreased interest in usual activities: Reduced motivation for daily activities, work, and social interactions.
- Difficulty concentrating: Mental fog affecting memory, planning, and organization.
- Fatigue or lack of energy: Persistent tiredness making everyday tasks exhausting.
- Changes in appetite: Binge eating, specific food cravings, or decreased appetite.
- Sleep problems: Insomnia or hypersomnia affecting overall sleep quality.
- Feeling overwhelmed or out of control: Inability to handle stress or manage daily responsibilities.
- Physical symptoms: May include breast tenderness, headaches, joint or muscle pain, bloating, and weight gain.
How can I differentiate between PMDD and PMS
To differentiate between Premenstrual Dysphoric Disorder (PMDD) and Premenstrual Syndrome (PMS), consider the following key factors:
Severity of Symptoms
- PMS: Symptoms are generally mild to moderate and may cause some discomfort but typically don’t significantly disrupt daily life.
- PMDD: Symptoms are much more severe and can severely impact quality of life, work, and relationships.
Emotional and Mood Symptoms
- PMS: May include mild mood swings, irritability, and feeling a bit depressed.
- PMDD: Involves severe mood swings, intense feelings of depression (potentially including suicidal thoughts), extreme anxiety, and uncontrollable anger or irritability.
Impact on Daily Functioning
- PMS: Generally allows for normal daily activities with minimal disruption.
- PMDD: Often leads to significant impairment in work, school, or social activities.
Timing and Duration
- Both PMS and PMDD symptoms typically occur in the week or two before menstruation and improve within a few days after the period starts.
- PMDD symptoms are present for about 6.5 days during each menstrual cycle.
Diagnosis Criteria
- PMDD: Requires at least five symptoms, including at least one mood-related symptom, present in two consecutive menstrual cycles.
- PMS: Does not have strict diagnostic criteria and is generally less severe.
Resolution of Symptoms
- PMDD: Symptoms completely resolve at the beginning of the period or shortly after.
- PMS: Symptoms may improve but might not fully resolve.
To accurately differentiate between PMS and PMDD, it’s crucial to track symptoms over several menstrual cycles and consult with a healthcare provider for a proper diagnosis.