Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that affects 5-8% of menstruating women. It is characterized by intense emotional, cognitive, and physical symptoms that occur during the luteal phase of the menstrual cycle, typically 1-2 weeks before menstruation begins.
Key features of PMDD include:
- Severe mood symptoms: Depression, irritability, anxiety, and mood swings
- Physical symptoms: Breast tenderness, bloating, fatigue, and changes in appetite or sleep patterns
- Cognitive symptoms: Difficulty concentrating and forgetfulness
- Timing: Symptoms begin 7-10 days before menstruation and improve within a few days after the period starts
- Impact: Symptoms are severe enough to significantly disrupt daily functioning, relationships, and quality of life
Unlike PMS, PMDD causes extreme mood shifts that can severely impact a person’s life[6]. The exact cause is unknown, but it’s believed to be related to an abnormal reaction to normal hormonal changes during the menstrual cycle, possibly involving serotonin deficiency.
Treatment options for PMDD may include hormonal contraceptives, antidepressants (particularly SSRIs), cognitive behavioral therapy, and lifestyle changes. In severe cases, surgical interventions may be considered.
What it’s like to have PMDD?
Living with Premenstrual Dysphoric Disorder (PMDD) can be an intense and challenging experience. Women with PMDD often describe their symptoms as “life-controlling,” significantly impacting their daily functioning and quality of life. Here’s what it’s like to have PMDD:
- Severe Mood Changes: Women experience extreme emotional shifts, including deep depression, anxiety, irritability, and anger.
- Physical Discomfort: Symptoms like bloating, breast tenderness, fatigue, and headaches are common.
- Cognitive Impairment: Difficulty concentrating, forgetfulness, and decreased cognitive function can occur.
- Relationship Strain: The condition often leads to interpersonal conflicts and difficulties in maintaining relationships.
- Occupational Challenges: PMDD can significantly impact work performance and daily activities.
- Cyclical Nature: Symptoms typically appear 1-2 weeks before menstruation and improve within a few days after the period starts.
- Heightened Sensitivity: Some women report feeling extremely sensitive to their surroundings, including lights, sounds, and even their own thoughts and actions.
- Suicidal Thoughts: In severe cases, women may experience suicidal ideation or attempts.
- Constant Preoccupation: Even during symptom-free periods, women may worry about the next premenstrual phase.
- Sleep Disturbances: Insomnia and changes in sleep patterns are common.
The severity of PMDD symptoms often leads women to feel out of control and can significantly disrupt their personal, social, and professional lives.
It’s important to note that PMDD is a medical condition requiring proper diagnosis and treatment, not simply a case of being “dramatic” or “oversensitive”.
How does PMDD impact mental health
PMDD significantly impacts mental health, causing severe emotional and psychological distress that can disrupt daily life. Key effects include:
- Severe mood changes: Extreme depression, anxiety, irritability, and anger.
- Suicidal thoughts: PMDD increases suicidal ideation four-fold and suicide attempt risk seven-fold.
- Cognitive impairment: Difficulty concentrating, forgetfulness, and decreased cognitive function.
- Heightened sensitivity: Increased sensitivity to surroundings, including lights, sounds, and personal thoughts.
- Self-critical thoughts: Increased sensitivity to rejection and feelings of worthlessness.
- Sleep disturbances: Insomnia and changes in sleep patterns.
- Anxiety and panic attacks: Feelings of tension, being on edge, and experiencing panic.
- Relationship strain: Conflicts with family, coworkers, and friends due to mood swings and irritability.
- Loss of interest: Decreased interest in normal activities and relationships.
- Emotional dysregulation: Some individuals may use substance use or self-harm as coping mechanisms.
These symptoms significantly impact quality of life, with women experiencing PMDD potentially losing three quality-adjusted life years during their lifetime due to premenstrual symptoms.