Could Premenstrual Dysphoric Disorder Explain Your Mood Swings?

Mar 29, 2018

We’ve all experienced the rollercoaster that is PMS: snappy outbursts, crying spells, insomnia, fatigue, breast tenderness, abdominal pain, bloating, headaches, potato chip cravings…it’s a wild ride. But for up to 8 percent of premenstrual women (per a study in the journal American Family Physician), that ride is so severe they have trouble functioning in daily life. They suffer from a condition called premenstrual dysphoric disorder (PMDD)—otherwise known as PMS on steroids.

Wondering if you’ve got PMDD? The condition shares a bunch of physical symptoms with PMS, but it’s the severity of the emotional symptoms that cause PMDD to stand out, says Mary Jane Minkin, M.D., a board-certified ob-gyn and a clinical professor at Yale University School of Medicine. (Since you can’t test for it, a diagnosis comes from a doctor’s evaluation.)

Women with PMDD have episodes of depression, irritability, moodiness, anxiety, or anger a week or two before their period. Symptoms are so intense that they start to affect their daily routine and relationships. It’s the timing of the emotional ups and downs that sets PMDD apart from something like bipolar disorder or depression. “PMDD only occurs after ovulation (about two weeks after your period) and eases up a few days after you start your period. So if your symptoms are severe throughout the entire month, by definition it can’t be PMDD,” says Minkin.

It’s good to be your own advocate if you suspect you’ve got more than regular ol’ PMS—docs and psychiatrists have misdiagnosed PMDD in the past, and it was only labeled a distinct mental disorder a few years back by the latest Diagnostic and Statistical Manual, DSM-5.

Track your symptoms (and your periods) in a diary and bring it in to your physician who can help spot that cyclical pattern and rule out other conditions like thyroid disease or anemia.

There’s no magic pill to treat PMDD, but going on birth control or switching over to a continuous BC pill (one with no period breaks) can stabilize your hormones and offer some relief. Practicing relaxation techniques, regular exercise, and cognitive behavioral therapy is also helpful, and some women are prescribed antidepressants to temper the mood swings brought on by the condition. Unfortunately, this is one menstrual-related malady that a piece of chocolate won’t fix.

by Kristen Dold For Women’s Health Mag