Premenstrual Dysphoric Disorder: Information, Symptoms, Treatment and More

Premenstrual Dysphoric Depression (PMDD) is a form of a condition known as Premenstrual Syndrome, and also a sub-type of Depression.

The condition is characterised by a woman having symptoms of depression at the start of their period. These symptoms will typically be accompanied by fatigue, irritability and mood swings.

However, the symptoms will generally disappear within a week, but will return at the start of the next period. This cycle continues – and causes significant distress.

It will also cause impairment in a range of contexts, just like all other forms of Depression. Fortunately, treatment is available, and generally involves talking therapy, and some form of medication.

What are the symptoms of Premenstrual Dysphoric Disorder?

The symptoms of PMDD can range slightly from person-to-person. PMDD features similar symptoms to those seen in the other forms of Depression, albeit with a few differences.

The symptoms are predominantly psychological, though can be physical too. 

Psychological Symptoms

• Continuous low mood or sadness
• Mood swings
• Feelings of hopelessness and helplessness
• Struggling to concentrate,
• Anxiety
• Irritability
• Suicidal thoughts or self-harm.

Physical Symptoms

• Lack of energy
• Loss of libido
• Gaining appetite and weight, cravings for food
• Sleep problems
• Tiredness
• Unexplained aches
• Restlessness
• Tenderness in the breast

These symptoms will typically lead to a change in the behaviour of an individual. As mentioned earlier, the symptoms should resolve once a period has finished.

The person should feel better, although this will typically only be until the next period begins. As alluded to above, this is not an exhaustive list of depressive symptoms.

What are the causes of Premenstrual Dysphoric Disorder?

It isn’t entirely known what causes PMDD. However, some factors do appear to be involved, while risk factors exist. It is possible that a range of factors contribute to the onset of the illness.

It is believed that PMDD is best associated with an individual being highly sensitive to changes in hormone levels. During the menstrual cycle, hormone levels will fluctuate – with the symptoms of PMDD tending to only arise at the start of a period.

It is believed that having a low level of the chemical serotonin in the brain may be another risk factor. Again, hormonal changes can lead to a decrease in serotonin.

Traumatic or highly-stressful experiences often contribute to the condition. Genetics may also be involved – or at least act as a risk factor for those with a family member with the condition.

It could be that a few different factors are involved. Several events can act as a trigger to depression developing, sometimes there is simply no cause.

Diagnosis of Premenstrual Dysphoric Disorder

It is important for an individual to see a Doctor if they believe they are suffering from PMDD. This is particularly important in cases where an individual is having suicidal thoughts.

There is no laboratory test or other medical examination that can determine whether or not an individual has PMDD. Instead, a doctor can only make a diagnosis based on a meeting with an individual.

Tests may be carried out to eliminate the possibility of a physical cause being behind the symptoms.

At an appointment, a doctor will ascertain the feelings and condition of a patient by asking several questions. You are encouraged to be as honest as possible.

Questions are normally based around the severity and impact of symptoms, how long they have been present, possible causes and queries regarding any family history of mental illness.

In terms of the actual symptoms, for PMDD to be diagnosed, a patient will satisfy the following criteria:

• At least five of the following:
  • Depressed mood for the majority of the day, over the course of a few weeks.
  • Loss of interest and enjoyment in formally-enjoyable activities
  • Increase or decrease in appetite and subsequent weight gain/loss.
  • Problems sleeping.
  • General fatigue or lack of energy.
  • Feelings of guilt or worthlessness.
  • Poor concentration, difficulty in decision-making.
  • Lethargy or the feeling of being slowed down, as noticed by those around you.
  • Thoughts of self-harm and/or suicidal ideation.
• The symptoms do not last longer than 7-10 days
• The symptoms return at the start of the next period
• There is a period of remission in between the above two areas

It is possible that an individual will instead be diagnosed with a different type of Depression, or an Anxiety based condition. Once a diagnosis has been made, treatment can proceed.

How is Premenstrual Dysphoric Disorder treated?

PMDD is a condition that causes significant distress. However, treatment is available. In many cases, a full recovery can be made. There are many different types of treatment that may be used:

Self help

There are plenty of self-help materials on the internet available, including around our website. Additionally, regular exercise can help alleviate some of the symptoms of depression. A healthy diet is also a useful. Self-help can prove very helpful in cases of mild depression.

Talking Therapy

Talking therapy can help with PMDD. There are several different types of therapy that are used.

Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.

Cognitive Analytical Therapy (CAT): Cognitive Analytical Therapy provides a form of therapy that combines cognitive and psychoanalytic approaches to mental health. The aim is to instil techniques into an individual that should help improve the symptoms of their condition. There is a very strong focus on the relationship between therapist and client in this type of therapy.

Additionally, there are a range of other types of talking therapies available. There are many ways that talking therapy can help. We have more information on our Therapy section.

Medication

There are a few different types of medicines that can be used. Antidepressants are commonly used, although their effectiveness isn’t completely clear.

Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.

Mild painkillers like paracetamol or ibuprofen can be used, though these can only provide some relief against symptoms.

Summary

PMDD is a very serious condition that is often downplayed. But it is important to seek treatment for this condition. Taking steps towards seeking help is the first step towards recovery.

If you need any additional support, our website has a lot of information to assist you.

See Also

• Depression Section
• What is the Prognosis for Depression?
• Therapy Homepage
• Medicine Homepage