PMS or PMDD? Here's how to tell
Premenstrual syndrome. Just about every female gets it. Some experts say as many as 90% of menstruating women. Personally, I’ve never heard a joke about PMS that made me laugh, and I’ll bet every woman will join me bristling at being accused of “just being hormonal.”
There are a wide variety of signs and symptoms of PMS, including mood swings, tender breasts, food cravings, fatigue, irritability and depression. Mayo Clinic says that “symptoms tend to recur in a predictable pattern. But the physical and emotional changes you experience with premenstrual syndrome may vary from just slightly noticeable all the way to intense.”
However, sometimes, those “intense” symptoms aren’t PMS at all. They are a defined depressive disorder called premenstrual dysphoric disorder (PMDD). Psych Central’s website says, “In PMDD, you experience severe psychological and physical symptoms in the week or two before your period. PMDD can affect any person in their childbearing years and significantly interferes with your daily functioning.”
Women’s Health Magazine’s website has an article in which women share their experiences with PMDD. Here are two samples:
“My PMS was tolerable until my second child was born and then everything went off the rails. I’d be looking forward to plans with others, happy, and then about 10 to 14 days before my flow would start, my mood would turn on a dime. I’d be horrible — crying, screaming that ‘nobody understands’ — just so much emotional pain. I’d basically lock myself up in the bedroom for a full day to cry, get angry, and feel sorry for myself. It took three doctors before I finally found one who would listen to me before I was finally diagnosed with PMDD,” Colleen, a 50-year-old woman, said.
A 39-year-old woman named Mandy said, “My PMDD manifests in both mental and physical symptoms. From the time I got my period at age 12, I’ve had extreme cramps and heavy bleeding … I’d have to take six to eight ibuprofen at a time to deal with cramps, and if I didn’t, I’d end up on the floor sweating like I had the flu. Sometimes I’d even throw up.”
Psych Central emphasizes that symptoms are both physical and psychological. Psychologically, they include agitation, anxiety, crying, depression, difficulty concentrating, feeling out of control, insomnia, irritability, panic attacks, severe fatigue, lack of interest in usual activities, and feeling overwhelmed.
“Physical symptoms might look like: breast fullness and tenderness, dizziness, food cravings, GI problems (cramps, constipation, nausea), headache, heart palpitations, hot flashes, joint or muscle pain, and reduced sex drive,” they said.
Today, the cause is unknown. But the good news is that research studies are ongoing. Although these factors won’t cause PMDD, you may have a higher chance of developing PMDD if you have a family history of PMS or PMDD; a personal or family history of mood or anxiety conditions, smoke, or experience high stress.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, lines out the criteria to help physicians detect and diagnose PMDD. Since it's connected to the menstrual cycle, it differs from other depressive disorders and will be watched over a year.
Part of the criteria is that you suffer at least five symptoms a week before your period, the symptoms start to improve during your period, and they totally resolve the week after menstruation. There are also criteria for how many psychological or physical symptoms, but the explanation is too long to print here.
Basically, Psych Central says that “all these symptoms must affect your ability to function in daily life, including social and work settings. Your symptoms also cannot be due to another medical condition like major depressive disorder or hyperthyroidism, or due to substance use."
A nice long talk with your primary care provider is a good place to start treatment. He or she may refer you to a mental healthcare provider. There are things you can do for yourself like aerobic exercises, yoga and aromatherapy. You should refrain from alcohol, caffeine and sugar; increase protein, and utilize stress management and relaxation techniques.
If at-home remedies don’t work, know that PMDD is highly treatable with medications and cognitive behavioral therapy. You can find relief from your symptoms and improve your quality of life. Trust me.
Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com.
