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Premenstrual Dysphoric Disorder (PMDD): Symptoms, Causes, Treatment

PMDD: Premenstrual Dysphoric Disorder

PMDD (Premenstrual Dysphoric Disorder) is a severe form of PMS (Premenstrual Syndrome). In this disorder, a woman feels irritable, angry, shows major depression symptoms* and lives in tension before her menstruation.

About 3-8% of women suffer from this disorder during their menstruation years.

It starts interfering with social and occupational life of a woman.

Anxiety disorder, SAD (Seasonal Affective Disorder)* and Major Depression* is more prevalent in women suffering from premenstrual dysphoric disorder than their counterparts.

[ * SAD (Seasonal Affective Disorder) and Major Depression are discussed at the end of this article ]

PMDD Causes

  • Large intake of caffeine
  • Hereditary
  • Hormonal changes resulting out of a woman’s menstrual cycle
  • No exercise
  • Lack of serotonin
  • Consumption of alcohol
  • Overweight

PMDD Symptoms

Though the symptoms of PMDD are similar to that of PMS, they are more severe in nature when compared to its counterpart and include at-least one mood symptom. They can be observed two weeks prior to the menstrual bleeding.

The number and severity of PMDD symptoms tend to vary from woman to woman. Plus, the severity varies from month to month. PMDD symptoms usually begin in the late luteal phase of menstruation. Symptoms immediately end once the woman gets her chums. However, PMDD symptoms reappear every month before a woman’s menstrual cycle. Below is a list of some of the common symptoms of PMDD. Atleast 5 symptoms should be present in order to diagnose PMDD in a woman.
  • Frequent headaches
  • Sudden increase in appetite
  • Mood swings
  • Feel fatigue
  • Increased conflicts with the people around
  • Get angry easily
  • Frequent crying without valid reasons
  • Irritated behavior
  • Difficulty in concentrating on given tasks
  • Absentmindedness
  • Depressed mood all the time
  • Get panic attacks
  • Acne or other skin problems
  • Feel out of control or over-whelmed
  • Aggression
  • Swollen face or nose
  • Go through nervousness
  • Abdominal bloating
  • Anxiety
  • Heart palpitations
  • Disinterest in daily activities
  • Excessive tension
  • Stomach or bowel upset
  • Weight gain
  • Increase or decrease in sex drive
  • Get joint or muscle pain
  • Sleeping too much or too less
Remember that the symptoms need to be severe in order to diagnose PMDD and we all know that precaution is better than cure. So if you find some of the above-listed symptoms present in you persisting for two weeks till your menstruation, then it would be better to consult a doctor before it seriously starts affecting your personal, professional and social life.

PMDD Diagnosis

It is very difficult to diagnose premenstrual dysphoric disorder through laboratory tests. The doctor generally relies on the patient’s history, does a physical examination and psychological evaluation to rule out other disorders.

PMDD Treatment

The main objective of treatment is to reduce the sufferings of woman and make her fit mentally as well as physically so that she can cope up with the fast modern life.

Each woman can experience different symptoms, some more debilitating than others. With regard to treatment for PMDD, this means that a ‘one size fits all’ approach doesn’t work.

The primary goal of PMDD treatment is to reduce the woman’s suffering and the disruption to her social relationships.

There are 3 broad approaches to treating PMDD:

Prescribed Medication – This includes anti-depressants, anti-anxiety drugs, analgesics, hormones and diuretics.

Psychobehavioural Therapy – This includes exercise and psychotherapies such as cognitive-behavioral therapy, coping skills training and relaxation techniques.

Nutrition – This includes diet modification, vitamins, minerals and herbal preparations.

PMDD Prognosis

After a woman is given proper treatment, there are 95% chances that she will recover from this disorder.


SAD (Seasonal Affective Disorder)

SAD (acronym for Seasonal Affective Disorder) is a type of depression that occurs at a specific time of the year, usually during summer or winter. It is therefore called as winter depression, summer depression, winter blues, summer blues, seasonal depression and sad disorder. It is very common in Northern Europe and North Atlantic regions. It occurs more in women than in men. Also, people with seasonal depression are more likely to develop major depressive disorder and about 20% of them can also fall prey to bipolar disorder.

SAD Symptoms

  • Increase in diet resulting into weight gain
  • Excessive sleeping resulting into difficulty waking up in the morning
  • Loss of interest in daily activities
  • Lack of energy
  • Difficulty in focusing on work
  • Social withdrawal
  • Low sexual interest

SAD Diagnosis & Tests

The doctor relies on the patient’s physical and mental behavioral changes. In some cases, he might perform a blood test and conduct physical examination to disqualify symptoms that match with other types of depression.

SAD Treatment

Seasonal Affective Disorder can be treated through anti-depressant drugs, light therapy, CBT (cognitive behavioral therapy), psychotherapy and negative air ionization therapy. Besides, below are the other small methods which you can do on your own.
  • Exercise every morning to help combat stress and anxiety.
  • Plan your breakfast and lunches outside the home or office place. Expose yourself to the brighter light of the day. Helps a lot.
  • Make sure the environment in your house or office is sunnier and brighter. Prefer sitting next to windows with the curtains open.
  • Take out time to socialize with people whom you enjoy being with.
  • If feasible, plan short trips to warmer places if you get winter blues or on cooler places in case of summer blues.

SAD Prevention

Though there is no concrete way of preventing the occurrence of seasonal affective disorder, symptoms when treated early can help from getting the condition worsen.

  Read more here onDealing With and Preventing SAD

Clinical Depression / Major Depression (Major Depressive Disorder) 

Clinical depression (also known as major depressive disorder, major depression, recurrent depressive disorder, unipolar depression or unipolar disorder) is a type of depression that is characterized by excessive low mood and losing of interest in daily activities. Such sadness persists for more than two weeks. It affects a person’s personal and professional life. It also disturbs eating and sleeping patterns.

Every year, about 20% of the people who suffer from major depressive disorder commit suicide. In adults, the ratio in which it affects man and woman is 1:2.

Who gets Clinical Depression?

Well, it is not a selective disorder. It can affect anyone irrespective of the age at any point in their life. Children, teens, adults or older adults – it spares nobody. About 10-20% of the world’s population is reported to be clinically depressed every year. The disorder is quite prevalent in United States and UK.

Causes of Major Depression

There are many causes behind the development of clinical depression symptoms. It may be caused due to chemical imbalances in the brain resulted by mood disorders. Other times, it maybe developing due to an existing disease being suffered by the patient. About 20-30% of people who have been reported with medical illness like cancer, diabetes and stroke develop major depressive disorder at some point in their illness.

Major Depression Diagnosis

Though there are no laboratory tests to diagnose this major disorder, doctors rely on the patient’s health and experience as well as the behavior of the patient as reported by his family and friends. Many people avoid seeing a doctor even if they feel change in their moods and behavior. Remember, if it is not detected at an early stage, the situation might worsen. It is therefore a must to seriously go for a proper treatment.

Major Depression Treatment 

This mental disorder can be treated by the following ways:
  • Taking antidepressant drugs as prescribed by the doctor
  • In some cases, the doctor can also suggest to go for a psychotherapy which is one type of talk therapy.
  • If the drugs do not bring out the desired effects, then ECT (Electroconvulsive Therapy) is given to the patient.


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