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Premenstrual Dysphoric Disorder: It's Not Just Really Bad PMS

Updated: Nov 13, 2019

PMS can vary from woman to woman, month to month. A disorder is diagnosed when symptoms are super-severe every month.

The Office on Women's Health defines PMDD thus:

Premenstrual dysphoric disorder (PMDD) is a health problem that is similar to premenstrual syndrome (PMS) but is more serious. PMDD causes severe irritability, depression, or anxiety in the week or two before your period starts. Symptoms usually go away two to three days after your period starts. You may need medicine or other treatment to help with your symptoms.

Do some quick math, and you'll realize that PMDD can dominate a woman's life for up to seventeen days out of each month--that's up to roughly 57% of her life!

And while women experiencing the much more common PMS (which affects approximately 100% of women on one level or another at least occasionally, while PMDD is diagnosed in only 5% of us) may ironically complain that, "My life is over!"--to those with PMDD, that statement might seem to ring more literally true.

This is not to trivialize PMS. "Regular" old premenstrual syndrome sucks. There's a reason women used to be confined to bed while experiencing their "moonblood," and even the most liberated of us have probably secretly wished at least once that we still had that excuse to hide from the world during this time!

Symptoms of PMDD include:

  • Lasting irritability or anger that may affect other people

  • Feelings of sadness or despair, or even thoughts of suicide

  • Feelings of tension or anxiety

  • Panic attacks

  • Mood swings or crying often

  • Lack of interest in daily activities and relationships

  • Trouble thinking or focusing

  • Tiredness or low energy

  • Food cravings or binge eating

  • Trouble sleeping

  • Feeling out of control

  • Physical symptoms, such as cramps, bloating, breast tenderness, headaches, and joint or muscle pain

(list compiled by

You may be thinking that that list is nearly identical to that of major depressive disorder, and it is. The main difference between PMDD and MDD is that list of physical symptoms at the end there. Also, a woman can have PMDD but not full-time clinical depression, just like the same is true the other way around.

The main difference between PMDD and PMS is one small phrase contained in the first symptom on the list: "that may affect other people." It's generally easier to keep PMS, in all its terrible glory, more-or-less to ourselves; PMDD can cause mood swings and temporary, but sudden changes in lifestyle that have a direct effect on those close to you.

Here's an example: you and your family have a fun weekend planned. But when the weekend rolls around, Mom is premenstrual. While PMS may make the weekend a little less fun for Mom, she's not likely to back out of it altogether. PMDD can have Mom down for the count, so now not only Mom, but also Dad and the kids are disappointed because Mom's not a part of their weekend.

The good news is that this scenario isn't a guarantee: personally, my time with family and doing other things I enjoy affects my PMDD for the better, rather than PMDD affecting those things for the worse.

So if you've been feeling like PMS gets you down so much more than other women you know, that may be because it actually does. You may say to yourself, What's my problem? It's just my period--every woman gets one!

If this sounds familiar, talk to your doctor about it. There are medications that can help, as well as non-medicinal coping methods if popping pills isn't your thing. Just like with depression, physical exercise, a healthy diet, therapy and an active social life--particularly healthy doses of "girl's time" (whatever that entails for you and your friends)--can also do a world of good.

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